Conceptions of Healthy Aging Held by Relatives of Older Persons in Isan-Thai Culture: A Phenomenographic Study.

PubMed

Manasatchakun, Pornpun; Roxberg, Åsa; Asp, Margareta

2018-01-01

In Thailand, family nurses are expected to provide support for older persons and their family members to promote healthy aging. Family bonds are strong, and relatives are expected to take care of their older family members. However, there is limited research on how older persons' family members perceive healthy aging. This study aimed to describe the conceptions of healthy aging held by the children and grandchildren of older persons in northeast Thailand. In a phenomenographic study, 14 interviews were performed to qualitatively analyze different conceptions of healthy aging. Four descriptive categories emerged: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. The conceptions of healthy aging entail both autonomy and interdependence. The relative's perspective needs to be considered when policies relating to healthy aging are implemented in the community and when family nurses provide support to families to promote healthy aging.

Longitudinal motivational predictors of dietary self-care and diabetes control in adults with newly diagnosed type 2 diabetes mellitus.

PubMed

Nouwen, Arie; Ford, Teri; Balan, Andreea Teodora; Twisk, Jos; Ruggiero, Laurie; White, David

2011-11-01

This prospective study examined relationships between constructs from social-cognitive theory (Bandura, 1986) and self-determination theory (Deci & Ryan, 1985; Deci & Ryan, 1991) and the diabetes outcomes of dietary self-care and diabetes control. Longitudinal data were collected from 237 people newly diagnosed with Type 2 diabetes who filled in questionnaires on dietary self-care, and motivational factors derived from social-cognitive theory and self-determination theory. Blood samples were taken to assess diabetes control (HbA1c). Repeated measurements were taken every 3-4 months for a total of five time points over 18 months. Predictor measures included autonomy support, autonomous and controlled motivation, amotivation, dietary self-efficacy, positive and negative outcome expectancies for dietary self-care and self-evaluation. Age, sex, BMI, and diabetes knowledge were included as control measures. Using Generalized Estimating Equations (GEE) analyses two models were tested: a standard model reflecting longitudinal associations between absolute values of predicted and outcome variables; and a change model examining motivational predictors of changes over time in diabetes outcomes of dietary self-care and diabetes control (HbA1c). Dietary self-care was longitudinally associated with self-efficacy, self-evaluation (the strongest predictor) autonomy support and autonomous motivation, but not with controlled motivation or outcome expectancies. Changes in dietary self-care were predicted by changes in self-efficacy, self-evaluation, and controlled motivation but not by changes in autonomous motivation or autonomy support. Negative outcome expectancies regarding diet were longitudinally associated with HbA1c, and changes in negative outcome expectancies predicted changes in HbA1c. However, there were indications that dietary self-care predicted changes in HbA1c. The results indicate that autonomy support, self-efficacy and, in particular, self-evaluation are key targets for interventions to improve dietary self-care. PsycINFO Database Record (c) 2011 APA, all rights reserved.

The cascading development of autonomy and relatedness from adolescence to adulthood.

PubMed

Oudekerk, Barbara A; Allen, Joseph P; Hessel, Elenda T; Molloy, Lauren E

2015-01-01

A developmental cascade model of autonomy and relatedness in the progression from parent to friend to romantic relationships across ages 13, 18, and 21 was examined among 184 adolescents (53% female, 58% Caucasian, 29% African American) recruited from a public middle school in Virginia. Parental psychological control at age 13 undermined the development of autonomy and relatedness, predicting relative decreases in autonomy and relatedness with friends between ages 13 and 18 and lower levels of autonomy and relatedness with partners at age 18. These cascade effects extended into adult friendships and romantic relationships, with autonomy and relatedness with romantic partners at age 18 being a strong predictor of autonomy and relatedness with both friends and partners at age 21. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

Healthy children's perceptions of medicines: a review.

PubMed

Hämeen-Anttila, Katri; Bush, Patricia J

2008-06-01

Chronically ill children's perceptions of medicines have been widely studied, but healthy children's less often. However, information on healthy children's beliefs and attitudes about medicine use is needed to be able to target health education messages about medicines appropriately. A literature review was performed to determine schoolchildren's attitudes, beliefs, and knowledge about medicines; autonomy in using medicines; expectations of using medicines; and questions about medicines, so as to guide the development of a medicine education curriculum and to inform health care professionals who communicate with children. This study was a review of literature from 17 countries. The review indicated that children of school age tend to view medicines cautiously. Although age is a factor, children have very limited ideas about how medicines work and issues around medicine efficacy are confusing to them. Even young children recognize that medicines may have harmful effects and, children of all ages and cultures studied want to learn more about medicines. Autonomy in medicine use is surprisingly high and disturbing given that knowledge of medicines is poor. Primary conclusions drawn are (1) children of the same age in different cultures appear similar in their attitudes, beliefs, behaviors, and desires to learn about medicines; (2) children lack information about medicines, especially in view of their levels of autonomy; and (3) health educators and health care professionals should educate children about rational medicine use, at appropriate cognitive development levels, before the children become independent medicine users.

Intergenerational Patterns of Values and Autonomy Expectations in Cultures of Relatedness and Separatedness.

ERIC Educational Resources Information Center

Stewart, Sunita Mahtani; Bond, Michael Harris; Deeds, Osvelia; Chung, Siu Fung

1999-01-01

Investigated value priorities and autonomy expectations in 59 pairs of Caucasian and 66 pairs of Asian teenagers and their mothers in Hong Kong. Findings support models that predict persistent family interdependence despite adoption of many individualist values in modernizing collectivist cultures. (SLD)

Experienced job autonomy among maternity care professionals in The Netherlands.

PubMed

Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G; Verhoeven, Corine J

2017-11-01

High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care system and whether they expect a new system of integrated maternity care to affect their experienced job autonomy. A cross-sectional survey. The Leiden Quality of Work Life Questionnaire was used to assess experienced job autonomy among maternity care professionals. Data were collected in the Netherlands in 2015. 799 professionals participated of whom 362 were primary care midwives, 240 obstetricians, 93 clinical midwives and 104 obstetric nurses. The mean score for experienced job autonomy was highest for primary care midwives, followed by obstetricians, clinical midwives and obstetric nurses. Primary care midwives scored highest in expecting to lose their job autonomy in an integrated care system. There are significant differences in experienced job autonomy between maternity care professionals. When changing the maternity care system it will be a challenge to maintain a high level of experienced job autonomy for professionals. A decrease in job autonomy could lead to a reduction in job related wellbeing and in satisfaction with care among pregnant women. Copyright © 2017. Published by Elsevier Ltd.

The Effects of Autonomy Gap in Personnel Policy, Principal Leadership and Teachers' Self-Efficacy on Their Organizational Commitment

ERIC Educational Resources Information Center

Dou, Diya; Devos, Geert; Valcke, Martin

2016-01-01

School autonomy in personnel policy is important to effective personnel management. With increased autonomy in personnel policy, principals could wield their leadership to improve teachers' organizational commitment. However, little is known about whether the given autonomy in personnel policy meets principals' expectation and whether and how the…

Controlled Autonomy: Novice Principals' Schema for District Control and School Autonomy

ERIC Educational Resources Information Center

Weiner, Jennie M.; Woulfin, Sarah L.

2017-01-01

Purpose: The purpose of this paper is to gain insights into how a group of novice principals, all in schools that deployed principles of autonomy as mechanisms for improvement, conceptualized what the authors label "controlled autonomy"--a condition in which school leaders are expected to both make site-based decisions and be accountable…

Parental Autonomy Support, Community Feeling and Student Expectations as Contributors to Later Achievement among Adolescents

ERIC Educational Resources Information Center

Froiland, John Mark; Worrell, Frank C.

2017-01-01

This longitudinal study examined the relationships among parental autonomy support, student intrinsic life goals (i.e. community feeling), student expectations for long-term educational attainment and later academic performance (measured by GPA) in 227 students in an ethnically and racially diverse high school. Hypotheses were tested with…

Conceptions of Healthy Aging Held by Relatives of Older Persons in Isan-Thai Culture: A Phenomenographic Study

PubMed Central

Roxberg, Åsa; Asp, Margareta

2018-01-01

In Thailand, family nurses are expected to provide support for older persons and their family members to promote healthy aging. Family bonds are strong, and relatives are expected to take care of their older family members. However, there is limited research on how older persons' family members perceive healthy aging. This study aimed to describe the conceptions of healthy aging held by the children and grandchildren of older persons in northeast Thailand. In a phenomenographic study, 14 interviews were performed to qualitatively analyze different conceptions of healthy aging. Four descriptive categories emerged: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. The conceptions of healthy aging entail both autonomy and interdependence. The relative's perspective needs to be considered when policies relating to healthy aging are implemented in the community and when family nurses provide support to families to promote healthy aging. PMID:29593905

Autonomy, Positive Relationships, and IL-6: Evidence for Gender-Specific Effects

PubMed Central

Eisenlohr-Moul, Tory A.; Segerstrom, Suzanne C.

2014-01-01

Objectives A body of evidence indicates that women value relationship-centered aspects of well-being more than men do, while men value autonomy-centered aspects of well-being more than women do. The current study examined whether gender moderates relations between autonomy and positive relationships and interleukin-6 (IL-6), a cytokine associated with inflammatory processes. Aspects of well-being consistent with gender-linked values were expected to be most health-protective such that positive relationships would predict lower IL-6 only or more strongly in women, and autonomy would predict lower IL-6 only or more strongly in men. Methods In the first study, a sample of 119 older adults (55% female) living in Kentucky were visited in their homes for interviews and blood draws. In the second study, a sample of 1,028 adults (45% female) living across the United States (U.S.) underwent a telephone interview followed by a visit to a research center for blood draws. Results In the Kentucky sample, autonomy was quadratically related to IL-6 such that average autonomy predicted higher IL-6; this effect was stronger in men, providing support for our hypothesis only at above average levels of IL-6. In the U.S. national sample, more positive relationships were associated with lower IL-6 in women only. When the national sample was restricted to match the Kentucky sample, higher autonomy was associated with lower IL-6 in men only. Conclusions Results provide preliminary evidence for gender-specific effects of positive relationships and autonomy on IL-6. Further work is needed to establish the generalizability of these effects to different ages, cultures, and health statuses. PMID:22908985

[Empowerment of children and adolescents--the role of personal and social resources and personal autonomy for subjective health].

PubMed

Erhart, M; Wille, N; Ravens-Sieberer, U

2008-12-01

Scientific research on empowerment so far is nearly exclusively focused on the adult population. Nevertheless, it is possible to show a link between empowerment and a) the developmental psychology concepts of resilience, b) autogenetic concepts and c) concepts of risks and resources. This paper aims to study the role of personal, familial and other social resources as well as personal autonomy for subjective health-ratings. A secondary analysis of the health data of 7,000 children and adolescents aged 10-17 years of the German health behaviour in school-aged children (HBSC) study as well as 1,700 children aged 11-17 years of the mental health module (BELLA Study) within the German health interview and examination survey for children and adolescents (KiGGS) was performed. Statistical analyses encompassed analyses of variance and linear regression. Analyses of the HBSC study showed a protective effect for school-class climate as well as parental support, whereby school was associated with fewer self-reported health complaints. Analyses of the BELLA/KiGGS study showed personal, familial and other social resources as well as personal autonomy as unique predictors for a better health-related quality of life (KINDL-R). This was true even if psychological problems were observed. The results confirm the importance of strengthening personal, familial and other social resources as well as the principal importance of personal autonomy for coping with health risks and health impairments. Future research explicitly focussed on empowerment could relate to the role of personal resources within children's and adolescents' contact with the medical and health care system. It can be expected that strengthening personal resources benefits and improves the communication and active participation of children and adolescents within treatment-decision and -evaluation.

Motivational orientation, expectancies, and vulnerability for depression in women.

PubMed

Horvath, Peter; Bissix, Glyn; Sumarah, John; Crouchman, Erin; Bowdrey, Jennifer

2008-01-01

In this study, motivational components in the personal styles of sociotropy and autonomy were examined in a sample of 284 women. One hypothesis was that self-validation needs would account for the vulnerability for depressive symptoms in these personal styles. A second hypothesis was that the association of these personal styles with depressive symptoms would be moderated by expectations and perceptions of how likely these validation needs would be met. As predicted, it was found that validation seeking mediated the association of sociotropy and autonomy with depressive symptoms in these women. Another finding was that expectancies moderated the effects of sociotropy and autonomy to predict depressive symptoms. Negative expectancies in women high on these personal styles together further increased the level of depressive symptoms. These findings are compatible with theories emphasizing the importance of situational factors in the onset and maintenance of depression in women.

Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; van der Hoek, Lucas S; Francke, Anneke L

2015-12-01

The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staff exists or is expected in many countries. It is important to retain existing nursing staff in the healthcare sector to ensure a stable home-care workforce for the future. However, to date there has been little research about the job factors in home care that affect whether staff are considering leaving the healthcare sector. The main purpose of the study was to examine how home-care nursing staff's self-perceived autonomy relates to whether they have considered leaving the healthcare sector and to assess the possible mediating effect of work engagement. The questionnaire-based, cross-sectional study involved 262 registered nurses and certified nursing assistants employed in Dutch home-care organisations (mean age of 51; 97% female). The respondents were members of the Dutch Nursing Staff Panel, a nationwide group of nursing staff members in various healthcare settings (67% response rate). The questionnaire included validated scales concerning self-perceived autonomy and work engagement and a measure for considering pursuing an occupation outside the healthcare sector. Logistic regression and mediation analyses were conducted to test associations between self-perceived autonomy, work engagement and considering leaving the healthcare sector. Nursing staff members in home care who perceive more autonomy are more engaged in their work and less likely to have considered leaving the healthcare sector. The positive association between self-perceived autonomy and considering leaving, found among nursing staff members regardless of their level of education, is mediated by work engagement. In developing strategies for retaining nursing staff in home care, employers and policy makers should target their efforts at enhancing nursing staff's autonomy, thereby improving their work engagement. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: results from the KORA-Age study.

PubMed

Mueller, Martin; Strobl, Ralf; Jahn, Klaus; Linkohr, Birgit; Ladwig, Karl Heinz; Mielck, Andreas; Grill, Eva

2014-10-01

The impact of vertigo and dizziness on healthy ageing, and especially on participation, is not fully understood. The objective of this study was to investigate the association of vertigo and dizziness with self-perceived participation and autonomy in older non-institutionalised individuals, adjusted for the presence of other health conditions. Specifically, we wanted to investigate the different effects of vertigo and dizziness on specific components of participation, i.e. restrictions in indoor and outdoor autonomy, family role, social life and relationships, and work and education. Data originate from the second wave of the German KORA-Age cohort study collected in 2012. Participation and autonomy was investigated with the Impact on Participation and Autonomy Questionnaire. We used robust regression to analyse the association of vertigo and dizziness with self-perceived participation and autonomy adjusted for covariates. A total of 822 participants (49.6% female) had a mean age of 78.1 years (SD 6.39). Participation and autonomy were significantly lower in participants with vertigo and dizziness across all domains. Adjusted for age, sex, and chronic conditions, vertigo and dizziness were significantly associated with participation restrictions in all domains except social life and relationships. The results of our study indicate that vertigo and dizziness contribute to restrictions in participation and autonomy in individuals of older age. Recognising vertigo and dizziness as independent contributors to loss of autonomy and decreased chances for independent living may create new options for patient care and population health, such as the designing of complex interventions to maintain participation and autonomy.

Effects of an autonomy-supportive exercise instructing style on exercise motivation, psychological well-being, and exercise attendance in middle-age women.

PubMed

Moustaka, Frederiki C; Vlachopoulos, Symeon P; Kabitsis, Chris; Theodorakis, Yannis

2012-01-01

The present study evaluated the effectiveness of an autonomy-supportive intervention based on self-determination theory in influencing perceptions of autonomy support, basic psychological needs, behavioral regulations, subjective vitality, and exercise behavior. 35 female exercise participants age 30 to 58 years who enrolled to an 8-week exercise program attended 24 exercise classes that were taught using either an autonomy-supportive (n = 19) or a lack of autonomy support (n = 16) instructing style. The experimental group reported an increase in perceived autonomy support, the fulfillment of the needs for autonomy and competence, identified regulation, intrinsic motivation, and subjective vitality. They also reported higher attendance rates during the program and greater participation to moderate and/or mild nonstructured exercise during 5 weeks after the end of the program. The control group reported a decrease in perceived autonomy support, the needs for autonomy and competence, intrinsic motivation, and subjective vitality. The results supported tenets of self-determination theory and highlighted the motivational and psychological benefits of an autonomy-supportive exercise instructing style among middle-age women.

A Four-Part Model of Autonomy during Emerging Adulthood: Associations with Adjustment

ERIC Educational Resources Information Center

Lamborn, Susie D.; Groh, Kelly

2009-01-01

We found support for a four-part model of autonomy that links connectedness, separation, detachment, and agency to adjustment during emerging adulthood. Based on self-report surveys of 285 American college students, expected associations among the autonomy variables were found. In addition, agency, as measured by self-reliance, predicted lower…

From perceived autonomy support to intentional behaviour: Testing an integrated model in three healthy-eating behaviours.

PubMed

Girelli, Laura; Hagger, Martin; Mallia, Luca; Lucidi, Fabio

2016-01-01

A motivational model integrating self-determination theory, the theory of planned behaviour, and the health action process approach was tested in three samples in three behavioural contexts: fruit and vegetable, breakfast, and snack consumption. Perceived support for autonomous (self-determined) forms of motivation from parents and autonomous motivation from self-determination theory were hypothesised to predict intention and behaviour indirectly via the mediation of attitude and perceived behavioural control from the theory of planned behaviour. It was also expected that planning strategies would mediate the effect of intention on behaviour. Relations in the proposed models were expected to be similar across the behaviours. A two-wave prospective design was adopted. Three samples of high-school students (total N = 1041; 59.60% female; M age = 17.13 years ± 1.57) completed measures of perceived autonomy support, autonomous motivation, theory of planned behaviour constructs, planning strategies and behaviour for each of the three behavioural contexts. Three months later, 816 participants (62,24% female; M age: 17.13 years, SD = 1.58) of the initial sample self-reported their behaviour referred to the previous three months. Structural equation models provided support for the key hypothesised effects of the proposed model for the three health-related behaviours. Two direct effects were significantly different across the three behaviours: the effect of perceived autonomy support on perceived behavioural control and the effect of attitude on intention. In addition, planning strategies mediated the effect of intention on behaviour in fruit and vegetable sample only. Findings extend knowledge of the processes by which psychological antecedents from the theories affect energy-balance related behaviours. Copyright © 2015 Elsevier Ltd. All rights reserved.

Does company-sponsored egg freezing promote or confine women's reproductive autonomy?

PubMed

Mertes, Heidi

2015-08-01

A critical ethical analysis of the initiative of several companies to cover the costs of oocyte cryopreservation for their healthy employees. The main research question is whether such policies promote or confine women's reproductive autonomy. A distinction needs to be made between the ethics of AGE banking in itself and the ethics of employers offering it to their employees. Although the utility of the former is expected to be low, there are few persuasive arguments to deny access to oocyte cryopreservation to women who are well informed about the procedure and the success rates. However, it does not automatically follow that it would be ethically unproblematic for employers to offer egg banking to their employees. For these policies to be truly 'liberating', a substantial number of conditions need to be fulfilled, which can be reduced to three categories: (1) women should understand the benefits, risks and limitations, (2) women should feel no pressure to take up the offer; (3) the offer should have no negative effect on other family-friendly policies and should in fact be accompanied by such policies. Fulfilling these conditions may turn out to be impossible. Thus, regardless of companies' possible good intentions, women's reproductive autonomy is not well served by offering them company-sponsored AGE banking.

Relational autonomy: moving beyond the limits of isolated individualism.

PubMed

Walter, Jennifer K; Ross, Lainie Friedman

2014-02-01

Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.

Estimated maturity status and perceptions of adult autonomy support in youth soccer players.

PubMed

Cumming, Sean P; Battista, Rebecca A; Martyn, Standage; Ewing, Martha E; Malina, Robert M

2006-10-01

In this study, we examined the relations between biological maturity status, body mass index, age, and perceptions of adult autonomy support in the context of youth soccer. A total of 70 female and 43 male soccer players, aged 9 - 15 years, completed three adult-specific versions (i.e. mother, father, coach) of the perceived autonomy support subscale from the Interpersonal Style Scale. The participants' percent predicted adult stature was used as an estimate of biological maturity status. Multiple linear regression analyses revealed that advanced maturity status in male players predicted lower perceptions of autonomy support from the coach. Maturity status was unrelated to perceptions of autonomy support from the coach in female soccer players, and paternal and maternal autonomy support in male and female players. Age and body mass index were unrelated to perceptions of adult (i.e. coach, mother, father) autonomy support in male and female players.

External and Other Threats to Institutional Autonomy

ERIC Educational Resources Information Center

Millett, John D.

1977-01-01

Institutional autonomy is discussed in terms of: (1) what functions society expects higher education to perform: (2) the effect of institutional dependence on public financing; and (3) the social importance of higher education. (LBH)

Cultural orientations, parental beliefs and practices, and latino adolescents' autonomy and independence.

PubMed

Roche, Kathleen M; Caughy, Margaret O; Schuster, Mark A; Bogart, Laura M; Dittus, Patricia J; Franzini, Luisa

2014-08-01

Despite the salience of behavioral autonomy and independence to parent-child interactions during middle adolescence, little is known about parenting processes pertinent to youth autonomy development for Latino families. Among a diverse sample of 684 Latino-origin parent-adolescent dyads in Houston, Texas, this study examines how parents' cultural orientations are associated directly and indirectly, through parental beliefs, with parenting practices giving youth behavioral autonomy and independence. Informed by social domain theory, the study's parenting constructs pertain to youth behaviors in an "ambiguously personal" domain-activities that adolescents believe are up to youth to decide, but which parents might argue require parents' supervision, knowledge, and/or decision-making. Results for latent profile analyses of parents' cultural identity across various facets of acculturation indicate considerable cultural heterogeneity among Latino parents. Although 43% of parents have a Latino cultural orientation, others represent Spanish-speaking/bicultural (21%), bilingual/bicultural (15%), English-speaking/bicultural (15%), or US (6%) cultural orientations. Structural equation modeling results indicate that bilingual/bicultural, English-speaking/bicultural, and US-oriented parents report less emphasis on the legitimacy of parental authority and younger age expectations for youth to engage in independent behaviors than do Latino-oriented parents. Parental beliefs endorsing youth's behavioral independence and autonomy, in turn, are associated with less stringent parental rules (parental report), less parental supervision (parental and youth report), and more youth autonomy in decision-making (parental and youth report). Evidence thus supports the idea that the diverse cultural orientations of Latino parents in the US may result in considerable variations in parenting processes pertinent to Latino adolescents' development.

Early and middle adolescents' autonomy development: impact of maternal HIV/AIDS.

PubMed

Murphy, Debra A; Greenwell, Lisa; Resell, Judith; Brecht, Mary-Lynn; Schuster, Mark A

2008-04-01

Progression toward autonomy is considered of central importance during the adolescent period. For young adolescents with an HIV-infected parent, there may be additional challenges. This study investigated current autonomy among early and middle adolescents affected by maternal HIV (N = 108), as well as examined longitudinally the children's responsibility taking when they were younger (age 6-11; N = 81) in response to their mother's illness and their current autonomy as early/middle adolescents. In analyses of self-care and family autonomy, children with greater attachment to their mothers had higher autonomy, and there was a trend for children who drink or use drugs alone to have lower autonomy. In analyses of management autonomy, attachment to peers was associated with higher autonomy. Trajectory group findings indicate that those children who had taken on more responsibility for instrumental caretaking roles directly because of their mother's illness showed better autonomy development as early and middle age adolescents. Therefore, 'parentification' of young children with a mother with HIV may not negatively affect later autonomy development.

A Bargain Half Fulfilled: Teacher Autonomy and Accountability in Traditional Public Schools and Public Charter Schools

ERIC Educational Resources Information Center

Oberfield, Zachary W.

2016-01-01

Public charter schools (PCS) are thought to succeed because they have greater autonomy and are held more accountable than traditional public schools (TPS). Though teachers are central to this expectation, there is little evidence about whether teachers in PCS enjoy more autonomy and are held more accountable than teachers in TPS. Also, it is…

Autonomy and Acceptance of Long-Term Care

ERIC Educational Resources Information Center

Hsu, Hui-Chuan; Ting, Yu-Shan; Jiang, Ting-Wen; Chien, Ming-Chih; Chien, Chih-Hsin

2009-01-01

This study explored the relationship between four types of autonomy (health autonomy, informational autonomy, living autonomy, and financial autonomy) and the acceptance of five types of long-term care (adult day care, respite care, assisted living, unit care, and group home) for the elderly in Taiwan. Data were collected from 167 middle-aged and…

Who makes the choice? Rethinking the role of autonomy and relatedness in Chinese children's motivation.

PubMed

Bao, Xue-Hua; Lam, Shui-Fong

2008-01-01

The importance of autonomy for children's motivation in collectivistic cultures has been debated hotly. With the understanding that autonomy is not equivalent to freedom of choice, 4 studies addressed this debate by investigating how socioemotional relatedness, choice, and autonomy were related to Chinese children's motivation. Study 1 (N = 56, mean age = 10.77 years), Study 2 (N = 58, mean age = 10.59), and Study 3 (N = 48, mean age = 10.53) found consistently that freedom of choice mattered less if children were socioemotionally close to the adults who made choices for them. However, Study 4 (N = 99, mean age = 11.27) showed that autonomy mattered at every level of socioemotional relatedness. These results suggested that socioemotional relatedness might have facilitated internalization and that children who did not have choice might still feel autonomous.

Autonomy and autonomy competencies: a practical and relational approach.

PubMed

Atkins, Kim

2006-10-01

This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals' formation of choices. In response to this problem, I will present a brief overview of Diana Meyers's account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical 'self-reading'. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills.

Predicting individual differences in autonomy-connectedness: the role of body awareness, alexithymia, and assertiveness.

PubMed

Bekker, Marrie H J; Croon, Marcel A; van Balkom, Esther G A; Vermee, Jennifer B G

2008-06-01

Autonomy-connectedness is the capacity for being on one's own as well as for satisfactorily engaging in interpersonal relationships. Associations have been shown between autonomy-connectedness components (self-awareness, sensitivity to others, and the capacity for managing new situations) and various indices of psychopathology. Both in a theoretical sense as well as for enhancing treatment and prevention, it is relevant to identify which factors most powerfully predict individual differences in autonomy-connectedness: body awareness, alexithymia, or assertiveness. The present study examined this question in a clinical sample of women who were diagnosed as having autonomy problems (N=52) and in a female nonclinical community sample (N=59). In line with expectations, assertiveness was a strong predictor of (all three components of) autonomy-connectedness, as was emotionalizing, one of the alexithymia-components, but the latter in an opposite direction than we had expected: the higher an individual's ability to emotionalize was, the less self-aware and capable to manage new situations that person was, and the more sensitive to others. Cognitive alexithymia contributed to self-awareness as well as to the capacity for managing new situations, and one of the components of body awareness appeared to predict capacity for managing new situations. Our results indicate that assertiveness training and the enhancement of emotion regulation are important elements of autonomy-connectedness targeted interventions. (c) 2008 Wiley Periodicals, Inc.

Undermining Adolescent Autonomy With Parents and Peers: The Enduring Implications of Psychologically Controlling Parenting

PubMed Central

Hare, Amanda L.; Szwedo, David E.; Schad, Megan M.; Allen, Joseph P.

2014-01-01

This study used a longitudinal, multi-method design to examine whether teens’ perceptions of maternal psychological control predicted lower levels of adolescent autonomy displayed with their mothers and peers over time. Significant predictions from teens’ perceptions of maternal psychological control to teens’ displays of autonomy in maternal and peer relationships were found at age 16 after accounting for adolescent displays of autonomy with mothers and peers at age 13, indicating relative changes in teens’ autonomy displayed with their mother and a close peer over time. Results suggest that the ability to assert one’s autonomy in mid-adolescence may be influenced by maternal behavior early in adolescence, highlighting the importance of parents minimizing psychological control to facilitate autonomy development for teens. PMID:26788023

Working together versus working autonomously: a new power-dependence perspective on the individual-level of analysis.

PubMed

de Jong, Simon B

2014-01-01

Recent studies have indicated that it is important to investigate the interaction between task interdependence and task autonomy because this interaction can affect team effectiveness. However, only a limited number of studies have been conducted and those studies focused solely on the team level of analysis. Moreover, there has also been a dearth of theoretical development. Therefore, this study develops and tests an alternative theoretical perspective in an attempt to understand if, and if so why, this interaction is important at the individual level of analysis. Based on interdependence theory and power-dependence theory, we expected that highly task-interdependent individuals who reported high task autonomy would be more powerful and better performers. In contrast, we expected that similarly high task-interdependent individuals who reported less task autonomy would be less powerful and would be weaker performers. These expectations were supported by multi-level and bootstrapping analyses performed on a multi-source dataset (self-, peer-, manager-ratings) comprised of 182 employees drawn from 37 teams. More specifically, the interaction between task interdependence and task autonomy was γ =.128, p <.05 for power and γ =.166, p <.05 for individual performance. The 95% bootstrap interval ranged from .0038 to .0686.

Autonomy Support and Intrinsic Goal Progress Expectancy and Its Links to Longitudinal Study Effort and Subjective Wellbeing: The Differential Mediating Effect of Intrinsic and Identified Regulations and the Moderator Effects of Effort and Intrinsic Goals

ERIC Educational Resources Information Center

Waaler, Rune; Halvari, Halgeir; Skjesol, Knut; Bagoien, Tor Egil

2013-01-01

The authors tested a self-determination theory (Deci & Ryan, 2000) process model of subjective wellbeing among students at Norwegian Folk High Schools. In this model the authors hypothesized that students' intrinsic goal progress expectancy in the chosen study activity and perceived autonomy support from teachers would be positively associated…

The key actors maintaining elders in functional autonomy in Bobo-Dioulasso (Burkina Faso)

PubMed Central

2014-01-01

Background Globally, a significant increase in functional disability among the elderly is expected in the near future. It is therefore vital to begin considering how Sub-Saharan Africa countries can best start building or strengthening the care and support system for that target population. Study objectives are: 1) identify the key actors of the social system who maintain elders in functional autonomy at home in Bobo-Dioulasso (Burkina Faso) and 2) to describe the functional status of older people living at home. Methods We conducted a longitudinal descriptive study among the elderly aged 60 and above (351). Their functional status was evaluated using the Functional Autonomy Measurement System (SMAF). Data analysis was done using the statistical software package STATA (SE11). Results In Bobo-Dioulasso, 68% of seniors have good functional capacity or a slight incapacity and 32% have moderate to severe incapacities. Older people die before (3%) or during (14%) moderate to severe disabilities. This would mean that the quality of medical and/or social care is not good for maintaining functional autonomy of older people with moderate to severe disabilities. Two main groups of people contribute to maintain elders in functional autonomy: the elderly themselves and their family. Community, private or public structures for maintaining elders in functional autonomy are non-existent. The social system for maintaining elders in functional autonomy is incomplete and failing. In case of functional handicap at home, the elders die. But stakeholders are not conscious of this situation; they believe that this system is good for maintaining elders in functional autonomy. Conclusion It is likely that the absence of formal care and support structure likely shortens the lifespan of severely disabled older people. Stakeholders have not yet looked at this possibility. The stakeholders should seriously think about: 1) how to establish the third level of actors who can fulfill the needs to maintain elders in functional autonomy that are not satisfied by others (family members or the older individuals themselves), and 2) how to reinforce the role of each actor and the collaboration between the different groups of people of this system. PMID:24997509

Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

PubMed

Rantakokko, Merja; Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Kauppinen, Markku; Rantanen, Taina

2017-08-01

The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period. Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy). Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p < .001). Over the follow-up, autonomy in participation outdoors declined more among those reporting multiple environmental barriers compared to those reporting none (age- and sex-adjusted group*time β = .629, s.e. = .277, p = .023). Adjustment for cognitive functioning, education, number of chronic conditions and change in walking difficulty did not influence the association. Perceived environmental barriers to outdoor mobility accelerate the decline in autonomy in participation outdoors among older community-dwelling people. Understanding factors affecting autonomy can help in finding ways to support the sense of autonomy as people age.

Autonomy Support and Its Links to Physical Activity and Competitive Performance: Mediations through Motivation, Competence, Action Orientation and Harmonious Passion, and the Moderator Role of Autonomy Support by Perceived Competence

ERIC Educational Resources Information Center

Halvari, Hallgeir; Ulstad, Svein Olav; Bagoien, Tor Egil; Skjesol, Knut

2009-01-01

The purpose of the present study was to test a Self-Determination Theory (SDT) process model in relation to involvement in physical activity and competitive performance among students (N = 190). In this model, perceived autonomy support from teachers and coaches was expected to be positively related to autonomous motivation, perceived competence,…

The Charter School Experience: Autonomy in Practice

ERIC Educational Resources Information Center

McDonald, Tonya Senne

2013-01-01

While traditional public school and charter school systems continue to undergo dramatic reforms in response to the educational crisis, charter schools are praised as possessing the distinguishing characteristic of maintaining autonomy in exchange for increased accountability (Buckley & Schneider, 2009). The expectations for charter schools are…

Coping with Stress in the Special Education Classroom.

ERIC Educational Resources Information Center

Brownell, Mary

1997-01-01

Discusses the stress that special education teachers may feel by role overload and lack of autonomy. Stress relieving strategies are described, including setting realistic expectations, making distinctions between the job and personal life, increasing autonomy, looking for alternative sources of reinforcement, increasing efficacy, and developing…

Autonomy, positive relationships, and IL-6: evidence for gender-specific effects.

PubMed

Eisenlohr-Moul, Tory; Segerstrom, Suzanne

2013-05-01

A body of evidence indicates that women value relationship-centred aspects of well-being more than men do, while men value autonomy-centred aspects of well-being more than women do. The current study examined whether gender moderates relations between autonomy and positive relationships and interleukin-6 (IL-6), a cytokine associated with inflammatory processes. Aspects of well-being consistent with gender-linked values were expected to be most health protective such that positive relationships would predict lower IL-6 only or more strongly in women, and autonomy would predict lower IL-6 only or more strongly in men. In the first study, a sample of 119 older adults (55% female) living in Kentucky were visited in their homes for interviews and blood draws. In the second study, a sample of 1,028 adults (45% female) living across the United States underwent a telephone interview followed by a visit to a research centre for blood draws. In the Kentucky sample, autonomy was quadratically related to IL-6 such that moderate autonomy predicted higher IL-6; this effect was stronger in men. In the US national sample, more positive relationships were associated with lower IL-6 in women only. When the national sample was restricted to match the Kentucky sample, moderate autonomy was again associated with higher IL-6 in men only. Results provide preliminary evidence for gender-specific effects of positive relationships and autonomy on IL-6. Further work is needed to establish the generalizability of these effects to different ages, cultures, and health statuses. What is already known on this subject? A host of previous work indicates that women value relationship-centred aspects of well-being more than men, while men value autonomy-centred aspects of well-being more than women. Further, there is some evidence suggesting that well-being consistent with gender-linked values is more health protective, such that relationships are more protective for women than for men, while autonomy is more protective for men than for women. What does this study add We provide preliminary support for the hypothesis that gender moderates the associations of autonomy and positive relationships with IL-6. Specifically, higher levels of positive relationships may be associated with lower IL-6 in women only, whereas moderate levels of autonomy may be associated with higher IL-6 in males only, particularly among older adults. ©2012 The British Psychological Society.

Toward a More Comprehensive Concept of Successful Aging: Disability and Care Needs

PubMed Central

Wahl, Hans-Werner

2017-01-01

Abstract Rowe and Kahn’s model of Successful Aging 2.0 argues that changing environmental settings, societal policies, and individual life styles will lead to a significant extension of healthy life years. Recent epidemiological research, however, confirms the dilemma that the ongoing extension of life expectancy prolongs not only the years in good health but also those in poor health. We see it as a major limitation that Rowe and Kahn’s model is not able to cover the emerging linkage between increasing life expectation and aging with disability and care needs. Therefore, we suggest a set of propositions towards a more comprehensive model of successful aging which captures desirable living situations including for those who grow old with disabilities and care needs. We describe individual, environmental, and care related strategies and resources for autonomy and quality of life when facing disabilities and care needs in late life, putting emphasis on inter-individual differences and social inequality. We argue that expanding the traditional concept of successful aging to aging with disabilities and care needs serves not to undermine, but rather to anchor the concept in aging science and in public perception. PMID:27988482

Chilean Adolescents' and Parents' Views on Autonomy Development

ERIC Educational Resources Information Center

Martínez, M. Loreto; Pérez, J. Carola; Cumsille, Patricio

2014-01-01

This study aims to understand Chilean parents' and adolescents' conceptions of autonomy and whether they hold different expectations for autonomous behaviors by generation and socioeconomic level. A qualitative approach to data collection was used through separate focus groups of parents and adolescents from different socioeconomic condition.…

Additive benefits of autonomy support and enhanced expectancies for motor learning.

PubMed

Wulf, Gabriele; Chiviacowsky, Suzete; Cardozo, Priscila Lopes

2014-10-01

Two factors that have been shown to facilitate motor learning are autonomy support (AS) and enhanced expectancies (EE) for performance. We examined the individual and combined influences of these factors. In a 2 × 2 design, participants learning a novel motor skill (throwing with the non-dominant arm) were or were not provided a choice (AS) about the ball color on each of 6 10-trial blocks during practice, and were or were not given bogus positive social-comparative feedback (EE). This resulted in four groups: AS/EE, AS, EE, and C (control). One day after the practice phase, participants completed 10 retention and 10 transfer trials. The distance to the target--a bull's eye with a 1m radius and 10 concentric circles--was 7.5m during practice and retention, and 8.5m during transfer. Autonomy support and enhanced expectancies had additive advantages for learning, with both main effects being significant for retention and transfer. On both tests, the AS/EE group showed the greatest throwing accuracy. Also, the accuracy scores of the AS and EE groups were higher than those of the C group. Furthermore, self-efficacy measured after practice and before retention and transfer was increased by both AS and EE. Thus, supporting learners' need for autonomy by given them a small choice--even though it was not directly related to task performance--and enhancing their performance expectancies appeared to independently influence learning. Copyright © 2014 Elsevier B.V. All rights reserved.

Evaluations of Conflicts Between Latino Values and Autonomy Desires Among Puerto Rican Adolescents.

PubMed

Villalobos Solís, Myriam; Smetana, Judith G; Tasopoulos-Chan, Marina

2017-09-01

Puerto Rican adolescents (N = 105; M age  = 15.97 years, SD = 1.40) evaluated hypothetical situations describing conflicts between Latino values (family obligations and respeto) and autonomy desires regarding personal, friendship, and dating activities. Adolescents judged that peers should prioritize Latino values over autonomy, which led to greater feelings of pride than happiness. However, they believed that teens would prioritize autonomy over Latino values, which led to greater feelings of happiness than pride. Adolescents reasoned about autonomy desires as personal issues, whereas reasoning about Latino values was multifaceted, including references to conventions and concerns for others. Furthermore, judgments and reasoning depended on the type of autonomy desire and Latino value and sometimes, by participants' age and sex. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management

PubMed Central

Beacham, Barbara L.; Deatrick, Janet A.

