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Self-determination
Kinds of Self-determination Terms modified by Self-determination Selected AbstractsScience, Self-Determination, and Imagining the NationINTERNATIONAL STUDIES REVIEW, Issue 4 2007Marc Howard Ross No abstract is available for this article. [source] Self-Regulation and the Problem of Human Autonomy: Does Psychology Need Choice, Self-Determination, and Will?JOURNAL OF PERSONALITY, Issue 6 2006Richard M. Ryan ABSTRACT The term autonomy literally refers to regulation by the self. Its opposite, heteronomy, refers to controlled regulation, or regulation that occurs without self-endorsement. At a time when philosophers and economists are increasingly detailing the nature of autonomy and recognizing its social and practical significance, many psychologists are questioning the reality and import of autonomy and closely related phenomena such as will, choice, and freedom. Using the framework of self-determination theory (Ryan & Deci, 2000), we review research concerning the benefits of autonomous versus controlled regulation for goal performance, persistence, affective experience, quality of relationships, and well-being across domains and cultures. We also address some of the controversies and terminological issues surrounding the construct of autonomy, including critiques of autonomy by biological reductionists, cultural relativists, and behaviorists. We conclude that there is a universal and cross-developmental value to autonomous regulation when the construct is understood in an exacting way. [source] The Wilsonian Moment: Self-Determination and the International Origins of Anticolonial Nationalism by Erez ManelaNATIONS AND NATIONALISM, Issue 3 2008FRANK NINKOVICH [source] Female and National Self-Determination: A Gender Re-reading of ,The Apogee of Nationalism'NATIONS AND NATIONALISM, Issue 4 2000Glenda Sluga This article offers a gender re-reading of the international history of the post-First World War peace process, a period when nationalism is said to have reached its ,apogee', when national self-determination and mutual cooperation between nations in the form of a League of Nations defined liberal aspirations for a democratic new world order. It was also a period when international women's organisations emphasised female self-determination as both a national and international issue. Juxtaposed, these two aspects of the history of the peace of 1919 shed light on the importance of sex difference to the idea of national self-determination and to the overlapping constitution of the national and the international as spheres of political agency and influence in the early twentieth century. [source] Obligation as Self-Determination: A Critique of Hegel and KorsgaardPACIFIC PHILOSOPHICAL QUARTERLY, Issue 2 2003Mark Shelton I examine the differences between their accounts in order to show that their efforts suffer from a common inadequacy, namely, overlooking that there are two distinct ways we can value things as self-determining agents. I maintain that accounting for the actual stringency of moral judgment depends on explaining the superiority of one of these ways of valuing over the other. [source] Placing Indigenous Rights to Self-Determination in an Ecological ContextRATIO JURIS, Issue 2 2002Barbara Ann Hocking In this paper the author focuses on Australian land management and in particular on the environmental management issues that could have been prompted by the High Court recognition in 1996 (in Wik Peoples v. The State of Queensland) that native title to land and pastoral leaseholdings can co-exist. Drawing on themes of self-determination and co-existence, the paper looks at more specific topics such as aboriginal title to land,what has been called land rights or native title in Australia,and some implications of that for land, sea and resource management. Central to this analysis are competing theories of Aboriginal land management and links between Aboriginal traditional knowledge and conservation of species. These are illustrated through the marine mammal, the dugong. The Australian debates lead to the Canadian debates and then to Scandinavia and the role of the Sami people in protection and management of the Arctic region. Issues of indigenous self determination inevitably provide an overall theme to these discussions. As a matter of global concern, the paper asks, but does not decide, whether indigenous peoples may manage fragile eco-systems more effectively than outsiders. It maintains that what is important in this context is a broader question. This concerns how culturally inclusive land and resource management can emerge from recognition of indigenous land and human rights and how comparative developments can provide crucial cross-jurisdictional information for future developments and opportunities in the interests of environmental conservation. [source] National Self-Determination, Global Equality and Moral ArbitrarinessTHE JOURNAL OF POLITICAL PHILOSOPHY, Issue 3 2010Chris Armstrong First page of article [source] Global Innovation in MNCs: The Effects of Subsidiary Self-Determination and Teamwork,THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 5 2007Ram Mudambi The ability of multinational corporations (MNCs) to leverage their innovation competencies across globally dispersed subsidiaries is an increasingly valuable source of competitive advantage. As multinational enterprises turn to foreign subsidiaries for research and development (R&D) and product development, questions arise regarding the most effective organizational structures for global innovation. Although organizational conditions that satisfy the needs for self-determination and teamwork have long been considered intrinsic motivators, past research has not analyzed the consequences of intrinsic motivators on global innovation. The basic research question is this: In globally dispersed subsidiary R&D units, what organizational conditions and motivators are associated with the highest knowledge output? A sample of 275 globally dispersed R&D subsidiaries were studied from 1995 to 2002. Data were collected from a postal survey, field and telephone interviews, and secondary sources. Subsidiary self-determination and teamwork were found to have a significant effect on knowledge output, as objectively measured by patent citations. Subsidiary self-determination on inputs such as sourcing and hiring, and self-determination on outputs such as marketing and product development, emerged as positive determinants of knowledge generation in R&D subsidiaries. In addition, interteam cooperation and intrateam cooperation were significant determinants of knowledge generation by subsidiaries. These findings highlight the importance of self-determination, teamwork, and cooperation to knowledge creation and innovations. Managers face the tough challenge of how to motivate globally dispersed knowledge workers to conduct research that will generate knowledge and will strengthen firm performance. The results provide theoretical and practical insights on how MNCs can leverage their innovation competencies across foreign R&D subsidiaries. [source] Indigenous Epistemologies and Education,Self-Determination, Anthropology, and Human RightsANTHROPOLOGY & EDUCATION QUARTERLY, Issue 1 2005Teresa L. McCarty First page of article [source] Self-determination of patients with rheumatoid arthritis: Model development during action researchINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2008Päivi Löfman The purpose of this article is to describe the content and the development of the model to promote self-determination of patients with rheumatoid arthritis from a point of view of patients and nurses. For the patients the data were gathered using semistructured interviews and for the nurses through three focus groups in the initial and evaluation phases. The data were analysed by themes using qualitative content analysis. The model consisted of the concept of self-determination, impediments to and preconditions for self-determination, promoting and focusing on consequences. Patient's activity was a new view of the concept. Impediments to self-determination were linked to limitations and preconditions to patients' freedom to express themselves. Support developed an important factor promoting self-determination. The results indicate a clear need for various types of supportive nursing care to promote self-participation in patient care. [source] The Impact of Personal Characteristics of People with Intellectual and Developmental Disability on Self-determination and Autonomous FunctioningJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2003Michael L. Wehmeyer Background, Many people assume that the presence of an intellectual disability precludes a person from becoming self-determined. Recent research, however, has suggested that the environments in which people live, learn, work or play may play a more important role in promoting self-determination then do personal characteristics of the person, including level of intelligence. Methods, This study examined the self-determination and autonomous functioning of 301 adults with intellectual disability or a developmental disability without concomitant intellectual impairments (e.g. persons with cerebral palsy, epilepsy and spina bifida) as a function of personal characteristics of individuals. Results, Intellectual capacity was not a significant contributor to either self-determination or autonomous functioning for this group. Opportunities to make choices, however, contributed significantly and positively to greater self-determination and autonomy. Intelligence scores did, however, predict whether the person worked or lived in more or less restrictive settings, though for the latter, both self-determination and autonomous functioning also contributed significantly. Conclusions, These findings are discussed with regard to the role of personal characteristics, particularly intelligence level, in promoting self-determination and more positive adult outcomes. [source] Self-determination, social abilities and the quality of life of people with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 11 2007L. Nota Summary Background The international literature has documented that self-determination is impacted by environmental factors, including living or work settings; and by intraindividual factors, including intelligence level, age, gender, social skills