Nurses’ provisions for self-determination in residents with cognitive impairment who live in a residential aged care facility: a scoping review
Notice bibliographique
Résumé
OBJECTIVE: This scoping review aimed to map the existing literature about nursing provisions for self-determination in residents with cognitive impairments living in residential aged care facilities. INTRODUCTION: Freedom to decide for oneself and express preferences about daily care is important for all older adults. When older adults transition to residential aged care facilities, they may experience barriers to self-determination due to routine care practices and staff attitudes about autonomy. This is particularly true for residents living with cognitive impairments. Residents with cognitive impairments are often prevented from making choices that nursing staff perceive to be unwise or harmful, as nurses uphold their professional duties to protect and care. This can result in the denial of preferences and the right to self-determination. Mapping the ways nurses balance their duty to protect with residents' rights to self-determine provides insight into nurses' roles and residents' experiences of care. INCLUSION CRITERIA: Research and narrative articles about nursing provisions for self-determination in residents with cognitive impairments living in residential aged care facilities were included in this review. The main concepts explored were nurses' provisions and residents' self-determination. Self-determination included residents' preferences and expressions of choice, while nurses' intentional reactions to residents' preferences were considered nurses' provisions. METHODS: The review included qualitative and quantitative studies as well as text and opinion papers. Only studies and papers published in English from 1992 onwards were included. The databases searched were CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), and ERIC (EBSCO). The search for unpublished papers included ProQuest Nursing and Allied Health Database, ProQuest Dissertations and Theses, and Google (with advanced search strategies). The reference lists of included articles were searched for additional studies not captured by the search strategy. Data were extracted using a standardized tool created by the authors and included details on study design, strategies to promote, and conditions that deny residents' self-determination. Charting tables were developed to record and analyze data related to the review questions. RESULTS: The final set of 17 articles were published from 1995 to 2018. The literature was analyzed in relation to the review's four questions to map the boundaries of the nurse's role in providing for residents' self-determination. Nurses' roles as investigators, advocates, protectors, and assessors emerged as critical to providing for self-determination. CONCLUSIONS: Literature about this topic has tended to describe nursing provisions for self-determination in people with cognitive impairments in terms of an ethical dilemma between the resident's right to act autonomously and their right to protection as a vulnerable population. In mapping the literature, this scoping review demonstrates a more complex process at work in providing for self-determination in the context of cognitive impairment and highlights a need for deeper reflexivity around nurses' understandings of personhood and autonomy. Further research should focus on determining if nurses' perceptions of residents' experience with self-determination are accurate. The complexity of self-determination in the context of cognitive impairment and nurses' advocacy role highlights the need for ongoing support and education for staff working in residential aged care facilities.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».