2013-01-01

Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

Prediction of peer-rated adult hostility from autonomy struggles in adolescent–family interactions

PubMed Central

ALLEN, JOSEPH P.; HAUSER, STUART T.; O’CONNOR, THOMAS G.; BELL, KATHY L.

2006-01-01

Observed parent–adolescent autonomy struggles were assessed as potential predictors of the development of peer-rated hostility over a decade later in young adulthood in both normal and previously psychiatrically hospitalized groups of adolescents. Longitudinal, multireporter data were obtained by coding family interactions involving 83 adolescents and their parents at age 16 years and then obtaining ratings by close friends of adolescents’ hostility at age 25 years. Fathers’ behavior undermining adolescents’ autonomy in interactions at age 16 years were predictive of adolescents-as-young-adults’ hostility, as rated by close friends at age 25 years. These predictions contributed additional variance to understanding young adult hostility even after accounting for concurrent levels of adolescent hostility at age 16 years and paternal hostility at this age, each of which also significantly contributed to predicting future hostility. Results are discussed as highlighting a pathway by which difficulties attaining autonomy in adolescence may presage the development of long-term difficulties in social functioning. PMID:11893089

Market liberalism in health care: a dysfunctional view of respecting "consumer" autonomy.

PubMed

Kekewich, Michael A

2014-03-01

The unfortunately vast history of paternalism in both medicine and clinical research has resulted in perpetually increasing respect for patient autonomy and free choice in Western health care systems. Beginning with the negative right to informed consent, the principle of respect for autonomy has for many patients evolved into a positive right to request treatments and expect accommodation. This evolution of patient autonomy has mirrored a more general social attitude of market liberalism where increasing numbers of patients have come to embody the role of the "consumer." This paper explores this transformation and critiques the current way in which respect for patient autonomy is put into practice. Ultimately, this paper concludes that the consumer view of patient autonomy is dysfunctional. Moreover, this paper argues that, based on the inherent goals of medicine, some form of paternalism is required in any meaningfully therapeutic relationship.

Are the Motivational Effects of Autonomy-Supportive Conditions Universal? Contrasting Results Among Indians and Americans.

PubMed

Tripathi, Ritu; Cervone, Daniel; Savani, Krishna

2018-04-01

In Western theories of motivation, autonomy is conceived as a universal motivator of human action; enhancing autonomy is expected to increase motivation panculturally. Using a novel online experimental paradigm that afforded a behavioral measure of motivation, we found that, contrary to this prevailing view, autonomy cues affect motivation differently among American and Indian corporate professionals. Autonomy-supportive instructions increased motivation among Americans but decreased motivation among Indians. The motivational Cue × Culture interaction was extraordinarily large; the populations exhibited little statistical overlap. A second study suggested that this interaction reflects culturally specific norms that are widely understood by members of the given culture. When evaluating messages to motivate workers, Indians, far more than Americans, preferred a message invoking obligations to one invoking autonomous personal choice norms. Results cast doubt on the claim, made regularly in both basic and applied psychology, that enhancing autonomy is a universally preferred method for boosting motivation.

The moderating role of autonomy and control on the benefits of written emotion expression.

PubMed

Weinstein, Netta; Hodgins, Holley S

2009-03-01

Two studies examined the hypothesis that relative to control motivation, autonomy motivation is associated with effective written expression and regulation, leading to positive emotional, physical, and cognitive outcomes over time. Participants viewed a Hiroshima-Nagasaki documentary in each of two sessions. Study 1 showed that dispositionally autonomous participants, particularly those who expressed, had positive well-being, energy, and memory after the second viewing. Study 2 explored benefits of situational motivation by priming autonomy and control. Results showed that dispositionally controlled individuals received the same benefits as autonomous individuals only when primed with autonomy and encouraged to express. Coding of writing content revealed that the benefits of autonomy were mediated by nondefensive and effective emotional processing, as reflected in greater use of self-referencing and cognitive mechanism words and lower use of concrete words. Results support the expectation that autonomy relates to effective expression and emotion regulation, leading to positive functioning over time.

Fathers' Autonomy Support and Social Competence of Sons and Daughters

ERIC Educational Resources Information Center

Corwyn, Robert F.; Bradley, Robert H.

2016-01-01

Relations between paternal autonomy support and four aspects of adolescent social competence and responsibility at age 16 were examined using data from the NICHD Study of Early Child Care and Youth Development. With controls on maternal autonomy support, significant relations were observed between paternal autonomy support and three of the four…

Are the benefits of autonomy satisfaction and the costs of autonomy frustration dependent on individuals' autonomy strength?

PubMed

Van Assche, Jasper; van der Kaap-Deeder, Jolene; Audenaert, Elien; De Schryver, Maarten; Vansteenkiste, Maarten

2018-01-29

From a self-determination theory perspective, individuals are assumed to benefit and suffer from, respectively, the satisfaction and frustration of the psychological need for autonomy, even if they score low on autonomy strength. Yet, previous studies on need strength are scarce, operationalized need strength differently, and produced inconsistent findings. In two studies among 224 South African adults (M age  = 24.13, SD = 4.25; 54.0% male) and 156 Belgian prisoners (M age  = 38.60, SD = 11.68; 88.5% male), we investigated the moderating role of autonomy valuation and desire in the relations of autonomy satisfaction and frustration with a variety of well-being and ill-being indicators. Study 1 provided some evidence for the moderating role of mostly explicit autonomy desire (rather than explicit autonomy valuation). In Study 2, neither explicit nor implicit autonomy desire played a consistent moderating role. Overall, these findings are congruent with a moderate (albeit not with a strong) interpretation of the universality claim made within self-determination theory, provide initial evidence for a differentiation between deficit-based and growth-oriented interpersonal differences in need strength, and indicate that the potential moderating role of need strength deserves continued attention before any firm conclusions can be drawn. © 2018 Wiley Periodicals, Inc.

The role of observed autonomy support, reciprocity, and need satisfaction in adolescent disclosure about friends.

PubMed

Wuyts, Dorien; Soenens, Bart; Vansteenkiste, Maarten; Van Petegem, Stijn

2018-06-01

Although research increasingly addresses the role of parenting in fostering adolescent disclosure, most research relied on self-report measures of parenting and did not address the role of autonomy support. In the present observational study (conducted in Belgium), with 62 mother-adolescent dyads (mean age mothers = 44 years; mean age adolescents = 14 years; 77% of adolescents female), we rated mothers' provision of autonomy support during a 10-minute conversation about friendships. We found that observed maternal autonomy support was related positively to adolescents' degree of and volitional reasons for disclosure about friends. These associations were mediated by observed non-verbal reciprocity during the conversation and by adolescent satisfaction of their needs for autonomy and relatedness. Mothers' autonomy-support and mother-adolescent reciprocity also predicted mothers' own psychological need satisfaction and conversation pleasure. The relevance of the findings for adolescent autonomy and disclosure are discussed. Copyright © 2018. Published by Elsevier Ltd.

Women’s Autonomy and its Relationship to Children’s Nutrition Among the Rendille of Northern Kenya

PubMed Central

BRUNSON, EMILY K.; SHELL-DUNCAN, BETTINA; STEELE, MATTHEW

2014-01-01

This study explores the effect of women’s autonomy on children’s health. Research was conducted among the Rendille, a traditionally nomadic pastoralist population living in northern Kenya. Using data collected from 435 women and 934 of their children, we tested the hypothesis that women with higher levels of autonomy would have children with better nutrition. Results of our study indicated that while women’s autonomy had no effect on younger—ages 0–35 months—children’s nutrition as measured by WHZ scores, greater levels of women’s autonomy were significantly associated with improved nutrition among older—ages 3–10 years—children. These results suggest that women’s autonomy is an important factor in relation to children’s health in some circumstances. In addition to exploring the applied aspects of our findings, we also suggest how considering the concept of women’s autonomy may add to the existing literature on parental investment. PMID:18792063

Women's reproductive autonomy: medicalisation and beyond.

PubMed

Purdy, L

2006-05-01

Reproductive autonomy is central to women's welfare both because childbearing takes place in women's bodies and because they are generally expected to take primary responsibility for child rearing. In 2005, the factors that influence their autonomy most strongly are poverty and belief systems that devalue such autonomy. Unfortunately, such autonomy is a low priority for most societies, or is anathema to their belief systems altogether. This situation is doubly sad because women's reproductive autonomy is intrinsically valuable for women and also instrumentally valuable for the welfare of humankind. This paper takes for granted the moral and practical necessity of such autonomy and digs deeper into the question of what such a commitment might entail, focusing on the mid-level policy making that, at least in the US and Canada, plays a significant role in shaping women's options. This paper examines a large teaching hospital's policy on reduction of multifetal pregnancies. The policy permits reduction of triplets to twins, but not twins to a singleton. As there is no morally relevant difference between these two types of reduction, it is evident that inappropriate medicalisation can still limit women's autonomy in undesirable ways.

Women's reproductive autonomy: medicalisation and beyond

PubMed Central

Purdy, L

2006-01-01

Reproductive autonomy is central to women's welfare both because childbearing takes place in women's bodies and because they are generally expected to take primary responsibility for child rearing. In 2005, the factors that influence their autonomy most strongly are poverty and belief systems that devalue such autonomy. Unfortunately, such autonomy is a low priority for most societies, or is anathema to their belief systems altogether. This situation is doubly sad because women's reproductive autonomy is intrinsically valuable for women and also instrumentally valuable for the welfare of humankind. This paper takes for granted the moral and practical necessity of such autonomy and digs deeper into the question of what such a commitment might entail, focusing on the mid‐level policy making that, at least in the US and Canada, plays a significant role in shaping women's options. This paper examines a large teaching hospital's policy on reduction of multifetal pregnancies. The policy permits reduction of triplets to twins, but not twins to a singleton. As there is no morally relevant difference between these two types of reduction, it is evident that inappropriate medicalisation can still limit women's autonomy in undesirable ways. PMID:16648280

Conflict negotiation and autonomy processes in adolescent romantic relationships: an observational study of interdependency in boyfriend and girlfriend effects.

PubMed

McIsaac, Caroline; Connolly, Jennifer; McKenney, Katherine S; Pepler, Debra; Craig, Wendy

2008-12-01

This study examined the association between conflict negotiation and the expression of autonomy in adolescent romantic partners. Thirty-seven couples participated in a globally coded conflict interaction task. Actor-partner interdependence models (APIM) were used to quantify the extent to which boys' and girls' autonomy was linked solely to their own negotiation of the conflict or whether it was linked conjointly to their own and their partners' negotiation style. Combining agentic autonomy theories and peer socialization models, it was expected that boys' and girls' autonomy would be associated only with their own conflict behaviors when they employed conflict styles reflective of their same gender repertoire, and associated conjointly with self and partner behaviors when they employed gender-atypical conflict styles. Instead of an equal, albeit distinct, positioning in the autonomy dynamic, the results suggested that girls' autonomy is associated solely with their own conflict behaviors, whereas boys' autonomy is jointly associated with their own and their partners' conflict behaviors. We discuss the relative power of boys and girls in emergent dyadic contexts, emphasizing how romantic dynamics shape salient abilities.

Developmental Patterns in Decision-Making Autonomy across Middle Childhood and Adolescence: European American Parents’ Perspectives

PubMed Central

Wray-Lake, Laura; Crouter, Ann C.; McHale, Susan M.

2010-01-01

Longitudinal patterns in parents’ reports of youth decision-making autonomy from ages 9 to 20 were examined in a study of 201 European American families with two offspring. Multilevel modeling analyses revealed that decision-making autonomy increased gradually across middle childhood and adolescence before rising sharply in late adolescence. Social domain theory was supported by analyses of eight decision types spanning prudential, conventional, personal, and multifaceted domains. Decision making was higher for girls, youth whom parents perceived as easier to supervise, and youth with better educated parents. Firstborns and secondborns had different age-related trajectories of decision-making autonomy. Findings shed light on the developmental trajectories and family processes associated with adolescents’ fundamental task of gaining autonomy. PMID:20438465

Regulatory Autonomy and Performance: The Reform of Higher Education Re-Visited

ERIC Educational Resources Information Center

Enders, Jurgen; de Boer, Harry; Weyer, Elke

2013-01-01

The main aim of this article is to contribute to the understanding of organizational autonomy and control in higher education reform and related expectations as regards the performance of universities. Our analyses draws on principal-agent models as a normative theory of policy reform, and institutionalist approaches in public policy and…

Low-Income Latina Mothers' Expectations for Their Pregnant Daughters' Autonomy and Interdependence

ERIC Educational Resources Information Center

Nadeem, Erum; Romo, Laura F.

2008-01-01

Forty-five pregnant Latina adolescents and their mothers (23 English-speaking, 22 Spanish-speaking) were videotaped conversing about feelings and plans related to the adolescent's pregnancy. The prevalence of the mothers' messages about the daughter's reliance on the family unit (interdependence) and the daughter's self-sufficiency (autonomy) were…

First- and second-born adolescents' decision-making autonomy throughout adolescence.

PubMed

Campione-Barr, Nicole; Lindell, Anna K; Short, Stephen D; Greer, Kelly Bassett; Drotar, Scott D

2015-12-01

First- and second-born adolescents' and their parents' perceptions of adolescents' decision-making autonomy were compared from ages 12 to 19 in a longitudinal sample of 145 predominantly White, middle class families. Utilizing a multivariate, multilevel modeling approach, differences in perceptions of adolescents' autonomy between parents and each adolescent, as well as by social-cognitive domain were examined. The present study found that when comparing parents' perceptions of their children at the same age, second-borns were granted more autonomy regarding conventional issues than first-borns during early adolescence, but by later adolescence first-borns were granted more autonomy regarding prudential issues than second-borns. However, comparisons between adolescents' and siblings' perceptions showed no differences. Potential reasons for, and implications of, differences in perceptions of adolescent autonomy are discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

The Relationship between Parent Expectations and Postschool Outcomes of Adolescents with Disabilities

ERIC Educational Resources Information Center

Doren, Bonnie; Gau, Jeff M.; Lindstrom, Lauren E.

2012-01-01

A secondary analysis was conducted of the National Longitudinal Transition Study-2 to examine (a) main effects of parents' school and postschool outcome expectations on the actual outcomes achieved, (b) demographic moderators, and (c) adolescent autonomy as a mediator of parent expectations and outcomes. Parent expectations were found to…

Resource allocation in health care and the role of personal autonomy.

PubMed

Gandjour, A

2015-03-01

Resource allocation decisions in health care require the consideration of ethical values. Major ethical theories include Amartya Sen's capability approach, Norman Daniels's theory of justice for health, and preference utilitarian theory. This paper argues that while only preference utilitarian theory explicitly considers the impact of an individual's actions on others, all 3 theories agree in terms of providing individual autonomy. Furthermore, it shows that all 3 theories emphasise the role of informed preferences in securing individual autonomy. Still, stressing personal autonomy has limited direct implications for priority setting. 2 priority rules for resource allocation could be identified: 1) to give priority to patients with mental disability (over those with pure physical disability); and 2) to give priority to patients with a large expected loss of autonomy without treatment. © Georg Thieme Verlag KG Stuttgart · New York.

Health care autonomy in children with chronic conditions: implications for self-care and family management.

PubMed

Beacham, Barbara L; Deatrick, Janet A

2013-06-01

Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review links the 3 concepts and discusses the implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

Underage abortion and beyond: developments of Spanish law in competent minor's autonomy.

PubMed

Ribot, Jordi

2012-01-01

This paper examines the recent developments in underage abortion and related questions in Spanish law. Despite the prevalence of the language of autonomy, like in Britain, children's interests are not defined in Spain by relying exclusively on the competent child's views. Parental opinion and societal expectations are given due weight, although sometimes only implicitly. Calculated ambiguity in legal practice and in the relevant legal texts provides evidence of the pervasive influence of deeply rooted distrust as against clear-cut rules favouring a young person's autonomy.

Identifying Configurations of Perceived Teacher Autonomy Support and Structure: Associations with Self-Regulated Learning, Motivation and Problem Behavior

ERIC Educational Resources Information Center

Vansteenkiste, Maarten; Sierens, Eline; Goossens, Luc; Soenens, Bart; Dochy, Filip; Mouratidis, Athanasios; Aelterman, Nathalie; Haerens, Leen; Beyers, Wim

2012-01-01

Grounded in self-determination theory, the aim of this study was (a) to examine naturally occurring configurations of perceived teacher autonomy support and clear expectations (i.e., a central aspect of teacher structure), and (b) to investigate associations with academic motivation, self-regulated learning, and problem behavior. Based on…

Achievement Motivation among Urban Adolescents: Work Hope, Autonomy Support, and Achievement-Related Beliefs

ERIC Educational Resources Information Center

Kenny, Maureen E.; Walsh-Blair, Lynn Y.; Blustein, David L.; Bempechat, Janine; Seltzer, Joanne

2010-01-01

Drawing upon expectancy value, hope, and self-determination theories, this study explores the contributions of work-based beliefs and autonomy support as predictors of adaptive achievement-related beliefs. Two hundred and one urban high school students who were enrolled in a work-based learning program completed measures of work hope, autonomy…

Adolescent Secretive Behavior: African American and Hmong Adolescents' Strategies and Justifications for Managing Parents' Knowledge about Peers

ERIC Educational Resources Information Center

Bakken, Jeremy P.; Brown, B. Bradford

2010-01-01

Drawing upon the expectancy violation-realignment theory of autonomy development, this qualitative study examined African American and Hmong adolescent autonomy-seeking behaviors and parent-child communication about activities and relationships with peers. Twenty-two African American and 11 Hmong adolescents in grades 6-12 and 14 African American…

The impact of financial constraints and incentives on professional autonomy.

PubMed

Lewis, Jenny M; Marjoribanks, Tim

2003-01-01

General practice has been the subject of extensive reforms over the 1990s in Australia as elsewhere. Reforms have attempted to improve quality and contain the overall cost of health care, and have often been seen as reducing the autonomy of medical professionals. This paper examines the impact of financial constraints and incentives introduced during the 1990s on Australian GPs' perceptions of autonomy. An existing seven component definition of autonomy and six themes that emerged from reviewing publications were used to construct focus group questions. A total of 25 GPs participated in four focus groups. Those who participated believe that their financial autonomy has been diminished by policy changes and consumer expectations. They also perceive that their ability to control clinical decisions, which they regard as the most important aspect of professional autonomy, has been reduced along with financial autonomy. Organized medicine in Australia sees financial accountability and clinical decision making as polar opposites, and has continued to argue that fee-for-service payment is the only appropriate method of remuneration, despite increasing evidence that this does not guarantee clinical autonomy. Major changes to the financing of general practice in Australia are required to address the concerns of GPs, governments and patients.

Meta-synthesis on nurse practitioner autonomy and roles in ambulatory care.

PubMed

Wang-Romjue, Pauline

2018-04-01

Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments. © 2017 Wiley Periodicals, Inc.

Adoption of clinical decision support systems in a developing country: Antecedents and outcomes of physician's threat to perceived professional autonomy.

PubMed

Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh; Nezakati, Hossein

2015-08-01

The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework. Data from a stratified sample of 335 Malaysian physicians working in 12 public and private hospitals in Malaysia were collected to test the hypotheses using Structural Equation Modeling (SEM). The important findings of our research are: (1) factors such as perceived threat to professional autonomy, performance expectancy, and physicians' involvement in making decision about CDSS have significant impact on physicians' intention to adopt CDSS; (2) physicians' attitude toward knowledge sharing, interactivity perception and computer self-efficacy of physicians play a crucial role in influencing their perceived threat to professional autonomy; and (3) social network, shared goals and OCB (helping behavior) impact physicians' attitude toward knowledge sharing. The findings provide a comprehensive understanding of the factors that influence physicians' intention to adopt CDSS in a developing country. The results can help hospital managers manage CDSS implementation in an effective manner. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Early, on-time, and late behavioural autonomy in adolescence: psychosocial correlates in young and middle adulthood.

PubMed

Pavlova, Maria K; Haase, Claudia M; Silbereisen, Rainer K

2011-04-01

Drawing on two nationally representative German studies (N(1) = 1744, N(2) = 759), we examined correlates of early, on-time, and late curfew autonomy, a retrospective indicator of behavioural autonomy, in young and middle adulthood (19-37 years of age). Adjustment in four domains was considered: educational attainment, externalizing problem behaviour, subjective well-being, and interpersonal relationships. The early group showed lower adjustment in multiple domains across young and middle adulthood. The late group reported a mixed pattern of adjustment at younger ages (lower externalizing problems, but lower positive affect, lower importance of peers, and lower likelihood to have a partner) and positive adjustment in all domains at older ages. Timing effects were controlled for sociodemographic characteristics and retrospective measures of early adversities, pubertal timing, disclosure to parents, and peer group affiliation in adolescence. Findings show that late behavioural autonomy in its correlates is not simply the opposite of early behavioural autonomy. Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above.

PubMed

Wiktorsson, Stefan; Rydberg Sterner, Therese; Mellqvist Fässberg, Madeleine; Skoog, Ingmar; Ingeborg Berg, Anne; Duberstein, Paul; Van Orden, Kimberly; Waern, Margda

2018-01-16

Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt. There were no sex differences in depression and anxiety. Forty-five percent of the men and 14% of the women had a history of substance use disorder ( p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men ( p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1%, p = 0.64). We found strikingly similar figures for depression scores, functional disability and attributions for attempting suicide in older men and women. Larger studies are needed in diverse settings as sex differences might be influenced by cultural context.

Is autonomy related to the quality of performance of everyday activities in children with spina bifida?

PubMed

Peny-Dahlstrand, Marie; Krumlinde-Sundholm, Lena; Gosman-Hedström, Gunilla

2012-01-01

To investigate the relationship between the level of autonomy and the quality of performance of everyday activities in a population-based cohort of children with spina bifida and to study the agreement between the children's and the parents' ratings of autonomy. 50 dyads of children (aged 6-14) with spina bifida and their parents rated the children's level of autonomy with an adapted, Swedish version of the Autonomy Scale from the Arc's Self-Determination Scale. Each child's quality of performance of everyday activities was assessed with the Assessment of Motor and Process Skills (AMPS). The autonomy levels of the children with spina bifida were rated to be lowest in daily routines and highest in leisure activities. Binary logistic regression analyses revealed that age, motor skills and process skills were all significantly related to the autonomy level, but that process skills appeared to predominate in this respect. Concerning the perception of the autonomy level, little agreement was found between each child and his/her parent. It is important to understand and support the development of process skills as expressed in task performance in children with spina bifida and to pay attention to both the parent's and the child's opinion when setting goals and plans for interventions.

Participation in policy discourse: new form of exclusion for seniors with disabilities?

PubMed

Raymond, Émilie; Grenier, Amanda

2013-06-01

Recent discourses on aging emphasize the value of older people's social participation. How participation is defined in policy, however, may not correspond with seniors' realities. This article reports on the results of a critical discourse analysis conducted on aging policy in Quebec between 2005 and 2011. Results indicate that participation definitions can be problematic recommendations, standards, and expectations. Over time, participation increasingly came to be defined as productivity. The participation context also changed from collective responsibility to community adjustment and personal choice. Finally, policy texts reflected a polarization between activity and a loss of autonomy that linked participation with health status. Results suggest that, although innovative in the Canadian context, articulation of participation in Quebec's recent policies on aging lacks the politics from which to discuss difference, otherness, and access to participative opportunities. The case of older people's aging with disabilities illustrates the challenges of the new participatory agenda.

As time goes by we improve a little more: relationship expectations of young women in Mexico.

PubMed

Belknap, Ruth Ann

2010-10-01

In this qualitative narrative study I explore expectations regarding male-female relationships and perceptions about intimate partner violence (IPV) with young urban women in the state of Veracruz, Mexico. Carol Gilligan's work informed the analysis of the narratives. Themes identified follow: violence at home, resistance, and relational autonomy. The collective story these women tell is that they are familiar with violence in the home, they resist violence and gender inequality, they seek equality in intimate partner relationships, and they plan for futures where the centrality of family is valued in combination with a strong commitment to their own autonomy.

[The effect of gender on the physician's role. Attitudes and expectations of medical students examined by a questionnaire at the start of their studies].

PubMed

Odborg, M H; Eriksen, T R; Petersson, B H

1995-09-04

A questionnaire was given to 254 medical students matriculated in 1992/93 concerning their motivation for wanting to become a doctor, attitudes towards which qualities a doctor should have and their potential choice of medical specialty. The analysis focuses on whether answers are relation-orientated (i.e. directed towards relations to others) or autonomy-orientated (i.e. directed towards rationality and independence). The results show that motivations for becoming a doctor are both relation- and autonomy-orientated. Most students expect the doctor to both be able to relate to the patient and be professionally competent. No gender differences could be demonstrated concerning motivations for becoming a doctor or which qualities a good doctor should possess. Significant gender differences were displayed concerning choice of specialty, most women aiming towards relation-orientated specialties and most men aiming towards autonomy-orientated specialties. It is concluded that the growing proportion of women doctors could change the medical profession towards becoming more patient- and relation-orientated, however their choice of relation-orientated and lower prestige specialties could result in less overall influence than one might otherwise expect.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.

PubMed

Hendrick, C Emily; Marteleto, Leticia

2017-06-01

Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras

PubMed Central

Hendrick, C. Emily; Marteleto, Leticia

2017-01-01

Maternal decision-making autonomy has been linked to positive outcomes for children’s health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children’s outcomes into adolescence and whether it impacts other domains of children’s lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents’ environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12–16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011–12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents’ school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers’ high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents’ school enrollment above and beyond other maternal, household, and regional influences. PMID:29075048

Effects of perceived autonomy support and basic need satisfaction on quality of life in hemodialysis patients.

PubMed

Chen, Mei-Fang; Chang, Ray-E; Tsai, Hung-Bin; Hou, Ying-Hui

2018-03-01

Despite a growing understanding of health-related quality of life (HRQOL) and its determinants in hemodialysis (HD) patients, little is known about the effects and interrelationships concerning the perception of autonomy support and basic need satisfaction of HD patients on their HRQOL. Based on self-determination theory (SDT), this study examines whether HD patients' perceived autonomy support from health care practitioners (physicians and nurses) relates to the satisfaction of HD patients' basic needs and in turn influences their HRQOL. A questionnaire was administered to 250 Taiwanese HD patients recruited from multiclinical centers and regional hospitals in northern Taiwan. Structural equation modeling (SEM) analysis was conducted to examine the causal relationships between patient perceptions of autonomy support and HRQOL through basic need satisfaction. The empirical results of SEM indicated that the HD patients' perceived autonomy support increased the satisfaction of their basic needs (autonomy, competency, and relatedness), as expected. The higher degree of basic need satisfaction led to higher HRQOL, as measured by physical and mental component scores. Autonomy support from physicians and nurses contributes to improving HD patients' HRQOL through basic need satisfaction. This indicates that staff caring for patients with severe chronic diseases should offer considerable support for patient autonomy.

The role of sex, attachment and autonomy-connectedness in personality functioning.

PubMed

Bachrach, Nathan; Croon, Marcel A; Bekker, Marrie H J

2015-11-01

Previous studies have found significant relationships among sex, attachment and autonomy-connectedness and DSM-IV personality characteristics. In the present study, we aimed to add to the current knowledge about attachment-related aspects of personality pathology, by examining the relationships of these same variables with dimensions of pathological personality structure as conceptualized by Kernberg. The study was performed among 106 ambulatory patients from a Dutch mental healthcare institute. A path model based upon neo-analytical object relation theory and attachment theory was tested. We expected significant associations among sex, attachment, autonomy and aspects of personality functioning. Both insecure attachment styles as well as the autonomy-connectedness components of sensitivity to others (SO) and capacity of managing new situations predicted general personality dysfunctioning significantly. More specifically, reality testing was negatively predicted by the autonomy component of capacity of managing new situations, and aggression was significantly predicted by sex as well as both insecure attachment styles. We advise scientists as well as clinicians to be alert on sex differences in autonomy-connectedness and aspects of personality dysfunctioning. Taking sex-specific variations in attachment and autonomy into account next to a more explicit focus on insecure attachment styles and autonomy problems may enhance, the current relatively low, treatment effectiveness for personality pathology. Copyright © 2015 John Wiley & Sons, Ltd.

Contextual Specificity in the Relationship between Maternal Autonomy Support and Children's Socio-emotional Development: A Longitudinal Study from Preschool to Preadolescence.

PubMed

Matte-Gagné, Célia; Harvey, Brenda; Stack, Dale M; Serbin, Lisa A

2015-08-01

The benefits of an autonomy supportive environment have been established as a key component in children's development at various ages. Nonetheless, research examining the outcomes of early autonomy supportive environments has largely neglected socio-emotional development. The first objective of the present longitudinal study was to examine the socio-emotional outcomes associated with maternal autonomy support during the preschool period. Second, we explored the contextual specificity of the relationships between maternal autonomy support and children's later socio-emotional outcomes. Finally, we investigated the indirect effect of maternal autonomy support on children's later socio-emotional outcomes through earlier children's socio-emotional outcomes. Sixty-six mothers and their pre-school aged children (41 girls) were followed during preschool (Time 1), elementary school (Time 2) and preadolescence (Time 3). Maternal autonomy support (Time 1) was measured in two contexts (free-play and interference task) using observational coding. Furthermore, the children's internalizing and externalizing problems as well as their social competence were measured at Times 2 and 3. The results revealed the importance of maternal autonomy support during preschool for children's later socio-emotional development, especially during challenging contexts, and the mediating role of children's socio-emotional outcomes during elementary school in the link between maternal autonomy support during the preschool years and children's later socio-emotional outcomes during preadolescence. The results highlight the contextual specificity of the relationship between maternal autonomy support and children's later socio-emotional development and reveal one of the mechanisms through which the effect of early childhood parental autonomy support on children's later socio-emotional development is carried forward over time.

Anxiety and Autonomy in Adolescence among Father-Orphaned Kibbutz Children.

ERIC Educational Resources Information Center

Kurtz, Chaya; And Others

1993-01-01

Measured anxiety and autonomy in kibbutz father-orphaned (n=28) and nonorphaned (n=42) adolescents. Found no significant differences on levels of manifest anxiety and autonomy. When groups were broken down according to gender and age, found that older father-orphan girls manifested significantly greater anxiety than any group and significantly…

Regional resources buffer the impact of functional limitations on perceived autonomy in older adults with multiple illnesses.

PubMed

Schüz, Benjamin; Westland, Josh N; Wurm, Susanne; Tesch-Römer, Clemens; Wolff, Julia K; Warner, Lisa M; Schwarzer, Ralf

2016-03-01

Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy. (c) 2016 APA, all rights reserved).

[Relevant Factors on Cognitive Evaluation of the Portuguese Population].

PubMed

Oliveira, Catarina Resende; Mota-Pinto, Anabela; Rodrigues, Vítor; Alves, Catarina

2017-04-28

Aging is an inevitable process that has a social impact in the forecoming decades, and it will present a great challenge regarding public health. An efficient health system requires a reflection on the preventive measures to be implemented. The study population comprised a total number of 2672 individuals of both genders, aged 55 years and over, residents in continental Portugal, to whom a questionnaire was applied that included the following sections: Social network; Locomotion; Physical autonomy; Instrumental autonomy; Cognitive assessment; Physical activity. The study of aging in the Portuguese population found that physical autonomy for tasks related to daily life are associated with better cognitive evaluation. A statistically significant association was found between performance in cognitive assessment and gender, age, schooling, the fact of living alone, the number of hours being alone, autonomy to walk in the street, washing, dressing, eating, preparing meals, doing shopping, managing money and taking medications and washer / treat clothing. Cognitive evaluation is negatively influenced by the number of hours that an individual is alone. Activities of daily life must be valued, since they require the ability to plan and carry out tasks and their preservation is a key component in successful aging.

Early, On-Time, and Late Behavioural Autonomy in Adolescence: Psychosocial Correlates in Young and Middle Adulthood

ERIC Educational Resources Information Center

Pavlova, Maria K.; Haase, Claudia M.; Silbereisen, Rainer K.

2011-01-01

Drawing on two nationally representative German studies (N[subscript 1] = 1744, N[subscript 2] = 759), we examined correlates of early, on-time, and late curfew autonomy, a retrospective indicator of behavioural autonomy, in young and middle adulthood (19-37 years of age). Adjustment in four domains was considered: educational attainment,…

Gender in Adolescent Autonomy: Distinction between Boys and Girls Accelerates at 16 Years of Age

ERIC Educational Resources Information Center

Fleming, Manuela

2005-01-01

Introduction: Autonomy is a major developmental feature of adolescents. Its success mediates transition into adulthood. It involves a number of psychological parameters, including desire, conflict with parents and actual achievement. Method: How male and female adolescents view autonomy was investigated in a large sample of 12-17 year-old…

Maternal Autonomy- and Connectedness-Oriented Parenting Behaviors as Predictors of Children's Social Behaviors in China

ERIC Educational Resources Information Center

Liu, Mowei; Chen, Xinyin; Zheng, Shujie; Chen, Huichang; Wang, Li

2009-01-01

The purpose of the study was to examine the contributions of maternal encouragement of autonomy and maternal encouragement of connectedness to the prediction of children's social behaviors. A sample of children (N = 94), initially aged two years, and their mothers in China participated in the two-year longitudinal study. Child autonomy and…

Autonomy- vs. Connectedness-Oriented Parenting Behaviours in Chinese and Canadian Mothers

ERIC Educational Resources Information Center

Liu, Mowei; Chen, Xinyin; Rubin, Kenneth H.; Zheng, Shujie; Cui, Liying; Li, Dan; Chen, Huichang; Wang, Li

2005-01-01

The purpose of the study was to investigate maternal socialization goal-oriented behaviours in Chinese and Canadian mothers. Participants were samples of children at 2 years of age and their mothers in P.R. China and Canada. Data on child autonomy and connectedness and maternal encouragement of autonomy and connectedness were collected from…

Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh

PubMed Central

Sharma, Arpana

2013-01-01

Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. PMID:24575305

The strange case of Mr. H. Starting dialysis at 90 years of age: clinical choices impact on ethical decisions.

PubMed

Piccoli, Giorgina Barbara; Sofronie, Andreea Corina; Coindre, Jean-Philippe

2017-11-09

Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. Mr. H is a ninety-year-old patient with end-stage kidney disease that is no longer manageable with conservative care, in spite of optimal nutritional management, good blood pressure control and strict clinical and metabolic evaluations; dialysis is the next step, but its morbidity is challenging. The case is analysed according to principlism (beneficence, non-maleficence, justice and respect for autonomy). In the setting of care, dialysis is available without restriction; therefore the principle of justice only partially applied, in the absence of restraints on health-care expenditure. The final decision on whether or not to start dialysis rested with Mr. H (respect for autonomy). However, his choice depended on the balance between beneficence and non-maleficence. The advantages of dialysis in restoring metabolic equilibrium were clear, and the expected negative effects of dialysis were therefore decisive. Mr. H has a contraindication to peritoneal dialysis (severe arthritis impairing self-performance) and felt performing it with nursing help would be intrusive. Post dialysis fatigue, poor tolerance, hypotension and intrusiveness in daily life of haemodialysis patients are closely linked to the classic thrice-weekly, four-hour schedule. A personalized incremental dialysis approach, starting with one session per week, adapting the timing to the patient's daily life, can limit side effects and "dialysis shock". An individualized approach to complex decisions such as dialysis start can alter the delicate benefit/side-effect balance, ultimately affecting the patient's choice, and points to a narrative, tailor-made approach as an alternative to therapeutic nihilism, in very old and fragile patients.

Self-determined motivation in physical education and its links to motivation for leisure-time physical activity, physical activity, and well-being in general.

PubMed

Bagøien, Tor Egil; Halvari, Hallgeir; Nesheim, Hallgeir

2010-10-01

The present study tested a trans-contextual model based on self-determination theory of the relations between motivation in physical education, motivation in leisure-time physical activity, physical activity, and psychological well-being. Participants were 329 Norwegian upper secondary school students (M age = 16.5 yr., SD = 0.7). Students' perceptions of autonomy-supportive teachers in physical education were expected to be positively associated with students' psychological needs satisfaction in physical education, which was expected to be positively related to autonomous motivation for physical education participation. In turn, autonomous motivation for physical education was expected to be positively associated with perceived competence and autonomous motivation for leisure-time physical activity, which both were expected to be positively associated with leisure-time physical activity and psychological well-being in general. Structural equation models and bootstrapping supported the hypotheses and the indirect links between variables. Sex differences indicate that more research is needed on how to motivate girls to be more physically active in leisure time.

Standby-battery autonomy versus power quality

NASA Astrophysics Data System (ADS)

Bitterlin, Ian F.

Batteries are used in a wide variety of applications as an energy store to bridge gaps in the primary source of supplied power for a given period of time. In some cases this bridging time, the battery's "autonomy", is fixed by local legislation but it is also often set by historically common practices. However, even if common practice dictates a long autonomy time, we are entering a new era of "cost and benefit realism" underpinned by environmentally friendly policies and we should challenge these historical practices at every opportunity if it can lead to resource and cost savings. In some cases the application engineer has no choice in the design autonomy; either follow a piece of local legislation (e.g. 4 h autonomy for a "life safety" application), or actually work out what is needed! An example of the latter would be for a remote site, off-grid, using integrated wind/solar power (without emergency generator back-up) where you may have to design-in several days' battery autonomy. This short paper proposes that a battery's autonomy should be related to the time expected for the system to be without the primary power source, balanced by the capital costs and commercial risk of power failure. To discuss this we shall consider the factors in selecting the autonomy time and other related aspects for high voltage battery systems used in facility-wide uninterruptible power supply (UPS) systems.

International variations in application of the best-interest standard across the age spectrum.

PubMed

Laventhal, N; Verhagen, A A E; Hansen, T W R; Dempsey, E; Davis, P G; Musante, G A; Wiles, A; Meadow, W; Janvier, A

2017-02-01

Ethically and legally, assertions that resuscitation is in a patient's best interest should be inversely correlated with willingness to forego intensive care (and accept comfort care) at the surrogate's request. Previous single country studies have demonstrated a relative devaluation of neonates when compared with other critically ill patients. In this international study, physicians in Argentina, Australia, Canada, Ireland, The Netherlands, Norway and the United States were presented with eight hypothetical vignettes of incompetent critically ill patients of different ages. They were asked to make assessments about best interest, respect for surrogate autonomy and to rank the patients in a triage scenario. In total, 2237 physicians responded (average response rate 61%). In all countries and scenarios, participants did not accept to withhold resuscitation if they estimated it was in the patient's best interest, except for scenarios involving neonates. Young children (other than neonates) were given high priority for resuscitation, regardless of existing disability. For neonates, surrogate autonomy outweighed assessment of best interest. In all countries, a 2-month-old-infant with meningitis and a multiply disabled 7-year old were resuscitated first in the triage scenario, with more variable ranking of the two neonates, which were ranked below patients with considerably worse prognosis. The value placed on the life of newborns is less than that expected according to predicted clinical outcomes and current legal and ethical theory relative to best interests. Value assessments on the basis of age, disability and prognosis appear to transcend culture, politics and religion in this domain.