and adaptive behaviour. In addition, self-determination has been correlated with improved quality of life (QoL). This study sought to contribute to the growing literature base in this area by examining the relationship among and between personal characteristics, self-determination, social abilities and the environmental living situations of people with intellectual disabilities (ID). Methods The study involved 141 people with ID residing in Italy. Healthcare professionals and social workers who had known participants for at least 1 year completed measures of self-determination, QoL and social skills. Analysis of variance was conducted to verify whether different levels of intellectual impairment were associated with different degrees of the dependent variables. The Pearson product,moment correlation was used to examine any relationships among dependent variables and IQ scores. Finally, discriminant function analysis was used to examine the degree to which IQ score, age, self-determination and social abilities predicted membership in groups that were formed based on living arrangement, and on QoL status (high vs. low). Results The anova determined, as expected, that participants with more severe ID showed the lowest levels of self-determination, QoL and social abilities. Discriminant function analysis showed that (a) individuals attending day centres were distinguished from those living in institutions in that they were younger and showed greater autonomy of choice and self-determination in their daily activities; (b) basic social skills and IQ score predicted membership in the high or low QoL groups; and (c) the IQ score predicted membership in the high or low self-determination groups. A manova conducted to examine gender- and age-level differences on self-determination found gender differences; women had higher self-determination scores than men. Conclusions These findings contribute to an emerging knowledge base pertaining to the role of intraindividual and environmental factors in self-determination and QoL. In general, the study replicated findings pertaining to the relative contribution of intelligence to self-determination and QoL, added information about the potential contribution of social abilities, and pointed to the potentially important role of opportunities to make choices as a particularly important aspect of becoming more self-determined, at least in the context of residential settings. [source] Predicting physical activity and outcome expectations in cancer survivors: an application of Self-Determination TheoryPSYCHO-ONCOLOGY, Issue 7 2006Philip M. Wilson Abstract The purpose of this study was to examine the contributions of autonomous and controlled motives drawn from Self-Determination Theory (SDT; Intrinsic Motivation and Self-determination in Human Behavior. Plenum Press: New York, 1985; Handbook of Self-determination Research. University of Rochester Press: New York, 2002) towards predicting physical activity behaviours and outcome expectations in adult cancer survivors. Participants were cancer-survivors (N=220) and a non-cancer comparison cohort (N=220) who completed an adapted version of the Treatment Self-Regulation Questionnaire modified for physical activity behaviour (TSRQ-PA), an assessment of the number of minutes engaged in moderate-to-vigorous physical activity (MVPA) weekly, and the anticipated outcomes expected from regular physical activity (OE). Simultaneous multiple regression analyses indicated that autonomous motives was the dominant predictor of OEs across both cancer and non-cancer cohorts (R2adj=0.29,0.43), while MVPA was predicted by autonomous (,'s ranged from 0.21 to 0.34) and controlled (,'s ranged from ,0.04 to ,0.23) motives after controlling for demographic considerations. Cancer status (cancer versus no cancer) did not moderate the motivation,physical activity relationship. Collectively, these findings suggest that the distinction between autonomous and controlled motives is useful and compliments a growing body of evidence supporting SDT as a framework for understanding motivational processes in physical activity contexts with cancer survivors. Copyright © 2005 John Wiley & Sons, Ltd. [source] Mediation and feminism: Common values and challengesCONFLICT RESOLUTION QUARTERLY, Issue 1 2000Marsha Lichtenstein Mediation, and transformative mediation in particular, share several values, despite feminist criticisms of mediation. This article discusses three of the elements that mediation and feminism share. Both promote self-determination, both encourage strengthening values such as empathy and caring in the public sphere, and both deal with the issue of power and have attempted to redefine power to include behaviors other than dominance. Because feminism has gone through the growing pains of shifting from a homogeneous and middle-class movement to a colorful pluralistic social movement, it may serve as a model for the mediation movement as it expands and faces the demands of a demo-graphically diverse constituency. [source] SUICIDE, RISK, AND INVESTMENT IN THE HEART OF THE AFRICAN MIRACLECULTURAL ANTHROPOLOGY, Issue 4 2009JULIE LIVINGSTON ABSTRACT This essay considers new forms of investment, risk, and