3 research outputs found
The 'Choice and Autonomy Framework' : implications for occupational therapy practice
Introduction
This paper presents findings from a PhD study exploring
autonomy of adults with physical disability. The plethora
of descriptions of autonomy in psychological, occupational
therapy and rehabilitation literature (e.g. Ryan and Deci 2000,
Rogers 1982, Cardol et al 2002) detracts from the centrality
of autonomy and results in difficulty incorporating it into
occupational therapy practice. This paper presents a framework
providing an integrated, clinically useful approach to autonomy.
Methods
Sixteen people were recruited, based on age, gender,
impairment and living circumstances (community/residential
settings). All have significant physical disability, use a wheelchair
and require personal assistance for some/all self-care activities.
Qualitative methods were used for data collection, including
life-history narrative, diary information and extensive interview.
An integrated method of analysis was used, including content
analysis and bracketing.
Results
The ‘Choice and Autonomy Framework’ consists of five strands,
including:
• the meaning of autonomy
• whether or not autonomy is a goal or value
• the experience of autonomy
• personality factors that impact autonomy
• environmental features that enhance or negate autonomy.
This paper will describe each strand, as derived from the
research. The results suggest that, contrary to common wisdom (Hmel and Pincus 2002), autonomy is not necessarily a universal
goal for people with physical disability; an understanding of the
person’s own perspective will enhance person-centred practice
and enable therapists to further recognise individuality of clients.
It will argue that the concept of autonomy needs to be further
understood and incorporated into occupational therapy practice