Perceived teaching behaviors and self-determined motivation in physical education: a test of self-determination theory.

PubMed

Koka, Andre; Hagger, Martin S

2010-03-01

In the present study, we tested the effects of specific dimensions of perceived teaching behaviors on students' self-determined motivation in physical education. In accordance with the tenets of self-determination theory (Deci & Ryan, 1985, 2000), we expected the psychological needs for competence, autonomy, and relatedness would mediate these effects. Secondary school students (N=498) ages 12-17 years completed measures of perceived teaching behaviors for seven dimensions: (a) democratic behavior, (b) autocratic behavior (c) teaching and instruction, (d) situation consideration, (e) positive general feedback, (f) positive nonverbal feedback, and (h) negative nonverbal feedback. They also completed measures of perceived satisfaction for competence, autonomy, relatedness, and self-determined motivation. A path-analytic model revealed a positive, indirect effect of perceived positive general feedback on self-determined motivation. The effects of perceived autocratic behavior and negative nonverbal feedback were direct and negative, whereas the effects of teaching and instruction and situation consideration were direct and positive. Results suggest that feedback, situation consideration, and teaching and instruction are essential antecedents to self-determined motivation.

Empowering the poor: A field study of the social psychological consequences of receiving autonomy or dependency aid in Panama.

PubMed

Alvarez, Katherina; van Leeuwen, Esther; Montenegro-Montenegro, Esteban; van Vugt, Mark

2018-04-01

This field study investigated the consequences of receiving poverty aid through conditional transfer programmes in the form of autonomy-oriented help (i.e., cash) or dependency-oriented help (i.e., vouchers) in impoverished rural communities in Panama. The empowering effects of autonomy- (vs. dependency-) help have so far only been studied in laboratory settings, or in settings where help could easily be refused. Little is known about the reactions of people who rely on help for extended periods of time. This study provides insights into how aid recipients are influenced by the type of aid they receive. Results showed that, as expected, recipients of cash reported more autonomy, empowerment, and life improvements than recipients of vouchers. Training, another type of autonomy-oriented help, was positively related to empowerment, personal, and family change beliefs. These findings illustrate the benefits of autonomy-oriented help programmes in empowering people from extremely poor communities around the world, who rely on aid for extended periods of time. © 2018 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Family Cultures in The Context of Migration and Ageing.

PubMed

Albert, Isabelle; Coimbra, Stephanie Barros

2017-06-01

Intergenerational family relations are embedded in family cultures which influence how families regulate their relations over the whole life span with regard to key issues, such as autonomy and relatedness, or support exchange and reciprocity, and which may vary inter- and intraculturally. Migrant families undoubtedly face a special situation as values and expectations from the culture of origin and from the host cultural context might differ. Not much is known yet about how migrant families adapt their family cultures to the host cultural context. The present article will focus on aspects of intergenerational family regulation by taking into account family cultures of migrant compared to non-migrant families in a life span perspective. We will illustrate our theoretical outline by presenting first results from the IRMA-study comparing Luxembourgish and Portuguese immigrant families living in Luxembourg. We focus on issues of family cohesion, enmeshment and normative expectations regarding adult children's support for their ageing parents, by drawing both on quantitative questionnaire as well as qualitative interview data. Implications for the experience of ambivalence and conflicts as well as well-being of family members from both generations will be discussed.

Individuation and Parents as People: Measurement Concerns regarding Two Aspects of Autonomy

ERIC Educational Resources Information Center

Andersen, Brian; LaVoie, Joseph C.; Dunkel, Curt S.

2007-01-01

The focus of this study was on examining two assumed components of adolescent autonomy-individuation and perceiving parents as people and the validity of their measurement. Participating in the study were 67 students in grades 9 and 11 (ages 14-17 years) and 118 college students (ages 18-27 years). Each student completed two measures of…

Stability of Maternal Autonomy Support between Infancy and Preschool Age

ERIC Educational Resources Information Center

Matte-Gagne, Celia; Bernier, Annie; Gagne, Christine

2013-01-01

The goals of this article were to examine (1) the relative and absolute stability of maternal autonomy support between infancy and preschool age, and (2) the moderating role of child gender, maternal attachment state of mind, and stressful life events. Sixty-nine mother-child dyads participated in five visits when the child was 8, 15, and 18…

Job-Occupation Misfit as an Occupational Stressor

ERIC Educational Resources Information Center

Ford, Michael T.

2012-01-01

Drawing from theory on met expectations, person-environment fit, and social information processing, misfit between the pressure and autonomy experienced by workers and that which would be expected given their occupational roles was examined as a predictor of job satisfaction, perceived support, and depression. Results from a nationally (U.S.)…

Autonomy support, basic psychological needs and well-being in Mexican athletes.

PubMed

López-Walle, Jeanette; Balaguer, Isabel; Castillo, Isabel; Tristán, José

2012-11-01

Based on Basic Needs Theory, one of the mini-theories of Self-determination Theory (Ryan & Deci, 2002), the present study had two objectives: (a) to test a model in the Mexican sport context based on the following sequence: perceived coach autonomy support, basic psychological needs satisfaction, and psychological well-being, and b) to analyze the mediational effect of the satisfaction of perceived coach autonomy support on indicators of psychological well-being (satisfaction with life and subjective vitality). Six hundred and sixty-nine young Mexican athletes (Boys = 339; Girls = 330; M(age) = 13.95) filled out a questionnaire assessing the study variables. Structural equations analyses revealed that perceived coach autonomy support predicted satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Furthermore, basic need satisfaction predicted subjective vitality and satisfaction with life. Autonomy, competence and relatedness partially mediated the path from perceived coach autonomy support to psychological well-being in young Mexican athletes.

When does transformational leadership enhance employee proactive behavior? The role of autonomy and role breadth self-efficacy.

PubMed

Den Hartog, Deanne N; Belschak, Frank D

2012-01-01

Two multisource studies address the interactive effects of personal and contextual variables on employees' proactive behavior. In line with previous work, we find positive main effects of transformational leadership, role breadth self-efficacy, and job autonomy on employee proactive behavior (personal initiative in Study 1 and prosocial proactive behavior in Study 2). As expected, a 3-way interaction qualifies these main effects: In situations of high autonomy, transformational leadership relates positively to proactive behavior for individuals high (but not low) on self-efficacy. Vice versa, in situations low on job autonomy, transformational leadership relates positively to proactive behavior for individuals low (but not high) on self-efficacy. This pattern is found both for self-ratings and peer-ratings of employees' proactive behavior in Study 1 and for supervisor ratings of such behavior in Study 2.

Live as we choose: The role of autonomy support in facilitating intrinsic motivation.

PubMed

Meng, Liang; Ma, Qingguo

2015-12-01

According to Self-determination Theory (SDT), autonomy is a basic psychological need, satisfaction of which may lead to enhanced intrinsic motivation and related beneficial outcomes. By manipulating the opportunity to choose between tasks of equal difficulty, throughout the motivational process, the effect of autonomy support was examined both behaviorally and electrophysiologically. More negative stimulus-preceding negativity (SPN) and an enlarged FRN loss-win difference wave (d-FRN) indicated an enhanced expectation toward the positive outcome (during the anticipation stage) as well as intensified intrinsic motivation toward the task (during the outcome appraisal stage) when choice was available. Taken together, results of the present study suggest d-FRN upon feedback as a real-time electrophysiological indicator of intrinsic/autonomous motivation and illustrate the important role of autonomy-supportive job design in the workplace. Copyright © 2015 Elsevier B.V. All rights reserved.

Patient autonomy preferences among hypertensive outpatients in a primary care setting in Japan.

PubMed

Nomura, Kyoko; Ohno, Maiko; Fujinuma, Yasuki; Ishikawa, Hirono

2007-01-01

To investigate autonomy preferences and the factors to promote active patient participation in a primary care setting in Japan. Ninety-two hypertensive outpatients who consecutively visited a Japanese hospital between January and May of 2005 in Tokyo, Japan. This cross-sectional study was conducted by using a self-administered questionnaire. The main outcome measures were patient preferences for autonomy (i.e., decision-making and information-seeking preferences), measured by the Autonomy Preference Index (API). The variables studied were patient sociodemographic characteristics, physician characteristics based on patient preference (i.e., ability to communicate, extent of clinical experience, qualifications, educational background, gender, and age), and the Multidimensional Health Locus of Control. On the API scale from 0 to 100, the patients had an intermediate desire for decision-making (median: 51) and a greater desire for information (median: 95). A multivariate regression model indicated that decision-making preference increased when patients were woman and decreased as physician age increased, and information-seeking preference was positively associated with good communication skills, more extensive clinical experience, physicians of middle age, and patient beliefs that they were responsible for their own health, and was negatively associated with a preference for man physicians. Physicians may need to understand that patient autonomy preferences pertain to physician age and gender, physician communication ability and extent of clinical experience, and patient beliefs about self-responsibility toward health, and could use the information to promote reliable patient-physician relationships.

Emotional autonomy and depression among Chinese adolescents.

PubMed

Chou, K L

2000-06-01

Depression is quite common among young people in Hong Kong Chinese society. This study examined the association between emotional autonomy and depressive symptomatology among Chinese young people in Hong Kong. The respondents were 512 young people between 16 and 18 years of age from a cross-sectional study in Hong Kong. Significant bivariate relationships were found between depressive symptomatology and three dimensions of emotional autonomy (individuation, nondependency on parents, and deidealization of parents). Using multiple regression models, the author found that depressive symptomatology was associated with two aspects of emotional autonomy: individuation and deidealization of parents. Results indicate that the relationships between depressive symptomatology and these three aspects of emotional autonomy are similar in both individualistic and collectivistic societies.

Emotional autonomy and problem behavior among Chinese adolescents.

PubMed

Chou, Kee-Lee

2003-12-01

The author examined the association between emotional autonomy and problem behavior among Chinese adolescents living in Hong Kong. The respondents were 512 adolescents, 16 to 18 years of age, who were interviewed for a cross-sectional study. Three dimensions of emotional autonomy including individuation, nondependency on parents, and de-idealization of parents were significantly and positively correlated with the amount of problem behavior the participants engaged in during the past 6 months. Using a simple linear multiple regression model, the author found that problem behavior was associated with only one aspect of emotional autonomy-individuation. Results indicated that the relationship between problem behavior and three aspects of emotional autonomy was similar in both individualistic and collectivistic societies.

Autonomy and structure can enhance motivation of volunteers in sport organizations.

PubMed

Hsu, Wei Ting; Wu, Kou Hsien; Wang, Yi Ching; Hsiao, Chia Huei; Wu, Hui Chin

2013-12-01

The goal was better understanding of the motivational factors of volunteers in non-profit sport organizations. The roles of two factors provided by supervisors to their subordinates were examined: autonomy support, i.e., the encouragement of self-initiation and emphasis on choice rather than control, and structure, i.e., the introduction of order, definite procedures, and rules. 489 sport volunteers (289 men, 200 women; M age = 31.2 yr., SD = 7.4) were administered questionnaires assessing their perceived autonomy support, structure, and motivation. Regression analysis indicated that perceived autonomy support predicted motivation. Structure also mediated the effect of perceived autonomy support on motivation. Supervisors of sport organizations should provide adequate structure for their volunteers.

"Ultimately, mom has the call": Viewing clinical trial decision making among patients with ovarian cancer through the lens of relational autonomy.

PubMed

Asiedu, Gladys B; Ridgeway, Jennifer L; Carroll, Katherine; Jatoi, Aminah; Radecki Breitkopf, Carmen

2018-04-14

This study employs the concept of relational autonomy to understand how relational encounters with family members (FMs) and care providers may shape decisions around ovarian cancer patients' clinical trial (CT) participation. The study also offers unique insights into how FMs view patients' decision making. In-depth interviews were conducted with 33 patients with ovarian cancer who had been offered a CT and 39 FMs. Data were inductively analysed using a thematic approach and deductively informed by constructs derived from the theory of relational autonomy (RA). Patients' relationships, experiences and social status were significant resources that shaped their decisions. Patients did not give equal weight to all relationships and created boundaries around whom to include in decision making. Doctors' recommendations and perceived enthusiasm were described as influential in CT decisions. Both patients with ovarian cancer and their FMs maintained that patients have the "final say," indicating an individualistic autonomy. However, maintaining the "final say" in the decision-making process is constitutive of patients' relationships, emphasizing a relational approach to autonomy. FMs support patients' autonomy and they do so particularly when they believe the patient is capable of making the right choices. Although ethical principles underlying informed consent for CT participation emphasize individual autonomy, greater attention to relational autonomy is warranted for a more comprehensive understanding of CT decision making. © 2018 Mayo Clinic. Health Expectations published by John Wiley & Sons Ltd.

Mother–Adolescent Agreement Regarding Decision-Making Autonomy: A Longitudinal Comparison of Families of Adolescents with and without Spina Bifida

PubMed Central

Devine, Katie A.; Wasserman, Rachel M.; Gershenson, Lily S.; Essner, Bonnie S.

2011-01-01

Objective Longitudinal comparison of mother and adolescent agreement regarding decision-making autonomy for adolescents with and without spina bifida (SB). Methods Forty-two mother–adolescent dyads of adolescents with SB and 55 comparison dyads reported on who was responsible for decision-making across five waves of data collection, beginning at age 8 or 9 years through age 16 or 17 years. Results The proportion of tasks that dyads agreed were decided by adolescents increased over time for both samples beginning at age 12 or 13 years, but appeared to be delayed by roughly two years for youth with SB and was lower for youth with SB from lower socioeconomic (SES) backgrounds. Mothers and adolescents with low SES demonstrated higher proportions of tasks that dyads agreed were decided by mothers. Conclusions SB and low SES are risk factors for lower levels of agreed-upon decision-making autonomy. Future studies should examine how parent–adolescent agreement regarding autonomy relates to psychosocial outcomes. PMID:20943730

Post-sterilization autonomy among young mothers in South India.

PubMed

Pallikadavath, Saseendran; Rajan, Irudaya; Singh, Abhishek; Ogollah, Reuben; Page, Samantha

2015-01-01

This study examined the post-sterilization autonomy of women in south India in the context of early sterilization and low fertility. Quantitative data were taken from the third round of the National Family Health Survey (NFHS-3) carried out in 2005-06, and qualitative data from one village each in Kerala and Tamil Nadu during 2010-11. The incident rate ratios and thematic analysis showed that among currently married women under the age of 30 years, those who had been sterilized had significantly higher autonomy in household decision-making and freedom of mobility compared with women who had never used any modern family planning method. Early age at sterilization and low fertility enables women to achieve the social status that is generally attained at later stages in the life-cycle. Policies to capitalize on women's autonomy and free time resulting from early sterilization and low fertility should be adopted in south India.

[Autonomy insurance: An essential innovation in response to the challenges of aging].

PubMed

Hébert, Réjean

2012-03-01

The aging population and the epidemic of chronic diseases requires an accompanying finance reform of long-term care that will become increasingly dominant. Many countries have faced this situation and have set up a separate public funding for such care on the basis of a universal insurance covering both home care and institutions. Canada and Quebec must adopt such autonomy insurance and create a separate fund financed partly by a more judicious use of current budgets and tax credits, and also by a significant investment in home care. An autonomy support benefit could be allocated in kind to fund public services and by contract to pay for services delivered by private, voluntary, and social economy agencies. This benefit would be established following a standardized assessment of functional autonomy achieved by the case manager who will manage the services and control their quality.

Ageism and Autonomy in Health Care: Explorations Through a Relational Lens.

PubMed

Pritchard-Jones, Laura

2017-03-01

Ageism within the context of care has attracted increasing attention in recent years. Similarly, autonomy has developed into a prominent concept within health care law and ethics. This paper explores the way that ageism, understood as a set of negative attitudes about old age or older people, may impact on an older person's ability to make maximally autonomous decisions within health care. In particular, by appealing to feminist constructions of autonomy as relational, I will argue that the key to establishing this link is the concept of self-relations such as self-trust, self-worth and self-esteem. This paper aims to demonstrate how these may be impacted by the internalisation of negative attitudes associated with old age and care. In light of this, any legal or policy response must be sensitive to and flexible enough to deal with the way in which ageism impacts autonomy.

Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan.

PubMed

Cheng, Shao-Yi; Lin, Wen-Yuan; Cheng, Ya-Hui; Huang, Chien Hsiun; Chen, Ching-Yu; Hwang, Shinn-Jang; Tsai, Shih-Tzu; Chiu, Tai-Yuan

2016-02-01

Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. The good death score at admission, clear consciousness, number of admission days beyond 7, better physical care, higher physician-assessed autonomy, better emotional support, better communication, better continuity of life, and physician-reported rate of closure were factors affecting the quality of dying. Further analysis identified age (p = 0.031), consciousness (p = 0.01), and total good death scale score at death (p < 0.001) as determinants of physician-assessed autonomy. We concluded that physician-assessed autonomy would affect a good death and was highly correlated with age, consciousness level, and quality of dying at the end for advanced cancer patients in Taiwan. Copyright © 2015 John Wiley & Sons, Ltd.

A relational perspective on autonomy for older adults residing in nursing homes.

PubMed

Sherwin, Susan; Winsby, Meghan

2011-06-01

To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.

A relational perspective on autonomy for older adults residing in nursing homes

PubMed Central

Sherwin, Susan; Winsby, Meghan

2011-01-01

Abstract Aim  To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Background  Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. Methods  We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. Conclusion  We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent’s deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. PMID:21029285

Measuring the Perception of the Teachers' Autonomy-Supportive Behavior in Physical Education: Development and Initial Validation of a Multi-Dimensional Instrument

ERIC Educational Resources Information Center

Tilga, Henri; Hein, Vello; Koka, Andre

2017-01-01

This research aimed to develop and validate an instrument to assess the students' perceptions of the teachers' autonomy-supportive behavior by the multi-dimensional scale (Multi-Dimensional Perceived Autonomy Support Scale for Physical Education). The participants were 1,476 students aged 12- to 15-years-old. In Study 1, a pool of 37 items was…

Effectiveness of a self-management program for dual sensory impaired seniors in aged care settings: study protocol for a cluster randomized controlled trial.

PubMed

Roets-Merken, Lieve M; Graff, Maud J L; Zuidema, Sytse U; Hermsen, Pieter G J M; Teerenstra, Steven; Kempen, Gertrudis I J M; Vernooij-Dassen, Myrra J F J

2013-10-07

Five to 25 percent of residents in aged care settings have a combined hearing and visual sensory impairment. Usual care is generally restricted to single sensory impairment, neglecting the consequences of dual sensory impairment on social participation and autonomy. The aim of this study is to evaluate the effectiveness of a self-management program for seniors who acquired dual sensory impairment at old age. In a cluster randomized, single-blind controlled trial, with aged care settings as the unit of randomization, the effectiveness of a self-management program will be compared to usual care. A minimum of 14 and maximum of 20 settings will be randomized to either the intervention cluster or the control cluster, aiming to include a total of 132 seniors with dual sensory impairment. Each senior will be linked to a licensed practical nurse working at the setting. During a five to six month intervention period, nurses at the intervention clusters will be trained in a self-management program to support and empower seniors to use self-management strategies. In two separate diaries, nurses keep track of the interviews with the seniors and their reflections on their own learning process. Nurses of the control clusters offer care as usual. At senior level, the primary outcome is the social participation of the seniors measured using the Hearing Handicap Questionnaire and the Activity Card Sort, and secondary outcomes are mood, autonomy and quality of life. At nurse level, the outcome is job satisfaction. Effectiveness will be evaluated using linear mixed model analysis. The results of this study will provide evidence for the effectiveness of the Self-Management Program for seniors with dual sensory impairment living in aged care settings. The findings are expected to contribute to the knowledge on the program's potential to enhance social participation and autonomy of the seniors, as well as increasing the job satisfaction of the licensed practical nurses. Furthermore, an extensive process evaluation will take place which will offer insight in the quality and feasibility of the sampling and intervention process. If it is shown to be effective and feasible, this Self-Management Program could be widely disseminated. ClinicalTrials.gov, NCT01217502.

Effectiveness of a self-management program for dual sensory impaired seniors in aged care settings: study protocol for a cluster randomized controlled trial

PubMed Central

2013-01-01

Background Five to 25 percent of residents in aged care settings have a combined hearing and visual sensory impairment. Usual care is generally restricted to single sensory impairment, neglecting the consequences of dual sensory impairment on social participation and autonomy. The aim of this study is to evaluate the effectiveness of a self-management program for seniors who acquired dual sensory impairment at old age. Methods/Design In a cluster randomized, single-blind controlled trial, with aged care settings as the unit of randomization, the effectiveness of a self-management program will be compared to usual care. A minimum of 14 and maximum of 20 settings will be randomized to either the intervention cluster or the control cluster, aiming to include a total of 132 seniors with dual sensory impairment. Each senior will be linked to a licensed practical nurse working at the setting. During a five to six month intervention period, nurses at the intervention clusters will be trained in a self-management program to support and empower seniors to use self-management strategies. In two separate diaries, nurses keep track of the interviews with the seniors and their reflections on their own learning process. Nurses of the control clusters offer care as usual. At senior level, the primary outcome is the social participation of the seniors measured using the Hearing Handicap Questionnaire and the Activity Card Sort, and secondary outcomes are mood, autonomy and quality of life. At nurse level, the outcome is job satisfaction. Effectiveness will be evaluated using linear mixed model analysis. Discussion The results of this study will provide evidence for the effectiveness of the Self-Management Program for seniors with dual sensory impairment living in aged care settings. The findings are expected to contribute to the knowledge on the program’s potential to enhance social participation and autonomy of the seniors, as well as increasing the job satisfaction of the licensed practical nurses. Furthermore, an extensive process evaluation will take place which will offer insight in the quality and feasibility of the sampling and intervention process. If it is shown to be effective and feasible, this Self-Management Program could be widely disseminated. Clinical trials registration ClinicalTrials.gov, NCT01217502. PMID:24099315

Career Preference among Universities' Faculty: Literature Review

ERIC Educational Resources Information Center

Alenzi, Faris Q.; Salem, Mohamed L.

2007-01-01

Why do people enter academic life? What are their expectations? How can they maximize their experience and achievements, both short- and long-term? How much should they move towards commercialization? What can they do to improve their career? How much autonomy can they reasonably expect? What are the key issues for academics and aspiring academics…

The Development of Taking Responsibility and Its Influence in Organisations

ERIC Educational Resources Information Center

Klutmann, Beate

2007-01-01

Modern managers expect staff to accept more responsibility. However, not all of them want to take more responsibility. Others complain of not having enough responsibility entrusted to them and expect more autonomy and decision-making. In this paper, responsibility is defined as being accountable and fulfilling one's duty while being in charge.…

Parental Autonomy Granting and School Functioning among Chinese Adolescents: The Moderating Role of Adolescents’ Cultural Values

PubMed Central

Wang, Cixin; Do, Kieu Anh; Bao, Leiping; Xia, Yan R.; Wu, Chaorong

2017-01-01

School adjustment and achievement are important indicators of adolescents’ well-being; however, few studies have examined the risk and protective factors predicting students’ school adjustment and achievement at the individual, familial, and cultural level. The present study examined the influences of individual and familial factors and cultural values on Chinese adolescents’ school functioning (e.g., school adjustment and grades). It also tested whether cultural values moderated the relationship between parenting and adolescents’ school functioning. Self-report data were collected from a stratified random sample of 2,864 adolescents (51.5% female, mean age = 15.52 years, grade 6th – 12th) from 55 classrooms, in 13 schools in Shanghai, China. Results showed that self-esteem (bse→adj = 0.05, SE = 0.01, p < 0.001; bse→grades = 0.08, SE = 0.02, p < 0.001), parent–adolescent conflict (bconflict→adj = -0.03, SE = 0.00, p < 0.001; bconflict→grades = -0.04, SE = 0.01, p < 0.001), and conformity to parental expectations (bconform→adj = -0.03, SE = 0.02, p < 0.05; bconform→grades = 0.10, SE = 0.04, p < 0.05) all had significant effects on both school adjustment and grades, respectively. More importantly, results showed that independent self-construal moderated the relationship between parental autonomy granting and adolescents’ grades (bindepxautom = 0.06, SE = 0.02, p < 0.01). The findings suggest that cultural values may influence adolescents’ appraisal of parental autonomy granting, which then impacts their school functioning. PMID:29326622

Parenting styles in a cultural context: observations of "protective parenting" in first-generation Latinos.

PubMed

Domenech Rodríguez, Melanie M; Donovick, Melissa R; Crowley, Susan L

2009-06-01

Current literature presents four primary parenting styles: authoritative, authoritarian, permissive, and neglectful. These styles provide an important shortcut for a constellation of parenting behaviors that have been characterized as consisting of warmth, demandingness, and autonomy granting. Empirically, only warmth and demandingness are typically measured. Research reporting on parenting styles in Latino samples has been equivocal leading to questions about conceptualization and measurement of parenting styles in this ethnic/cultural group. This lack of consensus may result from the chasm between concepts (e.g., authoritarian parenting) and observable parenting behaviors (e.g., warmth) in this ethnic group. The present research aimed to examine parenting styles and dimensions in a sample of Latino parents using the two usual dimensions (warmth, demandingness) and adding autonomy granting. Traditional parenting styles categories were examined, as well as additional categorizations that resulted from adding autonomy granting. Fifty first-generation Latino parents and their child (aged 4-9) participated. Parent-child interactions were coded with the Parenting Style Observation Rating Scale (P-SOS). In this sample, the four traditional parenting categories did not capture Latino families well. The combination of characteristics resulted in eight possible parenting styles. Our data showed the majority (61%) of Latino parents as "protective parents." Further, while mothers and fathers were similar in their parenting styles, expectations were different for male and female children. The additional dimensions and implications are discussed. The importance of considering the cultural context in understanding parenting in Latino families is emphasized, along with directions for future research.

Is Attachment at Ages 1, 6 and 16 Related to Autonomy and Relatedness Behavior of Adolescents in Interaction towards Their Mothers?

ERIC Educational Resources Information Center

Becker-Stoll, Fabienne; Fremmer-Bombik, Elisabeth; Wartner, Ulrike; Zimmermann, Peter; Grossmann, Klaus E.

2008-01-01

This study investigates whether attachment quality at ages 1, 6 and 16 is related to autonomy and relatedness behavior in adolescence. In a follow-up of the Regensburg Longitudinal Study, forty-three 16-year-old adolescents and their mothers were assessed in a revealed differences task and a planning a vacation task. Attachment was assessed during…

Frailty's Place in Ethics and Law: Some Thoughts on Equality and Autonomy and on Limits and Possibilities for Aging Citizens.

PubMed

McNally, Mary; Lahey, William

2015-01-01

Consideration of ethical and legal themes relating to frailty must engage with the concern that frailty is a pejorative concept that validates and reinforces the disadvantage and vulnerability of aging adults. In this chapter, we consider whether a greater focus on frailty may indeed be part of the solution to the disadvantages that aging adults face in achieving equality and maintaining their autonomy within systems that have used their frailty to deny them equality and autonomy. First, by examining equality both as an ethical norm and as a requirement for protections against discrimination, we raise questions about the grounds on which health providers and health systems can be required to give equal concern and respect to the needs of frail older persons. Second, we explore autonomy and identify the tension between meaningful self-determination and prevailing ethical and legal norms associated with informed choice. Third, we argue that a proper understanding of frailty is essential within both of these themes; it respects equality by enabling health providers and systems to identify and address the distinct care needs of aging adults and helps to align informed choice theory with appropriate processes for decision-making about those needs. 2015 S. Karger AG, Basel.

Desire for autonomy in health care decisions: a general population survey.

PubMed

Cullati, Stéphane; Courvoisier, Delphine S; Charvet-Bérard, Agathe I; Perneger, Thomas V

2011-04-01

To examine factors associated with desire for autonomy in health care decisions in the general population. Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

PubMed Central

Hébert, Rejean

1982-01-01

Care of the aged necessitates a functional diagnosis, with which physicians have little familiarity. The author reviews the principles of autonomy and dependence, applying them to the health care context. He proposes a method of sifting the necessary factors in measuring functional autonomy in elderly people. PMID:21286203

Assessment of Parent Orientation towards Autonomy vs. Control in Promoting Children's Healthy Eating and Exercise.

PubMed

Chiang, Evelyn S; Padilla, Miguel A

2012-07-01

Self-determination theory has been widely applied to understanding individuals' health-related behaviors such as eating healthy foods and exercising. Different reasons for engagement are associated with varying levels of personal agency or autonomy. Authority figures in the environment can be supportive of autonomy or, in contrast, controlling. Although researchers have assessed individuals' perceptions of the autonomy-support in their environments, studies have not directly examined the authority figures' orientations to autonomy with respect to health contexts. A new scale, Parent Orientations to Health, was created to investigate parent orientation to autonomy and control with respect to healthy eating and exercise in children. One hundred and forty-three parents of elementary school-aged children responded to the scale. Scale validation and reliability results indicate that the scale successfully assessed parent orientation towards autonomy for children in health contexts. Furthermore, parent autonomy orientation varied according to child weight status and the healthiness of the child's diet. Parent orientation towards autonomy can be evaluated through the use of the Parent Orientations to Health scale. In addition, parent autonomy orientation is associated with both the healthiness of the child's diet (as perceived by the parent) and the child's body mass index. © 2012 The Authors. Applied Psychology: Health and Well-Being © 2012 The International Association of Applied Psychology.

Examining Emerging-Adults' and Parents' Expectations about Autonomy during the Transition to College

ERIC Educational Resources Information Center

Kenyon, DenYelle Baete; Koerner, Susan Silverberg

2009-01-01

Our research goals were to document levels and examine the potential discrepancies of emerging-adults' and parents' expectations for autonomous behavior during the transition to college. Quantitative and qualitative data were collected from 204 incoming college freshmen (n = 150 females, n = 54 males) and 226 parents (n = 173 mothers, n = 53…

Exploring the Relationship between Fidelity of Implementation and Academic Achievement in a Third-Grade Gifted Curriculum: A Mixed-Methods Study

ERIC Educational Resources Information Center

Azano, Amy; Missett, Tracy C.; Callahan, Carolyn M.; Oh, Sarah; Brunner, Marguerite; Foster, Lisa H.; Moon, Tonya R.

2011-01-01

This study used sequential mixed-methods analyses to investigate the effectiveness of a research-based language arts curriculum for gifted third graders. Using analytic induction, researchers found that teachers' beliefs and expectations (time, sense of autonomy, expectations for students, professional expertise) influenced the degree to which…

Autonomy, filial piety, and parental authority: a two-year longitudinal investigation.

PubMed

Liu, Yih-Lan

2013-01-01

A 2-year longitudinal study was conducted to test 3 causal models about adolescent autonomy, filial piety, beliefs about parental authority, and obedience in terms of personal, prudential, and multifaceted issues. Four hundred and thirty-six students from 10 junior and senior high schools in Taiwan (boys, n = 223; senior high school, n = 211) participated in the study. Hypothesis I predicted that autonomy (individuating autonomy vs. relating autonomy) would positively correlate with beliefs about authority legitimacy and obligation to obey, but was not supported. Hypothesis 2 predicted that filial piety (authoritarian piety vs. reciprocal piety) would positively associate with authority beliefs, and was partially supported. Authoritarian piety showed the positive relation with authority beliefs. Hypothesis 3 predicted that beliefs about authority legitimacy and obligation to obey would positively associate with obedience, and was supported. Hypothesis 4 predicted that age might moderate the structure models across domains, but the results indicated that age did not moderate the structural model in the prudential and multifaceted domains. The overall findings of this study reveal that adolescent beliefs about authority serve as a mediator between authoritarian piety and obedience, suggesting that traditional piety still has an influence on parent-child interaction in today's society.

The jingle-jangle fallacy in adolescent autonomy in the family: in search of an underlying structure.

PubMed

Van Petegem, Stijn; Vansteenkiste, Maarten; Beyers, Wim

2013-07-01

The construct of autonomy has a rich, though quite controversial, history in adolescent psychology. The present investigation aimed to clarify the meaning and measurement of adolescent autonomy in the family. Based on theory and previous research, we examined whether two dimensions would underlie a wide range of autonomy-related measures, using data from two adolescent samples (N = 707, 51 % girls, and N = 783, 59 % girls, age range = 14-21 years). Clear evidence was found for a two-dimensional structure, with the first dimension reflecting "volition versus pressure", that is, the degree to which adolescents experience a sense of volition and choice as opposed to feelings of pressure and coercion in the parent-adolescent relationship. The second dimension reflected "distance versus proximity", which involves the degree of interpersonal distance in the parent-adolescent relationship. Whereas volition related to higher well-being, less problem behavior and a secure attachment style, distance was associated mainly with more problem behavior and an avoidant attachment style. These associations were not moderated by age. The discussion focuses on the meaning of adolescent autonomy and on the broader implications of the current findings.

Relational Autonomy in Assisted Living: A Focus on Diverse Care Settings for Older Adults

PubMed Central

Perkins, Molly M.; Ball, Mary M.; Whittington, Frank J.; Hollingsworth, Carole

2012-01-01

Consistent with Western cultural values, the traditional liberal theory of autonomy, which places emphasis on self-determination, liberty of choice, and freedom from interference by others, has been a leading principle in health care discourse for several decades. In context to aging, chronic illness, disability, and long-term care, increasingly there has been a call for a relational conception of autonomy that acknowledges issues of dependency, interdependence, and care relationships. Although autonomy is a core philosophy of assisted living (AL) and a growing number of studies focus on this issue, theory development in this area is lagging and little research has considered race, class, or cultural differences, despite the growing diversity of AL. We present a conceptual model of autonomy in AL based on over a decade of research conducted in diverse facility settings. This relational model provides an important conceptual lens for understanding the dynamic linkages between varieties of factors at multiple levels of social structure that shape residents' ability to maintain a sense of autonomy in this often socially challenging care environment. Social and institutional change, which is ongoing, as well as the multiple and ever-changing cultural contexts within which residents are embedded, are important factors that shape residents' experiences over time and impact resident-facility fit and residents' ability to age in place. PMID:22707852

Adolescent Self-Reported Physical Activity and Autonomy: A Case for Constrained and Structured Environments?

PubMed

Rachele, Jerome N; Jaakkola, Timo; Washington, Tracy L; Cuddihy, Thomas F; McPhail, Steven M

2015-09-01

The provision of autonomy supportive environments that promote physical activity engagement have become popular in contemporary youth settings. However, questions remain about whether adolescent perceptions of their autonomy have implications for physical activity. The purpose of this investigation was to examine the association between adolescents' self-reported physical activity and their perceived autonomy. Participants (n = 384 adolescents) aged between 12 and 15 years were recruited from six secondary schools in metropolitan Brisbane, Australia. Self-reported measures of physical activity and autonomy were obtained. Logistic regression with inverse probability weights were used to examine the association between autonomy and the odds of meeting youth physical activity guidelines. Autonomy (OR 0.61, 95% CI 0.49-0.76) and gender (OR 0.62, 95% CI 0.46-0.83) were negatively associated with meeting physical activity guidelines. However, the model explained only a small amount of the variation in whether youth in this sample met physical activity guidelines (R(2) = 0.023). For every 1 unit decrease in autonomy (on an index from 1 to 5), participants were 1.64 times more likely to meet physical activity guidelines. The findings, which are at odds with several previous studies, suggest that interventions designed to facilitate youth physical activity should limit opportunities for youth to make independent decisions about their engagement. However, the small amount of variation explained by the predictors in the model is a caveat, and should be considered prior to applying such suggestions in practical settings. Future research should continue to examine a larger age range, longitudinal observational or intervention studies to examine assertions of causality, as well as objective measurement of physical activity. Key pointsAutonomy was negatively associated with meeting physical activity recommendationsThe findings suggest that more structured environments would facilitate physical activityThe small amount of variation explained by the predictors in the model is a caveat.

Women's autonomy in household decision-making: a demographic study in Nepal.

PubMed

Acharya, Dev R; Bell, Jacqueline S; Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R

2010-07-15

How socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal. This study aims to explore the links between women's household position and their autonomy in decision making. We used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257). The data consists of women's four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives. A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making. Women's autonomy in decision making is positively associated with their age, employment and number of living children. Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure. There is a mixed variation in women's autonomy in the development region across all outcome measures. Western women are more likely to make decision in own health care (1.2-1.6), while they are less likely to purchase daily household needs (0.6-0.9). Women's increased education is positively associated with autonomy in own health care decision making (p < 0.01), however their more schooling (SLC and above) shows non-significance with other outcome measures. Interestingly, rich women are less likely to have autonomy to make decision in own healthcare. Women from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making. Women's autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum. A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources. This will lead the women to be more autonomous in decision making in the due course.

Autonomy-connectedness mediates sex differences in symptoms of psychopathology

PubMed Central

Bekker, Marrie H. J.; van Assen, Marcel A. L. M.

2017-01-01

Objectives This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder). Method Participants (N = 5,525) from a representative community sample in the Netherlands filled out questionnaires regarding the variables under study. Results Autonomy-connectedness (self-awareness, SA; sensitivity to others, SO; capacity for managing new situations, CMNS) fully mediated the sex differences in depression and anxiety, and partly in eating disorder -(drive for thinness, bulimia, and body dissatisfaction) and anti-social personality disorder characteristics. The mediations followed the expected sex-specific patterns. SO related positively to the internalizing disorder indices, and negatively to the anti-social personality disorder. SA related negatively to all disorder indices; and CMNS to all internalizing disorder indices, but positively to the anti-social personality disorder. Conclusion Treatment of depression, anxiety, but also eating disorders and the antisocial personality disorder may benefit from a stronger focus on autonomy strengthening. PMID:28771498

Autonomy-connectedness mediates sex differences in symptoms of psychopathology.

PubMed

Bekker, Marrie H J; van Assen, Marcel A L M

2017-01-01

This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder). Participants (N = 5,525) from a representative community sample in the Netherlands filled out questionnaires regarding the variables under study. Autonomy-connectedness (self-awareness, SA; sensitivity to others, SO; capacity for managing new situations, CMNS) fully mediated the sex differences in depression and anxiety, and partly in eating disorder -(drive for thinness, bulimia, and body dissatisfaction) and anti-social personality disorder characteristics. The mediations followed the expected sex-specific patterns. SO related positively to the internalizing disorder indices, and negatively to the anti-social personality disorder. SA related negatively to all disorder indices; and CMNS to all internalizing disorder indices, but positively to the anti-social personality disorder. Treatment of depression, anxiety, but also eating disorders and the antisocial personality disorder may benefit from a stronger focus on autonomy strengthening.

Autonomy and social norms in a three factor grief model predicting perinatal grief in India.

PubMed

Roberts, Lisa R; Lee, Jerry W

2014-01-01

Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.

"Girl Power!": The Relationship between Women's Autonomy and Children's Immunization Coverage in Ethiopia.