self-determination, among Botswana's middle and aspirant classes, as well as the loneliness and rage that are at stake when they fail. In it, I use specific instances and more widespread talk of suicides and murder,suicides contemplated, attempted, and accomplished as a vehicle for pondering the social dimensions of investment, and the perils of secrecy and the loneliness that shadow it. Amid a new regime of risk, investment, and self-determination brought by discontinuities of economic boom and widespread AIDS death over the past decade, Batswana are facing new questions about how to invest in relationships, selves, and futures. The essay concludes with a radically different context, a cancer ward, where Batswana seek to exile suicide and nihilism from the beds, minds, and hearts of patients through processes of socialization and paternalism that deny self-determination, while at the same time questing for and demanding investment in high-tech biomedicine. [source] ARGUING OVER [THE] REMOTE CONTROL: WHY INDIGENOUS POLICY NEEDS TO BE BASED ON EVIDENCE AND NOT HYPERBOLEECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2007BOYD H. HUNTER Recent public debate on Indigenous issues has been provoked, inter alia, by a 2005 Centre for Independent Studies paper by Helen Hughes and Jenness Warin, who focused on the extent to which policies have been effective in improving the living conditions of Indigenous Australians since the era of self-determination commenced. Unfortunately, the quality of historical data is questionable, and hence we need an appreciation of the reliability of estimates. The 2002 National Aboriginal and Torres Strait Islander Social Survey allows a detailed interrogation of the reliability of estimates. This paper critically analyses socioeconomic changes between 1994 and 2002 for remote and other areas by comparing the recent data with analogous data collected in 1994. Changes in health status and a range of socio-economic indicators are documented to provide a more balanced assessment of the level of economic and social development in the respective areas. [source] Translating the Ideal of Deliberative Democracy into Democratic Education: Pure Utopia?EDUCATIONAL PHILOSOPHY AND THEORY, Issue 3 2010David Lefrançois Abstract Is the idea that the self-determination of all citizens influences progress towards democracy not merely a dream that breaks itself against the hard historical reality of political societies? Is not the same fate reserved for all pedagogical innovations in democratic education that depend on this great dream? It is commonplace to assert this logic to demonstrate the inapplicability of the ideas of both democracy and of democratic education. Though this argument is prominent and recurring in the history of political and educative ideas, in response we can ask ourselves if the gap between the ideal and the reality is effectively insuperable and must be considered an incontestable fact. The double objective of this article is to determine explicitly the meaning and extent of this gap in the context of democracy and of education and to demonstrate that this gap is neither static nor permanent, but is susceptible to being narrowed, from generation to generation. [source] The Limited Modesty of SubsidiarityEUROPEAN LAW JOURNAL, Issue 3 2005N. W. Barber In the process of discussing the European principle, a contrast is drawn with the Catholic principle of subsidiarity and with the rival doctrine of national self-determination. It is argued that the European principle is a central part of the Union's constitutional identity, and, as such, crucial to an understanding of the European project. [source] Constitutional Irresolution: Law and the Framing of Civil SocietyEUROPEAN LAW JOURNAL, Issue 4 2003Emilios Christodoulidis I will explore some of the more adventurous and persuasive such attempts to argue for an inclusive constitutionalism, one that supposedly reaches out to civil society and in order to do so relaxes the rigidity of its own terms, to harbour and host the diversity it aspires to represent. I will argue that these attempts at inclusion create constitutional irresolutions either forcing impossible demands on constitutionalism or dispelling the disorganisation it is meant to give expression to. I will then argue that in spite of the inability to capture them as constitutional moments, politics of ,pure presence' and real self-determination are possible, and against constitutional mystifications, resistance might find its opportunity in praxis, understood in the language of praxis philosophy (more specifically the work of Antonio Negri). [source] Acquiring a Community: The Acquis and the Institution of European Legal OrderEUROPEAN LAW JOURNAL, Issue 4 2003Hans Lindahl The emblematic manifestation of this passage, in the framework of the European legal order, is the acquis communautaire: what is the nature of the process that leads from acquired community to acquiring a community? In a first, preparatory, step, it will be argued that determinate conceptions of truth, time and the giving and taking of reason underlie the process of acquiring a European community. These findings are confronted, in a second step, with Antonio Negri's