摘要
在台灣，病人自主權利法已於2019年1月公布施行以保障病人的自主權，此法意味著：在某些情況下，病人可以基於自己的真實願望做出醫療決定。因此，護理人員在臨床如何幫助個案進行解放性決策，實為一重要議題。事實上，2013年NANDA（北美護理診斷協會）已提出新護理診斷「解放性決策障礙（impaired emancipated decision-making）」，但目前關於解放決策概念的研究甚少，為幫助護理人員充分理解此概念，界定明確的定義十分重要。本研究利用Walker和Avant概念分析方法來定義和描述本研究中解放決策的概念，並利用數據庫進行文獻檢索。「解放性決策」是一個複雜的決策過程，意指個案從不平等的環境中意識到限制並且引發反思，試圖脫離原有限制，做出最合適的選擇。根據文獻，此概念之定義屬性之三要素為：自主（autonomy），獨立（independent） 及一致性（congruency）。本文對於此概念的分析可幫助護理人員澄清和理解此概念，進而採取更適當的護理措施，而運用會談、溝通等技巧協助個案，才能幫助個案真正成為「自我決策過程中的主角」。此外，也可以更進一步的分辨與其他決策理論之概念差異，為未來進一步研究奠定基礎。
並列摘要
＂Patient Autonomy Act＂ in Taiwan has legislated for the right of Patient Autonomy in 2019. The autonomy right means: under some circumstances, the patient could make medical decision according to his/her own true desire. Therefore, how nurses help them to make emancipated decision also be a significant nursing concern in clinical settings. In 2013, NANDA (North American Nursing Diagnosis Association) has presented the new nursing diagnosis as ＂impaired emancipated decision-making＂. However, there are few researches about this nursing diagnosis or concept of emancipated decision. To better understand about this concept for nurses, a clear definition is important. This study utilized the Walker and Avant method of concept analysis to define and describe the concept of emancipated decision. Literature searching was conducted through databases and materials in English, Korean and Chinese. The results showed that ＂Emancipated decision making＂ is a complex decision-making process from an aware of limitation and reflection in the inequal environment, then attempt to emancipate the limitation and make the most appropriate choice. According to the literature, the concept is characterized by three attributes: autonomy, independent and congruency. This study dedicated to clarify this concept for nurses to understand of the attributes of emancipated decision during practice or research. Moreover, we can further distinguish the conceptual differences between Emancipated Decision Making Theory and other decision-making theory and lay the foundation for future research. We could let the patients truly become the protagonist in the process of decision-making through dialogue and communication.