PubMed

Ebot, Jane O

2015-09-18

Although immunizations are efficient and cost effective methods of reducing child mortality, worldwide, approximately 2 million children die yearly of vaccine-preventable diseases. Researchers and health organizations have detailed information on the positive relationship between women's autonomy and children's health outcomes in developing countries. This study investigates the links between women's household autonomy and children's immunization status using data from a nationally representative sample of children aged 12-30 months (N = 2941) from the 2011 Ethiopia Demographic and Health Survey. The results showed that women's socioeconomic status and household autonomy were significantly associated with children's immunization status. Overall, the implications of this study align with those of the Millennium Development Goal #3: improvements in women's household autonomy are linked to more positive child health outcomes.

Respect for autonomy in the healthcare context: observations from a qualitative study of young adults with cerebral palsy.

PubMed

Racine, E; Larivière-Bastien, D; Bell, E; Majnemer, A; Shevell, M

2013-11-01

Respect for patient autonomy is a cornerstone of contemporary medical ethics and clinical practice. In its different shapes and forms (e.g. being informed, being engaged in discussions and decisions about medical care and being supported in developing healthcare preferences and choices), patient autonomy has been fostered by both paediatric and adult professional societies. The transition from paediatric to adult care creates a complex situation where autonomy for medical decisions shifts to the developing adolescent. More specific challenges to respect for autonomy may be experienced by young adults with cerebral palsy in the transition period where, for example, language and motor impairments may affect communication skills and this may be conflated with cognitive disability. To characterize perspectives towards autonomy in the healthcare context for young adults with cerebral palsy. We carried out semi-structured interviews with 14 young adults (aged 18-25) with cerebral palsy. The audiotaped interviews were transcribed verbatim and analysed using a conventional thematic qualitative content analysis. Participants displayed a range of attitudes towards autonomy, suggesting that the value of autonomy is considered in light of competing values and of context. Testimonials from participants demonstrated that both contextual (e.g. ill-adapted health care, lack of specialized public transport) and relational (e.g. attitudes towards parental involvement in decision making) factors negatively or positively impact autonomy. We observed that there were four key elements interwoven in participants' characterization of autonomy: the coupling of decisional and physical autonomy, the influences of family and society on autonomy, the influence of healthcare professionals on autonomy and the need for preparation for autonomy. © 2012 John Wiley & Sons Ltd.

Parental autonomy-support, intrinsic life goals, and well-being among adolescents in China and North America.

PubMed

Lekes, Natasha; Gingras, Isabelle; Philippe, Frederick L; Koestner, Richard; Fang, Jianqun

2010-08-01

Self-determination theory proposes that prioritizing intrinsic life goals, such as community involvement, is related to well-being, whereas focusing on extrinsic life goals, such as financial success, is associated with lower well-being and that parenting influences the type of life goals that youth adopt. In a sample of 515 Chinese (56% female, mean age = 15.50) and 567 North American (52% male, mean age = 14.17) adolescents, a model of the relationships between parenting, life goals, and well-being was investigated and confirmed for intrinsic life goals. Across societies, autonomy-supportive parenting was associated with the endorsement of intrinsic life goals, which in turn was associated with well-being. Intrinsic life goals partially mediated the relationship between parental autonomy-support and well-being. These findings suggest that, cross-culturally, prioritizing intrinsic life goals is related to increased well-being among adolescents and that parents could encourage intrinsic life goals by being supportive of their children's autonomy.

State governance versus dentists' autonomy - the case of Swedish dental care.

PubMed

Franzén, Cecilia

2018-03-01

A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists' autonomy and whether the government's political intentions can be fulfilled. The paper is based on documents from government authorities and professional theories. The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists' professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations. This article shows that the state's governance does not directly detail dentists' work, which indicates a balance between state governance and dentists' autonomy. However, further research is required to get knowledge on Swedish dentists' view of the governance.

Organizational factors related to the confidence of workers in working with residents with dementia or depression in aged care facilities.

PubMed

McCabe, Marita P; Mellor, David; Karantzas, Gery; Von Treuer, Kathryn; Davison, Tanya E; O'Connor, Daniel

2017-05-01

There has been limited research examining how organizational factors are associated with the level of confidence of residential aged care staff in managing both residents' depression and the behavioural and psychological symptoms of residents with dementia (BPSD). This study investigated this issue. A cross-sectional study design was employed. In total, 255 aged care staff (131 senior staff, 124 junior staff) from 21 residential care facilities participated in the study. All staff completed measures of self-efficacy in managing BPSD as well as confidence in working with older people with depression. They also completed measures of organizational climate (autonomy, cohesion, trust, pressure, support, recognition, fairness and encouragement of innovation) and measures of workplace experience (job role, number of years working in aged care facilities), job stress and satisfaction, and knowledge of depression. The results demonstrated that autonomy, trust, support, and job stress were associated with confidence in managing BPSD, while the factors related to confidence in managing depression were autonomy, support, job stress, job satisfaction, and knowledge of depression. These findings highlight that organizational climate factors need to be addressed in order to increase staff confidence in managing BPSD and depression. In particular, the findings demonstrate the importance of fostering organizational environments in which autonomy is promoted and there is support and cooperation among aged care staff. Attention to these factors is likely to increase the confidence of staff as they carry out their carer role.

Women's decision-making autonomy and children's schooling in rural Mozambique.

PubMed

Luz, Luciana; Agadjanian, Victor

2015-03-24

Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.

Does maternal autonomy influence feeding practices and infant growth in rural India?

PubMed Central

Shroff, Monal R.; Griffiths, Paula L.; Suchindran, Chirayath; Nagalla, Balakrishna; Vazir, Shahnaz; Bentley, Margaret E.

2011-01-01

The high prevalence of child under-nutrition remains a profound challenge in the developing world. Maternal autonomy was examined as a determinant of breast feeding and infant growth in children 3 to 5 months of age. Cross-sectional baseline data on 600 mother-infant pairs were collected in 60 villages in rural Andhra Pradesh, India. The mothers were enrolled in a longitudinal randomized behavioral intervention trial. In addition to anthropometric and demographic measures, an autonomy questionnaire was administered to measure different dimensions of autonomy (e.g. decision-making, freedom of movement, financial autonomy, and acceptance of domestic violence). We conducted confirmatory factor analysis on maternal autonomy items and regression analyses on infant breast feeding and growth after adjusting for socioeconomic and demographic variables, and accounting for infant birth weight, infant morbidity, and maternal nutritional status. Results indicated that mothers with higher financial autonomy were more likely to breastfeed 3–5 month old infants. Mothers with higher participation in decision-making in households had infants that were less underweight and less wasted. These results suggest that improving maternal financial and decision-making autonomy could have a positive impact on infant feeding and growth outcomes. PMID:21742425

Does maternal autonomy influence feeding practices and infant growth in rural India?

PubMed

Shroff, Monal R; Griffiths, Paula L; Suchindran, Chirayath; Nagalla, Balakrishna; Vazir, Shahnaz; Bentley, Margaret E

2011-08-01

The high prevalence of child under-nutrition remains a profound challenge in the developing world. Maternal autonomy was examined as a determinant of breast feeding and infant growth in children 3-5 months of age. Cross-sectional baseline data on 600 mother-infant pairs were collected in 60 villages in rural Andhra Pradesh, India. The mothers were enrolled in a longitudinal randomized behavioral intervention trial. In addition to anthropometric and demographic measures, an autonomy questionnaire was administered to measure different dimensions of autonomy (e.g. decision-making, freedom of movement, financial autonomy, and acceptance of domestic violence). We conducted confirmatory factor analysis on maternal autonomy items and regression analyses on infant breast feeding and growth after adjusting for socioeconomic and demographic variables, and accounting for infant birth weight, infant morbidity, and maternal nutritional status. Results indicated that mothers with higher financial autonomy were more likely to breastfeed 3-5 month old infants. Mothers with higher participation in decision-making in households had infants that were less underweight and less wasted. These results suggest that improving maternal financial and decision-making autonomy could have a positive impact on infant feeding and growth outcomes. Published by Elsevier Ltd.

Parental Psychological Control and Autonomy Granting: Distinctions and Associations with Child and Family Functioning.

PubMed

Kunz, Jennifer Hauser; Grych, John H

2013-04-01

OBJECTIVE: This study utilized an observational coding scheme to identify parenting behavior reflecting psychological control and autonomy granting and examined relations between these parenting dimensions and indices of child and family functioning. DESIGN: A community sample of 90 preadolescents (aged 10.5 to 12 years) and both of their parents engaged in a triadic interaction that was coded for parental psychological control and autonomy granting. Participants also completed measures of child adjustment, interparental conflict, and triangulation. RESULTS: Factor analyses indicated that a two-factor model better fit the data than a one-factor model, suggesting that psychological control and autonomy granting are best conceptualized as independent but related constructs. Parental psychological control and autonomy granting exhibited some shared and some unique correlates with indices of child and family functioning. Hierarchical regressions revealed significant interactions between these dimensions, suggesting that the strength of some associations between parents' use of psychological control and youth adjustment problems depends on the level of autonomy granting exhibited by the parent. CONCLUSIONS: By examining psychological control and autonomy granting simultaneously as unique constructs, this study identifies patterns of psychological control and autonomy granting that undermine youth adjustment. Findings inform targeted intervention efforts for families of preadolescent youth.

Trajectories of autonomy development across the adolescent transition in children with spina bifida.

PubMed

Friedman, Deborah; Holmbeck, Grayson N; DeLucia, Christian; Jandasek, Barbara; Zebracki, Kathy

2009-02-01

The current study investigated individual growth in autonomy development across the adolescent transition, comparing the trajectories of children with and without spina bifida. Individual growth curve modeling procedures were utilized to describe the developmental course of autonomy across four waves of data collection, from ages 9 to 15, and to test whether illness status [spina bifida vs. matched comparison group (N = 68 for both groups at Time 1)] would significantly predict individual variability in autonomy development. Potential moderators [child gender, SES, and Peabody Picture Vocabulary Test (PPVT) score] of the association between illness status and autonomy development were also examined. Children with spina bifida demonstrated distinct developmental trajectories, though the nature of the group differences varied by type of autonomy development (emotional vs. behavioral), context (i.e. school vs. family), and reporter. Significant interactions with PPVT score and child gender were found. Overall, children with spina bifida show considerable developmental resiliency, but may lag behind their peers in specific areas of autonomy. Boys with spina bifida, and children with spina bifida who have lower than average levels of verbal intelligence, appear to be at greater risk for exhibiting delays in autonomy development.

The psychological contracts of National Health Service nurses.

PubMed

Purvis, Lynne J; Cropley, Mark

2003-03-01

Following the psychological contract model of the employee-employer exchange relationship is offered as a means of understanding the expectations of a UK sample of 223 National Health Service (NHS) nurses in association with their leaving intentions. A pilot study involving 21 NHS nurses, using the repertory grid technique was conducted to elicit contract expectations. Twenty-nine categories of expectation were identified through content analysis. The study proper, employed a survey developed on the basis of results from the pilot study to identify contract profiles among 223 nurses from three London/South-east NHS hospitals, using the Q-sort method. Type of contract held (relational/transactional), satisfaction (job and organization), and leaving intentions were also examined. Q-analysis yielded four contract profiles among the nurses sampled: 'self-development and achievement'; 'belonging and development'; 'competence and collegiality' and 'autonomy and development'. Correlation analysis demonstrated that leaving intentions were associated with a need for personal autonomy and development, and the violation of expectations for being appreciated, valued, recognized and rewarded for effort, loyalty, hard-work and achievement, negative endorsement of a relational contract, positive endorsement of a transactional contract, and job and organizational dissatisfaction. Findings illustrate the diagnostic utility of the term psychological contract for understanding the expectations of NHS nurses. The potential significance of these findings for managing nurse retention is highlighted.

Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community.

PubMed

Zeal, Carley; Higgins, Jenny A; Newton, Shaunna R

2018-01-01

Long-acting reversible contraceptives (LARCs) are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over bleeding patterns, and autonomy in the provider/patient relationship. Within most themes, women made both positive and negative associations between perceived autonomy and LARC. The provider/patient relationship was a modifier of other themes, in that cooperative relationships may overshadow other perceived reductions in autonomy, and more unbalanced relationships may heighten perceived reductions in autonomy. Ever-users were more likely to report increased autonomy with LARC use, whereas never-users were more likely to express concerns about loss of autonomy with LARC. This study suggests that perceived autonomy may influence women's perceptions of LARC as well as their uptake of these contraceptive methods, with several factors both positively and negatively related to women's perceived autonomy. We encourage the integration of these findings into patient-centered counseling as well as educational materials for LARC.

Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community

PubMed Central

Zeal, Carley; Higgins, Jenny A.; Newton, Shaunna R.

2018-01-01

Abstract Long-acting reversible contraceptives (LARCs) are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over bleeding patterns, and autonomy in the provider/patient relationship. Within most themes, women made both positive and negative associations between perceived autonomy and LARC. The provider/patient relationship was a modifier of other themes, in that cooperative relationships may overshadow other perceived reductions in autonomy, and more unbalanced relationships may heighten perceived reductions in autonomy. Ever-users were more likely to report increased autonomy with LARC use, whereas never-users were more likely to express concerns about loss of autonomy with LARC. This study suggests that perceived autonomy may influence women's perceptions of LARC as well as their uptake of these contraceptive methods, with several factors both positively and negatively related to women's perceived autonomy. We encourage the integration of these findings into patient-centered counseling as well as educational materials for LARC. PMID:29588877

Increasing autonomy in publically owned services.

PubMed

Cameron, Ailsa; Allen, Pauline; Williams, Lorraine; Durand, Mary Alison; Bartlett, Will; Perotin, Virginie; Hutchings, Andrew

2015-01-01

The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered. Data are drawn from the evaluation of the Department of Health's CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed. The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity. Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs. As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England.

Decision-making for non-invasive prenatal testing for Down syndrome: Hong Kong Chinese women's preferences for individual vs relational autonomy.

PubMed

Lau, J Y C; Yi, H; Ahmed, S

2016-05-01

Individual autonomy in antenatal screening is internationally recognized and supported. Policy and practice guidelines in various countries place emphasis on the woman's right to make her own decision and are related to concepts such as self-determination, independence, and self-sufficiency. In contrast, the dominant perspective in Chinese medical ethics suggests that the family is pivotal in making medical decisions, hence providing support for relational autonomy. This study explored Hong Kong Chinese pregnant women's preferences for individual vs relational autonomy for non-invasive prenatal testing (NIPT) for Down syndrome. A qualitative study was carried out using semi-structured interviews with 36 women who had undertaken NIPT in Hong Kong. The findings show that most Hong Kong Chinese women valued aspects of both relational and individual autonomy in decision-making for NIPT. Women expected support from doctors as experts on the topic and wanted to involve their husband in decision-making while retaining control over the outcome. Somewhat surprisingly, the findings do not provide support for the involvement of family members in decision-making for NIPT. The adequacy of current interpretations of autonomy in prenatal testing policies as an individual approach needs discussion, where policy developers need to find a balance between individual and relational approaches. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Women's Autonomy and Its Correlates in Western Nepal: A Demographic Study.

PubMed

Bhandari, Tulsi Ram; Kutty, V Raman; Ravindran, T K Sundari

2016-01-01

Despite various efforts for enhancing women's autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women's autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women's autonomy using a recently developed women's autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women's autonomy was 23.34 ± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple's education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women's education (OR = 8.14, CI = 3.77-17.57), husband's education (OR = 2.63, CI = 1.69-4.10) and economic status of household (OR = 1.42, CI = 1.01-2.03) on women's autonomy. When we adjusted women's education for husband's education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77-17.57) to (OR = 6.32, CI = 2.77-14.46)} and was a mediator effect. The economic status of household also had mediator effect on women's autonomy through their education. Education status of women is a key predictor of women's autonomy in Kapilvastu district. Husband's education and economic status of the household are other important predictors of women's autonomy which have a mediator effect on women's autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women's autonomy.

Autonomy and Reproductive Rights of Married Ikwerre Women in Rivers State, Nigeria.

PubMed

Princewill, Chitu Womehoma; Jegede, Ayodele Samuel; Wangmo, Tenzin; Riecher-Rössler, Anita; Elger, Bernice Simone

2017-06-01

A woman's lack of or limited reproductive autonomy could lead to adverse health effects, feeling of being inferior, and above all being unable to adequately care for her children. Little is known about the reproductive autonomy of married Ikwerre women of Rivers State, Nigeria. This study demonstrates how Ikwerre women understand the terms autonomy and reproductive rights and what affects the exercise of these rights. An exploratory research design was employed for this study. A semi-structured interview schedule was used to conduct thirty-four in-depth interviews and six focus group discussions with purposively sampled educated, semi-educated, and uneducated Ikwerre women in monogamous or polygynous marriages. The collected data was analysed qualitatively with MAXQDA 11 using open and axial coding. The interviews and focus group responses reveal a low level of awareness of autonomy and reproductive rights amongst the Ikwerre women in Nigeria. While some educated women were aware of their reproductive rights, cultural practices were reported to limit the exercise of these rights. Participants reported that Ikwerre culture is a patriarchal one where married women are expected to submit and obey their husbands in all matters; and a good married woman according to Ikwerre standard is one who complies with this culture. Women's refusal of sexual advances from their husbands is described as not being acceptable in this culture; and hence rape in marriage is not recognized in Ikwerre culture. Education and awareness creation on the importance of women's reproductive autonomy could improve their reproductive rights and autonomy in marital settings. Overcoming the patriarchal aspects of Ikwerre culture-for example, the greater value placed on male children than female children and treating women as incompetent individuals-is necessary to promote gender equality as well as help improve women's reproductive autonomy.

Learning climate and feedback as predictors of dental students' self-determined motivation: The mediating role of basic psychological needs satisfaction.

PubMed

Orsini, C; Binnie, V; Wilson, S; Villegas, M J

2018-05-01

The aim of this study was to test the mediating role of the satisfaction of dental students' basic psychological needs of autonomy, competence and relatedness on the association between learning climate, feedback and student motivation. The latter was based on the self-determination theory's concepts of differentiation of autonomous motivation, controlled motivation and amotivation. A cross-sectional correlational study was conducted where 924 students completed self-reported questionnaires measuring motivation, perception of the learning climate, feedback and basic psychological needs satisfaction. Descriptive statistics, Cronbach's alpha scores and bivariate correlations were computed. Mediation of basic needs on each predictor-outcome association was tested based on a series of regression analyses. Finally, all variables were integrated into one structural equation model, controlling for the effects of age, gender and year of study. Cronbach's alpha scores were acceptable (.655 to .905). Correlation analyses showed positive and significant associations between both an autonomy-supportive learning climate and the quantity and quality of feedback received, and students' autonomous motivation, which decreased and became negative when correlated with controlled motivation and amotivation, respectively. Regression analyses revealed that these associations were indirect and mediated by how these predictors satisfied students' basic psychological needs. These results were corroborated by the structural equation analysis, in which data fit the model well and regression paths were in the expected direction. An autonomy-supportive learning climate and the quantity and quality of feedback were positive predictors of students' autonomous motivation and negative predictors of amotivation. However, this was an indirect association mediated by the satisfaction of students' basic psychological needs. Consequently, supporting students' needs of autonomy, competence and relatedness might lead to optimal types of motivation, which has an important influence on dental education. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Work autonomy of certified nursing assistants in long-term care facilities: discrepant perceptions between nursing supervisors and certified nursing assistants.

PubMed

Liu, Li-Fan; Liu, Wei-Pei; Wang, Jong-Yi

2011-09-01

Despite increasing demand of certified nursing assistants (CNAs) in long-term care (LTC) facilities, their work autonomy delegated by nursing supervisors remains ambiguous and varied. This study investigates the CNAs' role in LTC facilities by examining the degrees of work autonomy of CNAs from the perspectives of nursing supervisors and CNAs. Whether the characteristics of institutions including ownership of facilities, bed size, staffing levels, and the occupancy rate affected the CNAs' work autonomy and delegations was also examined. A stratified random sampling method was used to sample LTC facilities in Taiwan. A self-administered structured questionnaire was answered by a senior nursing supervisor and CNA in each sampled institution for their perception of work autonomy in the 5 main aspects of CNAs' job contents: personal care, affiliated nursing care, auxiliary medical service, social care, and administration services. Student t test and general linear models (GLM) were used to test the mean differences of CNAs' work autonomy and their relationship with the institutions' characteristics. Nursing supervisors and CNAs both rated the highest scores of work autonomy in the aspect of personal care, and the lowest scores in the aspect of affiliated nursing care. However, the nursing supervisors expected higher work autonomy of CNAs on the work items particularly in affiliated nursing care and auxiliary medical services than did the CNAs (P < .05). The institutional-level factors were significantly associated with perceptions of nursing supervisors toward CNAs' work autonomy. The ownership (hospital-based or freestanding homes), sizes (capacity), occupancy rates, CNA staff numbers of the long-term care facilities, and resident numbers were related to the CNAs' work autonomy as perceived by their nursing supervisors. No difference between the aspects of administration activities and social care was seen. There are discordance views towards CNAs' work autonomy both in nursing supervisors and CNAs across different settings in LTC institutions. The characteristics of institutions influence perceptions of CNAs' work autonomy as perceived by nursing supervisors. Clear and mandated regulation of CNA job contents is needed for their work identity and autonomy to improve the quality of care in LTC facilities. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Parental Autonomy Granting and School Functioning among Chinese Adolescents: The Moderating Role of Adolescents' Cultural Values.

PubMed

Wang, Cixin; Do, Kieu Anh; Bao, Leiping; Xia, Yan R; Wu, Chaorong

2017-01-01

School adjustment and achievement are important indicators of adolescents' well-being; however, few studies have examined the risk and protective factors predicting students' school adjustment and achievement at the individual, familial, and cultural level. The present study examined the influences of individual and familial factors and cultural values on Chinese adolescents' school functioning (e.g., school adjustment and grades). It also tested whether cultural values moderated the relationship between parenting and adolescents' school functioning. Self-report data were collected from a stratified random sample of 2,864 adolescents (51.5% female, mean age = 15.52 years, grade 6th - 12th) from 55 classrooms, in 13 schools in Shanghai, China. Results showed that self-esteem ( b se→adj = 0.05, SE = 0.01, p < 0.001; b se→grades = 0.08, SE = 0.02, p < 0.001), parent-adolescent conflict ( b conflict→adj = -0.03, SE = 0.00, p < 0.001; b conflict→grades = -0.04, SE = 0.01, p < 0.001), and conformity to parental expectations ( b conform→adj = -0.03, SE = 0.02, p < 0.05; b conform→grades = 0.10, SE = 0.04, p < 0.05) all had significant effects on both school adjustment and grades, respectively. More importantly, results showed that independent self-construal moderated the relationship between parental autonomy granting and adolescents' grades ( b indepxautom = 0.06, SE = 0.02, p < 0.01). The findings suggest that cultural values may influence adolescents' appraisal of parental autonomy granting, which then impacts their school functioning.

Foundations of Academic Freedom: Making New Sense of Some Aging Arguments

ERIC Educational Resources Information Center

Andreescu, Liviu

2009-01-01

The article distinguishes between the various arguments traditionally offered as justifications for the principle of academic freedom. Four main arguments are identified, three consequentialist in nature (the argument from truth, the democratic argument, the argument from autonomy), and one nonconsequentialist (a variant of the autonomy argument).…

Mobile-Assisted Language Learning and Language Learner Autonomy

ERIC Educational Resources Information Center

Lyddon, Paul

2016-01-01

In the modern age of exponential knowledge growth and accelerating technological development, the need to engage in lifelong learning is becoming increasingly urgent. Successful lifelong learning, in turn, requires learner autonomy, or "the capacity to take control of one's own learning" (Benson, 2011, p. 58), including all relevant…

Women's autonomy and men's involvement in child care and feeding as predictors of infant and young child anthropometric indices in coffee farming households of Jimma Zone, South West of Ethiopia.

PubMed

Abate, Kalkidan Hassen; Belachew, Tefera

2017-01-01

Most of child mortality and under nutrition in developing world were attributed to suboptimal childcare and feeding, which needs detailed investigation beyond the proximal factors. This study was conducted with the aim of assessing associations of women's autonomy and men's involvement with child anthropometric indices in cash crop livelihood areas of South West Ethiopia. Multi-stage stratified sampling was used to select 749 farming households living in three coffee producing sub-districts of Jimma zone, Ethiopia. Domains of women's Autonomy were measured by a tool adapted from demographic health survey. A model for determination of paternal involvement in childcare was employed. Caring practices were assessed through the WHO Infant and young child feeding practice core indicators. Length and weight measurements were taken in duplicate using standard techniques. Data were analyzed using SPSS for windows version 21. A multivariable linear regression was used to predict weight for height Z-scores and length for age Z-scores after adjusting for various factors. The mean (sd) scores of weight for age (WAZ), height for age (HAZ), weight for height (WHZ) and BMI for age (BAZ) was -0.52(1.26), -0.73(1.43), -0.13(1.34) and -0.1(1.39) respectively. The results of multi variable linear regression analyses showed that WHZ scores of children of mothers who had autonomy of conducting big purchase were higher by 0.42 compared to children's whose mothers had not. In addition, a child whose father was involved in childcare and feeding had higher HAZ score by 0.1. Regarding age, as for every month increase in age of child, a 0.04 point decrease in HAZ score and a 0.01 point decrease in WHZ were noted. Similarly, a child living in food insecure households had lower HAZ score by 0.29 compared to child of food secured households. As family size increased by a person a WHZ score of a child is decreased by 0.08. WHZ and HAZ scores of male child was found lower by 0.25 and 0.38 respectively compared to a female child of same age. Women's autonomy and men's involvement appeared in tandem with better child anthropometric outcomes. Nutrition interventions in such setting should integrate enhancing women's autonomy over resource and men's involvement in childcare and feeding, in addition to food security measures.

Women’s autonomy and men's involvement in child care and feeding as predictors of infant and young child anthropometric indices in coffee farming households of Jimma Zone, South West of Ethiopia

PubMed Central

Abate, Kalkidan Hassen; Belachew, Tefera

2017-01-01

Background Most of child mortality and under nutrition in developing world were attributed to suboptimal childcare and feeding, which needs detailed investigation beyond the proximal factors. This study was conducted with the aim of assessing associations of women’s autonomy and men’s involvement with child anthropometric indices in cash crop livelihood areas of South West Ethiopia. Methods Multi-stage stratified sampling was used to select 749 farming households living in three coffee producing sub-districts of Jimma zone, Ethiopia. Domains of women’s Autonomy were measured by a tool adapted from demographic health survey. A model for determination of paternal involvement in childcare was employed. Caring practices were assessed through the WHO Infant and young child feeding practice core indicators. Length and weight measurements were taken in duplicate using standard techniques. Data were analyzed using SPSS for windows version 21. A multivariable linear regression was used to predict weight for height Z-scores and length for age Z-scores after adjusting for various factors. Results The mean (sd) scores of weight for age (WAZ), height for age (HAZ), weight for height (WHZ) and BMI for age (BAZ) was -0.52(1.26), -0.73(1.43), -0.13(1.34) and -0.1(1.39) respectively. The results of multi variable linear regression analyses showed that WHZ scores of children of mothers who had autonomy of conducting big purchase were higher by 0.42 compared to children's whose mothers had not. In addition, a child whose father was involved in childcare and feeding had higher HAZ score by 0.1. Regarding age, as for every month increase in age of child, a 0.04 point decrease in HAZ score and a 0.01 point decrease in WHZ were noted. Similarly, a child living in food insecure households had lower HAZ score by 0.29 compared to child of food secured households. As family size increased by a person a WHZ score of a child is decreased by 0.08. WHZ and HAZ scores of male child was found lower by 0.25 and 0.38 respectively compared to a female child of same age. Conclusion Women’s autonomy and men’s involvement appeared in tandem with better child anthropometric outcomes. Nutrition interventions in such setting should integrate enhancing women’s autonomy over resource and men’s involvement in childcare and feeding, in addition to food security measures. PMID:28264008

Teacher’s Autonomy Support and Engagement in Math: Multiple Mediating Roles of Self-efficacy, Intrinsic Value, and Boredom

PubMed Central

Wang, Jia; Liu, Ru-De; Ding, Yi; Xu, Le; Liu, Ying; Zhen, Rui

2017-01-01

Previous studies have highlighted the impacts of environmental factors (teacher’s autonomy support) and individual factors (self-efficacy, intrinsic value, and boredom) on academic engagement. This study aimed to investigate these variables and examine the relations among them. Three structural equation models tested the multiple mediational roles of self-efficacy, intrinsic value, and boredom in the relation between teacher’s autonomy support and behavioral, emotional, and cognitive engagement, respectively, in math. A total of 637 Chinese middle school students (313 males, 324 females; mean age = 14.82) voluntarily participated in this study. Results revealed that self-efficacy, intrinsic value, and boredom played important and mediating roles between perceived teacher’s autonomy support and student engagement. Specifically, these three individual variables partly mediated the relations between perceived teacher’s autonomy support and behavioral and cognitive engagement, while fully mediating the relation between perceived teacher’s autonomy support and emotional engagement. These findings complement and extend the understanding of factors affecting students’ engagement in math. PMID:28690560

The role of sex and autonomy-connectedness in internalizing and externalizing personality pathology, coping and axis-I pathology: among psychiatric and healthy elderly.

PubMed

Bachrach, Nathan; Croon, Marcel; Bekker, Marrie

2017-06-01

In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age. A path model was tested which was based on neo-analytical object relation, attachment- and primary-personality theory, among 100 clinical and 106 non-clinical elderly. In line with our model, autonomy-connectedness (self-awareness and capacity of managing new situations) was strongly associated to internalizing PDS in both groups. In both groups, neither sex nor autonomy-connectedness predicted externalizing PDS. Sex, internalizing as well as externalizing PDS and reactive defensive coping were associated to axis-I psychopathology. We conclude that sex and autonomy-connectedness were, similarly as in adult populations, associated to internalizing PDS and axis-I pathology. Treatment of elderly with internalizing PDS and axis-I psychopathology should therefore focus on enhancing autonomy-connectedness.

Teacher's Autonomy Support and Engagement in Math: Multiple Mediating Roles of Self-efficacy, Intrinsic Value, and Boredom.

PubMed

Wang, Jia; Liu, Ru-De; Ding, Yi; Xu, Le; Liu, Ying; Zhen, Rui

2017-01-01

Previous studies have highlighted the impacts of environmental factors (teacher's autonomy support) and individual factors (self-efficacy, intrinsic value, and boredom) on academic engagement. This study aimed to investigate these variables and examine the relations among them. Three structural equation models tested the multiple mediational roles of self-efficacy, intrinsic value, and boredom in the relation between teacher's autonomy support and behavioral, emotional, and cognitive engagement, respectively, in math. A total of 637 Chinese middle school students (313 males, 324 females; mean age = 14.82) voluntarily participated in this study. Results revealed that self-efficacy, intrinsic value, and boredom played important and mediating roles between perceived teacher's autonomy support and student engagement. Specifically, these three individual variables partly mediated the relations between perceived teacher's autonomy support and behavioral and cognitive engagement, while fully mediating the relation between perceived teacher's autonomy support and emotional engagement. These findings complement and extend the understanding of factors affecting students' engagement in math.

The role of autonomy needs in suicidal ideation: integrating the interpersonal-psychological theory of suicide and self-determination theory.

PubMed

Hill, Ryan M; Pettit, Jeremy W

2013-01-01

This study investigated the role of autonomy satisfaction in the development of suicidal ideation by integrating two theoretical models of suicide-related behaviors. The first hypothesized a direct effect of autonomy on suicidal ideation. The second hypothesized an indirect effect of autonomy on suicidal ideation via perceived burdensomeness and thwarted belongingness. This was a cross-sectional study of 449 college students, who were predominantly female (73.1%) and Hispanic (70.6%), with a mean age of 20.40 years (SD = 4.38, range 18-50 years). Participants were recruited from a psychology participant pool and completed self-report survey measures for course credit. The model of indirect effects provided the best fit to the data; relatedness, autonomy, and competence were significantly associated with higher thwarted belongingness and perceived burdensomeness, which, in turn, were significantly associated with higher suicidal ideation. Future studies should test this model longitudinally and consider autonomy as a possible avenue for the prevention of suicide-related behaviors.

Women's household decision-making autonomy and contraceptive behavior among Bangladeshi women.

PubMed

Rahman, Md Mosfequr; Mostofa, Md Golam; Hoque, Md Aminul

2014-03-01

Women's autonomy is a potentially important but less studied indicator of using contraception among women as well as ability to control their fertility. This study explores women's decision-making autonomy as a potential indicator of the use of contraception in Bangladesh. This cross-sectional study utilizes data from the Bangladesh Demographic Health Survey (BDHS) 2007. Information of 8456 currently married and non-pregnant women aged 15-40 years are analyzed to meet up the objective of this study. The mean age of the respondents is 27.19 years and majority of the respondents are from rural areas (62.7%) and also Muslim (90.2%). A large number of women (26.1%) and their husbands (29.0%) have no education and 27.2% respondents were working at the time of interview. The mean number of living children is 2.14. 48.9% of the respondents are currently using a modern method of contraception. More than one-third women are not involved in their household decision-making. Results of this study indicate that household decision-making autonomy is significantly associated with current use of modern contraception, future intention to use contraception and discuss contraception with husband. This measure of women's autonomy provides additional independent explanatory power of contraceptive behavior net of some other socio-demographic variables. This study argues in favor of increasing women's autonomy to increase contraception using rate in this population. Copyright © 2013 Elsevier B.V. All rights reserved.

Political orientation and perceptions of adolescent autonomy and judicial culpability.

PubMed

Reppucci, N Dickon; Scott, Elizabeth; Antonishak, Jill

2009-01-01

This study probed general attitudes about processing youths in adult criminal court across a range of offenses, explored attitudes about age of autonomous decision-making for several activities outside the criminal justice context, and examined the interaction between these two realms. The major finding was that adults favor adult punishment of adolescent offenders at younger ages than they favor autonomy in other decision-making contexts; the gap is widest for those who identify themselves as conservatives. 2009 John Wiley & Sons, Ltd.

When Opportunity Knocks Twice: Dual Living Kidney Donation, Autonomy and the Public Interest

PubMed Central

Huxtable, Richard

2015-01-01

Abstract Living kidney transplantation offers the best treatment in terms of life‐expectancy and quality of life for those with end‐stage renal disease. The long‐term risks of living donor nephrectomy, although real, are very small, with evidence of good medium‐term outcomes. Who should be entitled to donate, and in which circumstances, is nevertheless a live question. We explore the ethical dimensions of a request by an individual to donate both of their kidneys during life: ‘dual living kidney donation’. Our ethical analysis is tethered to a hypothetical case study in which a father asks to donate a kidney to each of his twin boys. We explore the autonomy of the protagonists, alongside different dimensions of the public interest, such as the need to protect not only the recipients, but also the donor and even the wider community. Whilst acknowledging objections to ‘dual‐donation’, not least by reference to the harms that the donor might be expected to endure, we suggest there is a prima facie case for permitting this, provided that both donor and recipients are willing and that due attention is paid to such considerations as the autonomy and welfare of all parties, as well as to the wider ramifications of acting on such a request. We argue for broader interpretations of the concepts of autonomy and welfare, recognizing the importance of relationships and the relevance of more than merely physical well‐being. Equipped with such a holistic assessment, we suggest there is a prima facie case for allowing ‘dual living kidney donation’. PMID:26194324

Forced to be free? Increasing patient autonomy by constraining it

PubMed Central

2014-01-01

It is universally accepted in bioethics that doctors and other medical professionals have an obligation to procure the informed consent of their patients. Informed consent is required because patients have the moral right to autonomy in furthering the pursuit of their most important goals. In the present work, it is argued that evidence from psychology shows that human beings are subject to a number of biases and limitations as reasoners, which can be expected to lower the quality of their decisions and which therefore make it more difficult for them to pursue their most important goals by giving informed consent. It is further argued that patient autonomy is best promoted by constraining the informed consent procedure. By limiting the degree of freedom patients have to choose, the good that informed consent is supposed to protect can be promoted. PMID:22318413

Forced to be free? Increasing patient autonomy by constraining it.

PubMed

Levy, Neil

2014-05-01

It is universally accepted in bioethics that doctors and other medical professionals have an obligation to procure the informed consent of their patients. Informed consent is required because patients have the moral right to autonomy in furthering the pursuit of their most important goals. In the present work, it is argued that evidence from psychology shows that human beings are subject to a number of biases and limitations as reasoners, which can be expected to lower the quality of their decisions and which therefore make it more difficult for them to pursue their most important goals by giving informed consent. It is further argued that patient autonomy is best promoted by constraining the informed consent procedure. By limiting the degree of freedom patients have to choose, the good that informed consent is supposed to protect can be promoted.

Women’s decision-making autonomy and children’s schooling in rural Mozambique

PubMed Central

Luz, Luciana; Agadjanian, Victor

2015-01-01

BACKGROUND Women’s decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women’s autonomy and children’s schooling. OBJECTIVE To examine the relationship between rural women’s decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child’s gender. METHODS The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. RESULTS The results show a positive association of women’s decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women’s autonomy is net of other women’s characteristics typically associated with enrollment and does not mediate the effects of those characteristics. CONCLUSIONS Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters’ schooling and may have a greater say in making and implementing decisions regarding daughters’ education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women’s status on children’s educational outcomes. PMID:26491400

Parental Psychological Control and Autonomy Granting: Distinctions and Associations with Child and Family Functioning

PubMed Central

Kunz, Jennifer Hauser; Grych, John H.

2012-01-01

Objective This study utilized an observational coding scheme to identify parenting behavior reflecting psychological control and autonomy granting and examined relations between these parenting dimensions and indices of child and family functioning. Design A community sample of 90 preadolescents (aged 10.5 to 12 years) and both of their parents engaged in a triadic interaction that was coded for parental psychological control and autonomy granting. Participants also completed measures of child adjustment, interparental conflict, and triangulation. Results Factor analyses indicated that a two-factor model better fit the data than a one-factor model, suggesting that psychological control and autonomy granting are best conceptualized as independent but related constructs. Parental psychological control and autonomy granting exhibited some shared and some unique correlates with indices of child and family functioning. Hierarchical regressions revealed significant interactions between these dimensions, suggesting that the strength of some associations between parents’ use of psychological control and youth adjustment problems depends on the level of autonomy granting exhibited by the parent. Conclusions By examining psychological control and autonomy granting simultaneously as unique constructs, this study identifies patterns of psychological control and autonomy granting that undermine youth adjustment. Findings inform targeted intervention efforts for families of preadolescent youth. PMID:23418403

Goals and everyday problem solving: examining the link between age-related goals and problem-solving strategy use.

PubMed

Hoppmann, Christiane A; Coats, Abby Heckman; Blanchard-Fields, Fredda

2008-07-01

Qualitative interviews on family and financial problems from 332 adolescents, young, middle-aged, and older adults, demonstrated that developmentally relevant goals predicted problem-solving strategy use over and above problem domain. Four focal goals concerned autonomy, generativity, maintaining good relationships with others, and changing another person. We examined both self- and other-focused problem-solving strategies. Autonomy goals were associated with self-focused instrumental problem solving and generative goals were related to other-focused instrumental problem solving in family and financial problems. Goals of changing another person were related to other-focused instrumental problem solving in the family domain only. The match between goals and strategies, an indicator of problem-solving adaptiveness, showed that young individuals displayed the greatest match between autonomy goals and self-focused problem solving, whereas older adults showed a greater match between generative goals and other-focused problem solving. Findings speak to the importance of considering goals in investigations of age-related differences in everyday problem solving.