theory of the multitude as a constituent power, which opposes revolutionary self-determination to representation. Deconstructing this massive opposition, this paper explores three ways in which representation is at work in revolutionary self-determination. As will become clear in the course of the debate, instituting (European) community turns on the interval linking and separating law ,and' disorganised civil society. [source] Couples with Schizophrenia "Becoming like Others" in South Korea: Marriage as Part of a Recovery ProcessFAMILY PROCESS, Issue 3 2009MYUNG-YEE YU PH.D. Very little is known about the married life of couples with schizophrenia. In this paper, authors report perceptions and experiences of 5 married couples with schizophrenia on their strategies in forming and maintaining healthy marriage. Our data reveal that participants had realistic expectations of marriage, and recognized benefits as well as obstacles in their marriages with respect to their recovery. This paper examines the importance of extended family members, mental health professionals, and the larger society's attitudes toward marriage as a factor in the recovery process for persons with schizophrenia. The authors identify implications for mental health professionals regarding the respect of client dignity and the applicability of a strengths perspective when working with couples with schizophrenia. The authors argue that mental health professionals' decisions regarding the balance between respecting a client's self-determination and protecting a client from risks associated with cohabitation and marriage should no longer be a dilemma for those working with people with mental illness. RESUMEN Se sabe muy poco de la vida matrimonial de las parejas que padecen esquizofrenia. En este trabajo, los autores informan sobre las percepciones y las experiencias de 5 parejas casadas que padecen esquizofrenia y sus estrategias para constituir y mantener un matrimonio sano. Nuestros datos revelan que los participantes tuvieron expectativas realistas en relación con el matrimonio, y reconocieron los beneficios y los obstáculos de sus matrimonios con respecto a su recuperación. Este artículo analiza la importancia de los familiares, de las actitudes de los profesionales de la salud mental y de la sociedad en general hacia el matrimonio como factor en el proceso de recuperación para las personas con esquizofrenia. Los autores identifican las implicancias para los profesionales de la salud mental con respecto a la dignidad del paciente y la aplicabilidad de una perspectiva de énfasis en las virtudes cuando se trabaja con parejas que padecen esquizofrenia. Los autores sostienen que las decisiones de los profesionales de la salud mental con respecto al equilibrio entre respetar la autodeterminación de un paciente y proteger a un paciente de los riesgos asociados con la convivencia y el matrimonio ya no debería ser un dilema para aquellos que trabajan con personas que tienen enfermedades mentales. Palabras clave: preservación del matrimonio, esquizofrenia, coreano, recuperación, dignidad del paciente, perspectiva de énfasis en las virtudes [source] PERI-URBAN AGROFORESTRY IN THE BRAZILIAN AMAZON,GEOGRAPHICAL REVIEW, Issue 2 2000VANESSA A. V. SLINGER ABSTRACT. Together, urbanization and the search for sustainable development present a dilemma in the Brazilian Amazon: how to accommodate an expanding urban population while creating and maintaining sustainable production systems that feed the people and manage the forest. A unique peri-urban agroforestry project, implemented by a municipal government in western Amazonia and concerned with a citywide influx of rural agriculturalists and former forest-dwelling extractive producers, is examined as a source of food and self-determination. Peri-urban agroforestry seems to be a viable option for other Amazonian cities that are experiencing increasing urbanization and its associated problems. [source] Expanding the Andersen Model: The Role of Psychosocial Factors in Long-Term Care UseHEALTH SERVICES RESEARCH, Issue 5 2002Elizabeth H Bradley Objective. To examine a prevailing conceptual model of health services use (Andersen 1995) and to suggest modifications that may enhance its explanatory power when applied to empirical studies of race/ethnicity and long-term care. Study Setting. Twelve focus groups of African-American (five groups) and white (seven groups) individuals, aged 65 and older, residing in Connecticut during 2000. Study Design. Using qualitative analysis, data were coded and analyzed in NUD-IST 4 software to facilitate the reporting of recurrent themes, supporting quotations, and links among the themes for developing the conceptual framework. Specific analysis was conducted to assess distinctions in common themes between African-American and white focus groups. Data Collection. Data were collected using a standardized discussion guide, augmented by prompts for clarification. Audio taped sessions were transcribed and independently coded by investigators and crosschecked to enhance coding validity. An audit trail was maintained to document analytic decisions during data analysis and interpretation. Principal Findings. Psychosocial factors (e.g., attitudes