自主是醫護倫理裡不可或缺的一項對待病患之原則,在從事護理業務時不論護生或護士均常將尊重病患的自主掛在腦海裡當口號用。一則因為自主這一詞在國內有諸多不明確的說法;另則,老年人的身體功能逐漸減退情況下,將自主視同獨立性來談論,在臨床實務運用上將無法使老人群體廣為受惠。因此,有待藉由概念分析方法來對自主作一番徹底地澄清說明。本文針對自主的本質,整理出三個核心特徵:知覺到自己的需求 或目標、理性判斷後的行動和主觀評價,同時以典型案例、邊緣案例、相反案例和相關案例舉例說明之。在實證研究文獻討論部份,另可提供國內對老年人自主性未來相關研究之參考。
Autonomy is an important health care principle. However, discussion and appropriate application of this concept to the elderly in Taiwan has been limited. This study applied concept analysis strategy to explore the concept of autonomy. The critical attributes of autonomy, such as awareness of needs and goals, action through reasoned judgment and subjective evaluation, were illustrated by case studies, including model cases, borderline cases, contrasting cases and related cases. Besides, discussion of empirical studies provided a guide for further research on elderly autonomy.