Trajectories of Ethnic-Racial Identity and Autonomy Among Mexican-Origin Adolescent Mothers in the United States.

PubMed

Umaña-Taylor, Adriana J; Updegraff, Kimberly A; Jahromi, Laudan B; Zeiders, Katharine H

2015-01-01

This study examined trajectories of ethnic-racial identity (ERI) and autonomy development among Mexican-origin adolescent females in the United States (N = 181; M(age) at Wave 1 = 16.80 years, SD = 1.00) as they transitioned through the first 5 years of parenthood. Trajectories of ERI and autonomy also were examined in relation to psychosocial functioning. Unconditional latent growth models indicated significant growth in autonomy, ERI resolution, and ERI affirmation from middle to late adolescence. Conditional latent growth models indicated that autonomy and ERI exploration growth trajectories were positively associated with psychosocial adjustment. Although adolescent mothers are experiencing transitions that are not normative during adolescence, they also engage in normative developmental processes, and their engagement in such processes is linked with better adjustment. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

Developing child autonomy in pediatric healthcare: towards an ethical model.

PubMed

Martakis, Kyriakos; Brand, Helmut; Schröder-Bäck, Peter

2018-06-01

The changes initiated by the new National Civil and Commercial Code in Argentina underline the pediatric task to empower children's and adolescents' developing autonomy. In this paper, we have framed a model describing autonomy in child healthcare. We carried out a literature review focusing on i) the concept of autonomy referring to the absolute value of the autonomous individual, and ii) the age-driven process of competent decisionmaking development. We summarized our findings developing a conceptual model that includes the child, the pediatrician and the parents. The pediatricianchild relationship is based on different forms of guidance and cooperation, resulting in varying levels of activity and passivity. Parental authority influences the extent of autonomy, based on the level of respect of the child's moral equality. Contextual, existential, conceptual, and socialethical conditions shall be considered when applying the model to facilitate dialogue between pediatricians, children, parents and other actors. Sociedad Argentina de Pediatría.

Parental Autonomy Support in Two Cultures: The Moderating Effects of Adolescents' Self-Construals.

PubMed

Marbell-Pierre, Kristine N; Grolnick, Wendy S; Stewart, Andrew L; Raftery-Helmer, Jacquelyn N

2017-10-23

Parental autonomy support has been related to positive adolescent outcomes, however, its relation to outcomes in collectivist cultural groups is unclear. This study examined relations of specific autonomy supportive behaviors and outcomes among 401 adolescents (M age  = 12.87) from the United States (N = 245) and collectivist-oriented Ghana (N = 156). It also examined whether adolescents' self-construals moderated the relations of specific types of autonomy support with outcomes. Factor analyses indicated two types of autonomy support: perspective taking/open exchange and allowance of decision making/choice. In both countries, perspective taking/open exchange predicted positive outcomes, but decision making/choice only did so in the United States. With regard to moderation, the more independent adolescents' self-construals, the stronger the relations of decision making/choice to parental controllingness and school engagement. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Attitudes of Dental Hygienists towards Independent Practice and Professional Autonomy.

PubMed

Catlett, April

2016-08-01

The purpose of this cross-sectional, quantitative research was to examine if registered dental hygienists feel competent to work independently based on regulations of dental supervision. A stratified sample of 360 dental hygienists from 8 states completed the Dempster Practice Behaviors Scale survey. ANOVA and MANOVA analyses revealed how state dentist supervision level, age, degree of education, employment status, gender and years of clinical experience affect the perceived autonomy of professional dental hygienists. The response rate included 360 dental hygienists from 8 states. According to the findings age, education level and gender affected the hygienist's level of autonomy. In all 8 states, the registered dental hygienists have a high level of autonomy and feel competent to work independently. The DPBS scores of the sample registered dental hygienists suggest that they feel prepared and competent to perform preventive dental hygiene services without dentist supervision. The attitudes of the dental hygienist sample from each of the 4 state dentist supervision levels supports a move toward achieving professional jurisdiction of preventive dental care within the U.S. Copyright © 2016 The American Dental Hygienists’ Association.

The Mediating Effect of Intrinsic Motivation to Learn on the Relationship between Student´s Autonomy Support and Vitality and Deep Learning.

PubMed

Núñez, Juan L; León, Jaime

2016-07-18

Self-determination theory has shown that autonomy support in the classroom is associated with an increase of students' intrinsic motivation. Moreover, intrinsic motivation is related with positive outcomes. This study examines the relationships between autonomy support, intrinsic motivation to learn and two motivational consequences, deep learning and vitality. Specifically, the hypotheses were that autonomy support predicts the two types of consequences, and that autonomy support directly and indirectly predicts the vitality and the deep learning through intrinsic motivation to learn. Participants were 276 undergraduate students. The mean age was 21.80 years (SD = 2.94). Structural equation modeling was used to test the relationships between variables and delta method was used to analyze the mediating effect of intrinsic motivation to learn. Results indicated that student perception of autonomy support had a positive effect on deep learning and vitality (p < .001). In addition, these associations were mediated by intrinsic motivation to learn. These findings suggest that teachers are key elements in generating of autonomy support environment to promote intrinsic motivation, deep learning, and vitality in classroom. Educational implications are discussed.

Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life.

PubMed

Dzeng, Elizabeth; Colaianni, Alessandra; Roland, Martin; Chander, Geetanjali; Smith, Thomas J; Kelly, Michael P; Barclay, Stephen; Levine, David

2015-05-01

Controversy exists regarding whether the decision to pursue a do-not-resuscitate (DNR) order should be grounded in an ethic of patient autonomy or in the obligation to act in the patient's best interest (beneficence). To explore how physicians' approaches to DNR decision making at the end of life are shaped by institutional cultures and policies surrounding patient autonomy. We performed semistructured in-depth qualitative interviews of 58 internal medicine physicians from 4 academic medical centers (3 in the United States and 1 in the United Kingdom) by years of experience and medical subspecialty from March 7, 2013, through January 8, 2014. Hospitals were selected based on expected differences in hospital culture and variations in hospital policies regarding prioritization of autonomy vs best interest. This study identified the key influences of institutional culture and policies on physicians' attitudes toward patient autonomy in DNR decision making at the end of life. A hospital's prioritization of autonomy vs best interest as reflected in institutional culture and policy appeared to influence the way that physician trainees conceptualized patient autonomy. This finding may have influenced the degree of choice and recommendations physician trainees were willing to offer regarding DNR decision making. Trainees at hospitals where policies and culture prioritized autonomy-focused approaches appeared to have an unreflective deference to autonomy and felt compelled to offer the choice of resuscitation neutrally in all situations regardless of whether they believed resuscitation to be clinically appropriate. In contrast, trainees at hospitals where policies and culture prioritized best-interest-focused approaches appeared to be more comfortable recommending against resuscitation in situations where survival was unlikely. Experienced physicians at all sites similarly did not exclusively allow their actions to be defined by policies and institutional culture and were willing to make recommendations against resuscitation if they believed it would be futile. Institutional cultures and policies might influence how physician trainees develop their professional attitudes toward autonomy and their willingness to make recommendations regarding the decision to implement a DNR order. A singular focus on autonomy might inadvertently undermine patient care by depriving patients and surrogates of the professional guidance needed to make critical end of life decisions.

ARMD Strategic Thrust 6: Assured Autonomy for Aviation Transformation

NASA Technical Reports Server (NTRS)

Ballin, Mark; Holbrook, Jon; Sharma, Shivanjli

2016-01-01

In collaboration with the external community and other government agencies, NASA will develop enabling technologies, standards, and design guidelines to support cost-effective applications of automation and limited autonomy for individual components of aviation systems. NASA will also provide foundational knowledge and methods to support the next epoch. Research will address issues of verification and validation, operational evaluation, national policy, and societal cost-benefit. Two research and development approaches to aviation autonomy will advance in parallel. The Increasing Autonomy (IA) approach will seek to advance knowledge and technology through incremental increases in machine-based support of existing human-centered tasks, leading to long-term reallocation of functions between humans and machines. The Autonomy as a New Technology (ANT) approach seeks advances by developing technology to achieve goals that are not currently possible using human-centered concepts of operation. IA applications are mission-enhancing, and their selection will be based on benefits achievable relative to existing operations. ANT applications are mission-enabling, and their value will be assessed based on societal benefit resulting from a new capability. The expected demand for small autonomous unmanned aircraft systems (UAS) provides an opportunity for development of ANT applications. Supervisory autonomy may be implemented as an expansion of the number of functions or systems that may be controlled by an individual human operator. Convergent technology approaches, such as the use of electronic flight bags and existing network servers, will be leveraged to the maximum extent possible.

Students' Perceptions of Motivational Climate and Enjoyment in Finnish Physical Education: A Latent Profile Analysis.

PubMed

Jaakkola, Timo; Wang, C K John; Soini, Markus; Liukkonen, Jarmo

2015-09-01

The purpose of this study was to identify student clusters with homogenous profiles in perceptions of task- and ego-involving, autonomy, and social relatedness supporting motivational climate in school physical education. Additionally, we investigated whether different motivational climate groups differed in their enjoyment in PE. Participants of the study were 2 594 girls and 1 803 boys, aged 14-15 years. Students responded to questionnaires assessing their perception of motivational climate and enjoyment in physical education. Latent profile analyses produced a five-cluster solution labeled 1) 'low autonomy, relatedness, task, and moderate ego climate' group', 2) 'low autonomy, relatedness, and high task and ego climate, 3) 'moderate autonomy, relatedness, task and ego climate' group 4) 'high autonomy, relatedness, task, and moderate ego climate' group, and 5) 'high relatedness and task but moderate autonomy and ego climate' group. Analyses of variance showed that students in clusters 4 and 5 perceived the highest level of enjoyment whereas students in cluster 1 experienced the lowest level of enjoyment. The results showed that the students' perceptions of various motivational climates created differential levels of enjoyment in PE classes. Key pointsLatent profile analyses produced a five-cluster solution labeled 1) 'low autonomy, relatedness, task, and moderate ego climate' group', 2) 'low autonomy, relatedness, and high task and ego climate, 3) 'moderate autonomy, relatedness, task and ego climate' group 4) 'high autonomy, relatedness, task, and moderate ego climate' group, and 5) 'high relatedness and task but moderate autonomy and ego climate' group.Analyses of variance showed that clusters 4 and 5 perceived the highest level of enjoyment whereas cluster 1 experienced the lowest level of enjoyment. The results showed that the students' perceptions of motivational climate create differential levels of enjoyment in PE classes.

Women's autonomy in health care decision-making in developing countries: a synthesis of the literature.

PubMed

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women's autonomy in developing countries describe the relationship between women's autonomy and their health care decision-making, and identify sociodemographic factors that influence women's autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women's decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries' national health surveys. Most studies examined women's autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women's health care decision-making autonomy. Gaps in existing literature regarding women's autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance.

Women’s autonomy in health care decision-making in developing countries: a synthesis of the literature

PubMed Central

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women’s autonomy in developing countries describe the relationship between women’s autonomy and their health care decision-making, and identify sociodemographic factors that influence women’s autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women’s decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries’ national health surveys. Most studies examined women’s autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women’s health care decision-making autonomy. Gaps in existing literature regarding women’s autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance. PMID:27354830

Women’s Autonomy and Its Correlates in Western Nepal: A Demographic Study

PubMed Central

Bhandari, Tulsi Ram; Kutty, V. Raman; Ravindran, T. K. Sundari

2016-01-01

Despite various efforts for enhancing women’s autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women’s autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women’s autonomy using a recently developed women’s autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women’s autonomy was 23.34± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple’s education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women’s education (OR = 8.14, CI = 3.77–17.57), husband’s education (OR = 2.63, CI = 1.69–4.10) and economic status of household (OR = 1.42, CI = 1.01–2.03) on women’s autonomy. When we adjusted women’s education for husband’s education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77–17.57) to (OR = 6.32, CI = 2.77–14.46)} and was a mediator effect. The economic status of household also had mediator effect on women’s autonomy through their education. Education status of women is a key predictor of women’s autonomy in Kapilvastu district. Husband’s education and economic status of the household are other important predictors of women’s autonomy which have a mediator effect on women’s autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women’s autonomy. PMID:26799217

Prediction of sport adherence through the influence of autonomy-supportive coaching among spanish adolescent athletes.

PubMed

Almagro, Bartolomé J; Sáenz-López, Pedro; Moreno, Juan A

2010-01-01

The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key pointsImportance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes.Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation.Intrinsic motivation predicted the intention to be physically active in the future.

Prediction of Sport Adherence Through the Influence of Autonomy-Supportive Coaching Among Spanish Adolescent Athletes

PubMed Central

Almagro, Bartolomé J.; Sáenz-López, Pedro; Moreno, Juan A.

2010-01-01

The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key points Importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Intrinsic motivation predicted the intention to be physically active in the future. PMID:24149380

Individual and community levels of maternal autonomy and child undernutrition in India.

PubMed

Rajaram, Ramaprasad; Perkins, Jessica M; Joe, William; Subramanian, S V

2017-03-01

Investigate the relationship between maternal autonomy at multiple levels and the risk of child stunting, underweight, and wasting in India. Data were from a 2005-2006 nationally representative, cross-sectional sample of 51,555 children under 5 years from 29 states in India. Multilevel, multivariable, logistic regression analyses were used to estimate the odds of child stunting, underweight, and wasting in relation to maternal autonomy in healthcare, movement, and money at the individual level and community level, while adjusting for several child, maternal, and household factors. When only adjusting for child age and sex, children in communities with a high proportion of women with autonomy in healthcare, or movement, or money, separately, had a lower risk of being stunted, underweight, or wasted, separately. However, adjusting for other explanatory factors attenuated these relationships and made them statistically insignificant. Individual maternal autonomy in any of the three domains was not associated with any of the outcomes. The results suggest that caution should be taken when interpreting the direct relevance of maternal autonomy at both individual and community levels to measures of child undernutrition.

The Role of Parental Involvement in the Autonomy Development of Traditional-Age College Students

ERIC Educational Resources Information Center

Cullaty, Brian

2011-01-01

Increased parental involvement in higher education has led to a rise in the number of parent interactions with university faculty and staff. The purpose of this study was to explore how parental involvement influences the process of college student autonomy development and to examine the implications of this process for college administrators.…

Reciprocal Associations between Connectedness and Autonomy among Korean Adolescents: Compatible or Antithetical?

ERIC Educational Resources Information Center

Yu, Jeong Jin

2011-01-01

The primary goal of this study was to examine the longitudinal reciprocal relationships between connectedness to parents and autonomy among Korean adolescents using five annual waves of the Korea Youth Panel Survey. The sample consisted of 3,449 adolescents, whose mean age was 13.79 years at Wave 1. Contrary to the mainstream findings in…

Ethical dimensions of quality of life in aging: autonomy vs. collectivism in the United States and Canada.

PubMed

Clark, P G

1991-10-01

Ethical concepts lie at the core of how quality of life in aging is defined and enhanced. Although recent American attention has been largely focused on autonomy as an important value for quality of life in old age, there is real danger in emphasizing personal independence at the expense of community or collectivism. This conceptual analysis compares and contrasts these value orientations in the U.S. and Canada and examines their relationship to the concept of quality of life in aging. It also explores implications of the analysis for expanding our understanding of the importance of value dimensions in comparative gerontology, and suggests ways of integrating individualistic and collectivistic ideals in gerontological policies and programs.

Autonomous System Technologies for Resilient Airspace Operations

NASA Technical Reports Server (NTRS)

Houston, Vincent E.; Le Vie, Lisa R.

2017-01-01

Increasing autonomous systems within the aircraft cockpit begins with an effort to understand what autonomy is and developing the technology that encompasses it. Autonomy allows an agent, human or machine, to act independently within a circumscribed set of goals; delegating responsibility to the agent(s) to achieve overall system objective(s). Increasingly Autonomous Systems (IAS) are the highly sophisticated progression of current automated systems toward full autonomy. Working in concert with humans, these types of technologies are expected to improve the safety, reliability, costs, and operational efficiency of aviation. IAS implementation is imminent, which makes the development and the proper performance of such technologies, with respect to cockpit operation efficiency, the management of air traffic and data communication information, vital. A prototype IAS agent that attempts to optimize the identification and distribution of "relevant" air traffic data to be utilized by human crews during complex airspace operations has been developed.

The role of individual differences in particular autonomy-connectedness in women's and men's work-family balance.

PubMed

Bekker, Marrie H J; Willemse, Jolanda J P; De Goeij, Jacqueline W J M

2010-05-01

Individual differences are increasingly considered important in the relationship between work-family balance and health. The present study examined the role of autonomy-connectedness in positive and negative work-family interaction and family-work interaction. We also investigated the relationship of work-family interaction and family-work interaction with positive and negative affect, coping patterns, and demographic characteristics. All variables under study were measured with questionnaires in a Dutch sample of 205 respondents. As expected, the individual difference factors were substantially associated with work-family interaction and family-work interaction; together they accounted for 10 to 39% of their variance. In particular, negative affect and the autonomy-connectedness components Sensitivity to others and Capacity for managing new situations appeared to be strongly related to work-family interactions. Health implications of the findings are discussed and recommendations for further research are presented.

Autonomy and social functioning of recently admitted nursing home residents.

PubMed

Paque, Kristel; Goossens, Katrien; Elseviers, Monique; Van Bogaert, Peter; Dilles, Tinne

2017-09-01

This paper examines recently admitted nursing home residents' practical autonomy, their remaining social environment and their social functioning. In a cross-sectional design, 391 newly admitted residents of 67 nursing homes participated. All respondents were ≥65 years old, had mini-mental state examination ≥18 and were living in the nursing home for at least 1 month. Data were collected using a structured questionnaire and validated measuring tools. The mean age was 84, 64% were female, 23% had a partner, 80% children, 75% grandchildren and 59% siblings. The mean social functioning score was 3/9 (or 33%) and the autonomy and importance of autonomy score 6/9 (or 67%). More autonomy was observed when residents could perform activities of daily living more independently, and cognitive functioning, quality of life and social functioning were high. Residents with depressive feelings scored lower on autonomy and social functioning compared to those without depressive feelings. Having siblings and the frequency of visits positively correlated with social functioning. In turn, social functioning correlated positively with quality of life. Moreover, a higher score on social functioning lowered the probability of depression. Autonomy or self-determination and maintaining remaining social relationships were considered to be important by the new residents. The remaining social environment, social functioning, quality of life, autonomy and depressive feelings influenced each other, but the cause--effect relation was not clear.

When Opportunity Knocks Twice: Dual Living Kidney Donation, Autonomy and the Public Interest.

PubMed

Bailey, Phillippa; Huxtable, Richard

2016-02-01

Living kidney transplantation offers the best treatment in terms of life-expectancy and quality of life for those with end-stage renal disease. The long-term risks of living donor nephrectomy, although real, are very small, with evidence of good medium-term outcomes. Who should be entitled to donate, and in which circumstances, is nevertheless a live question. We explore the ethical dimensions of a request by an individual to donate both of their kidneys during life: 'dual living kidney donation'. Our ethical analysis is tethered to a hypothetical case study in which a father asks to donate a kidney to each of his twin boys. We explore the autonomy of the protagonists, alongside different dimensions of the public interest, such as the need to protect not only the recipients, but also the donor and even the wider community. Whilst acknowledging objections to 'dual-donation', not least by reference to the harms that the donor might be expected to endure, we suggest there is a prima facie case for permitting this, provided that both donor and recipients are willing and that due attention is paid to such considerations as the autonomy and welfare of all parties, as well as to the wider ramifications of acting on such a request. We argue for broader interpretations of the concepts of autonomy and welfare, recognizing the importance of relationships and the relevance of more than merely physical well-being. Equipped with such a holistic assessment, we suggest there is a prima facie case for allowing 'dual living kidney donation'. © 2015 The Authors. Bioethics Published by John Wiley & Sons Ltd.

Expert consensus of general surgery residents' proficiency with common endocrine operations.

PubMed

Phitayakorn, Roy; Kelz, Rachel R; Petrusa, Emil; Sippel, Rebecca S; Sturgeon, Cord; Patel, Kepal N; Perrier, Nancy D

2017-01-01

Proficiency with common endocrine operations is expected of graduating, general surgery residents. However, no expert consensus guidelines exist about these expectations. Members of the American Association of Endocrine Surgeons were surveyed about their opinions on resident proficiency with common endocrine operations. Overall response rate was 38%. A total of 92% of the respondents operate with residents. On average, they believed that the steps of a total thyroidectomy for benign disease and a well-localized parathyroidectomy could be performed by a postgraduate year 4 surgery resident. Specific steps that they thought might require more training included decisions to divide the strap muscles or leaving a drain. Approximately 66% of respondents thought that a postgraduate year 5 surgery resident could independently perform a total thyroidectomy for benign disease, but only 45% felt similarly for malignant thyroid disease; 79% thought that a postgraduate year 5 surgery resident could independently perform a parathyroidectomy. Respondents' years of experience correlated with their opinions about resident autonomy for total thyroidectomy (benign r = 0.38, P < .001; malignant r = 0.29, P = .001) but not parathyroidectomy. On multivariate analysis, sex and years of experience of the respondents were independently associated with opinions on autonomy but only for total thyroidectomy for benign disease (P = .001). Annual endocrine volume of the respondents did not correlate with beliefs in autonomy. There was general agreement among responding members of the AAES about resident proficiency and autonomy with common endocrine operations. As postgraduate year 5 residents may not be proficient in advanced endocrine operations, opportunities exist to improve training prior to the transition to independent practice for graduates that anticipate performing endocrine operations routinely. Copyright © 2016 Elsevier Inc. All rights reserved.

Is Parenting Associated with Teenagers' Early Sexual Risk-Taking, Autonomy And Relationship with Sexual Partners?

PubMed Central

Parkes, Alison; Henderson, Marion; Wight, Daniel; Nixon, Catherine

2011-01-01

CONTEXT: Extensive research has explored the relationship between parenting and teenagers’ sexual risk-taking. Whether parenting is associated with wider aspects of teenagers’ capacity to form satisfying sexual relationships is unknown. METHODS: Self-reported data were collected in 2007 from 1,854 students, whose average age was 15.5 years, in central Scotland. Multivariate analyses examined associations between parenting processes and sexual outcomes (delayed first intercourse, condom use and several measures reflecting the context or anticipated context of first sex). RESULTS: Parental supportiveness was positively associated with all outcomes (betas, 0.1–0.4), and parental values restricting intercourse were positively associated with all outcomes except condom use (0.1–0.5). Parental monitoring was associated only with delayed intercourse (0.2) and condom use (0.2); parental rules about TV content were associated with delayed intercourse (0.7) and expecting sex in a relationship, rather than casually (0.8). Frequency of parental communication about sex and parental values endorsing contraceptive use were negatively associated with teenagers’ delayed intercourse (–0.5 and –0.3, respectively), and parents’ contraceptive values were negatively associated with teenagers’ expecting sex in a relationship (–0.5). Associations were partly mediated by teenagers’ attitudes, including value placed on having sex in a relationship. CONCLUSIONS: Parents may develop teenagers’ capacity for positive and safe early sex by promoting skills and values that build autonomy and encourage sex only within a relationship. Interventions should promote supportive parenting and transmission of values, avoid mixed messages about abstinence and contraception, and acknowledge that teenagers may learn more indirectly than directly from parents about sex. PMID:21388503

The Effects of Feedback Valence and Style on Need Satisfaction, Self-Talk, and Perseverance Among Tennis Players: An Experimental Study.

PubMed

De Muynck, Gert-Jan; Vansteenkiste, Maarten; Delrue, Jochen; Aelterman, Nathalie; Haerens, Leen; Soenens, Bart

2017-02-01

Grounded in self-determination theory, this experimental study examined whether the valence (i.e., positive vs. negative) and style (i.e., autonomy-supportive vs. controlling) of normative feedback impact the self-talk, motivational experiences (i.e., psychological need satisfaction and enjoyment), and behavioral functioning (i.e., perseverance and performance) of tennis players (N = 120; M age  = 24.50 ± 9.86 years). Positive feedback and an autonomy-supportive style positively influenced players' enjoyment and perseverance, with psychological need satisfaction and self-talk playing an intervening role. While positive feedback yielded its beneficial effect via greater competence satisfaction and decreased negative self-talk, the beneficial impact of an autonomy-supportive communication style was explained via greater autonomy satisfaction.

Effects of teacher autonomy support and students' autonomous motivation on learning in physical education.

PubMed

Shen, Bo; McCaughtry, Nate; Martin, Jeffrey; Fahlman, Mariane

2009-03-01

This study applied self-determination theory to investigate the effects of students' autonomous motivation and their perceptions of teacher autonomy support on need satisfaction adjustment, learning achievement, and cardiorespiratory fitness over a 4-month personal conditioning unit. Participants were 253 urban adolescents (121 girls and 132 boys, ages = 12-14 years). Based on a series of multiple regression analyses, perceived autonomy support by teachers significantly predicted students'need satisfaction adjustment and led to learning achievement, especially for students who were not autonomously motivated to learn in physical education. In turn, being more autonomous was directly associated with cardiorespiratory fitness enhancement. The findings suggest that shifts in teaching approaches toward providing more support for students' autonomy and active involvement hold promise for enhancing learning.

Cultivating Conformists or Raising Rebels? Connecting Parental Control and Autonomy Support to Adolescent Delinquency.

PubMed

Brauer, Jonathan R

2017-06-01

This study investigates short-term and long-term associations between parenting in early adolescence and delinquency throughout adolescence using data from the National Longitudinal Surveys. Multilevel longitudinal Poisson regressions show that behavioral control, psychological control, and decision-making autonomy in early adolescence (ages 10-11) are associated with delinquency trajectories throughout adolescence (ages 10-17). Path analyses reveal support for three mediation hypotheses. Parental monitoring (behavioral control) is negatively associated with delinquency in the short term and operates partly through changes in self-control. Parental pressure (psychological control) shows immediate and long-lasting associations with delinquency through changes in self-control and delinquent peer pressures. Decision-making autonomy is negatively associated with delinquency in the long term, yet may exacerbate delinquency in early adolescence by increasing exposure to delinquent peers. © 2016 The Author. Journal of Research on Adolescence © 2016 Society for Research on Adolescence.

From isolation and dependence to autonomy - expectations before and experiences after cochlear implantation in adult cochlear implant users and their significant others.

PubMed

Mäki-Torkko, Elina Margareetta; Vestergren, Sara; Harder, Henrik; Lyxell, Björn

2015-01-01

The aim of the study was to examine pre-operative expectations and the post-operative experiences related to cochlear implants (CI) in CI-users and their significant others. A questionnaire was used and the responses were analysed by means of The Qualitative Content Analysis. All adults implanted between 1992 and 2010, who had had their implants for a minimum of 12 months (n = 120) were contacted. Response rate was high (90.8%), and all-inclusive answers were received from 101 CI-users (84.2%). The overall sense of increased well-being and life satisfaction was described as having lived in two different worlds, one with the auditory stimulation and one without. In the overall sense of increased well-being and satisfaction three interwoven subcategories, alienation - normality, fear - autonomy, and living a social life emerged. When CI-users and their significant others recalled the time prior to receiving the CI, a sense of fear was present with origins in the concern for the respondents' (CI-users) ability to cope and care independently in society. Conversely, after the implantation both parties emphasized the notion of a distinct transformation within the CI-user towards autonomy. Communication was highlighted as a large part of living social life. The CI increases well-being and satisfaction for both CI-users and their significant others, which is especially evident regarding enhanced autonomy, normality and living social life. Before implantation it is important to discuss the fact that phone calls and listening to music are improvement expectations that might not be met by the CI. The perceived life changes affect the lives of both the CI-users and the significant others, a finding important to take into consideration before implantation and during rehabilitation after the implantation. Before implantation it is important to inform both CI-recipients and significant others about the length of time required to be able to hear selectively after the implantation and about past experiences of CI-users.

Cultural differences in the relationships among autonomy support, psychological need satisfaction, subjective vitality, and effort in British and Chinese physical education.

PubMed

Taylor, Ian M; Lonsdale, Chris

2010-10-01

Using basic psychological needs theory (BPNT; Ryan & Deci, 2000) as our guiding framework, we explored cultural differences in the relationships among physical education students' perceptions of teacher autonomy support, psychological need satisfaction, subjective vitality and effort in class. Seven hundred and fifteen students (age range from 13 to 15 years) from the U.K. and Hong Kong, China, completed a multisection inventory during a timetabled physical education class. Multilevel analyses revealed that the relationships among autonomy support, subjective vitality and effort were mediated by students' perceptions of psychological need satisfaction. The relationship between autonomy support and perceptions of competence was stronger in the Chinese sample, compared with the U.K. sample. In addition, the relationship between perceptions of relatedness and effort was not significant in the Chinese students. The findings generally support the pan-cultural utility of BPNT and imply that a teacher-created autonomy supportive environment may promote positive student experiences in both cultures.

Level of autonomy of primary care nurse practitioners.

PubMed

Bahadori, Alex; Fitzpatrick, Joyce J

2009-09-01

The purpose of this descriptive study was to determine the level of autonomy of nurse practitioners (NPs) providing care to patients in a primary care setting. Data were collected from 48 primary care NPs (PCNPs) who attended a state clinical conference. The Dempster Practice Behavior Scale (DPBS) was used to measure the autonomy of the NPs. The total mean score for the DPBS in this study was 127 (SD = 10.25), indicating a very high level of autonomy of the NPs. The Empowerment subscale had the lowest overall mean score, and the Valuation subscale had the highest. There was no statistically significant relationship between level of autonomy and age, years worked as an RN, and years worked as an NP. This study provided evidence that PCNPs are highly autonomous professionals and continue to struggle with empowerment. NPs educationally prepared with a better knowledge of legal and political issues will be better suited to influence healthcare reform. NPs, as autonomous professionals, will be more likely to impact and shape future healthcare policy.

Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors.

PubMed

Amini, Kourosh; Negarandeh, Reza; Ramezani-Badr, Farhad; Moosaeifard, Mahdi; Fallah, Ramezan

2015-02-01

This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy. © 2013 Wiley Publishing Asia Pty Ltd.

Children's Daily Well-Being: The Role of Mothers', Teachers', and Siblings' Autonomy Support and Psychological Control

ERIC Educational Resources Information Center

van der Kaap-Deeder, Jolene; Vansteenkiste, Maarten; Soenens, Bart; Mabbe, Elien

2017-01-01

This study examined the unique relations between multiple sources (i.e., mothers, teachers, and siblings) of perceived daily autonomy support and psychological control and children's basic psychological needs and well-being. During 5 consecutive days, 2 children from 154 families (M[subscript age] youngest child = 8.54 years; SD = 0.89 and…

Autonomy Support and Structure Enhance Children's Memory and Motivation to Reminisce: A Parental Training Study

ERIC Educational Resources Information Center

Cleveland, Emily Sutcliffe; Morris, Ashley

2014-01-01

Thirty parents observed their preschoolers (M [subscript age] = 4;2) experience a standardized laboratory event and discussed the event with their child later that day. Children's memory for this event was subsequently tested at two delay intervals. Prior to the laboratory event, parents were randomly assigned to receive either autonomy-support…

Self-Perceived Participation and Autonomy at 1-Year Post Stroke: A Part of the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT Study).

PubMed

Törnbom, Karin; Hadartz, Kristin; Sunnerhagen, Katharina S

2018-04-01

Identifying factors predicting the long-term outcome of participation and autonomy after stroke is essential for developing individualized rehabilitation interventions. The aim was to describe self-assessed participation and autonomy and to explore factors associated with the same at 1 year post stroke. Participants consisted of 79 persons (mean age = 67) with a first-time stroke at the 1-year follow-up. To investigate perceived participation and autonomy at 1 year, a self-assessment questionnaire, the Impact on Participation and Autonomy-English version (IPA-E) was used. Multivariate logistic regression models were performed using age, gender, stroke severity, and functional dependency at discharge as potential contributors to the perceived level of participation and autonomy. A high percentage (70%-88%) evaluated their functions as fair to very good within all domains of the IPA-E at 1 year post stroke. However, around a fifth experienced their Family role as poor to very poor. Participants' functional dependency at discharge significantly influenced the outcome for the domains of Family role (odds ratio [OR] = 5.66, P < .01), Social relations (OR = 3.23, P < .03), and Autonomy indoors (OR = 3.44, P < .04) at 1 year post stroke. Aspects of the Family role domain deserve further attention in interventions aimed at improving participation and autonomy at 1 year post stroke. The results also indicate that supporting indoor autonomy and social relations of persons with stroke during the acute rehabilitation is important to enhance participation and autonomy at 1 year post stroke. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Effects of autonomy-supportive and controlling styles on situational self-determined motivation: some unexpected results of the commitment procedure.

PubMed

Amoura, Camille; Berjot, Sophie; Gillet, Nicolas; Caruana, Sylvain; Finez, Lucie

2015-02-01

Distinct and simultaneous effects of autonomy-supportive and controlling styles, usually considered as mutually exclusive, on situational self-determined motivation are tested. In Study 1, economics students (N = 100; 57 men, 43 women; M age = 21.5 yr.) were randomly assigned to one of the four experimental conditions (high vs. low) of autonomy supportive and/or controlling behaviors during a task. Results supported the independence of those constructs. An unexpected effect in regards to Self-determination Theory was found in the Low autonomy - High control condition in which self-determined motivation was observed. The interpretation for this specific condition, an effect due to the attempt to reduce cognitive dissonance triggered by the commitment procedure, was tested. In Study 2, sport students (N = 80, 44 men, 36 women; M age = 19.2 yr.) were randomly assigned to one of the three experimental conditions: No commitment, Commitment plus self-affirmation, and Commitment without self-affirmation. Results supported Study 1's interpretation: motivation was lower when participants were recruited without a commitment procedure or when they were invited to self-affirm than when participants recruited with a commitment procedure.

Achieving fertility control through woman’s autonomy and access to maternal healthcare: Are we on track? In-depth analysis of PDHS-2012-13

PubMed Central

Hassan, Sehar-un-Nisa; Siddiqui, Salma; Mahmood, Ayeshah

2015-01-01

Background and Objective: Fertility control preferences and maternal healthcare have recently become a major concern for developing nations with evidence suggesting that low fertility control rates and poor maternal healthcare are among major obstructions in ensuring health and social status for women. Our objective was toanalyze the factors that influence women’s autonomy, access to maternal healthcare, and fertility control preferences in Pakistan. Methods: Data consisted of 11,761 ever-married women of ages 15-49 years from PDHS, 2012-13. Variables included socio-demographics, women’s autonomy, fertility control preferences and access to maternal healthcare. Results: Findings from multivariate analysis showed that women’s younger age, having less than three number of children and independent or joint decision-making (indicators of high autonomy) remained the most significant predictors for access to better quality maternal healthcare and better fertility control preferences when other variables were controlled. Conclusion: Women’s access to good quality maternal health care and fertility control preferences are directly and indirectly influenced by their demographic characteristics and decision-making patterns in domestic affairs. PMID:26870096

Negotiating care: ties between aging mothers and their caregiving daughters.

PubMed

McGraw, Lori A; Walker, Alexis J

2004-11-01

Using a feminist social constructionist perspective, we illuminate how aging mothers and their caregiving daughters negotiate issues of connection, autonomy, and conflict. We conducted a qualitative analysis of videotaped interactions between 31 White mother-daughter pairs. We found that the mothers and daughters mostly (a) were attentive and responsive, (b) preserved mothers' autonomy, and (c) minimized open conflict and tension. Subtle behavioral cues visible on the videotapes also exposed underlying emotional tension in these relationships. These cues alerted us to important variation in relationship quality among the pairs. Three patterns of relating emerged: (a) symmetrically connected, (b) asymmetrically connected, and (c) symmetrically constrained. Our exploratory study suggests that a balance between autonomy and connection is fundamental to the success of these mother-daughter caregiving relationships. Not only is it important for frail mothers to be responsive to their caregiving daughter's needs, but also it is important for daughters to support the autonomy and independence of their mothers. Our study also highlights the importance of attentiveness in these relationships. Even when mothers, because of illness and frailty, were less capable of attending to their daughters' lives, daughters in connected pairs interacted with their mothers in attentive ways. In constrained pairs, neither intergenerational partner was attentive.

Toward increased autonomy in the surgical OR: needs, requests, and expectations.

PubMed

Kranzfelder, Michael; Staub, Christoph; Fiolka, Adam; Schneider, Armin; Gillen, Sonja; Wilhelm, Dirk; Friess, Helmut; Knoll, Alois; Feussner, Hubertus

2013-05-01

The current trend in surgery toward further trauma reduction inevitably leads to increased technological complexity. It must be assumed that this situation will not stay under the sole control of surgeons; mechanical systems will assist them. Certain segments of the work flow will likely have to be taken over by a machine in an automatized or autonomous mode. In addition to the analysis of our own surgical practice, a literature search of the Medline database was performed to identify important aspects, methods, and technologies for increased operating room (OR) autonomy. Robotic surgical systems can help to increase OR autonomy by camera control, application of intelligent instruments, and even accomplishment of automated surgical procedures. However, the important step from simple task execution to autonomous decision making is difficult to realize. Another important aspect is the adaption of the general technical OR environment. This includes adaptive OR setting and context-adaptive interfaces, automated tool arrangement, and optimal visualization. Finally, integration of peri- and intraoperative data consisting of electronic patient record, OR documentation and logistics, medical imaging, and patient surveillance data could increase autonomy. To gain autonomy in the OR, a variety of assistance systems and methodologies need to be incorporated that endorse the surgeon autonomously as a first step toward the vision of cognitive surgery. Thus, we require establishment of model-based surgery and integration of procedural tasks. Structured knowledge is therefore indispensable.

Intimate Partner Violence, Sexual Autonomy and Postpartum STD Prevention Among Young Couples: A Mediation Analysis.

PubMed

Willie, Tiara C; Callands, Tamora A; Kershaw, Trace S

2018-03-01

The transition to parenthood is a stressful time for young couples and can put them at risk for acquiring STDs. Mechanisms underlying this risk-particularly, intimate partner violence (IPV) and sexual autonomy-have not been well studied. Between 2007 and 2011, a prospective cohort study of the relationships and health of pregnant adolescents and their male partners recruited 296 couples at four hospital-based obstetrics and gynecology clinics in the U.S. Northeast; participants were followed up six and 12 months after the birth. Structural equation modeling identified associations among IPV at baseline and six months, sexual autonomy at six months and STD acquisition at 12 months. Mediating effects of sexual autonomy were tested via bootstrapping. Females were aged 14-21, and male partners were 14 or older. For females, IPV victimization at baseline was positively associated with the likelihood of acquiring a postpartum STD (coefficient, 0.4); level of sexual autonomy was inversely associated with the likelihood of acquiring an STD and of having a male partner who acquired one by the 12-month follow-up (-0.4 for each). For males, IPV victimization at baseline was negatively correlated with a female partner's sexual autonomy (-0.3) and likelihood of acquiring an STD (-0.7); victimization at six months was positively related to a partner's sexual autonomy (0.2). Sexual autonomy did not mediate these relationships. Females' sexual autonomy appears to protect against postpartum STDs for both partners. Future research should explore the efficacy of IPV-informed approaches to improving women's sexual and reproductive health. Copyright © 2018 by the Guttmacher Institute.

