Abstract
BackgroundIt is acknowledged that preservation of self-determination is very important in order for older adults to experience good quality of life, but to what degree and in what areas people receiving help from home care service experience self-determination is unknown. Few studies have examined the perception of self-determination in relation to quality of life among older adults living at home with help from home care services. Thus, the aim of this study was to explore perceptions of self-determination among older adults living at home with the support of home care services, and to test whether older adults who perceive a higher degree of self-determination also feel they have a better quality of life.MethodsThis cross-sectional study was conducted in one municipality in northern Sweden. A total of 134 older adults (≥ 65 years) were included. Data were collected by means of a survey including questionnaires about background characteristics, self-determination, and health-related quality of life. Descriptive statistics regarding background characteristics for groups with high and low self-determination respectively were presented and the differences between the groups were analyzed using the Chi-square test and the Mann-Whitney U test.ResultsOur main finding shows that the majority of older adults with support from home care services experience self-determination in the dimensions use of time, and self-care. However, a wide variation was found in self-reported self-determination in all dimensions. Results also show that the group with higher self-reported self-determination also reported a greater degree of experienced quality of life in comparison with the group with lower self-reported self-determination.ConclusionsIn line with earlier research, our results found a positive relation between self-determination and quality of life. The results are relevant for the care of older adults and indicate a need of further research. The results presented in this paper could serve as a guide when planning for improved self-determination among older adults in home care service.Trial registrationNCT02846246.
Highlights
It is reasonable to hypothesize that older adults living at home with support from home care services (HCS) have a better quality of life (QoL) if their own expressed needs regarding care and service are met
Participants had a mean age of 83 years; 69% had received help from HCS for 1–10 years; 59% had one or more visits each day; 81% lived in an apartment; 48% had completed elementary school; 86% were born in Sweden; 93% spoke Swedish as their mother tongue; 95% were dependent in I-activities of daily living (ADL) to any extent and 83% were dependent in P-ADL to any extent
Older adults who reported a greater degree of self-determination reported a significantly higher experienced QoL on the EQ-5D-5 L total, the EQ-VAS and the Nottingham Health Profile (NHP) total score in comparison with those who reported a lower degree of self-determination
Summary
It is reasonable to hypothesize that older adults living at home with support from home care services (HCS) have a better quality of life (QoL) if their own expressed needs regarding care and service are met. Few studies have examined the perception of self-determination in relation to quality of life among older adults living at home with help from home care services. The aim of this study was to explore perceptions of self-determination among older adults living at home with the support of home care services, and to test whether older adults who perceive a higher degree of self-determination feel they have a better quality of life. Autonomy is often used as a synonym for self-determination but is more closely linked to the idea of individuals taking their own decisions without being influenced by others This might make it problematic to use the concept of autonomy in connection with a person dependent on help and with decisions taken together with others [5]. It is reasonable to believe that promoting self-determination will increase overall QoL
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