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Scand J Occup Ther. 2014 Mar;21(2):116-24. doi: 10.3109/11038128.2013.853832. Epub 2013 Nov 29.

Self-determination and older people--a concept analysis.

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  • 1VĂ¥rdalinstitutet - The Swedish Institute for Health Sciences , Gothenburg , Sweden.



Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural.


To define and clarify the concept of self-determination in relation to community-dwelling frail older people.


Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes.


Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice.


This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

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