title: The illusion and the paradox of being autonomous, experiences from persons with spinal cord injury in their transition period from hospital to home.
abstract: OBJECTIVE
  To open a discourse on the concept of autonomy as a precursor for participation in individuals with Spinal Cord Injury (SCI) by exploring the experiences about their perceived autonomy in their transition period from hospital to home.
  
  
  METHODS
  Based on the 'grounded theory' approach; in-depth, semi structured interviews were conducted with 11 SCI-patients. A theoretical sampling strategy was used and the data was analysed according to the constant comparative method.
  
  
  RESULTS
  To capture this complexity of autonomy, the results have been structured in themes with regard to the self of the patient and his independency. The analysis showed four different typologies of how autonomy is perceived; (1) the active agent, (2) the active follower, (3) the passive follower and (4) the passive victim.
  
  
  CONCLUSIONS
  Rehabilitation professionals can help individuals in disconnecting their internalised ideal of independency to avoid the illusion of being autonomous and can gain insight in the patients' typology and empower patients to avoid the paradox of being autonomous. If the ultimate goal of rehabilitation is participation; empowering the patient to achieve a 'sense of agency' instead of autonomy is the central goal for rehabilitation professionals. Empowerment and agency are key topics for the patient to gain mastery over his own life.
authors: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium. dominique.vandevelde@ugent.be
authors: Dominique
authors: D
authors: Van de Velde
authors: Piet
authors: P
authors: Bracke
authors: Geert
authors: G
authors: Van Hove
authors: Staffan
authors: S
authors: Josephsson
authors: Ignaas
authors: I
authors: Devisch
authors: Guy
authors: G
authors: Vanderstraeten
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D003266:Continuity of Patient Care / Q000458:organization & administration; D005260:Female; D006761:Hospitals; D006801:Humans; D007088:Illusions / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D008962:Models, Theoretical; D010351:Patient Discharge; D010358:Patient Participation; D026684:Personal Autonomy; D011209:Power, Psychological; D036301:Qualitative Research; D012046:Rehabilitation / Q000458:organization & administration; D012648:Self Care; D012931:Social Environment; D013119:Spinal Cord Injuries / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires