AUTONOMY IN THE REHABILITATION OF STROKE PATIENTS IN NURSING-HOMES - A CONCEPT ANALYSIS

This article presents a concept analysis of autonomy in relation to th e rehabilitation of stroke patients. Analysis of the results of a lite rature survey provided three important concepts of autonomy in the fie ld of biomedical ethics: self-governance, self-realization and actual autonomy. These concepts are compared with concepts from caring scienc es and summarized in a table. The results indicate the importance of t he social environment (formal and informal caregivers) for the restora tion of autonomy. Because of the patient's condition and context, a so cial concept of autonomy makes more sense in the rehabilitation of str oke patients in nursing homes than does an individual concept. The con cept analysis sheds light on the fact that the majority of studies reg arding patient autonomy are primarily based on theoretical reflections , not on empirical studies. More research is warranted to gather infor mation on how patients themselves consider and appreciate autonomy dur ing rehabilitation, to explore the views of stroke patients' formal an d informal caregivers and to investigate whether a social concept of a utonomy is suitable for all phases of rehabilitation. Concerning the p ractice of rehabilitation, no definite conclusion can be given as yet.