Translated Titles

Concept Analysis of Autonomy




黃慧莉(Huei-Lih Hwang)

Key Words

autonomy ; concept analysis



Volume or Term/Year and Month of Publication

5卷2期(2003 / 04 / 01)

Page #

130 - 141

Content Language


Chinese Abstract

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。

English Abstract

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.

Topic Category 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
  1. 邱文彬(1999)。博士論文(博士論文)。台北,政治大學心理學系。
  2. Armon, C.,Commons, M. L.,Sinnott, J. D.,Richard, F. A.,Armon, C. (Eds.)(1989).Adult development.Ny:Praeger.
  3. Beauchamp, T. L.,Childress, J. F.(1983).Principles of biomedical ethics.New York:Oxford University Press.
  4. Blackhall, L.,Murphy, S. T.,Frank, G.,Michel, V.,Azen, S.(1995).Ethicity and attitudes toward patient autonomy.Journal of the American Medical Association,274(10),820-825.
  5. Castelluci, D. T.(1998).Issues for nurses regarding elder autonomy.Nursing Clinics of North America,33(2),265-274.
  6. Chabot, J. A.(1975).Dissertation Abstracts International.University Microfilms.
  7. Chickering, A. W.,Reisser, L.(1993).Education and Identity.San Francisco, CA:Jossey-Bass.
  8. Chodorow, N. J.(1989).Feminism and Psychoanalytic Theory.New Haven:Yale University Press.
  9. Collopy, B.(1988).Autonomy in long term care: some crucial distinctions.Gerontologist,28(suppl.),10-17.
  10. Davis, A. J.,Aroskar, M. L.,Liaschenko, J.,Drought, T. S.(1997).Ethical dilemmas nursing practice.Stamford:Appletion & Lange.
  11. Dunn, C.,Lesser, H. (edited)(1999).'The Effect of Ageing on Autonomy'
  12. Dworkin, G.(1988).The Theory and Practices of Autonomy.Cambridge:CPU.
  13. Erickson, H. C.,Tomlin, E. M.,Swain, M. A. P.(1983).Modeling and role-modeling: A theory and paradigm for nursing.Lexington, SC:Pine Press.
  14. Erikson, E.、Erikson, J.、Kivnick, H.、周伶利譯(2000)。Vital Involvement in Old Age。台北:張老師。
  15. Fung, L.(1994).Implementing the patient self-determination act: How to effectively engage Chinese American elderly persons in the decision of advance directives.Journal of Gerontological Social Work,22,161-174.
  16. Gove, P. B.(1967).Webster's New International Dictionary.New York:Dorset & Baber.
  17. Haug, M. R.,Ory, M. G.(1987).Issues in elderly patient-provider interactions.Research on Aging,9(1),3-44.
  18. Hertz, J. E. G.(1996).Conceptualization of perceived enactment of autonomy in the elderly.Issues in Mental Health Nursing,17,261-273.
  19. Hertz, J. E. G.(1991).The perceived enactment of autonomy scale: Measuring the potential for self-care action in the elderly.Dissertation Abstracts International,52(4)
  20. Hertz, J. E.,Anschutz, C.(2002).Relationships among perceived enactment of autonomy, self-care, and holistic health in community-dwelling older adults.Journal of Holistic Nursing,20(2),166-185.
  21. Hertz, J. E.,S. H. Gueldner,Poon, L. W. (Eds.)(1999).Gerontological nursing issues for the 21st century.Indianapolis:Center Nursing Press.
  22. Higgs, P.,MacDonald, L.,Ward, M.(1992).Responses to the institution among elderly patients in hospital long-stay care.Social Science and Medicine,35(3),287-293.
  23. Jary, D.、Jary, J.、周業謙、周光淦譯(1999)。The Harper Collins Dictionary of Sociology。台北:貓頭鷹。
  24. Kant, I.,Paton, H. J., (Trans.)(1964).Groundwork of the metaphysics of morals.NY:Harper & Row.
  25. Kohlberg, L.(1984).The philosophy of moral development Moral stages, their nature and validity.San Francisco:Harper & Row.
  26. Kurtines, W.(1978).A measure of autonomy.Journal of Personality Assessment,42,253-257.
