AUTONOMY AND SOCIAL PARTICIPATION OF NURSING HOME RESIDENTS: NURSES’ PERSPECTIVES

Abstract

The aim of this study was to examine organizational structures in nursing homes and nurses’ autonomy and participation in decision making. Additionally, nurses’ influence on the residents’ autonomy and social participation was examined. Twelve qualitative Interviews with nurses working in four different nursing homes were conducted. The participants were interviewed using a previously developed semi-standardized interview guide. Interviews were audio-recorded and transcribed verbatim. All transcripts were thematically analyzed using content analysis approach. The participants described a structured daily routine in the nursing homes, including basic care or meal times. Within these structures nurses are able to determine individual schedules and, in exceptional cases, to vary from daily routine. However, autonomous decision making was seen as a form of enhanced responsibility and therefore rejected, whereas more responsibility was associated with wanting higher salary and changes of existing structures. Nurses’ reported that they have a big influence on residents’ autonomy and social participation and great responsibility as to that matter. Nurses’ autonomy and participation in decision making may be limited by institutional structures and, moreover, nurses’ decision making is lacking autonomy and participation because they cannot or do not want to accept responsibility. Thus, the residents’ autonomy and social participation could be restricted because nursing home residents are influenced by nurses’ acting.