Patients' perceptions of self-determination as expressed in the context of care.
OBJECTIVE
The aim of this study was to describe patients' perceptions of how self-determination finds expression in the context of care.


BACKGROUND
Self-determination is an important concept within health care as well as an important patient right. New legislation on patient rights in Sweden and Europe is aimed at increased patient self-determination.


METHODS
Data were collected through semi-structured, tape-recorded interviews with 17 strategically chosen patients within somatic care and analysed using a method inspired by phenomenography.


RESULTS
The analysis found three descriptive categories of the informants' perceptions: trusting, accepting and a feeling of powerlessness. The patients expressed a great sense of trust and confidence in the care provided and they accepted the health care procedures. At the same time, they expressed a feeling of powerlessness because of not being part of decision-making, as well as lacking knowledge and information about treatment strategies. The patients wished to have the right of more self-determination but lacked the strength and knowledge to be able to influence their own care.


CONCLUSIONS
Patients' perceptions of self-determination suggest that, in their encounters with the professional care, knowledge is expressed as power. The feeling of a lack of self-determination can be reduced by help and support from a nurse who allocates time for communication in order to learn the patient's needs and reach a mutual understanding.
Nordgren
S
S
School of Social and Health Sciences, Halmstad University, and School of the Health Care Programme, Södra Vårdskolan, Halmstad, Sweden. lars.nordgren@bs.se
Fridlund
B
B
D000328:Adult; D000368:Aged; D005260:Female; D005610:Freedom; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009732:Nursing Care; D010344:Patient Advocacy; D010358:Patient Participation / Q000331:legislation & jurisprudence; D011209:Power, Psychological; D013548:Sweden