  27. Lemke, S.,Moos, R.(1986).Quality of residential settings for adults.Journal of Gerontology,41,268-276.
  28. Lewis, H.(1984).Self-determination: The aged client's autonomy in service encounters.Journal of Gerontological Social work,7(3),501-519.
  29. Lindley, R.(1986).Autonomy.London:Macmillian education Ltd.
  30. MacDonald, L. D.,Sibbald, B.,Hiare, C.(1988).Measuring patient satisfaction with life in a long-stay psychiatric hospital.International Journal of Social Psychiatrist,34,292-304.
  31. May, C.(1995).Patient autonomy and the politics of professional relationships.Journal of Advanced Nursing,21(1),83-87.
  32. McWillian, C.,Belle, B.,Carmichael, J.,Lehman, J.(1994).A new perspective on threatened autonomy in elderly persons: the disempowering process.Social Science and Medicine,38(2),327-338.
  33. Miller, B. L.(1988).Moral Problems in Medicine.New Jersey:Prentice-Hall, Inc..
  34. Nystrom, A.,Segesten, K.(1994).On sources of powerlessness in nursing home life.Journal of Advanced Nursing,19,124-133.
  35. Oleson, M.,Heading, C.,McGlynn, S. K.,Bistodeau, J. A.(1994).Quality of life in long-stay institutions in England: nurse and resident perceptions.Journal of Advanced Nursing,20,23-32.
  36. Paterson, R. W. K.(1979).Values, education and the adult.London:Routledge & Kegan Paul.
  37. Proot, I. M.,Crebolder, H. F. J. M.,Abu-Saad, H. H.,Macor, T. H. G. M.,Meulen, R. H. J. T.(2000).Facilitating and constraining factors on autonomy.Clinical Nursing Research,9(4),460-478.
  38. Proot, I. M.,Crebolder, H. F. J. M.,Huijer Abu-Saad, H.,Ter Meulen, R. H. J.(1998).Autonomy in the rehabilitation of stroke patients in nursing homes: a concept analysis.Scandinavian Journal of Caring Science,12,139-145.
  39. Schultz, K.,Singer, J.,Pope, K. (eds)(1978).The Power of Human Imagination: New Methods in Psychotherapy.New York:Plenum.
  40. Segura, N. J. M.,Bastida, B. N.,Marti, G. N.,Riba, R. M.(1997).Chronic patients at home. A descriptive and survival analysis at 2 years after the introduction of a home care program.Attention Primaria,19(7),351-356.
  41. Smith, J. A.(1981).The idea of health: A philosophical inquiry.Advances in Nursing Science,3(3),43-50.
  42. Walker, L. O.,Avant, K. C.(1995).Strategies for theory construction in nursing.Norwalk, CT:Appleton & Lange.
  43. Watson, R.(1994).Practical and ethical issues related to the care of elderly people with dementia.Nursing Ehtics,1(3),151-162.
  44. Weinberg, J. K.(1987).Aging and dependence: toward a redefinition of autonomy.The Journal of Contemporary Social Work,522-532.
  45. Wiens, A.(1993).Patient autonomy in care: a theoretical framework for nursing.Journal of Professional Nurse,9,95-103.
  46. Worthington, L.(1988).Denton, Tx.,Texas Woman`s University.
  47. 左秀靈(1990)。當代國語辭典。台北:建宏。
  48. 邱文彬、林郁華、費業勳(2000)。後皮亞傑學派的後形式思考與自主性之關係-從整體性發展觀。樹德科技大學學報,2(1),327-338。
  49. 邱清榮(1997)。碩士論文(碩士論文)。台北,政治大學社會學系。
  50. 施教裕(1996)。老人安養機構的運作模式和原則。社會福利,126,24-29。
  51. 張玉梅(1995)。碩士論文(碩士論文)。台北,國防護理學系。
  52. 張春興(1991)。張氏心理學辭典。台北:曉園。
  53. 許麗齡(1999)。護理倫理-病人的自主性。護理雜誌,46(4),57-61。
  54. 游恆山、袁山琦(1990)。心理學名詞辭典。台北:五南。
  55. 劉久清(1998)。個體自主性與民主。三民主義,18,151-165。
  56. 閻震興、高明(1984)。中文百科大辭典。台北:百科文化。
Times Cited
  1. 楊心茹(2014)。探討會計專業認同的前置因素。淡江大學會計學系碩士班學位論文。2014。1-92。 
  2. 賴玲惠(2008)。母親教養風格、幼兒自主性之研究 —以台北縣為例。臺東大學進修部暑期幼兒教育碩士班學位論文。2008。1-185。 
  3. 伍碧琦(2009)。病患與護理人員對病患自主權態度與經驗之比較。長榮大學護理學系(所)學位論文。2009。1-102。 
  4. 鍾佳芳(2013)。中高齡慢性精神病患健康促進生活型態與生活品質的預測因素。臺北醫學大學護理學系碩士暨碩士在職專班學位論文。2013。1-226。 
  5. 張曉文(2017)。生活討論會介入對護理之家老人憂鬱狀態、孤寂感、知覺自主性之成效。長榮大學護理學系(所)學位論文。2017。1-109。