The purpose of this article is to report findings from two studies of community-dwelling older adults. The focus of both studies was on delineating relationships among perceived enactment of autonomy (PEA) and selected self-care and health variables from the perspective of Modeling and Role-Modeling nursing theory. Results indicated that PEA, representing the potential for self-care action, was positively correlated to perceived control and morale in Study 1 and to life satisfaction in Study 2. Significant differences in PEA scores were found based on the health indicators of participation in social activities and reliance on others for shopping in Study 2. In addition, Study 1 found that morale, gender, age, perceived control, and education accounted for 39% of the variance in PEA. Implications are discussed for designing theory-based holistic nursing interventions to support PEA in older adults and to direct future research.
Get full access to this article
View all access options for this article.
References
1.
Adams, D.
(1969). Analysis of Life Satisfaction Index. Journal of Gerontology, 24, 470-474.
2.
American Holistic Nurses’ Association
. (2001, August 25). AHNA position statements. Flagstaff, AZ: Author. Retrieved August 25, 2001, from the World Wide Web: http://www.ahna.org/about/statements.html
3.
Anschutz, C. A. (2000). Perceived enactment of autonomy and life satisfaction: An elderly perspective. Unpublished master’s thesis, Fort Hays State University, Hays, KS.
4.
Beauchamp, T. L.
, & Childress, J. (1994). Principles of biomedical ethics (4th ed.). New York: Oxford University Press.
5.
Blitzan, J.
(1998). Emotional bondedness and subjective well-being. Journal of Gerontological Nursing, 24(9), 8-15.
6.
Bowlby, J.
(1969). Attachment. New York: Basic Books.
7.
Castelluci, D. T.
(1998). Issues for nurses regarding elder autonomy. Nursing Clinics of North America, 33(2), 265-274.
8.
Chang, B. L.
(1978). Generalized expectancy, situational perception, and morale among institutionalized aged. Nursing Research, 27, 316-324.
9.
Collopy, B. J.
(1988). Autonomy in long term care: Some crucial distinctions. The Gerontologist, 28(Suppl.), 10-17.
10.
Davies, S.
, Laker, S., & Ellis, L. (1997). Promoting autonomy and independence for older people within nursing practice: A literature review. Journal of Advanced Nursing, 26, 408-417.
11.
Deci, E. L.
, & Ryan, R. M. (1987). The support of autonomy and the control of behavior. Journal of Personality and Social Psychology, 53, 1024-1037.
12.
Engel, G. L.
(1968). A life setting conducive to illness: The giving-up given-up complex. Annals of Internal Medicine, 69, 293-300.
13.
Erickson, H. C.
(1984). Self-care knowledge: Relations among the concepts support, hope, control, satisfaction with daily life and physical health status. Dissertation Abstracts International, 46, 06B. (University Microfilms No. 84-12, 136)
14.
Erickson, H. C.
, Tomlin, E., & Swain, M. A. (1988). Modeling and role-modeling: A theory and paradigm for nursing. Lexington, SC: Pine Press. (Original work published 1983, Prentice-Hall)
15.
Erikson, E.
(1963). Childhood and society (2nd ed.). New York: W. W. Norton.
16.
Federal Interagency Forum on Aging-Related Statistics
. (2000). Older Americans 2000: Key indicators of well-being. Hyattsville, MD: Author. Retrieved November 5, 2000, from the World Wide Web: http://www.agingstats.gov/chartbook2000/population.html
17.
Goldberg, D.
(1972). The detection of psychiatric illness by questionnaire. London: Oxford University Press.
18.
Hertz, J. E.
(1991). The perceived enactment of autonomy scale: Measuring the potential for self-care action in the elderly. Dissertation Abstracts International, 52(04), 1953B. (University Microfilms No. 91-28, 248)
19.
Hertz, J. E.
(1996). Conceptualization of perceived enactment of autonomy in the elderly. Issues in Mental Health Nursing, 17, 261-273.