and knowledge, social norms, and perceived control) are identified as determinants of service use, thereby expanding the Andersen model (1995). African-American and white focus group members differed in their reported accessibility of information about long-term care, social norms concerning caregiving expectations and burden, and concerns of privacy and self-determination. Conclusions. More comprehensive identification of psychosocial factors may enhance our understanding of the complex role of race/ethnicity in long-term care use as well as the effectiveness of policies and programs designed to address disparities in long-term care service use among minority and nonminority groups. [source] Two steps forward, one step back: advance care planning, Australian regulatory frameworks and the Australian Medical AssociationINTERNAL MEDICINE JOURNAL, Issue 9 2007M Parker Abstract The Australian Medical Association has recently adopted a policy position concerning advance care planning, which is generally supportive of extending patient self-determination beyond the loss of decision-making capacity. It calls for uniform national legislation for legally enforceable advance health directives (AHD), and statutory protection for practitioners who comply with valid AHD, or who do not comply on several grounds. Analysis of the grounds for non-compliance indicate that they undermine patient autonomy, and aspects of the policy are inconsistent with current common law and statutory regimes that allow an adult to complete a legally binding AHD. The policy therefore threatens the patient self-determination, which it endorses, and places doctors who participate in advance care planning at legal risk. [source] Self-determination of patients with rheumatoid arthritis: Model development during action researchINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2008Päivi Löfman The purpose of this article is to describe the content and the development of the model to promote self-determination of patients with rheumatoid arthritis from a point of view of patients and nurses. For the patients the data were gathered using semistructured interviews and for the nurses through three focus groups in the initial and evaluation phases. The data were analysed by themes using qualitative content analysis. The model consisted of the concept of self-determination, impediments to and preconditions for self-determination, promoting and focusing on consequences. Patient's activity was a new view of the concept. Impediments to self-determination were linked to limitations and preconditions to patients' freedom to express themselves. Support developed an important factor promoting self-determination. The results indicate a clear need for various types of supportive nursing care to promote self-participation in patient care. [source] Videotaped recording as a method of participant observation in psychiatric nursing researchJOURNAL OF ADVANCED NURSING, Issue 5 2000Eila Latvala RN PhD Videotaped recording as a method of participant observation in psychiatric nursing research This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients. [source] Person-Centred Planning in its Strategic Context: Reframing the Mansell/Beadle-Brown CritiqueJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2004David Towell Valuing People, the English national strategy launched in 2001 is founded on the twin principles of self-determination and social inclusion. It promotes a vision of people with intellectual disabilities in the mainstream of life. To achieve this goal, it seeks to integrate a wide variety of elements, in which person-centred planning (PCP) is one. The Mansell and Beadle-Brown review makes many interesting points about PCP in this context. We reframe their critique in three main ways: by more fully recognising the extent to which PCP is an intrinsic element of the national strategy, helping to operationalise its core principles; by crediting the ways in which individual planning and action are intended to become part of one continuous process; and by showing how the strategy addresses the challenge of scale by prioritising quality rather than quantity in implementing PCP, with the aspiration of creating a virtuous spiral of positive change. [source] The Impact of Personal Characteristics of People with Intellectual and Developmental Disability on Self-determination and Autonomous FunctioningJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2003Michael L. Wehmeyer Background, Many people assume that the presence of an intellectual disability precludes a person from becoming self-determined. Recent research, however, has suggested that the environments in which people live, learn, work or play may play a more important role in promoting self-determination then do personal characteristics of the person, including level of intelligence. Methods, This study examined the self-determination and autonomous functioning of 301 adults with intellectual disability or a developmental disability without concomitant intellectual impairments (e.g. persons with cerebral palsy, epilepsy and spina bifida) as a function of personal characteristics of individuals. Results, Intellectual capacity was not a