Paper
Monday, November 5, 2007
405
Older Adults' Descriptions of Environmental Factors that Promote a Sense of Autonomy
Judith E. Hertz, PhD, RN and Jeanette Rossetti, EdD, RN. School of Nursing, Northern Illinois University, DeKalb, IL, USA
| Learning Objective #1: provide examples of specific external environmental factors that facilitate a sense of autonomy in residents of senior apartments. |
| Learning Objective #2: delineate implications for future research and developing theory-based nursing interventions that promote a sense of autonomy and health in this older adult population. |
The purpose of this paper is to report findings from interviews with residents of independent living senior apartments in the Midwestern United States; the focus was on factors that influence their choices, personal needs and goals, and feelings of self-direction. The mid-range self-care theory from Modeling and Role-Modeling theory (Erickson et al., 1982) framed the study. From this perspective, perceived enactment of autonomy (PEA) is the feeling that one has choices, personal knowledge of needs and goals, and control over one’s life; it is prerequisite to self-care actions that promote health and quality of life. Older adults’ self-care actions to manage health processes when living with chronic illnesses and potential or actual functional declines are poorly understood. Likewise, little is known about specific factors that influence self-care actions, autonomy and quality of life from the perspective of older adults, especially the population who live independently in apartments. To address those gaps and prior to developing theory-based interventions that promote self-care via support for autonomy, interviews were conducted as part of a larger mixed method study. Respondents volunteered for the interview after completing written surveys. They were purposively selected based on age, self-rated health, and gender to obtain diverse views and until data saturation was reached. Ten women and four men aged 67 to 91 years responded to a semi-structured interview guide during a 45-minute taped interview. Traditional thematic analysis (Miles & Huberman, 1994) was used to analyze data. One theme that emerged was external environmental factors as facilitators to PEA; the theme’s subcategories were physical environment, living arrangement and interpersonal environment. These findings form a foundation for designing health promotion interventions through alterations in the environment. Results also have implications for future research, theory development and public policy targeted toward the growing population of older adults.