20.
Hertz, J. E.
(1999). Testing two self-care measures in elderly home care clients. In S. H. Gueldner & L. W. Poon (Eds.), Gerontological nursing issues for the 21st century (pp. 195-205). Indianapolis: Center Nursing Press.
21.
Hoyt, D.
, & Creech, J. (1983). The Life Satisfaction Index: A methodological and theoretical critique. Journal of Gerontology, 38, 111-116.
22.
Kramarow, E.
, Lentzner, H., Rooks, R., Weeks, J., & Saydah, S. (1999). Health and aging chartbook. Health, United States, 1999. Hyattsville, MD: National Center for Health Statistics. Retrieved November 5, 2000, from the World Wide Web: http://www.cdc.gov/nchs/data/hus99cht.pdf
23.
Lawton, M. P.
(1972). The dimensions of morale. In D. P. Kent, R. Kastenbaum, & S. Sherwood (Eds.), Research planning and action for the elderly: The power and potential of social science (pp. 144-165). New York: Behavioral.
24.
Lawton, M. P.
(1975). The Philadelphia Geriatric Center Morale Scale: A revision. Journal of Gerontology, 30, 85-89.
25.
Liang, J.
(1984). A structural integration of the Affect Balance Scale and the Life Satisfaction Index A. Journal of Gerontology, 40, 552-561.
26.
Liang, J.
, & Bollen, K. A. (1983). The structure of the Philadelphia Geriatric Center Morale Scale: A reinterpretation. Journal of Gerontology, 38, 181-189.
27.
Lindemann, E.
(1944). The symptomatology and management of acute grief. American Journal of Psychiatry, 101, 141-148.
28.
Maslow, A.
(1970). Motivation and personality (2nd ed.). New York: Harper & Row.
29.
McWilliams, C.
, Brown, J., Carmichael, J., & Lehman, J. (1994). Anew perspective on threatened autonomy in elderly persons: The disempowering process. Social Science and Medicine, 38, 327-338.
30.
Morris, J. N.
, & Sherwood, S. (1975). A retesting and modification of the Philadelphia Geriatric Center Morale Scale. Journal of Gerontology, 30, 77-84.
31.
Neugarten, B.
, Havighurst, R., & Tobin, S. (1961). The measurement of life satisfaction. Journal of Gerontology, 16, 136-143.
32.
Nunnally, J. C.
(1978). Psychometric theory (2nd ed.). New York: McGraw-Hill.
33.
Piaget, J.
(1952). The origins of intelligence in children. New York: International Universities Press.
34.
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, 460-478.
35.
Reinardy, J.
, & Kane, R. A. (1999). Choosing an adult foster home or a nursing home: Residents perceptions about decision making and control. Social Work, 44, 571-585.
36.
Searle, M.
, Mahon, M., Iso-Ahola, S., Sdrolias, H., & Dyck, J. (1995). Enhancing a sense of independence and psychological well-being among the elderly: A field experiment. Journal of Leisure Research, 27, 107-124.
37.
Selye, H.
(1974). Stress without distress. Philadelphia: Lippincott.
38.
Shomotkin, D.
(1991). The structure of the Life Satisfaction Index Ain elderly Israeli adults. International Journal of Aging and Human Development, 33, 131-150.
39.
Wilberding, J. Z.
(1985). Values clarification. In G. M. Bulechek & J. C. McCloskey (Eds.), Nursing interventions: Treatments for nursing diagnoses (pp. 173-184). Philadelphia: W. B. Saunders.
40.
Williams, G. C.
, Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21(10), 1644-1651.
41.
Wood, V.
, Wylie, M., & Sheafer, B. (1969). An analysis of a short self report measure of life satisfaction: Correlation with rater judgements. Journal of Gerontology, 24, 465-469.
42.
Zauszniewski, J.
(1997). Teaching resourcefulness skills to older adults. Journal of Gerontological Nursing, 23(2), 14-20.