Parent training education program: a pilot study, involving families of children with Prader-Willi syndrome.

PubMed

Kodra, Yllka; Kondili, Loreta A; Ferraroni, Alessia; Serra, Maria Antonietta; Caretto, Flavia; Ricci, Maria Antonietta; Taruscio, Domenica

2016-01-01

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by severe hypotonia during the neonatal period and the first two years of life, the onset of hyperphagia with a risk of obesity during infancy and adulthood, learning difficulties and behavioral or severe psychiatric problems. This complex disease has severe consequences and difficult management issues also for patients' families. Parents of children with PWS need appropriate psychoeducational intervention in order to better manage their children with PWS. The purpose of this study was the implementation and evaluation of a PWS psychoeducational parent training program. The Italian National Center for Rare Diseases implemented a pilot parent training program offered to parents of children with PWS. The intervention's effects was evaluated using questionnaires comprised of 11 items rated on a 7 point Likert scale. The intervention was offered to 43 parents. The behavior problems management, dietary restrictions, autonomy and relationships were indicated by parents as the priority topics which needed to be addressed. Evaluations, immediately post-intervention and after 6 months, were reported by parents, fulfilling specific questionnaires. 90% of parents involved in the study, appreciated the methodology, 86% felt more informed about PWS, 47-62% felt more capable to better approach behaviour's problems, 20-25% felt better about the child's health situation and future expectations. Feeling more capable to help the child autonomy and relationships were reported in 62% and 63% of parents respectively, which decreased significantly (p < 0.05) according to the evaluation 6 months after the intervention. Younger age of parents (< 44 years of age) was significantly correlated with better understanding on how to help the child's autonomy (OR: 0.05; CI: 0.04-0.8) and to better collaborate with the child's teachers (OR: 0.02; CI: 0.001-0.9). Parent training is a promising intervention for parents of children with behavior's problems. Interventions with a behaviorally oriented program, addressed to parents of PWS affected children, is a useful tool in increasing their ability to manage the problems related to the disease.

"Saying no is no easy matter" A qualitative study of competing concerns in rationing decisions in general practice

PubMed Central

Carlsen, Benedicte; Norheim, Ole Frithjof

2005-01-01

Background The general practitioner in Norway is expected to ensure equity and effectiveness through fair rationing. At the same time, due to recent reforms of the Norwegian health care sector, both the role of economic incentives and patient autonomy have been strengthened. Studies indicate that modern general practitioners, both in Norway and in other countries are uncomfortable with the gatekeeper role, but there is little knowledge about how general practitioners experience rationing in practice. Methods Through focus group interviews with Norwegian general practitioners, we explore physicians' attitudes toward factors of influence on medical decision making and how rationing dilemmas are experienced in everyday practice. Results Four major concerns appeared in the group discussions: The obligation to ration health care, professional autonomy, patient autonomy, and competition. A central finding was that the physicians find rationing difficult because saying no in face to face relations often is felt uncomfortable and in conflict with other important objectives for the general practitioner. Conclusion It is important to understand the association between using economic incentives in the management of health care, increasing patient autonomy, and the willingness among physicians to contribute to efficient, fair and legitimate resource allocation. PMID:16281967

Operationalizing multimorbidity and autonomy for health services research in aging populations - the OMAHA study

PubMed Central

2011-01-01

Background As part of a Berlin-based research consortium on health in old age, the OMAHA (Operationalizing Multimorbidity and Autonomy for Health Services Research in Aging Populations) study aims to develop a conceptual framework and a set of standardized instruments and indicators for continuous monitoring of multimorbidity and associated health care needs in the population 65 years and older. Methods/Design OMAHA is a longitudinal epidemiological study including a comprehensive assessment at baseline and at 12-month follow-up as well as brief intermediate telephone interviews at 6 and 18 months. In order to evaluate different sampling procedures and modes of data collection, the study is conducted in two different population-based samples of men and women aged 65 years and older. A geographically defined sample was recruited from an age and sex stratified random sample from the register of residents in Berlin-Mitte (Berlin OMAHA study cohort, n = 299) for assessment by face-to-face interview and examination. A larger nationwide sample (German OMAHA study cohort, n = 730) was recruited for assessment by telephone interview among participants in previous German Telephone Health Surveys. In both cohorts, we successfully applied a multi-dimensional set of instruments to assess multimorbidity, functional disability in daily life, autonomy, quality of life (QoL), health care services utilization, personal and social resources as well as socio-demographic and biographical context variables. Response rates considerably varied between the Berlin and German OMAHA study cohorts (22.8% vs. 59.7%), whereas completeness of follow-up at month 12 was comparably high in both cohorts (82.9% vs. 81.2%). Discussion The OMAHA study offers a wide spectrum of data concerning health, functioning, social involvement, psychological well-being, and cognitive capacity in community-dwelling older people in Germany. Results from the study will add to methodological and content-specific discourses on human resources for maintaining quality of life and autonomy throughout old age, even in the face of multiple health complaints. PMID:21352521

Education and Reproductive Autonomy: The Case of Married Nigerian Women.

PubMed

Princewill, Chitu Womehoma; De Clercq, Eva; Riecher-Rössler, Anita; Jegede, Ayodele Samuel; Wangmo, Tenzin; Elger, Bernice Simone

2017-01-01

In this article, we examine the influence of education on the exercise of married women's reproductive autonomy. We carried out 34 in-depth interviews (IDIs) with purposively sampled married Ikwerre women in Rivers State, Nigeria. The participants were between the ages of 22 and 60, had different educational backgrounds, and were in monogamous and polygynous marriages. Data were analyzed using MAXQDA 11 software. We found that although formal education enhanced women's ability to exercise reproductive autonomy, the culture of demanding absolute respect for men remains a major barrier. Formal education provides women with the knowledge that they need in order to access adequate health services for themselves and their children. Participants also believed that educating men was critical for the exercise of women's reproductive autonomy. The cultural aspects that promote female subordination and patriarchy should be addressed more openly in Nigeria.

Child Schooling in Ethiopia: The Role of Maternal Autonomy.

PubMed

Gebremedhin, Tesfaye Alemayehu; Mohanty, Itismita

2016-01-01

This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population.

Older kidney transplantation candidates' expectations of improvement in life and health following kidney transplantation: semistructured interviews with enlisted dialysis patients aged 65 years and older.

PubMed

Lønning, Kjersti; Midtvedt, Karsten; Heldal, Kristian; Andersen, Marit Helen

2018-06-22

The aim was to study the expectations of improvement in life and health following kidney transplantation (KTx) in a population of wait-listed patients ≥65 years with end-stage kidney disease. Qualitative research with individual in-depth interviews. Patients on dialysis enlisted for a KTx from a deceased donor were included from an ongoing study of older patients' perspectives on KTx. Qualitative face-to-face interviews were conducted in a safe and familiar setting, and were analysed thematically using the theoretical framework of lifespan. Fifteen patients (median age 70 years, range 65-82) from all parts of Norway were interviewed. Informants were included consecutively until no new information was gained. Two main themes were evident: receiving a kidney is getting life back and grasp the chance. In addition, the themes 'hard to loose capacity and strength', 'reduced freedom' and 'life on hold' described the actual situation and thereby illuminated the informants' expectations. The informants tried to balance positive expectations and realism towards KTx, and they were hoping to become free from dialysis and to live a normal life. This study shows that older KTx candidates comprise a heterogeneous group of patients who take individual approaches that allow them to maintain autonomy and control while waiting for a transplant. This study provides new knowledge about the older KTx candidates relevant for clinicians, patients and researchers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Longitudinal Associations of Autonomy, Relatedness, and Competence with the Well-being of Nursing Home Residents.

PubMed

Kloos, Noortje; Trompetter, Hester R; Bohlmeijer, Ernst T; Westerhof, Gerben J

2018-02-24

As proposed by the self-determination theory, satisfying nursing home residents' needs for autonomy, relatedness, and competence may improve their well-being. This is the first study to test the longitudinal relations of the satisfaction of these three basic psychological needs to the subjective well-being of nursing home residents and to determine whether a balance among the satisfaction of the three needs is important for well-being. Participants in this longitudinal survey study included 128 physically frail residents (mean age 85 years) at four Dutch nursing homes. Satisfaction of the three basic psychological needs was measured at baseline, and depressive feelings and life satisfaction 5-8 months later. Absolute differences between the three basic need satisfaction scores were summed to create a score of need satisfaction balance. All three needs were related to both well-being measures over time, although autonomy had the strongest relationships. Only autonomy and competence were uniquely associated with depressive feelings, and only autonomy was uniquely associated with life satisfaction. The need satisfaction balance score was related to well-being independent of the autonomy and relatedness scores. These results confirm that all three basic psychological needs are important for nursing home residents' well-being, with autonomy having the strongest and most consistent relationship to their well-being. Additionally, high satisfaction of one need does not compensate for low satisfaction of another. Supporting residents' needs for autonomy, relatedness, and competence should, therefore, have a central role in nursing home culture-change interventions.

Discrepancies in Autonomy and Relatedness Promoting Behaviors of Substance Using Mothers and Their Children: The Effects of a Family Systems Intervention.

PubMed

Zhang, Jing; Slesnick, Natasha

2017-03-01

Parents' and children's autonomy and relatedness behaviors are associated with a wide range of child outcomes. Yet, little is known about how parents and children's autonomy and relatedness behaviors jointly influence child outcomes. The current study captured this joint influence by exploring the longitudinal trajectory of mother-child discrepancies in autonomy and relatedness behaviors and its association with child problem behaviors. The effects of a family systems intervention on the trajectory of mother-child discrepancies were also examined. The sample included 183 substance using mothers and their children (M age = 11.54 years, SD = 2.55, range 8-16; 48 % females). Both the mother and child completed an assessment at baseline, 6- and 18-month post-baseline. A person-centered analysis identified subgroups varying in mother-child discrepancy patterns in their autonomy and relatedness behaviors. The results also showed that participation in the family systems therapy was associated with decreased mother-child discrepancies, and also a synchronous increase in mother's and child's autonomy and relatedness. Additionally, increased mother-child discrepancies and mother-child dyads showing no change in autonomy and relatedness was associated with higher levels of children's problem behaviors. The findings reveal a dynamic process of mother-child discrepancies in autonomy and relatedness behaviors related to child outcomes. The findings also support the effectiveness of the family systems therapy, and highlight the importance of understanding the complexities in family interactions when explaining children's problem behaviors.

Teacher Burnout.

ERIC Educational Resources Information Center

USA Today, 1985

1985-01-01

Teacher burnout is characterized by three factors: emotional exhaustion and fatigue; negative, cynical attitudes towards students; and the loss of feelings of accomplishment on the job. Important predictors of burnout include a lack of participation in decision-making, inappropriate job expectations, a lack of teacher autonomy, and role conflict.…

Correlates of preferences for autonomy in long-term care: results of a population-based survey among older individuals in Germany.

PubMed

Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

2018-01-01

Thus far, there is little evidence concerning the factors associated with preferences for autonomy in long-term care. Therefore, the aim of the present study was to investigate the correlates of preferences for autonomy in long-term care among older individuals in Germany. Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006). Multiple logistic regressions revealed that preferences for freedom of choice for foods were positively associated with living with partner or spouse (OR: 1.5 [1.0-2.2]), being born in Germany (OR: 1.9 [1.1-3.3]), and lower self-rated health (OR: 1.3 [1.1-1.6]). Preferences for freedom in choosing bedtime and sleep duration were positively associated with lower age (OR: 1.1 [1.0-1.1]) and having children (OR: 2.2 [1.0-4.9]). Preferences for customized living space were positively associated with being female (OR: 2.5 [1.4-4.5]) and being born in Germany (OR: 3.7 [1.9-7.1]). Neither preferences for decent and sanitary housing nor preferences for shared decision-making were associated with any of the independent variables. Various independent variables were associated with preferences for autonomy in long-term care. This suggests that preferences for care-related autonomy are complex. Knowing these might help refine long-term care health services.

[Dependency: possible risk or inevitable outcome?].

PubMed

Michel, J P; Kressig, R; Gold, G

1997-10-25

This is the burning issue of the hour. In attempting to resolve it within the context of advanced age, it is important to clarify the meaning of the words involved: Independence and autonomy are far from being synonyms. Independence refers to the ability to perform physical activities of daily living (bathing, eating, preparing meals, shopping, money management), whereas the second word, autonomy, refers more to the ability to make decisions, to reason, to express an appropriate opinion in a given situation. Hazard and inevitability are totally at variance. Hazard implies the likelihood of occurrence of an event harmful to health, or to the length or quality of life. Hazard is more or less predictable, whereas inevitability is the expression of a supernatural power controlling all events. To find out whether "dependency is a hazard or an inevitability", it is necessary to conduct a historical review of the extension in human longevity and in particular of the current "weight" of aging both on individuals and on society at large. In Geneva, the proportion of the over 65-year-olds grew from 5.1 percent in 1880 to 13.4 percent in 1990. During that time, the gain in life expectancy was 52.4 percent for Geneva males of 80 years of age and 93 percent for Geneva females of the same age. This drastic change in age groups was coupled with a noteworthy change in household sizes. In 1860, the number of persons per household was 4.5. In 1990, it was down to 2.2. Conversely, the number of inmates in Geneva's medico-social institutions went up from 649 to 1168 between 1982 and 1992. In this socio-economic and cultural perspective, the concept of "globality of the individual" throughout his lifetime explains: age-related physiological changes; the long-term repercussion of physical, professional or leisure activities; the consequences of the accumulation of such varied risk factors as overweight or its opposite, malnutrition, tobacco or stress. Such frailty caused by aging is an ideal breeding ground for disease. For now, what matters most is the functional consequence of disease. Is the disease acute or chronic? Two out of three deaths result from a chronic disease, which caused loss of function by organs (impairment), loss of function by the subject himself (disability) or loss of function by the individual in society (social handicap or disadvantage). Raising the question "Dependency: a hazard or an inevitability?" boils down to asking oneself about the place of disease in our society and its determinants, and about all aspects of medicine and especially of prevention. When detected, a susceptibility brings into play primary prevention, aimed at averting the onset of the disease. After a disease has set in, measures to prevent recurrence, or secondary prevention, are required. Lastly, prevention of dependency and of loss of autonomy is part of tertiary prevention. Except for violent traumatic accidents, the formulation of the above concepts proves that dependency is essentially "a hazard". Therefore, let us anticipate!

Marital Expectations in Strong African American Marriages.

PubMed

Vaterlaus, J Mitchell; Skogrand, Linda; Chaney, Cassandra; Gahagan, Kassandra

2017-12-01

The current exploratory study utilized a family strengths framework to identify marital expectations in 39 strong African American heterosexual marriages. Couples reflected on their marital expectations over their 10 or more years of marriage. Three themes emerged through qualitative analysis and the participants' own words were used in the presentation of the themes. African Americans indicated that there was growth in marital expectations over time, with marital expectations often beginning with unrealistic expectations that grew into more realistic expectations as their marriages progressed. Participants also indicated that core expectations in strong African American marriages included open communication, congruent values, and positive treatment of spouse. Finally, participants explained there is an "I" in marriage as they discussed the importance of autonomy within their marital relationships. Results are discussed in association with existing research and theory. © 2016 Family Process Institute.

Perceived class climate and school-aged children's life satisfaction: The role of the learning environment in classrooms.

PubMed

Rathmann, Katharina; Herke, Max G; Hurrelmann, Klaus; Richter, Matthias

2018-01-01

The aim of this study is to examine the impact of class-level class climate on school-aged children's life satisfaction. Data was derived from the German National Educational Panel Study (NEPS) using sixth grade school-aged children (n = 4,764, 483 classes). Class climate includes indicators of teachers' care and monitoring, demands, interaction, autonomy, as well as school-aged children's attitudes towards schoolwork at the class- and individual-level. Results showed that individual perceived class climate in terms of teachers' care and monitoring and autonomy was positively related to life satisfaction, whereas school-related demands were related to lower life satisfaction. Besides teachers' care and monitoring at class-level, indicators of class climate were not associated with school-aged children's life satisfaction, while the individual perceived class climate is more important for life satisfaction.

Perceived class climate and school-aged children's life satisfaction: The role of the learning environment in classrooms

PubMed Central

Herke, Max G.; Hurrelmann, Klaus; Richter, Matthias

2018-01-01

The aim of this study is to examine the impact of class-level class climate on school-aged children’s life satisfaction. Data was derived from the German National Educational Panel Study (NEPS) using sixth grade school-aged children (n = 4,764, 483 classes). Class climate includes indicators of teachers' care and monitoring, demands, interaction, autonomy, as well as school-aged children's attitudes towards schoolwork at the class- and individual-level. Results showed that individual perceived class climate in terms of teachers' care and monitoring and autonomy was positively related to life satisfaction, whereas school-related demands were related to lower life satisfaction. Besides teachers' care and monitoring at class-level, indicators of class climate were not associated with school-aged children’s life satisfaction, while the individual perceived class climate is more important for life satisfaction. PMID:29420540

Women's autonomy and reproductive health care utilisation: empirical evidence from Tajikistan.

PubMed

Kamiya, Yusuke

2011-10-01

Women's autonomy is widely considered to be a key to improving maternal health in developing countries, whereas there is no consistent empirical evidence to support this claim. This paper examines whether or not and how women's autonomy within the household affects the use of reproductive health care, using a household survey data from Tajikistan. Estimation is performed by the bivariate probit model whereby woman's use of health services and the level of women's autonomy are recursively and simultaneously determined. The data is from a sample of women aged 15-49 from the Tajikistan Living Standard Measurement Survey 2007. Women's autonomy as measured by women's decision-making on household financial matters increase the likelihood that a woman receives antenatal and delivery care, whilst it has a negative effect on the probability of attending to four or more antenatal consultations. The hypothesis that women's autonomy and reproductive health care utilisation are independently determined is rejected for most of the estimation specifications, indicating the importance of taking into account the endogenous nature of women's autonomy when assessing its effect on health care use. The empirical results reconfirm the assertion that women's status within the household is closely linked to reproductive health care utilisation in developing countries. Policymakers therefore need not only to implement not only direct health interventions but also to focus on broader social policies which address women's empowerment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Age-related normative values for handgrip strength and grip strength’s usefulness as a predictor of mortality and both cognitive and physical decline in older adults in northwest Russia

PubMed Central

Turusheva, A.; Frolova, E.; Degryse, J-M.

2017-01-01

Objectives: This paper sought to provide normative values for grip strength among older adults across different age groups in northwest Russia and to investigate their predictive value for adverse events. Methods: A population-based prospective cohort study of 611 community-dwelling individuals 65+. Grip strength was measured using the standard protocol applied in the Groningen Elderly Tests. The cut-off thresholds for grip strength were defined separately for men and women of different ages using a weighted polynomial regression. A Cox regression analysis, the c-statistic, a risk reclassification analysis, and bootstrapping techniques were used to analyze the data. The outcomes were the 5-year mortality rate, the loss of autonomy and mental decline. Results: We determined the age-related reference intervals of grip strength for older adults. The 5th and 10th percentiles of grip strength were associated with a higher risk for malnutrition, low autonomy, physical and mental functioning and 5-year mortality. The 5th percentile of grip strength was associated with a decline in autonomy. Conclusions: This study presents age- and sex-specific reference values for grip strength in the 65+ Russian population derived from a prospective cohort study. The norms can be used in clinical practice to identify patients at increased risk for adverse outcomes. PMID:28250246

[Perceived Autonomy in Old Age scale: Factor structure and psychometric properties of the Polish adaptation].

PubMed

Kroemeke, Aleksandra

2015-01-01

Sense of autonomy - the possibility to choose and decide - is one of the markers of positive and active aging. The goal of this study was to examine the Polish adaptation of the Perceived Autonomy in Old Age (PAA) scale and to determine its internal structure and psychometric properties: reliability, as well as construct and discriminant validity. 277 seniors (female=187; male=90), without cognitive function disorders aged 60 to 100 (M=77.4; SD=9.2) took part in the study. Apart from the PAA, the ADL and IADL scales (self-reliance assessment) were used, as well as the Emotional State Questionnaire (a measure for positive and negative emotions) and the WHOQoL-Brief (a measure for health-related quality of life). As a result of an exploratory and confirmation factor analysis a one-factor tool with five items was built. Reliability coefficients of the scale measured with the internal consistency method and test-retest were ≥ 0.80. Positive correlations were found with indicators in the ADL, IADL, as well as in the somatic and psychological domain of life quality, and positive emotions. Negative correlations were found for negative emotions. The obtained results indicated very high reliability and accuracy for the Polish adaptation of the SPA. The tool can be used as a predictor and/or indicator of successful aging and life quality of seniors.

Internet Use Frequency and Patient-Centered Care: Measuring Patient Preferences for Participation Using the Health Information Wants Questionnaire

PubMed Central

Wang, Mo; Feldman, Robert; Zhou, Le

2013-01-01

Background The Internet is bringing fundamental changes to medical practice through improved access to health information and participation in decision making. However, patient preferences for participation in health care vary greatly. Promoting patient-centered health care requires an understanding of the relationship between Internet use and a broader range of preferences for participation than previously measured. Objective To explore (1) whether there is a significant relationship between Internet use frequency and patients’ overall preferences for obtaining health information and decision-making autonomy, and (2) whether the relationships between Internet use frequency and information and decision-making preferences differ with respect to different aspects of health conditions. Methods The Health Information Wants Questionnaire (HIWQ) was administered to gather data about patients’ preferences for the (1) amount of information desired about different aspects of a health condition, and (2) level of decision-making autonomy desired across those same aspects. Results The study sample included 438 individuals: 226 undergraduates (mean age 20; SD 2.15) and 212 community-dwelling older adults (mean age 72; SD 9.00). A significant difference was found between the younger and older age groups’ Internet use frequencies, with the younger age group having significantly more frequent Internet use than the older age group (younger age group mean 5.98, SD 0.33; older age group mean 3.50, SD 2.00; t 436=17.42, P<.01). Internet use frequency was positively related to the overall preference rating (γ=.15, P<.05), suggesting that frequent Internet users preferred significantly more information and decision making than infrequent Internet users. The relationships between Internet use frequency and different types of preferences varied: compared with infrequent Internet users, frequent Internet users preferred more information but less decision making for diagnosis (γ=.57, P<.01); more information and more decision-making autonomy for laboratory test (γ=.15, P<.05), complementary and alternative medicine (γ=.32, P<.01), and self-care (γ=.15, P<.05); and less information but more decision-making autonomy for the psychosocial (γ=-.51, P<.01) and health care provider (γ=-.27, P<.05) aspects. No significant difference was found between frequent and infrequent Internet users in their preferences for treatment information and decision making. Conclusions Internet use frequency has a positive relationship with the overall preferences for obtaining health information and decision-making autonomy, but its relationship with different types of preferences varies. These findings have important implications for medical practice. PMID:23816979

Parenting style influences bullying: A longitudinal study comparing children with and without behavioural problems

PubMed Central

Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M.

2015-01-01

Background More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4 to 5 years was associated with changes in bullying over the next 4 years among children with Attention-deficit/Hyperactivity Disorder (ADHD) with and without comorbid Oppositional Defiant Disorder (ODD) relative to children without these disorders. Method Children from the New York metropolitan area (n = 162) were prospectively studied over 6 annual assessment points between preschool and 9 years of age. Parenting was assessed by laboratory observations of the parent and child; teachers rated child bullying, and parents reported on children's diagnostic status (Neither ADHD nor ODD, ADHD but not ODD, both ADHD and ODD). Results Children with comorbid ADHD and ODD were more likely to bully than the other two groups. Hierarchical linear modeling revealed a fall in bullying over five-years. Diagnostic status was significantly associated with initial levels of bullying. Irrespective of diagnostic group, children receiving more parent support for child autonomy at age 4 to 5 years showed a significantly greater decline in bullying than those provided with little support for autonomy. There was no longitudinal link between parent negative affect, emotionally supportive parenting and quality of parent-child interactions with bullying. Conclusions Greater parent support for child autonomy at age 4 to 5 years is related to reduced bullying. Interventions that encourage parent support for child autonomy at the time of entry into school may reduce bullying during early school years. PMID:26053670

Parenting style influences bullying: a longitudinal study comparing children with and without behavioral problems.

PubMed

Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M

2016-02-01

More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4-5 years was associated with changes in bullying over the next 4 years among children with Attention-deficit/Hyperactivity Disorder (ADHD) with and without comorbid Oppositional Defiant Disorder (ODD) relative to children without these disorders. Children from the New York metropolitan area (n = 162) were prospectively studied over six annual assessment points between preschool and 9 years of age. Parenting was assessed by laboratory observations of the parent and child; teachers rated child bullying, and parents reported on children's diagnostic status (Neither ADHD nor ODD, ADHD but not ODD, both ADHD and ODD). Children with comorbid ADHD and ODD were more likely to bully than the other two groups. Hierarchical linear modeling revealed a fall in bullying over five years. Diagnostic status was significantly associated with initial levels of bullying. Irrespective of diagnostic group, children receiving more parent support for child autonomy at age 4 to 5 years showed a significantly greater decline in bullying than those provided with little support for autonomy. There was no longitudinal link between parent negative affect, emotionally supportive parenting and quality of parent-child interactions with bullying. Greater parent support for child autonomy at age 4-5 years is related to reduced bullying. Interventions that encourage parent support for child autonomy at the time of entry into school may reduce bullying during early school years. © 2015 Association for Child and Adolescent Mental Health.

Diabetes Distress and Glycemic Control: The Buffering Effect of Autonomy Support From Important Family Members and Friends.

PubMed

Lee, Aaron A; Piette, John D; Heisler, Michele; Rosland, Ann-Marie

2018-06-01

To examine whether autonomy support (defined as social support for an individual's personal agency) for diabetes management from informal health supporters (family/friends) reduces the detrimental effects of diabetes distress on glycemic control. Three hundred eight veterans with type 2 diabetes and one or more risk factors for diabetes complications completed a survey that included measures of diabetes distress and perceived autonomy support from their main informal health supporter. Hemoglobin A 1c (HbA 1c ) data from 12 months before and after the survey were extracted from electronic medical records. Linear mixed modeling examined the main effects and interaction of autonomy support and diabetes distress on repeated measures of HbA 1c over the 12 months after the survey, controlling for mean prior 12-month HbA 1c , time, insulin use, age, and race/ethnicity. Diabetes distress ( B = 0.12 [SE 0.05]; P = 0.023) was associated with higher and autonomy support ( B = -0.16 [SE 0.07]; P = 0.032) with lower subsequent HbA 1c levels. Autonomy support moderated the relationship between diabetes distress and HbA 1c ( B = -0.13 [SE 0.06]; P = 0.027). Greater diabetes distress was associated with higher HbA 1c at low ( B = 0.21 [SE 07]; P = 0.002) but not high ( B = 0.01 [SE 0.07]; P = 0.890) levels of autonomy support. Autonomy support from main health supporters may contribute to better glycemic control by ameliorating the effects of diabetes distress. Interventions that reduce diabetes distress and enhance the autonomy supportiveness of informal supporters may be effective approaches to improving glycemic control. © 2018 by the American Diabetes Association.

Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? A longitudinal study.

PubMed

Portegijs, Erja; Rantakokko, Merja; Viljanen, Anne; Sipilä, Sarianna; Rantanen, Taina

2016-07-01

essential aspects of independence in community mobility among older people concern the control over where, when and how to participate (perceived autonomy), and actual mobility (life-space mobility; frequency, distance and need of assistance). We studied relationships between frailty and life-space mobility and perceived autonomy in participation outdoors among community-dwelling 75-90 years old people. longitudinal analyses of the 'Life-space mobility in old age' cohort study (n = 753). Life-space mobility (Life-Space Assessment, range 0-120) and perceived autonomy in participation outdoors (Impact on Participation and Autonomy subscale 'autonomy outdoors', range 0-20) were assessed at baseline and 2 years later. Baseline frailty indicators were unintentional weight loss (self-report), weakness (5 times chair rise), exhaustion (self-report), slowness (2.44 m walk) and low physical activity (self-report). in total, 53% had no frailty, 43% pre-frailty (1-2 frailty indicators) and 4% frailty (≥3 indicators). Generalised estimation equation models showed that life-space mobility was lower among those with frailty and pre-frailty compared with those without frailty and, in addition, declined at a faster pace. Perceived autonomy in participation outdoors was more restricted among those with frailty and pre-frailty compared with those without frailty, but the rate of decline did not differ. frailty was associated with more restricted life-space mobility and poorer perceived autonomy in the decision-making concerning community mobility. Over the follow-up, frailty predicted a steeper decline in life-space mobility but not in perceived autonomy. Further study is warranted to determine whether compensation strategies or changes in the valuation of activities underlie this discrepancy. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Expanding role for autonomy in military space

NASA Technical Reports Server (NTRS)

Evans, D. D.; Gajewski, R. R.

1985-01-01

The Jet Propulsion Laboratory is currently transferring satellite on-board autonomy technology to the USAF for use in military spacecraft as a means of lowering the ground support requirements. The techniques were proven on the Viking and Voyager spacecraft and permitted on-board fault detection and correction. New military satellites will incorporate an autonomous redundancy and maintenance management subsystem in an on-board computer, while the system will still be subject to ground-based safing commands for situations demanding deeper analyses. A level 5 autonomy will need 256 kb memory, 10 Mb nonvolatile data storage and 50 W power and will weigh 20 kg. Systems will be periodically checked and compared with an ideal in the data base. Deviations detected will result in a rollback and redundant examination by two microprocessors, which can initiate correction commands until operational criteria are met. The development of the expert systems to the point that they satisfy military specifications is expected to take 10 yr.

A conditional process model of children's behavioral engagement and behavioral disaffection in sport based on self-determination theory.

PubMed

Curran, Thomas; Hill, Andrew P; Niemiec, Christopher P

2013-02-01

The potential benefits of children's engagement in sport for their psychological, social, and physical health are well established. Yet children may also experience psychological and social impairments due, in part, to a variety of detrimental coach behaviors. In the current study, we proposed and tested a conditional process model of children's self-reported behavioral engagement and behavioral disaffection in sport based on self-determination theory. Results from a sample of 245 youth soccer players suggested that structure from coaches related positively to behavioral engagement and negatively to behavioral disaffection, and that these relations were mediated by athletes' basic psychological need satisfaction. Importantly, and in line with our hypotheses, these indirect effects were moderated by autonomy support from coaches, such that the mediation was evident only among those who reported higher levels of autonomy support. These findings underscore the importance of coaches' providing guidance, expectations, and feedback (i.e., structure) in a way that respects athletes' volition (i.e., autonomy support).

Child Schooling in Ethiopia: The Role of Maternal Autonomy

PubMed Central

Mohanty, Itismita

2016-01-01

This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population. PMID:27942039

PERCEIVED AUTONOMY SUPPORT AND BEHAVIORAL ENGAGEMENT IN PHYSICAL EDUCATION: A CONDITIONAL PROCESS MODEL OF POSITIVE EMOTION AND AUTONOMOUS MOTIVATION.

PubMed

Yoo, Jin

2015-06-01

A variety of theoretical perspectives describe the crucial behavioral roles of motivation and emotion, but how these interact with perceptions of social contexts and behaviors is less well understood. This study examined whether autonomous motivation mediated the relationship between perceived autonomy support and behavioral engagement in physical education and whether this mediating process was moderated by positive emotion. A sample of 592 Korean middle-school students (304 boys, 288 girls; M age = 14.0 yr., SD = 0.8) completed questionnaires. Autonomous motivation partially mediated the positive association between perceived autonomy support and behavioral engagement. Positive emotion moderated the relationship between autonomous motivation and behavioral engagement. This indirect link was stronger as positive emotion increased. These findings suggest the importance of integrating emotion into motivational processes to understand how and when perceived autonomy support is associated with behavioral engagement in physical education.

Job autonomy, its predispositions and its relation to work outcomes in community health centers in Taiwan.

PubMed

Lin, Blossom Yen-Ju; Lin, Yung-Kai; Lin, Cheng-Chieh; Lin, Tien-Tse

2013-06-01

It has been debated that employees in a government or public ownership agency may perceive less need for growth opportunities or high-powered incentives than is the case for employees in private organizations. This study examined employees' job autonomy in government-run community health centers, its predispositions and its relation to their work outcomes. A cross-sectional study was conducted in Taiwan. From 230 responding community health centers, 1380 staff members responded to the self-completed, structured questionnaire. Structural equation modeling revealed that employees' job autonomy has positive work outcomes: greater work satisfaction, and less intent to transfer and intentions to leave. In addition, job autonomy was related to employees' higher education levels, medical profession, permanent employment and serving smaller populations. Moreover, employees' age, educational levels, medical profession and employment status were found to be related to their work satisfaction, intent to transfer and intent to leave.

Examining the interaction of parental involvement and parenting style in predicting adherence in youth with type 1 diabetes.

PubMed

Landers, Sara E; Friedrich, Elizabeth A; Jawad, Abbas F; Miller, Victoria A

2016-03-01

This study examined whether aspects of parenting style (specifically, warmth, autonomy support, and coercion) moderated the association between parental involvement and adherence in youth with type 1 diabetes. Children ages 8 to 16 years with type 1 diabetes and a parent completed assessments of parental involvement, parenting style, and adherence. Parent autonomy support and coercion were associated with adherence but warmth was not. Child report of more parental involvement was associated with better adherence. Warmth, autonomy support, and coercion were not moderators. The findings underscore the importance of parental involvement, operationalized as responsibility for diabetes tasks, and parenting style, specifically coercion and autonomy support, for adherence in pediatric chronic illness management. Longitudinal research is needed to better understand how and why dimensions of involvement (e.g., responsibility, monitoring, support) vary over time and whether they impact outcomes differentially. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Direction of Influence between Parenting Style and Parental Involvement in Schooling Practices, and Students' Autonomy: A Short-Term Longitudinal Design.

ERIC Educational Resources Information Center

Deslandes, Rollande

This study examined the reciprocal influence between parenting style and parental involvement in schooling practices and adolescent autonomy over a 2-year period. Participating in the study were 872 adolescents with a mean age of 14.5 years at Time 1 and attending 5 French-speaking public high schools in Quebec, Canada. From the initial cohort,…

Mothers’ and Fathers’ Autonomy-Relevant Parenting: Longitudinal Links with Adolescents’ Externalizing and Internalizing Behavior

PubMed Central

Lansford, Jennifer E.; Laird, Robert D.; Pettit, Gregory S.; Bates, John E.; Dodge, Kenneth A.

2014-01-01

The goal of this study was to advance the understanding of separate and joint effects of mothers’ and fathers’ autonomy-relevant parenting during early and middle adolescence. In a sample of 518 families, adolescents (49% female; 83% European American, 16% African American, 1% other ethnic groups) reported on their mothers’ and fathers’ psychological control and knowledge about adolescents’ whereabouts, friends, and activities at ages 13 and 16. Mothers and adolescents reported on adolescents’ externalizing and internalizing behaviors at ages 12, 14, 15, and 17. Adolescents perceived their mothers as using more psychological control and having more knowledge than their fathers, but there was moderate concordance between adolescents’ perceptions of their mothers and fathers. More parental psychological control predicted increases in boys’ and girls’ internalizing problems and girls’ externalizing problems. More parental knowledge predicted decreases in boys’ externalizing and internalizing problems. The perceived levels of behavior of mothers and fathers did not interact with one another in predicting adolescent adjustment. The results generalize across early and late adolescence and across mothers’ and adolescents’ reports of behavior problems. Autonomy-relevant mothering and fathering predict changes in behavior problems during early and late adolescence, but only autonomy-relevant fathering accounts for unique variance in adolescent behavior problems. PMID:24337705

Mothers' and fathers' autonomy-relevant parenting: longitudinal links with adolescents' externalizing and internalizing behavior.

PubMed

Lansford, Jennifer E; Laird, Robert D; Pettit, Gregory S; Bates, John E; Dodge, Kenneth A

2014-11-01

The goal of this study was to advance the understanding of separate and joint effects of mothers' and fathers' autonomy-relevant parenting during early and middle adolescence. In a sample of 518 families, adolescents (49 % female; 83 % European American, 16 % African American, 1 % other ethnic groups) reported on their mothers' and fathers' psychological control and knowledge about adolescents' whereabouts, friends, and activities at ages 13 and 16. Mothers and adolescents reported on adolescents' externalizing and internalizing behaviors at ages 12, 14, 15, and 17. Adolescents perceived their mothers as using more psychological control and having more knowledge than their fathers, but there was moderate concordance between adolescents' perceptions of their mothers and fathers. More parental psychological control predicted increases in boys' and girls' internalizing problems and girls' externalizing problems. More parental knowledge predicted decreases in boys' externalizing and internalizing problems. The perceived levels of behavior of mothers and fathers did not interact with one another in predicting adolescent adjustment. The results generalize across early and late adolescence and across mothers' and adolescents' reports of behavior problems. Autonomy-relevant mothering and fathering predict changes in behavior problems during early and late adolescence, but only autonomy-relevant fathering accounts for unique variance in adolescent behavior problems.

“I Want Her to Make Correct Decisions on Her Own:” Former Soviet Union Mothers' Beliefs about Autonomy Development

PubMed Central

Komolova, Masha; Lipnitsky, Jane Y.

2018-01-01

This qualitative study examined Former Soviet Union (FSU) mothers' explicit and implicit attitudes and parenting practices around adolescents' autonomy development. Interviews were conducted with 10 mothers who had immigrated from the FSU to the US between 10 and 25 years ago, and who had daughters between the ages of 13 and 17 years. Mothers predominantly defined autonomy in terms of adolescents' ability to carry out instrumental tasks, make correct decisions, and financially provide for themselves, but rarely mentioned psychological or emotional independence. Mothers reflected on the various aspects of autonomy emphasized in their country of origin and America, and balancing the two sets of cultural values in their parenting. Although mothers discussed attempts to adopt a less authoritarian approach to parenting than they themselves experienced as children, some mothers' controlling attitudes were revealed through a close analysis of their language. The findings provide important insights into the parenting experiences of FSU immigrant mothers, and the way in which autonomy-related processes may vary cross-culturally. Implications for parenting and clinical practice are also discussed. PMID:29434558

"I Want Her to Make Correct Decisions on Her Own:" Former Soviet Union Mothers' Beliefs about Autonomy Development.