significant contributor to either self-determination or autonomous functioning for this group. Opportunities to make choices, however, contributed significantly and positively to greater self-determination and autonomy. Intelligence scores did, however, predict whether the person worked or lived in more or less restrictive settings, though for the latter, both self-determination and autonomous functioning also contributed significantly. Conclusions, These findings are discussed with regard to the role of personal characteristics, particularly intelligence level, in promoting self-determination and more positive adult outcomes. [source] Metasynthesis: withdrawing life-sustaining treatments: the experience of family decision-makersJOURNAL OF CLINICAL NURSING, Issue 2 2009Mary Ann Meeker Aim., The present study was undertaken to synthesise findings from qualitative investigations of family participation in decisions to withdraw and/or withhold life-sustaining treatment from a seriously ill family member. Background., As a consequence of increasing effectiveness and sophistication of available medical interventions, death is commonly preceded by a decision to withdraw or withhold potentially life-sustaining treatments. These decisions take place in a bioethical context characterised by the preeminence of self-determination, but patients are typically too ill to make their own decisions. Thus, family members are called upon to participate in these morally consequential decisions on the patient's behalf. Design., Metasynthesis Method., Metasynthesis is a form of inquiry that provides for integration of qualitative studies' findings to strengthen knowledge for practice and advance theoretical development. This metasynthesis was conducted using the constant comparative methods of grounded theory. Results., Family members engage in a process of participation in decision-making that is comprised of three major categories: reframing reality, relating and integrating. Surrogates used both cues and information as they reframed their understanding of the patient's status. Relationships with providers and with other family members powerfully influenced the decision-making process. Integrating was characterised by reconciling and going forward. This part of the process has both intrapersonal and interpersonal aspects and describes how family decision-makers find meaning in their experience and move forward in their lives. Conclusions., This synthesis provides a more comprehensive and empirically supported understanding of family members' experiences as they participate in treatment decisions for dying family members. Relevance to clinical practice., This metasynthesis provides evidence to improve family care during treatment withdrawal/withholding decision-making and a theoretical model that can be used to guide creation of clinical practice guidelines. Through increased understanding of family members' experiences, clinicians can more effectively support family decision-making processes. [source] Self-evaluation and peer review , an example of action research in promoting self-determination of patients with rheumatoid arthritisJOURNAL OF CLINICAL NURSING, Issue 3a 2007LicNSc, Päivi Löfman RN Aims and objectives., The aim of this paper was to describe the areas that have been performed well and the areas in need of further development of rheumatoid arthritis patients. Background., Nurses' self-evaluation and peer review are important methods for ascertaining the changes and success in the development of nursing practice. To date, there has been minimal research regarding the use of those evaluation methods in nursing practice. Design., The findings of self-evaluation and peer review of nurses are described in a participatory action research study aimed at promotion of self-determination for patients with rheumatoid arthritis. Methods., In self-evaluation, the collection of data was accomplished using a self-evaluation instrument with the permanent nursing staff (n = 18), then analysed through quantitative methods. For peer review, the data were gathered through focus groups (n = 21) using a tool similar to the one used for self-evaluation. The participants included many of the same nurses as in self-evaluation. The data were analysed using qualitative content analysis. Results., Well-performed areas in nursing of rheumatoid arthritis patients were found to be promoting patient participation, supporting self-determination, performing patient-centred nursing and raising patient self-respect. The areas in need of development were connected to the nursing staff themselves: increasing collaboration of nursing staff, decreasing authoritarianism in nursing care and developing nursing practice with colleagues. Conclusions., Self-evaluation and peer review are complementary and support one another, especially since nurses were found to be more critical in their self-evaluations than in peer review. Relevance to clinical practice., Both evaluation tools proved to be useful methods in the evaluation phase of the action research process as a means of professional development. Also assisting in the development of clinical nursing practice. [source] | |||||||||||||||||||||||||||||||||||||||||||