Abstract
BackgroundExperiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings themselves perceive autonomy in daily life. Further, there are no studies on the extent to which this perception can be influenced positively by participating in an individually tailored programme based on residents' own wishes for daily activities.Methods and designA total of 9 nursing homes and 55 participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual methods and equipment. Participants in each nursing home were divided by lot into either a control group or an intervention group. The control groups received their usual care and treatment.DiscussionThis study is designed to assess the status of perceived autonomy at baseline and to provide information about the effectiveness of individually tailored programmes according to perceptions of autonomy registered in institutionalised physically frail older people. This will add knowledge to assist response to present and future challenges in relation to health promotion initiatives for this group.Trial registration numberNCT00783055
Highlights
Experiencing autonomy is recognised to promote health and well-being for all age groups
This study is designed to assess the status of perceived autonomy at baseline and to provide information about the effectiveness of individually tailored programmes according to perceptions of autonomy registered in institutionalised physically frail older people
The Danish Technology Council claims that in the future the elderly population will be polarised into a large group of healthy elderly and a large group of frail elderly who due to medical improvements may live with chronic diseases in more years than previously observed [2]
Summary
Experiencing autonomy is recognised to promote health and well-being for all age groups. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings themselves perceive autonomy in daily life. Due to the limited number of studies concerning older people's perceptions of autonomy there is an evident need for more knowledge in order for politicians and planners to target the efforts to improve the documentation for health promotion strategies in this group. Giving up valued activities is found to threaten personal identity and indicate near-future physical decline [15]. It is an important task for staff to support residents in making choices about engaging and re-engaging in meaningful familiar and valued activities [16]. Sensitivity towards the activity choices of the residents' is constantly at risk of receding into the background due to time schedules and the organisation of work [12,14]
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