PubMed

Komolova, Masha; Lipnitsky, Jane Y

2017-01-01

This qualitative study examined Former Soviet Union (FSU) mothers' explicit and implicit attitudes and parenting practices around adolescents' autonomy development. Interviews were conducted with 10 mothers who had immigrated from the FSU to the US between 10 and 25 years ago, and who had daughters between the ages of 13 and 17 years. Mothers predominantly defined autonomy in terms of adolescents' ability to carry out instrumental tasks, make correct decisions, and financially provide for themselves, but rarely mentioned psychological or emotional independence. Mothers reflected on the various aspects of autonomy emphasized in their country of origin and America, and balancing the two sets of cultural values in their parenting. Although mothers discussed attempts to adopt a less authoritarian approach to parenting than they themselves experienced as children, some mothers' controlling attitudes were revealed through a close analysis of their language. The findings provide important insights into the parenting experiences of FSU immigrant mothers, and the way in which autonomy-related processes may vary cross-culturally. Implications for parenting and clinical practice are also discussed.

Executive functions in adolescents with spina bifida: relations with autonomy development and parental intrusiveness.

PubMed

Tuminello, Elizabeth R; Holmbeck, Grayson N; Olson, Rick

2012-01-01

The current study was part of a larger longitudinal investigation and examined the relation of parent-report and performance measures of executive functioning (EF) with measures of behavioral and emotional autonomy and parental intrusiveness in adolescents with and without spina bifida (SB; n=65 in a comparison sample and 61 in an SB sample; M age=14.55, SD=0.63). For both groups, higher levels of parent-reported EF problems predicted higher levels of observed child dependency and lower levels of teacher-reported intrinsic motivation. Higher scores on performance EF measures predicted lower levels of observed child dependency and observed maternal intrusiveness for both groups. In adolescents with SB only, higher performance EF scores predicted higher intrinsic motivation and emotional autonomy from both mother and father and predicted lower levels of observed paternal intrusiveness. While causal conclusions cannot be drawn, EFs appear to be closely related to autonomy development and parental intrusiveness, particularly for adolescents with SB. These results suggest that the inclusion of EF training in interventions targeting adolescents with SB may be beneficial for autonomy development.

Autonomy, coping strategies and psychological well-being in young professional tennis players.

PubMed

Romero Carrasco, Alicia Elena; Campbell, Rolando Zapata; López, Alejandra Letelier; Poblete, Ixa López; García-Mas, Alexandre

2013-01-01

This research aimed to analyze the role of Psychological Well-being factors in young professional tennis players, assigning special attention to their preferred coping strategies and perceived autonomy that specifically contribute to Psychological Well-being. The conceptual framework utilized for this study was Ryff's Psychological Well-being multidimensional model in order to focus our understanding towards how environment demands of professional sport affect athletes Psychological Well-being. Participants were 155 male professional tennis players with a mean age of 14.61 (SD = 1.86) engaged in South American Tennis Federation tournaments. Instruments utilized were Psychological Well Being Scale EBP, Díaz et al., 2006, Sport Coping Approach Questionnary Spanish version, ACSQ-1 (Kim, Duda, Tomas, & Balaguer, 2003) and Sport Perceived Autonomy Scale, Spanish version (Balaguer, Castillo, & Duda, 2008). Our research revealed that the greater autonomy young athletes perceive while being engaged in professional sport was because of the coping strategies they utilized such as active planning, cognitive restructuring, emotional calmness and seeking of social support. Results confirmed also that the greater perceived autonomy was explaining athletes high levels of Psychological Well-being.

Perceptions of 24/7 In-house Attending Coverage on Fellow Education and Autonomy in a Pediatric Cardiothoracic Intensive Care Unit.

PubMed

Owens, Sonal T; Owens, Gabe E; Rajput, Shaili H; Charpie, John R; Kidwell, Kelley M; Mullan, Patricia B

2015-01-01

The 24/7 in-house attending coverage is emerging as the standard of care in intensive care units. Implementation costs, workforce feasibility, and patient outcomes resulting from changes in physician staffing are widely debated topics. Understanding the impact of staffing models on the learning environment for medical trainees and faculty is equally warranted, particularly with respect to trainee education and autonomy. This study aims to elicit the perceptions of pediatric cardiology fellows and attendings toward 24/7 in-house attending coverage and its effect on fellow education and autonomy. We surveyed pediatric cardiology fellows and attendings practicing in the pediatric cardiothoracic intensive care unit (PCTU) of a large, university-affiliated medical center, using structured Likert response items and open-ended questions, prior to and following the transition to 24/7 in-house attending coverage. All (100%) trainees and faculty completed all surveys. Both prior to and following transition to 24/7 in-house attending coverage, all fellows, and the majority of attendings agreed that the overnight call experience benefited fellow education. At baseline, trainees identified limited circumstances in which on-site attending coverage would be critical. Preimplementation concerns that 24/7 in-house attending coverage would negatively affect the education of fellows were not reflected following actual implementation of the new staffing policy. However, based upon open-ended questions, fellow autonomy was affected by the new paradigm, with fellows and attendings reporting decreased "appropriateness" of autonomy after implementation. Our prospective study, showing initial concerns about limiting the learning environment in transitioning to 24/7 in-house attending coverage did not result in diminished perceptions of the educational experience for our fellows but revealed an expected decrease in fellow autonomy. The study indirectly facilitated open discussions about methods to preserve fellow education and warranted autonomy in our PCTU; however, continued efforts are needed to achieve the optimal balance between supervised training and the transition to autonomous practice. © 2015 Wiley Periodicals, Inc.

Discrepancies in Autonomy and Relatedness Promoting Behaviors of Substance Using Mothers and Their Children: The Effects of a Family Systems Intervention

PubMed Central

Slesnick, Natasha

2016-01-01

Parents’ and children’s autonomy and relatedness behaviors are associated with a wide range of child outcomes. Yet, little is known about how parents and children’s autonomy and relatedness behaviors jointly influence child outcomes. The current study captured this joint influence by exploring the longitudinal trajectory of mother–child discrepancies in autonomy and relatedness behaviors and its association with child problem behaviors. The effects of a family systems intervention on the trajectory of mother–child discrepancies were also examined. The sample included 183 substance using mothers and their children (M age = 11.54 years, SD = 2.55, range 8–16; 48 % females). Both the mother and child completed an assessment at baseline, 6- and 18-month post-baseline. A person-centered analysis identified subgroups varying in mother–child discrepancy patterns in their autonomy and relatedness behaviors. The results also showed that participation in the family systems therapy was associated with decreased mother–child discrepancies, and also a synchronous increase in mother’s and child’s autonomy and relatedness. Additionally, increased mother–child discrepancies and mother–child dyads showing no change in autonomy and relatedness was associated with higher levels of children’s problem behaviors. The findings reveal a dynamic process of mother–child discrepancies in autonomy and relatedness behaviors related to child outcomes. The findings also support the effectiveness of the family systems therapy, and highlight the importance of understanding the complexities in family interactions when explaining children’s problem behaviors. PMID:27480271

Pink Time: Evidence of Self-Regulated Learning and Academic Motivation among Undergraduate Students

ERIC Educational Resources Information Center

Baird, Timothy D.; Kniola, David J.; Lewis, Ashley L.; Fowler, Shelli B.

2015-01-01

This article describes and analyzes a classroom assignment to promote intrinsic motivation for learning in college students. Here, grades and instructor expectations for content are viewed as students' primary motivations for learning, and correspondingly present obstacles for improved critical thinking skills, student autonomy, and engagement.…

Taxation and the Preservation of Tribal Political and Geographical Autonomy.

ERIC Educational Resources Information Center

Clow, Richmond L.

1991-01-01

Examines the complexities of the taxation issue in Indian affairs, both for American Indian reservations and adjacent local governments. Demonstrates the role of statutes and case law in the recurring struggle to balance tribal immunities guaranteed by the federal government with the expectations of non-Indian taxpayers. (SV)

2010 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Volume 2, Main Findings

DTIC Science & Technology

2011-05-01

characteristics and student engagement , namely that students have clear roles and expectations, that instructors provide support for autonomy (a previously...C. J. (2009) Facilitators and outcomes of student engagement in a college setting. Journal of Psychology, 143, 5-27. USAREUR. (2007). Modular

Perceptual Articulation in Three Middle Eastern Culture

ERIC Educational Resources Information Center

Amir, Yehuda

1975-01-01

Noting that one would expect that members of cultural groups whose modes of child rearing foster individual autonomy would achieve more articulated perceptual functioning rather than persons reared in societies where conformity and emotional dependence are stressed, this article discusses a study which compared two Israeli sub-groups and two…

Performance Indicators as a Foundation of Institutional Autonomy: Implications for Higher Education Institutions in Europe

ERIC Educational Resources Information Center

Lewis, Darrell R.; Hendel, Darwin D.; Kallsen, Lincoln

2007-01-01

There has developed moderate discussion in European higher education about the use of performance indicators for both accountability and evaluation purposes. This paper begins by summarizing governmental expectations, institutional objections, and several of the controversies surrounding performance measures. We then report on using performance…

The Role of Self-Efficacy and Autonomy Support in School Psychologists' Use of ABA

ERIC Educational Resources Information Center

Runyon, Katie; Stevens, Tara; Roberts, Brook; Whittaker, Richelle; Clark, Ashley; Chapman, Christy K.; Boggs-Lopez, Misty

2018-01-01

The most recent version of the Individuals with Disabilities Education Improvement Act (IDEIA) emphasizes research-based intervention in the school setting. Administrators expect school psychologists to lead initiatives introducing interventions and techniques derived from scientific approaches, such as applied behavior analysis (ABA). However, in…

Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes.

PubMed

Mohn, J; Graue, M; Assmus, J; Zoffmann, V; B Thordarson, H; Peyrot, M; Rokne, B

2015-11-01

To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P < 0.001), indicating that lower perceived competence was associated with greater perceived distress. There was an indirect (fully mediated) relationship between autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control. © 2015 The Authors. Diabetic Medicine Published by John Wiley & Sons Ltd on behalf of Diabetes UK.

The moderating role of job resources in the relationship between job demands and interleukin-6 in an Italian healthcare organization.

PubMed

Falco, Alessandra; Dal Corso, Laura; Girardi, Damiano; De Carlo, Alessandro; Comar, Manola

2018-02-01

In this study we examined the association between job demands (JD), job resources (JR), and serum levels of a possible biomarker of stress, the pro-inflammatory cytokine interleukin-6 (IL-6). According to the buffer hypothesis of the Job Demands-Resources (JD-R) model, we expected that job resources-defined as job autonomy and social support from supervisor-might buffer the relationship between job demands, defined as emotional demands and interpersonal conflict with colleagues, and IL-6. Data from 119 employees in an Italian public healthcare organization (acute care hospital) were analyzed using multiple regression. In predicting IL-6, the interactions between emotional demands and JR and between interpersonal conflict with colleagues and job autonomy (but not social support) were significant, after controlling for the effect of age and gender. The association between JD and IL-6 was stronger for individuals with low levels of JR, so that levels of IL-6 were highest when JD were high and JR were low. Overall, these results are consistent with the buffer hypothesis of the JD-R model and also extend previous research, showing that the exposure to stressful situations at work, measured as high JD and low JR, is associated with higher levels of IL-6 in hospital employees. © 2017 Wiley Periodicals, Inc.

Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness.

PubMed

Rutten, Elisabeth A P; Bachrach, Nathan; van Balkom, Anton J L M; Braeken, Johan; Ouwens, Machteld A; Bekker, Marrie H J

2016-12-01

Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness. © 2015 The British Psychological Society.

A test of basic psychological needs theory in young soccer players: time-lagged design at the individual and team levels.

PubMed

González, L; Tomás, I; Castillo, I; Duda, J L; Balaguer, I

2017-11-01

Within the framework of basic psychological needs theory (Deci & Ryan, 2000), multilevel structural equation modeling (MSEM) with a time-lagged design was used to test a mediation model examining the relationship between perceptions of coaches' interpersonal styles (autonomy supportive and controlling), athletes' basic psychological needs (satisfaction and thwarting), and indicators of well-being (subjective vitality) and ill-being (burnout), estimating separately between and within effects. The participants were 597 Spanish male soccer players aged between 11 and 14 years (M = 12.57, SD = 0.54) from 40 teams who completed a questionnaire package at two time points in a competitive season. Results revealed that at the individual level, athletes' perceptions of autonomy support positively predicted athletes' need satisfaction (autonomy, competence, and relatedness), whereas athletes' perceptions of controlling style positively predicted athletes' need thwarting (autonomy, competence, and relatedness). In turn, all three athletes' need satisfaction dimensions predicted athletes' subjective vitality and burnout (positively and negatively, respectively), whereas competence thwarting negatively predicted subjective vitality and competence and relatedness positively predicted burnout. At the team level, team perceptions of autonomy supportive style positively predicted team autonomy and relatedness satisfaction. Mediation effects only appeared at the individual level. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Structure, coercive control, and autonomy promotion: A comparison of fathers' and mothers' food parenting strategies.

PubMed

Pratt, Mercedes; Hoffmann, Debra; Taylor, Maija; Musher-Eizenman, Dara

2017-05-01

This study explored differences in mothers' and fathers' food parenting strategies, specifically coercive control, structure, and autonomy promotion, and whether parenting style and parental responsibility for food parenting related to the use of these strategies. Parents of children aged 2.5-7.5 years ( N = 497) reported about their parenting practices and food parenting strategies. Parenting style accounted for the majority of the variance in food parenting. Fathers were more authoritarian than mothers. Authoritarian and permissive parenting practices were related to more coercive strategies. Mothers reported more food parenting responsibility. Responsibility was related to less coercive practices and more autonomy promotion and structure.

Correlates of preferences for autonomy in long-term care: results of a population-based survey among older individuals in Germany

PubMed Central

Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

2018-01-01

Purpose Thus far, there is little evidence concerning the factors associated with preferences for autonomy in long-term care. Therefore, the aim of the present study was to investigate the correlates of preferences for autonomy in long-term care among older individuals in Germany. Methods Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006). Results Multiple logistic regressions revealed that preferences for freedom of choice for foods were positively associated with living with partner or spouse (OR: 1.5 [1.0–2.2]), being born in Germany (OR: 1.9 [1.1–3.3]), and lower self-rated health (OR: 1.3 [1.1–1.6]). Preferences for freedom in choosing bedtime and sleep duration were positively associated with lower age (OR: 1.1 [1.0–1.1]) and having children (OR: 2.2 [1.0–4.9]). Preferences for customized living space were positively associated with being female (OR: 2.5 [1.4–4.5]) and being born in Germany (OR: 3.7 [1.9–7.1]). Neither preferences for decent and sanitary housing nor preferences for shared decision-making were associated with any of the independent variables. Conclusion Various independent variables were associated with preferences for autonomy in long-term care. This suggests that preferences for care-related autonomy are complex. Knowing these might help refine long-term care health services. PMID:29379274

Euthanasia or physician-assisted suicide? A survey from the Netherlands.

PubMed

Kouwenhoven, Pauline S C; van Thiel, Ghislaine J M W; Raijmakers, Natasja J H; Rietjens, Judith A C; van der Heide, Agnes; van Delden, Johannes J M

2014-03-01

Legalizing euthanasia or physician-assisted suicide (PAS) is a current topic of debate in many countries. The Netherlands is the only country where legislation covers both. To study physicians' experiences and attitudes concerning the choice between euthanasia and PAS. A questionnaire including vignettes was sent to a random sample of 1955 Dutch general practitioners, elderly care physicians and medical specialists. In total, 793 physicians (41%) participated. There was no clear preference for euthanasia (36%) or PAS (34%). Two thirds of physicians thought that PAS underlines the autonomy and responsibility of the patient and considered this a reason to choose PAS. Reasons for not choosing PAS were expected practical problems. A minority (22%) discussed the possibility of PAS with their patient in case of a request for assistance in dying. Patients receiving PAS more often experienced psychosocial suffering in comparison with patients receiving euthanasia. In vignettes of patients with a request for assistance in dying due to psychosocial suffering, physicians agreed more often with the performance of PAS than with euthanasia. Dutch physicians perceive a difference between euthanasia and PAS. Although they believe PAS underlines patient autonomy and responsibility, the option of PAS is rarely discussed with the patient. The more psychosocial in nature the patient's suffering, the more physicians choose PAS. In these cases, PAS seems to fulfil physicians' preferences to emphasize patient autonomy and responsibility. Expected technical problems and unfamiliarity with PAS also play a role. Paradoxically, the choice for PAS is predominantly a physician's one.

Cognitive Architectures and Autonomy: A Comparative Review

NASA Astrophysics Data System (ADS)

Thórisson, Kristinn; Helgasson, Helgi

2012-05-01

One of the original goals of artificial intelligence (AI) research was to create machines with very general cognitive capabilities and a relatively high level of autonomy. It has taken the field longer than many had expected to achieve even a fraction of this goal; the community has focused on building specific, targeted cognitive processes in isolation, and as of yet no system exists that integrates a broad range of capabilities or presents a general solution to autonomous acquisition of a large set of skills. Among the reasons for this are the highly limited machine learning and adaptation techniques available, and the inherent complexity of integrating numerous cognitive and learning capabilities in a coherent architecture. In this paper we review selected systems and architectures built expressly to address integrated skills. We highlight principles and features of these systems that seem promising for creating generally intelligent systems with some level of autonomy, and discuss them in the context of the development of future cognitive architectures. Autonomy is a key property for any system to be considered generally intelligent, in our view; we use this concept as an organizing principle for comparing the reviewed systems. Features that remain largely unaddressed in present research, but seem nevertheless necessary for such efforts to succeed, are also discussed.

Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning.

PubMed

Wulf, Gabriele; Lewthwaite, Rebecca

2016-10-01

Effective motor performance is important for surviving and thriving, and skilled movement is critical in many activities. Much theorizing over the past few decades has focused on how certain practice conditions affect the processing of task-related information to affect learning. Yet, existing theoretical perspectives do not accommodate significant recent lines of evidence demonstrating motivational and attentional effects on performance and learning. These include research on (a) conditions that enhance expectancies for future performance, (b) variables that influence learners' autonomy, and (c) an external focus of attention on the intended movement effect. We propose the OPTIMAL (Optimizing Performance through Intrinsic Motivation and Attention for Learning) theory of motor learning. We suggest that motivational and attentional factors contribute to performance and learning by strengthening the coupling of goals to actions. We provide explanations for the performance and learning advantages of these variables on psychological and neuroscientific grounds. We describe a plausible mechanism for expectancy effects rooted in responses of dopamine to the anticipation of positive experience and temporally associated with skill practice. Learner autonomy acts perhaps largely through an enhanced expectancy pathway. Furthermore, we consider the influence of an external focus for the establishment of efficient functional connections across brain networks that subserve skilled movement. We speculate that enhanced expectancies and an external focus propel performers' cognitive and motor systems in productive "forward" directions and prevent "backsliding" into self- and non-task focused states. Expected success presumably breeds further success and helps consolidate memories. We discuss practical implications and future research directions.

[Carers and the policy for autonomy].

PubMed

Naiditch, Michel

2016-03-01

Long-time invisible, the role of informal carers in providing assistance to elderly patients losing their autonomy is gaining recognition. A policy in favour of carers coordinated with that aimed at the people being cared for is necessary, but it is struggling to establish itself in France. Some progress can however be seen with the French bill on adapting society to the ageing of the population. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Defining Pleasure: A Focus Group Study of Solitary and Partnered Sexual Pleasure in Queer and Heterosexual Women.

PubMed

Goldey, Katherine L; Posh, Amanda R; Bell, Sarah N; van Anders, Sari M

2016-11-01

Solitary and partnered sexuality are typically depicted as fundamentally similar, but empirical evidence suggests they differ in important ways. We investigated how women's definitions of sexual pleasure overlapped and diverged when considering solitary versus partnered sexuality. Based on an interdisciplinary literature, we explored whether solitary pleasure would be characterized by eroticism (e.g., genital pleasure, orgasm) and partnered pleasure by nurturance (e.g., closeness). Via focus groups with a sexually diverse sample of women aged 18-64 (N = 73), we found that women defined solitary and partnered pleasure in both convergent and divergent ways that supported expectations. Autonomy was central to definitions of solitary pleasure, whereas trust, giving pleasure, and closeness were important elements of partnered pleasure. Both solitary and partnered pleasure involved exploration for self-discovery or for growing a partnered relationship. Definitions of pleasure were largely similar across age and sexual identity; however, relative to queer women, heterosexual women (especially younger heterosexual women) expressed greater ambivalence toward solitary masturbation and partnered orgasm. Results have implications for women's sexual well-being across multiple sexual identities and ages, and for understanding solitary and partnered sexuality as overlapping but distinct constructs.

Genetic and attachment influences on adolescents' regulation of autonomy and aggressiveness.

PubMed

Zimmermann, Peter; Mohr, Cornelia; Spangler, Gottfried

2009-11-01

Adolescence is a time when intense emotions are elicited within the parent-adolescent relationship, often when autonomy subjectively is endangered. As emotion dysregulation is one of the risk processes for the development of psychopathology, adolescence may be perceived as a highly sensitive period for maladjustment. Inter-individual differences in emotionality and emotion regulation have been shown to be influenced or moderated by molecular genetic differences in the serotonin transporter gene (5-HTT) and by attachment patterns. We investigated whether both the 5-HTT and attachment are associated with emotionality and emotion regulation in an observed adolescent-mother interaction and the personality traits aggressiveness and anxiety in adolescence. Ninety-one adolescents at age 12 were observed in interaction with their mothers during a standardized emotion-eliciting social task to assess emotionality and emotion regulation in relation to autonomy. Adolescents' aggressiveness and anxiety were assessed by mother report. Concurrent attachment quality was determined by an attachment interview. DNA samples were collected in order to assess the 5-HTTLPR, a repeat polymorphism in the promoter region of the serotonin transporter gene. While the short allele of the serotonin transporter gene was associated with a higher overall rate of autonomy behaviors, attachment security was related to more agreeable and less hostile autonomy. A significant interaction revealed a moderating effect of attachment security. Carriers of the short version of the 5-HTTLPR showed more agreeable autonomy when they had a secure attachment behavior strategy but showed more hostile autonomy when they were insecurely attached. Carriers of the short version of the 5-HTTLPR and insecurely attached adolescents were rated as more aggressive. The study suggests a gene-attachment interaction in adolescents where the adolescent's attachment status moderates a genetically based higher negative reactivity in response to threats to autonomy in social interactions.

Introduction of Formal Performance Appraisal of Academic Staff: The Management Challenges Associated with Effective Implementation

ERIC Educational Resources Information Center

Egginton, Bill E.

2010-01-01

Historically, higher educational institutions (HEIs) have been independent institutions, backed by an ideology that led staff to expect and enjoy high levels of independence and autonomy, relatively free from any sense of management, commercial responsibility and accountability. However, in recent times, the education sector has been subject to…

A Study of Path-Goal Relations between Leaders of College Principals and Their Subordinates in Pakistan

ERIC Educational Resources Information Center

Awan, Riffat-un-Nisa; Zaidi, Nayyar Raza

2009-01-01

This study was designed to investigate the relationship among leadership behavior of degree college principals, selected organizational and personal characteristics, and faculty job satisfaction, acceptance of leader and job expectancies. The moderators included task structure, role ambiguity, stress, need for autonomy, need for achievement,…

Youth "At Risk"? Young People, Sexual Health and Consent

ERIC Educational Resources Information Center

Powell, Anastasia

2007-01-01

In Australia, there is a growing expectation that sexuality education should reduce the risks associated with youth sex by providing young people with information on protecting their sexual health. However, this information may be insufficient to ensure that young people make choices that support their sexual safety and autonomy. This paper…

Tensions and Paradoxes in Teaching: Implications for Teacher Education

ERIC Educational Resources Information Center

Ben-Peretz, Miriam; Flores, Maria Assunção

2018-01-01

This paper focuses on the tensions and paradoxes in teaching. At present time, teacher education has the obligation to prepare teachers for diverse student populations, living in a highly varied context. This situation creates several competing expectations of the meaning of teacher education. For instance, preparing for professional autonomy in a…

Age-Differential Effects of Job Characteristics on Job Attraction: A Policy-Capturing Study.

PubMed

Zacher, Hannes; Dirkers, Bodil T; Korek, Sabine; Hughes, Brenda

2017-01-01

Based on an integration of job design and lifespan developmental theories, Truxillo et al. (2012) proposed that job characteristics interact with employee age in predicting important work outcomes. Using an experimental policy-capturing design, we investigated age-differential effects of four core job characteristics (i.e., job autonomy, task variety, task significance, and feedback from the job) on job attraction (i.e., individuals' rating of job attractiveness). Eighty-two employees between 19 and 65 years ( M age = 41, SD = 14) indicated their job attraction for each of 40 hypothetical job descriptions in which the four job characteristics were systematically manipulated (in total, participants provided 3,280 ratings). Results of multilevel analyses showed that the positive effects of task variety, task significance, and feedback from the job were stronger for younger compared to older employees, whereas we did not find significant age-differential effects of job autonomy on job attraction. These findings are only partially consistent with propositions of Truxillo et al.'s (2012) lifespan perspective on job design.

Is It All about Money? Work Characteristics and Women's and Men's Marriage Formation in Early Adulthood.

PubMed

Kuo, Janet Chen-Lan; Raley, R Kelly

2016-06-01

Using data from the NLSY 97, this paper investigates how work characteristics (earnings and autonomy) shape young adults' transition to first marriage separately for men and women. The results suggest that earnings are positively associated with marriage and that this association is as strong for women as men in their mid-to-late twenties. Additionally, occupational autonomy-having the control over one's own work structure-facilitates entry into first marriage for women in their mid-to late-20s but, for men, occupational autonomy is not associated with marriage at these ages. These results suggest that even as women's earnings are increasingly important for marriage, other aspects of work are also important for stable family formation.

[From dependency to autonomy, a geriatric pathway].

PubMed

Iglesias, Antoine; Da Costa Ribeiro, Florence; Pedra, Maryse; Chassaigne, Marie-Christine; Berbon, Caroline

Preventing dependency is essential in our ageing society. One of its components is the avoidable dependency which develops during a period of hospitalisation. Caregivers play an important role in helping the elderly person regain their autonomy. Various actions have been undertaken on this theme within the gerontology unit of Toulouse university hospital, including the creation of a multi-disciplinary group of experts among the caregivers working in the unit. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Health smart home for elders - a tool for automatic recognition of activities of daily living.

PubMed

Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

2008-01-01

Elders live preferently in their own home, but with aging comes the loss of autonomy and associated risks. In order to help them live longer in safe conditions, we need a tool to automatically detect their loss of autonomy by assessing the degree of performance of activities of daily living. This article presents an approach enabling the activities recognition of an elder living alone in a home equipped with noninvasive sensors.

[Aging and becoming vulnerable].

PubMed

Monod, Stéfanie; Sautebin, Annelore

2009-11-18

"The vulnerable are those whose autonomy, dignity and integrity are capable of being threatened". Based on this ethical definition of vulnerability, four risk factors of vulnerability might be identified among elderly persons, and are described in this article: the functional limitation, the loss of autonomy, the social precariousness and the restriction of access to medical care. A clinical case of elderly abuse is presented to illustrate vulnerability. Finally, some recommendations to lower the risk of vulnerability in elderly persons are proposed.

Perceived participation and autonomy: aspects of functioning and contextual factors predicting participation after stroke.

PubMed

Fallahpour, Mandana; Tham, Kerstin; Joghataei, Mohammad Taghi; Jonsson, Hans

2011-04-01

To describe perceived participation and autonomy among a sample of persons with stroke in Iran and to identify different aspects of functioning and contextual factors predicting participation after stroke. A cross-sectional study. A total of 102 persons, between 27 and 75 years of age, diagnosed with first-ever stroke. Participants were assessed for different aspects of functioning, contextual factors and health conditions. Participation was assessed using the Persian version of the Impact on Participation and Autonomy questionnaire. This study demonstrated that the majority of the study population perceived their participation and autonomy to be good to fair in the different domains of their participation, but not with respect to the autonomy outdoors domain. In addition, physical function was found to be the most important variable predicting performance-based participation, whereas mood state was the most important variable predicting social-based participation. The results emphasize the importance of physical function, mood state and access to caregiving services as predictors of participation in everyday life after stroke. Whilst there are two dimensions of participation in this Persian sample of persons with stroke, the factors explaining participation seem to be the same across the cultures.

Women at risk: Gender inequality and maternal health.

PubMed

Banda, Pamela C; Odimegwu, Clifford O; Ntoimo, Lorretta F C; Muchiri, Evans

2017-04-01

Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.

Unique Roles of Mothering and Fathering in Child Anxiety; Moderation by Child's Age and Gender

ERIC Educational Resources Information Center

Verhoeven, Marjolein; Bogels, Susan M.; van der Bruggen, Corine C.

2012-01-01

We examined the associations between the parenting dimensions autonomy granting, over control, and rejection and children's anxiety, in relation to parent and child gender and child age. Elementary school-aged children (n = 179, M[subscript age] = 10.27, SD = 1.30), adolescents (n = 127, M[subscript age] = 15.02, SD = 1.54) and both their parents…

Ethical Considerations in Balancing Parental Autonomy With Protecting a Child With Epilepsy From Harm.

PubMed

Miller-Horn, Jill

2016-02-01

Neurologists are expected to accommodate parental decisions in the medical care for their child, unless the parental decision places the child at an unnecessary risk of serious harm. Sometimes, respect for parental autonomy is in conflict with the physician's professional obligation to protect the patient from harm and to optimize treatment for a particular disease or condition. This case illustrates an ethical dilemma created when the neurologist and parent disagree about the most appropriate medical treatment for a child with epilepsy. Viewing the disagreement within an ethical framework, however, provides the parties to the disagreement with an opportunity to understand the beliefs and motivations of everyone involved and creates the potential for an outcome based upon the child's best interest.

Cognitive problems in patients in a cardiac rehabilitation program after an out-of-hospital cardiac arrest.

PubMed

Boyce-van der Wal, L W; Volker, W G; Vliet Vlieland, T P M; van den Heuvel, D M J; van Exel, H J; Goossens, P H

2015-08-01

Estimate prevalence of cognitive problems due to hypoxic brain injury in out-of-hospital cardiac arrest (OHCA) survivors referred for cardiac rehabilitation and association with quality of life as well as autonomy and participation. Prospective cohort study. Consecutive OHCA patients. The Mini-Mental State Examination (MMSE), Cognitive Failures Questionnaire (CFQ) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were administered 4 weeks after the OHCA. Cognitive problems were defined if MMSE <28, CFQ >32 or IQCODE >3.6. The Impact on Participation and Autonomy Questionnaire (IPAQ) (participation/autonomy), the SF-36 Health Survey (SF-36) (quality of life) and the Hospital Anxiety Depression Scale (HADS) (anxiety/depression) were administered. Correlations between cognitive problems and participation/autonomy and quality of life were calculated. 63 of 77 patients were male (82%), median age 59 years (range 15-84). MMSE median 29 (interquartile range 28-30), CFQ mean 20.9 (SD 9.4) and IQCODE mean 3.1 (SD 0.2). Eighteen patients (23%) scored positive for cognitive problems. Significant correlations were found between MMSE and IPAQ: autonomy inside (r = -0.38), family role (r = -0.26), autonomy outside (r = -0.32), social relations (r = -0.38) and social functioning (r = 0.32). MMSE was related to SF-36: social functioning (r = 0.32). The CFQ was related to IPAQ: autonomy outdoors (r = 0.29) and SF-36: bodily pain (r = -0.37), vitality (r = -0.25), mental health (r = -0.35) and role emotional (r = -0.40). The IQCODE was related to IPAQ: autonomy indoors (r = 0.26) and to SF-36: vitality (r = -0.33) and social functioning (r = -0.41). Twenty-three percent of the patients referred for cardiac rehabilitation showed cognitive problems. Associations were found between cognitive problems and several aspects of participation/autonomy and perceived quality of life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Women's autonomy and social support and their associations with infant and young child feeding and nutritional status: community-based survey in rural Nicaragua.

PubMed

Ziaei, Shirin; Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Hjern, Anders; Ekström, Eva-Charlotte

2015-08-01

To evaluate the associations of women's autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua. Cross-sectional study. Feeding practices and children's nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women's autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women's social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles. Los Cuatro Santos area, rural Nicaragua. A total of 1371 children 0-35 months of age. Children of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller. While lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.

Autonomy and dignity: a discussion on contingency and dominance.

PubMed

Van Brussel, Leen

2014-06-01

With dying increasingly becoming a medicalised experience in old age, we are witnessing a shift from concern over death itself to an interest in dying 'well'. Fierce discussions about end-of-life decision making and the permissibility of medical intervention in dying, discursively structured around the notion of a 'good' death, are evidence of this shift. This article focuses on 'autonomy' and 'dignity' as key signifiers in these discussions. Rather than being fully fixed and stable, both signifiers are contingent and carry a variety of meanings within different discursive projects. The article aims to distinguish the varieties of these signifiers by elaborating existing theoretical perspectives on autonomy and dignity, and also, starting from a perspective on mass media as sites of meaning production and contestation, to study the contingency of autonomy and dignity in Belgian newspaper coverage of four prominent euthanasia cases. By means of a discourse-theoretical textual analysis, this study exposes a dominant--yet contested--articulation of rational-personal autonomy and of dignity in external terms as something that can be obtained, retained or lost, rather than in terms of intrinsic human integrity. These logics of representation reflect a more general late modern dominance of liberal autonomy and of dignity as being closely connected to self-identity, but at the same time result in limited visibility of alternative ways of experiencing an autonomous and dignified death.

The Effects of Satisfaction of Basic Psychological Needs at School on Children's Prosocial Behavior and Antisocial Behavior: The Mediating Role of School Satisfaction.

PubMed

Tian, Lili; Zhang, Xiao; Huebner, E Scott

2018-01-01

Grounded in Basic Psychological Need Theory, we examined the direct effects of the satisfaction of three basic psychological needs at school (i.e., satisfaction of autonomy needs at school, satisfaction of relatedness needs at school, and satisfaction of competence needs at school) on prosocial behavior and antisocial behavior as well as the mediation effects of school satisfaction on the relations between the satisfaction of three basic psychological needs at school and prosocial behavior as well as antisocial behavior. We employed a sample of 801 Chinese children (429 males; M age = 9.47) in a three-wave longitudinal study, with each wave occurring 6 months apart. Direct and indirect effects were estimated by Structural Equation Modeling. Results indicated that: (1) Satisfaction of relatedness needs at school and competence needs at school, but not satisfaction of autonomy needs at school, displayed direct effects on prosocial behavior. Also, satisfaction of relatedness needs at school, but not satisfaction of autonomy needs at school or competence needs at school, displayed direct effects on antisocial behavior. (2) Both satisfaction of relatedness needs at school and competence needs at school displayed indirect effects on prosocial behavior and antisocial behavior via school satisfaction as a mediator. However, satisfaction of autonomy needs at school failed to have indirect effects on prosocial behavior or antisocial behavior via school satisfaction. These findings suggest differential predictors of children's prosocial and antisocial behavior, supporting the separability of the two constructs. The findings also suggest developmental differences in need satisfaction, with the satisfaction of autonomy needs playing a relatively less important role in school-age children. We also discussed limitations and practical applications of the study.

Childhood vaccination in rural southwestern Ethiopia: the nexus with demographic factors and women's autonomy.

PubMed

Wado, Yohannes Dibaba; Afework, Mesganaw Fantahun; Hindin, Michelle J

2014-01-01

Vaccination can reduce child mortality significantly and is a cost effective way to improve child health.Worldwide, more than 22 million children do not receive the basic recommended vaccinations.Vaccination coverage in Ethiopia remains low. Research on child health has focused on socio-economic factors such as maternal education and access to health care, but little attention has been given to demographic factors and women's autonomy within the household. The purpose of this study was to examine the influences of demographic factors and women's autonomy on the completion of childhood vaccination in rural Ethiopia. A cross-sectional community-based study was conducted in a Health and Demographic Survelliance System (HDSS) in southwestern Ethiopia. Data were drawn from a random sample of women with children aged 12-24 months (n = 889). Information on maternal socio-demographic characteristics and household variables were collected using an interviewer-administered structured questionnaire. Vaccination data were obtained from vaccination cards or mother's recall. Multivariate logistic regression was used to assess the association of independent variables with completion of childhood vaccination. Of 889 children aged 12-24 months, 690 (78%) had received at least one vaccination. Only 37% (95% CI, 33.5-39.9) were fully vaccinated. Women's decision making autonomy, number of under-five children in the household, mother's education, use of antenatal care services and proximity to health facility were the main factors associated with full vaccination status. Completion of basic vaccination series is very low in the study area. Initiatives that enhance women's autonomy within the household and that promote healthy timing and spacing of pregnancies may help in improving child health through vaccination.

Parental autonomy support and ethnic culture identification among second-generation immigrants.

PubMed

Abad, Neetu S; Sheldon, Kennon M

2008-08-01

Born and raised in the United States, children of immigrants often face conflict over whether to endorse the norms and traditions of the family's country of origin (the natal culture) or those of mainstream U.S. society (the host culture). The authors hypothesized that when immigrant parents allow children to make their own choices concerning their cultural identity, their children will be more likely to internalize the natal culture and will experience greater well-being. Ninety-nine college-aged 2nd-generation immigrants rated their well-being, perceptions of their mother's and father's autonomy support, and their endorsement of both natal and U.S. cultures. Results demonstrated that paternal, but not maternal, autonomy support predicted greater well-being and greater endorsement of the natal culture and that immersion in the natal culture predicted some indices of well-being. Several explanations for the possibly greater significance of paternal versus maternal autonomy support in the context of immigrant families are considered.

How you provide corrective feedback makes a difference: the motivating role of communicating in an autonomy-supporting way.

PubMed

Mouratidis, Athanasios; Lens, Willy; Vansteenkiste, Maarten

2010-10-01

We relied on self-determination theory (SDT; Deci & Ryan, 2000) to investigate to what extent autonomy-supporting corrective feedback (i.e., feedback that coaches communicate to their athletes after poor performance or mistakes) is associated with athletes' optimal motivation and well-being. To test this hypothesis, we conducted a cross-sectional study with 337 (67.1% males) Greek adolescent athletes (age M = 15.59, SD = 2.37) from various sports. Aligned with SDT, we found through path analysis that an autonomy-supporting versus controlling communication style was positively related to future intentions to persist and well-being and negatively related to ill-being. These relations were partially mediated by the perceived legitimacy of the corrective feedback (i.e., the degree of acceptance of corrective feedback), and, in turn, by intrinsic motivation, identified regulation, and external regulation for doing sports. Results indicate that autonomy-supporting feedback can be still motivating even in cases in which such feedback conveys messages of still too low competence.

A Multi-Informant Examination of Maternal Symptoms and Autonomy Granting in Youth Anxiety.

PubMed

Wei, Chiaying; Swan, Anna J; Makover, Heather B; Kendall, Philip C

2017-12-01

Evidence suggests the important role of (a) parenting behaviors and (b) parental psychopathology in the development and maintenance of youth anxiety. Using a multi-informant approach, the current study examined the association of maternal autonomy granting and maternal symptoms (i.e., anxiety and depression) with youth anxiety among mothers and 88 youth (ages of 6-17) diagnosed with a principal anxiety disorder. Results from the generalized estimating equations (GEE) analyses indicated that mothers reported higher youth anxiety symptoms compared to youth self-reports. Youth-perceived maternal autonomy granting was inversely associated with youth anxiety, and maternal self-reported anxiety and depressive symptoms significantly moderated this relationship: As mothers reported higher anxiety and depressive symptoms, the inverse association between parental autonomy granting and youth anxiety weakened. The interaction between parenting behavior and parental psychopathology significantly influenced youth anxiety symptoms, which presents important clinical implications to integrate into parenting work in the treatment of youth anxiety disorders.

