PRECONDITIONS FOR AND CONSEQUENCES OF SELF-DETERMINATION - THE PSYCHIATRIC-PATIENTS POINT-OF-VIEW

In the context of an interview study concerned with self-determination in psychiatric patients, this paper describes the preconditions for a nd consequences of self-determination from the point of view of psychi atric patients themselves. The data were collected in semi-structured interviews with long-term psychiatric patients (n = 72) and analysed u sing the method of content analysis. Responses on the preconditions fo r self-determination were grouped into three categories: firstly, ther e were those who said that reference to self-determination in the case of psychiatric patients is nonsense; secondly, there were those who s aid that self-determination requires no preconditions; and thirdly, th ere were those who said that there are certain preconditions, such as the ability to think and make decisions, activity, obedience, and illn ess. Both positive and negative consequences were identified in situat ions where self-determination is maintained, but only negative consequ ences in situations where self-determination is lost. On the basis of these tentative results, self-determination seemed to be relevant in p sychiatric nursing. We are continuing to develop and test an instrumen t for the evaluation of the opportunity for self-determination in clin ical practice.