Autonomy, belongingness, and engagement in school as contributors to adolescent psychological well-being.

PubMed

Van Ryzin, Mark J; Gravely, Amy A; Roseth, Cary J

2009-01-01

Self-determination theory emphasizes the importance of school-based autonomy and belongingness to academic achievement and psychological adjustment, and the theory posits a model in which engagement in school mediates the influence of autonomy and belongingness on these outcomes. To date, this model has only been evaluated on academic outcomes. Utilizing short-term longitudinal data (5-month timeframe) from a set of secondary schools in the rural Midwest (N = 283, M age = 15.3, 51.9% male, 86.2% White), we extend the model to include a measure of positive adjustment (i.e., hope). We also find a direct link between peer-related belongingness (i.e., peer support) and positive adjustment that is not mediated by engagement in school. A reciprocal relationship between academic autonomy, teacher-related belongingness (i.e., teacher support) and engagement in learning is supported, but this reciprocal relationship does not extend to peer-related belongingness. The implications of these findings for secondary schools are discussed.

How teacher emotional support motivates students: The mediating roles of perceived peer relatedness, autonomy support, and competence.

PubMed

Ruzek, Erik A; Hafen, Christopher A; Allen, Joseph P; Gregory, Anne; Mikami, Amori Yee; Pianta, Robert C

2016-04-01

Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11-17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools.

How teacher emotional support motivates students: The mediating roles of perceived peer relatedness, autonomy support, and competence

PubMed Central

Ruzek, Erik A.; Hafen, Christopher A.; Allen, Joseph P.; Gregory, Anne; Mikami, Amori Yee; Pianta, Robert C.

2017-01-01

Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11–17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools. PMID:28190936

Observed Macro- and Micro-Level Parenting Behaviors During Preadolescent Family Interactions as Predictors of Adjustment in Emerging Adults With and Without Spina Bifida

PubMed Central

Amaro, Christina M.; Devine, Katie A.; Psihogios, Alexandra M.; Murphy, Lexa K.; Holmbeck, Grayson N.

2015-01-01

Objective To examine observed autonomy-promoting and -inhibiting parenting behaviors during preadolescence as predictors of adjustment outcomes in emerging adults with and without spina bifida (SB). Methods Demographic and videotaped interaction data were collected from families with 8/9-year-old children with SB (n = 68) and a matched group of typically developing youth (n = 68). Observed interaction data were coded with macro- and micro-coding schemes. Measures of emerging adulthood adjustment were collected 10 years later (ages 18/19 years; n = 50 and n = 60 for SB and comparison groups, respectively). Results Autonomy-promoting (behavioral control, autonomy-relatedness) and -inhibiting (psychological control) observed preadolescent parenting behaviors prospectively predicted emerging adulthood adjustment, particularly within educational, social, and emotional domains. Interestingly, high parent undermining of relatedness predicted better educational and social adjustment in the SB sample. Conclusions Parenting behaviors related to autonomy have long-term consequences for adjustment in emerging adults with and without SB. PMID:24864277

The extent to which students' perceptions of faculties' teaching strategies, students' context, and perceptions of learner empowerment predict perceptions of autonomy in BSN students.

PubMed

Mailloux, Cynthia Glawe

2006-10-01

This descriptive correlational study examined the extent to which students' perceptions of faculties' teaching strategies, students' context, and perceptions of learner empowerment predicted perceptions of autonomy in senior female generic baccalaureate degree (BSN) students in Northeastern Pennsylvania, USA. Dunkin and Biddle's Model for Classroom Teaching (1974) provided the theoretical framework for this study. The sample of 198 female senior nursing students was drawn from 32 nursing programs accredited by the National League for Nursing Accrediting Commission [National League for Nursing Accrediting Commission (NLNAC) 2002. Directory of accredited programs. Retrieved July 16, 2002 from, http://www.nlnac.org/]. Three separate instruments were used in this study: (1) Learner Empowerment Measure [Frymier, A.B., Shulman, G.M., Houser, M., 1996. The development of a learner empowerment measure. Communication Education, 45, 181-199.]; (2) Autonomy, Caring Perspective [Boughn, S., 1995. An instrument for measuring autonomy related attitudes and behaviors in women nursing students. Journal of Nursing Education, 34, 106-113.] and (3) an investigator designed student demographic data questionnaire. Data were analyzed using stepwise multiple linear regression to estimate path coefficients. Inspection of the findings revealed that there was a significant direct effect (t = 4.299, p < .001) between perceptions of learner empowerment and perceptions of autonomy. Age was also found to have a statistically significant direct effect on perceptions of autonomy (t = 2.652, p = .009). The findings from this study support a link between learner empowerment, stated as a priority in nursing education, and autonomy identified as a priority in practice.

Item Response Theory analysis of the Autonomy over Tobacco Scale (AUTOS).

PubMed

Wellman, Robert J; Edelen, Maria Orlando; DiFranza, Joseph R

2015-06-01

The Autonomy over Tobacco Scale (AUTOS) is composed of 12-symptoms of nicotine dependence. While it has demonstrated excellent reliability and validity, several psychometric properties have yet to be investigated. We aimed to determine (1) whether items functioned differently across demographic groups, (2) the likelihood that individual symptoms would be endorsed by smokers at different levels of diminished autonomy, and (3) the degree of information provided by each item and the reliability of the full AUTOS across the range of diminished autonomy. Data for this study come from two convenience samples of American adult current smokers (n=777; 69% female; 88% white; Mage=34 years, range: 18-78), of whom 66% were daily smokers (Mcigarettes/smoking day=10.1, range: <1-70). Participants completed the AUTOS online as part of "a research study about the experiences people have when they smoke." After p value correction, items remained invariant across sex and minority status, while two items functioned differently according to age, with minimal impact on the total AUTOS score. Discriminative power of the items was high. The greatest amount of information is provided at just under one-half SD above the mean and the least at the extremes of diminished autonomy. The AUTOS maintains acceptable reliability (>0.70) across the range of diminished autonomy within which more than 95% of smokers' scores could be anticipated to fall. The AUTOS is a versatile and psychometrically sound instrument for measuring the loss of autonomy over tobacco use. Copyright © 2015 Elsevier Ltd. All rights reserved.

Developmental flexibility in the age of globalization: autonomy and identity development among immigrant adolescents.

PubMed

Fuligni, Andrew J; Tsai, Kim M

2015-01-03

The socioeconomic and cultural changes that result from an increasingly interconnected world have been speculated to have important implications for the nature of adolescent development. Unfortunately, the historical time necessary for these changes to take place means that definitive research on the impact of globalization necessarily will be slow in forthcoming. Adolescents from immigrant families, however, already experience the social and cultural shifts thought to typify globalization, and an analysis of their experiences could shed light on what to expect as existing national barriers become more permeable. The value of flexibility in the face of great social and cultural change appears to be the dominant theme from research on immigrant youth, although that flexibility can be constrained by socioeconomic, ethnic, and racial stratification systems in host societies. This review highlights the implications of these findings for what may lie ahead for teenagers as globalization continues to expand.

[Physician's professional retirement. Family dynamics].

PubMed

Aguirre Gas, Héctor G

2011-01-01

Human beings have a natural resistance to think about their old age, both personally and professionally. Governments have targeted efforts to successfully prolong the life of the population, situation which already is a social and economic problem. “Old is a person with physical, intellectual and emotional limitations, who has a reduced autonomy and welfare, as a result of the years lived”. Not everyone ages at the same age; it will depend on health, habits, physical and intellectual activity, nutritional status, vices and attitude towards life. A physician may decide not to continue exercising medicine due to: health problems, because they do not want to, because they do not feel competent, because of the risk of having to deal with a complaint or a lawsuit, to have a new life project, or because they have no patients. The options available for a doctor at the time of retirement will depend on his/her age, health status, stage of the aging process: autonomy, dependency or old age; his/her physical and mental condition, professional development, economic situation and family environment. A doctor may remain independent, join another family or seek shelter in a retirement home.

Spaceplane Technology and Research (STAR)

DTIC Science & Technology

1984-08-01

autonomy, flexibility , maneuverability, responsiveness, survivability and cost- effectiveness required of military aerospace operations as the result...orbit to simulate desired trajectory. Determine the ablative behavior and its effect on trajectory for various C/C composite materials. Expected... the 747-200F would potentially be the most flexible and cost- effective launch system. The associated use of stage-stations appears especially cost

Philosophy for Children as the Wind of Thinking

ERIC Educational Resources Information Center

Vansieleghem, Nancy

2005-01-01

In this paper I want to analyse the meaning of education for democracy and thinking as this is generally understood by Philosophy for Children. Although we may be inclined to applaud Philosophy for Children's emphasis on children, critical thinking, autonomy and dialogue, there is reason for scepticism too. Since we are expected as a matter of…

Perceived Teaching Behaviors and Self-Determined Motivation in Physical Education: A Test of Self-Determination Theory

ERIC Educational Resources Information Center

Koka, Andre; Hagger, Martin S.

2010-01-01

In the present study, we tested the effects of specific dimensions of perceived teaching behaviors on students' self-determined motivation in physical education. In accordance with the tenets of self-determination theory (Deci & Ryan, 1985, 2000), we expected the psychological needs for competence, autonomy, and relatedness would mediate these…

Quality Assurance of Quality Assurance Agencies from an Asian Perspective: Regulation, Autonomy and Accountability

ERIC Educational Resources Information Center

Hou, Angela Yung-Chi; Ince, Martin; Tsai, Sandy; Chiang, Chung Lin

2015-01-01

As quality guardians of higher education, quality assurance agencies are required to guarantee the credibility of the review process and to ensure the objectivity and transparency of their decisions and recommendations. These agencies are therefore expected to use a range of internal and external approaches to prove the quality of their review…

The Role of Teachers' Support in Predicting Students' Motivation and Achievement Outcomes in Physical Education

ERIC Educational Resources Information Center

Zhang, Tao; Solmon, Melinda A.; Gu, Xiangli

2012-01-01

Examining how teachers' beliefs and behaviors predict students' motivation and achievement outcomes in physical education is an area of increasing research interest. Guided by the expectancy-value model and self-determination theory, the major purpose of this study was to examine the predictive strength of teachers' autonomy, competence, and…

Do Students' Topic Interest and Tutors' Instructional Style Matter in Problem-Based Learning?

ERIC Educational Resources Information Center

Wijnia, Lisette; Loyens, Sofie M. M.; Derous, Eva; Schmidt, Henk G.

2014-01-01

Two studies investigated the importance of initial topic interest (i.e., expectation of interest) and tutors' autonomy-supportive or controlling instructional styles for students' motivation and performance in problem-based learning (PBL). In Study 1 (N = 93, a lab experiment), each student participated in a simulated group discussion in…

Coping with Stress in the Special Education Classroom: Can Individual Teachers More Effectively Manage Stress?. ERIC Digest #E545.

ERIC Educational Resources Information Center

Brownell, Mary

This digest discusses why special education teachers may become stressed by role overload and lack of autonomy, and presents strategies for successfully managing stresses related to teaching. Strategies include: (1) setting realistic expectations; (2) making distinctions between job and personal life; (3) finding ways to exercise professional…

Perceived Autonomy-Support, Expectancy, Value, Metacognitive Strategies and Performance in Chemistry: A Structural Equation Model in Undergraduates

ERIC Educational Resources Information Center

González, Antonio; Paoloni, Paola-Verónica

2015-01-01

Research in chemistry education has highlighted a number of variables that predict learning and performance, such as teacher-student interactions, academic motivation and metacognition. Most of this chemistry research has examined these variables by identifying dyadic relationships through bivariate correlations. The main purpose of this study was…

Perceived history of anaphylaxis and parental overprotection, autonomy, anxiety, and depression in food allergic young adults.

PubMed

Herbert, Linda J; Dahlquist, Lynnda M

2008-12-01

This study examined autonomy, anxiety, depression, and perceptions of parental behavior in 86 food allergic young adults and 344 healthy young adults between the ages of 18 and 22. Participants completed an online survey measuring self-reported autonomy, anxiety, depression, and perceptions of parental behavior. Results indicated that, as a group, food allergic young adults did not differ from healthy peers. However, food allergic young adults who reported having experienced an anaphylactic reaction described their disease as more severe, reported more worry about their disease, and rated their parents as more overprotective than food allergic young adults who reported never having experienced anaphylaxis. The experience of anaphylaxis may be a reliable indicator of food allergic individuals who are at risk for psychological distress.

Fighting fair: Adaptive Marital Conflict Strategies as Predictors of Future Adolescent Peer and Romantic Relationship Quality.

PubMed

Miga, Erin M; Gdula, Julie Ann; Allen, Joseph P

2012-08-01

This study examined the associations between reasoning during interparental conflict and autonomous adolescent conflict negotiation with peers over time. Participants included 133 adolescents and their parents, peers, and romantic partners in a multi-method, multiple reporter, longitudinal study. Interparental reasoning at adolescent age 13 predicted greater autonomy and relatedness in observed adolescent-peer conflict one year later and lower levels of autonomy undermining during observed romantic partner conflict five years later. Interparental reasoning also predicted greater satisfaction and affection in adolescent romantic relationships seven years later. Findings suggest that autonomy promoting behaviors exhibited in the interparental context may influence adolescents' own more autonomous approaches to subsequent peer and romantic conflict. Possible explanatory models are discussed, including social learning theory and attachment theory.

Limited rights of minors in the Dutch healthcare.

PubMed

Brands, Wolter; Brands, Marieke; Brands-Bottema, Gea

2014-11-30

In many countries, if not all, the autonomy of minors is limited. Especially in countries with comprehensive legislation in the field of health law the (lack of) autonomy of minors may create challenges. These problems become more complex if the costs of treatment are not paid by the government or covered by insurance. Some challenges are: At what age is a minor able to decide about his health? As not every treatment is the same, how should the system take this into account? The Netherlands has a long history of very comprehensive health care legislation. This legislation includes a section about the treatment of minors that addresses the questions of the conditions in which the autonomy of minors is limited. Though this legislation is limited to the Netherlands other countries face the same challenges.

Personality factors versus expectations and self-reported symptoms among patients awaiting advanced prosthodontic treatment.

PubMed

Hakestam, U; Söderfeldt, B; Rydén, O; Glantz, P O

1997-09-01

To assess simple questions for identifying patient personality traits among a normal Swedish population and to assess possible relationships between personality and symptoms, attitudes, dental problems, and received dental care, a questionnaire was sent to 489 subjects awaiting prosthodontic treatment (response rate 84.2%). Three personality traits could be identified: "Fearful-depressed" subjects consumed more tranquillisers, were worried and had many symptoms, whilst "Open-minded" were optimistic about treatment, had high expectations and few symptoms. "Control-minded" did not reveal worries and guarded their autonomy. It was concluded that personality indicators were related to clinically relevant factors: salience of teeth, perceptions of problems, dental attendance pattern, expectations and perceptions of symptoms.

Age-Differential Effects of Job Characteristics on Job Attraction: A Policy-Capturing Study

PubMed Central

Zacher, Hannes; Dirkers, Bodil T.; Korek, Sabine; Hughes, Brenda

2017-01-01

Based on an integration of job design and lifespan developmental theories, Truxillo et al. (2012) proposed that job characteristics interact with employee age in predicting important work outcomes. Using an experimental policy-capturing design, we investigated age-differential effects of four core job characteristics (i.e., job autonomy, task variety, task significance, and feedback from the job) on job attraction (i.e., individuals' rating of job attractiveness). Eighty-two employees between 19 and 65 years (Mage = 41, SD = 14) indicated their job attraction for each of 40 hypothetical job descriptions in which the four job characteristics were systematically manipulated (in total, participants provided 3,280 ratings). Results of multilevel analyses showed that the positive effects of task variety, task significance, and feedback from the job were stronger for younger compared to older employees, whereas we did not find significant age-differential effects of job autonomy on job attraction. These findings are only partially consistent with propositions of Truxillo et al.'s (2012) lifespan perspective on job design. PMID:28713322

Do positive relations with patients play a protective role for healthcare employees? Effects of patients' gratitude and support on nurses' burnout.

PubMed

Converso, Daniela; Loera, Barbara; Viotti, Sara; Martini, Mara

2015-01-01

A growing number of studies reveal that there are significant associations between a patient's perception of quality of care and a health professional's perceived quality of work life. Previous studies focused on the patients or on the workers. Alternatively, they center the discussion on either the negative or the positive effects, both on patients and care workers. This research work focuses on the positive relationship with patients-a possible resource for care workers. Study 1: A CFA was conducted to test the factorial structure and the tenure of the Italian version for patients of the Customer-initiated Support scale. Study 2: Using a multi-group path analysis, the effects of work characteristics and of the relationship with patients on burnout were tested in two different contexts: emergency and oncology ward. Study 1: The one-factor instrument shows good reliability, convergent, and divergent validity. Study 2: for oncology nurses cognitive demands, job autonomy, and support from patients have direct effects on emotional exhaustion and job autonomy; interactions between cognitive demands and patients' support have an effect on depersonalization. For emergency nurses cognitive demands and interactions between job autonomy and support from patients have effects on emotional exhaustion; job autonomy, patients support and gratitude have direct effects on personal accomplishment. RESULTS confirm expectations about the role of patients' support and gratitude in reducing nurses' burnout, with differences in the two contexts: emergency nurses show higher burnout and lower perception of positive relationship with patients, but present more intense protective effects of the interaction between job autonomy and support/gratitude. Suggestions can be offered to managers in developing interventions to promote "healthy organization" culture that consider jointly employees and patients' needs.

Do positive relations with patients play a protective role for healthcare employees? Effects of patients' gratitude and support on nurses' burnout

PubMed Central

Converso, Daniela; Loera, Barbara; Viotti, Sara; Martini, Mara

2015-01-01

Background: A growing number of studies reveal that there are significant associations between a patient's perception of quality of care and a health professional's perceived quality of work life. Previous studies focused on the patients or on the workers. Alternatively, they center the discussion on either the negative or the positive effects, both on patients and care workers. This research work focuses on the positive relationship with patients—a possible resource for care workers. Method: Study 1: A CFA was conducted to test the factorial structure and the tenure of the Italian version for patients of the Customer-initiated Support scale. Study 2: Using a multi-group path analysis, the effects of work characteristics and of the relationship with patients on burnout were tested in two different contexts: emergency and oncology ward. Results: Study 1: The one-factor instrument shows good reliability, convergent, and divergent validity. Study 2: for oncology nurses cognitive demands, job autonomy, and support from patients have direct effects on emotional exhaustion and job autonomy; interactions between cognitive demands and patients' support have an effect on depersonalization. For emergency nurses cognitive demands and interactions between job autonomy and support from patients have effects on emotional exhaustion; job autonomy, patients support and gratitude have direct effects on personal accomplishment. Conclusions: Results confirm expectations about the role of patients' support and gratitude in reducing nurses' burnout, with differences in the two contexts: emergency nurses show higher burnout and lower perception of positive relationship with patients, but present more intense protective effects of the interaction between job autonomy and support/gratitude. Suggestions can be offered to managers in developing interventions to promote “healthy organization” culture that consider jointly employees and patients' needs. PMID:25954227

[The concept of autonomy (synthetic and operation indicators of old age : a systemic approach).].

PubMed

Lebeau, A; Sicotte, C; Tilquin, C; Tremblay, L

1980-01-01

The present study is a follow-up of a research project made in 1978 by the Equipe de Recherche Opérationnelle en Santé (EROS) of the Department of Health Administration at the Université de Montréal. The aims were a) firstly to construct a classification instrument by type for long-term care patients, enabling us, to identify these beneficiaries' needs, as well as to guide their placement in a health services' system. And b) to evaluate this instrument (realibility and validity), c) to initiate its implementation and d) to utilize it for evaluating the present placement system. This study constitutes the first stage in an approach aimed at producing, on the basis of a systematic scanning of data collected within the framework of the above-mentioned project; a comprehensive descriptive analysis of the social/health characteristics of an aged population (65 years and over) in one of Quebec's social/ health regions i.e. Montreal's South Shore. At first, the authors define the context and the objectives of the study undertaken; secondly, they define the concept of autonomy by showing how the latter is expressed concretely according to the observation instrument (evaluation form of the individual's functional autonomy). Thirdly, a presentation is made of the method of measurement, as well as certain results concerning an index of restricted autonomy directly released to situations of observable behaviour (e, g. daily-life activities, exploring the outside world, and housekeeping).

Older adults' preferences for formal social support of autonomy and dependence in pain: development and validation of a scale.

PubMed

Bernardes, Sónia F; Matos, Marta; Goubert, Liesbet

2017-09-01

Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults' ability to engage in their daily activities. Assessing older adults' preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals' needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain ( M age  = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors ( r  = .56): (a) preferences for autonomy support ( α  = .99) and (b) preferences for dependence support ( α  = .98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence ( r  = .33) and the lower the desire for independence ( r  = -.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults' functional autonomy when in pain.

Antecedents of Chinese parents' autonomy support and psychological control: the interplay between parents' self-development socialization goals and adolescents' school performance.

PubMed

Wang, Qian; Chan, Hoi-Wing; Lin, Li

2012-11-01

Despite ample evidence for the benefits of parental autonomy support and the harms of parental psychological control to Chinese adolescents' well-being, little is known about what foreshadows these parenting behaviors among Chinese parents. The current research addressed this gap in the literature. It tested the hypothesis that parents' endorsement of self-development socialization goals (i.e., regarding a positive sense of self in terms of holding optimistic attitudes toward oneself, feeling autonomous in one's actions, and establishing one's independence from others, as important for adolescents to develop) and adolescents' school performance may interact to predict parental autonomy support and psychological control in urban China. Three hundred and forty-one Chinese seventh graders (mean age = 13.30 years, 58 % female) and their parents (186 mothers and 155 fathers) participated. Parents reported on their own and their spouses' endorsement of self-development socialization goals; adolescents reported on parental autonomy support and psychological control; and adolescents' grades were obtained from school records. Significant interactions were found between parents' socialization goals and adolescents' grades in predicting parenting behaviors. When adolescents were doing well at school, the stronger parents' endorsement of self-development socialization goals, the greater their autonomy support and the lesser their psychological control; when adolescents were doing poorly at school, regardless of parents' socialization goals, their autonomy support was relatively low and their psychological control was relatively high. These findings highlight a tension between parental concerns over adolescents' self-development and academic success, which needs to be resolved to promote autonomy support and prevent psychological control among urban Chinese parents.

[Cataract surgery and its impact on balance and autonomy in elderly].

PubMed

Raynal, M; Aupy, B; Jahidi, A; Ettien, D; Le Page, P; Briche, T; Kossowski, M; Pailllaud, E

2009-01-01

Cataract is a major cause of visual impairment among elderly. Cataract surgery improves visual afferencies and can have an impact on balance. The present study assessed the impact of cataract surgery upon balance and autonomy in elderly. We realized clinical examinations and objective tests the day before surgery and 2-months later. The initial cohort consisted of 66 patients that had to undergo a cataract surgery. Their mean age was 79 +/- 0.5. For logistic reasons, only 33 patients have been completely evaluated before and after surgery. Each patient underwent a history and examination that have assessed autonomy, walking, visual and then cochleo-vestibular functions including bone vibratory test and dynamic computerized posturography (Equitest). After 2 months, cataract surgery had no incidence on balance. The fear of falling has stayed the same whereas the number of falls has been noticeably reduced by surgery. The overall score of Equitest has shown an increase in visual dependence after surgery. Although cataract surgery has no incidence on autonomy, it may improve the quality of life among older people by leisure activities recovery. An early physical rehabilitation facilitated by visual improvement after surgery can also prevent visual dependence and autonomy loss. We recommend vestibular rehabilitation in elderly with major visual dependence.

Predicting dental attendance from dental hygienists' autonomy support and patients' autonomous motivation: A randomised clinical trial.

PubMed

Halvari, Anne E Münster; Halvari, Hallgeir; Williams, Geoffrey C; Deci, Edward L

2017-02-01

To test the hypothesis that a Self-Determination Theory (SDT) intervention designed to promote oral health care competence in an autonomy-supportive way would predict change in caries competence relative to standard care. Further, to test the SDT process path-model hypotheses with: (1) the intervention and individual differences in relative autonomous locus of causality (RALOC) predicting increases in caries competence, which in turn would positively predict dental attendance; (2) RALOC negatively predicting dental anxiety, which would negatively predict dental attendance; (3) RALOC and caries disease referred to the dentist after an autonomy-supportive clinical exam directly positively predicting dental attendance; and (4) the intervention moderating the link between RALOC and dental attendance. A randomised two-group experiment was conducted at a dental clinic with 138 patients (M age  = 23.31 yr., SD = 3.5), with pre- and post-measures in a period of 5.5 months. The experimental model was supported. The SDT path model fit the data well and supported the hypotheses explaining 63% of the variance in dental attendance. Patients personality (RALOC) and hygienists promoting oral health care competence in an autonomy-supportive way, performance of autonomy-supportive clinical exams and reductions of anxiety for dental treatment have important practical implications for patients' dental attendance.

Validity of the impact on participation and autonomy questionnaire: a comparison between two countries.

PubMed

Kersten, Paula; Cardol, Mieke; George, Steve; Ward, Christopher; Sibley, Andrew; White, Barney

2007-10-15

To evaluate the cross-cultural validity of the five subscales of the Impact on Participation and Autonomy (IPA) measure and the full 31-item scale. Data from two validation studies (Dutch and English) were pooled (n = 106). Participants (aged 18-75), known to rehabilitation services or GP practices, had conditions ranging from minor ailments to significant disability. Validity of the five subscales and the total scale was examined using Rasch analysis (Partial Credit Model). P values smaller than 0.01 were employed to allow for multiple testing. A number of items in all the subscales except 'Outdoor Autonomy' needed rescoring. One 'Indoor Autonomy' item showed uniform DIF by country and was split by country. One 'Work and Education' item displayed uniform and non-uniform DIF by gender. All the subscales fitted the Rasch model and were invariant across country. A 30-item IPA also fitted the Rasch model. The IPA subscales and a 30-item scale are invariant across the two cultures and gender. The IPA can be used validly to assess participation and autonomy in these populations. Further analyses are required to examine whether the IPA is invariant across differing levels of disability and other disease groups not included in this study.

Stereotypes of Middle-Aged and Elderly Professionals.

ERIC Educational Resources Information Center

Decker, Wayne H.

1983-01-01

Used the semantic differential technique to examine attitudes of 115 business students toward middle-aged and older professionals. Results showed older persons were rated lower in all professions and on all attitudinal dimensions (autonomy, effectiveness, personal acceptability). Ratings of professionals were higher than ratings of the average…

Intrinsic and Extrinsic School Motivation as a Function of Age: The Mediating Role of Autonomy Support

ERIC Educational Resources Information Center

Gillet, Nicolas; Vallerand, Robert J.; Lafreniere, Marc-Andre K.

2012-01-01

The main purpose of the present research was to investigate school intrinsic and extrinsic motivation, and amotivation as a function of age in a sample of 1,600 elementary and high school students aged 9-17 years. First, results revealed a systematic decrease in intrinsic motivation and self-determined extrinsic motivation from age 9 to 12 years,…

Effects of Gene × Attachment Interaction on Adolescents’ Emotion Regulation and Aggressive Hostile Behavior Towards their Mothers during a Computer Game

PubMed Central

Zimmermann, Peter; Spangler, Gottfried

2016-01-01

Adolescence is a time of increased emotionality and major changes in emotion regulation often elicited in autonomy-relevant situations. Both genetic as well as social factors may lead to inter-individual differences in emotional processes in adolescence. We investigated whether both 5-HTTLPR and attachment security influence adolescents’ observed emotionality, emotional dysregulation, and their aggressive hostile autonomy while interacting with their mothers. Eighty-eight adolescents at age 12 were observed in interaction with their mothers during a standardized, emotion eliciting computer game task. They were genotyped for the 5-HTTLPR, a repeat polymorphism in the promoter region of the serotonin transporter gene. Concurrent attachment quality was assessed by the Late Childhood Attachment Interview (LCAI). Results revealed a significant gene × attachment effect showing that ss/sl carriers of 5-HTTLPR show increased emotional dysregulation and aggressive hostile autonomy towards their mothers. The results of the study suggest that secure attachment in adolescence moderates the genetically based higher tendency for emotional dysregulation and aggressive reactions to restrictions of autonomy during emotional social interactions with their mothers. PMID:27378877

Impact of Maternal Household Decision-Making Autonomy on Child Nutritional Status in Bangladesh.

PubMed

Rahman, Md Mosfequr; Saima, Umme; Goni, Md Abdul

2015-07-01

This study examines the relationship between maternal household decision-making autonomy and children's nutritional status using data from 2011 Bangladesh Demographic and Health Survey. The analyses are restricted to 2056 currently married, nonpregnant women aged 15 to 49 years who had at least 1 birth 5 years preceding the survey. Theoretically relevant predictors of children's nutritional status including maternal autonomy are analyzed to identify factors significantly associated with children's nutritional status using stepwise logistic regression. Results indicate that 34.8% children are stunted, 16.1% are wasted, and 45.9% children are underweight. Children whose mothers participated in making all household decisions are 15%, 16%, and 32% significantly less likely to be stunted (odds ratio = 0.85; 95% CI = 0.67-0.98), underweight (odds ratio = 0.84; 95% CI = 0.70-0.98), and wasted (odds ratio = 0.68; 95% CI = 0.52-0.90), respectively, than mothers who did not participate in making any decision. Increasing maternal decision-making autonomy may reduce the prevalence of malnourished children as well as contribute to have a healthier future generation. © 2015 APJPH.

Effects of Gene × Attachment Interaction on Adolescents' Emotion Regulation and Aggressive Hostile Behavior Towards their Mothers during a Computer Game.

PubMed

Zimmermann, Peter; Spangler, Gottfried

2016-01-01

Adolescence is a time of increased emotionality and major changes in emotion regulation often elicited in autonomy-relevant situations. Both genetic as well as social factors may lead to inter-individual differences in emotional processes in adolescence. We investigated whether both 5-HTTLPR and attachment security influence adolescents' observed emotionality, emotional dysregulation, and their aggressive hostile autonomy while interacting with their mothers. Eighty-eight adolescents at age 12 were observed in interaction with their mothers during a standardized, emotion eliciting computer game task. They were genotyped for the 5-HTTLPR, a repeat polymorphism in the promoter region of the serotonin transporter gene. Concurrent attachment quality was assessed by the Late Childhood Attachment Interview (LCAI). Results revealed a significant gene × attachment effect showing that ss/sl carriers of 5-HTTLPR show increased emotional dysregulation and aggressive hostile autonomy towards their mothers. The results of the study suggest that secure attachment in adolescence moderates the genetically based higher tendency for emotional dysregulation and aggressive reactions to restrictions of autonomy during emotional social interactions with their mothers.

Exploring the association between insecure attachment styles and adolescent autonomy in family decision making: a differentiated approach.

PubMed

Van Petegem, Stijn; Beyers, Wim; Brenning, Katrijn; Vansteenkiste, Maarten

2013-12-01

The present investigation focuses on the associations between adolescents' insecure attachment styles (i.e., anxiety and avoidance) and their autonomous functioning in family decision making. In line with recent insights in the construct of adolescent autonomy, we combined two perspectives on autonomy, differentiating between the degree of independent versus dependent functioning and the self-endorsed and pressuring motives underlying (in)dependent functioning. A longitudinal sample of 327 adolescents (age range = 13-20 years; 64 % girls) completed questionnaires on attachment to the mother and father and on both autonomy operationalisations on two measurement moments spanning a 1-year interval. Structural equation modeling showed that attachment avoidance generally was unrelated to the degree of independent decision making and the motives underlying independent decision making, but related to more pressuring motives for dependent decision making. Anxiety, on the other hand, was associated with a lower degree of independent decision making as well as with more pressuring motives for both independent and dependent decision making. Cross-lagged paths were generally in line with these findings. Theoretical implications are outlined in the discussion.

Learner Resistance in Metacognition Training? An Exploration of Mismatches between Learner and Teacher Agendas

ERIC Educational Resources Information Center

Jing, Huang

2006-01-01

This paper examines how and why learner resistance (to the teacher's goals and expectations) occurred in a metacognition-training (MT) project, which aimed to enhance reflection and autonomy in EFL learning. MT was integrated into a regular EFL reading course for second-year BA TEFL undergraduates at a Chinese university. Learner resistance in the…

Conceptions and Expectations of Research Collaboration in the European Social Sciences: Research Policies, Institutional Contexts and the Autonomy of the Scientific Field

ERIC Educational Resources Information Center

Lebeau, Yann; Papatsiba, Vassiliki

2016-01-01

This paper investigates the interactions between policy drivers and academic practice in international research collaboration. It draws on the case of the Open Research Area (ORA), a funding scheme in the social sciences across four national research agencies, seeking to boost collaboration by supporting "integrated" projects. The paper…

The ethics of managing affective and emotional states to improve informed consent: autonomy, comprehension, and voluntariness.

PubMed

Braude, Hillel; Kimmelman, Jonathan

2012-03-01

Over the past several decades the 'affective revolution' in cognitive psychology has emphasized the critical role affect and emotion play in human decision-making. Drawing on this affective literature, various commentators have recently proposed strategies for managing therapeutic expectation that use contextual, symbolic, or emotive interventions in the consent process to convey information or enhance comprehension. In this paper, we examine whether affective consent interventions that target affect and emotion can be reconciled with widely accepted standards for autonomous action. More specifically, the ethics of affective consent interventions is assessed in terms of key elements of autonomy, comprehension and voluntariness. While there may appear to be a moral obligation to manage the affective environment to ensure valid informed consent, in circumstances where volunteers may be prone to problematic therapeutic expectancy, this moral obligation needs to be weighed against the potential risks of human instrumentalization. At this point in time we do not have enough information to be able to justify clearly the programmatic manipulation of human subjects' affective states. The lack of knowledge about affective interventions requires corresponding caution in its ethical justification. © 2010 Blackwell Publishing Ltd.

Residents' perceptions of an integrated longitudinal curriculum: a qualitative study.

PubMed

Lubitz, Rebecca; Lee, Joseph; Hillier, Loretta M

2015-01-01

The purpose of this study was to explore family medicine residents' perceptions of a newly restructured integrated longitudinal curriculum. A purposeful sample of 16 family medicine residents participated in focus group interviews conducted from a grounded theory perspective to identify the characteristics of this training model that contribute to and that challenge learning. Eight key themes were identified: continuity of care, relevance to family medicine, autonomy, program-focused preparation, professional development as facilitated by role modeling, patient volume, clarity of expectations for learners, and logistics. Positive learning experiences were marked by high levels of autonomy, continuity, and relevance to family medicine. Less favorable learning experiences were characterized by limited opportunities for continuity of care, limited relevance to family medicine practice and unclear expectations for the resident's role. Family physician-led learning experiences contributed to residents' understanding of the full scope of family medicine practice, more so than specialist-led experiences. The logistics of implementing the integrated block were challenging and negatively impacted continuity and learning. This study suggests that an integrated longitudinalized family medicine block training model has the potential to support the principles of a longitudinal integrated competency-based curriculum to effectively prepare residents for family medicine practice.

[Respecting minors' autonomy in child custody cases].

PubMed

Santa Rosa, Bárbara; Corte-Real, Francisco; Vieira, Duarte Nuno

2013-01-01

Child custody decisions are among the most difficult for judges to make. The possibility of child abuse allegations or parents' deviant/ psychopathologic behaviours within this context, make the decision further complicated. Based on jurisprudence the listening of children opinion is a way to protect their best interest. In fact children have the right to express an opinion in all matters affecting their life. It should be given proper consideration to children opinion according with his/her age and maturity. Nonetheless custody disputes are emotionally draining issues. Asking the child to express an opinion during a public hearing, most likely in the presence of both parents, its not recommended because this is a potential stressful experience. Child interviews should take place in a proper environment and be set to their age. Medicine and Psychology have an important role in assessing children cognitive, emotional and volitional abilities, which is essential to properly account their opinions according to autonomy degree. This essay analyses the contribution of medico-legal and/or psychological exams to respect the autonomy of the child in cases of regulation of parental responsibilities. The conclusion is the need to establish a symbiotic relationship between the medical and legal perspectives of the (open) concept of child's best interests.

Home care: from adequate funding to integration of services.

PubMed

Hébert, Réjean

2009-01-01

With the aging of the population, the healthcare system needs to shift from the actual hospital-centred system developed in the past century for dealing with acute diseases and a young population toward a home-centred system, more appropriate for serving older people with chronic diseases. Funding of home care should not only be significantly increased but also be managed differently. We propose the introduction of an autonomy support benefit (ASB) to cover costs related to disabilities, irrespective of living environment, and to set up a public universal autonomy insurance program that will cover the ASB. This insurance should be at least partly capitalized to provide for the aging of the population and to ensure intergenerational equity. Also, since the home is a much more complicated service-delivery environment than the hospital, these services must be coordinated and integrated. The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA) is a coordination-type model of integration that was implemented and evaluated in three areas (one urban and two rural) in and around Sherbrooke, Quebec. A four-year longitudinal quasi-experimental study with over 1,500 participants demonstrated its efficiency in improving system effectiveness at no extra cost.

Overlapping of duties and technical autonomy among nurses of the Family Health Strategy.

PubMed

Feliciano, Katia Virginia de Oliveira; Kovacs, Maria Helena; Sarinho, Silvia Wanick

2010-06-01

To understand how Estratégia Saúde da Família (Family Health Strategy) nurses experience the overlapping of duties and building of technical autonomy. This was a qualitative study performed with 22 nurses, in the city of Recife, Northeastern Brazil, between August 2005 and November 2006. Based on management evaluation (geographic access; conflicts in the team, between team and district and between team and community; and public violence in the area), four teams were selected in each of the six health districts. Semi-structured interviews were conducted. The main themes in the interview guide were about work expectations and relevance, its organization and process, and feelings towards these practices. The results were interpreted under the perspective of burnout. The nurses' opinion on the excessive number of families, insufficient organizational support and pressures from user demands that had not been met was recurrent. Overlapping of health care and management caused work overload, creating anxiety, impotence, frustration and the feeling of being treated unfairly when tasks were divided among team members. The clinical dimension of practice led to a feeling of insecurity of a technical and ethical nature, in addition to the satisfaction for the power and prestige achieved by the professional category. Specialized medical training represented an obstacle to autonomy and responsibility becoming interdependent. Stress, dissatisfaction, becoming physically and mentally ill, recognition of the relevance of work and importance of one's performance, and low work involvement were reported. In view of the lack of expectation of changes in the short term, the overlapping of low professional satisfaction and work overload causes negative attitudes, indicating the importance of health promotion to increase the possibility of influencing and changing work conditions.

Autonomy and Citizenship in the Late Third Age

ERIC Educational Resources Information Center

Luppi, Elena

2010-01-01

The research presented in this paper is focused on the concept of active citizenship in the third age. This topic has been investigated within a group of elderly people in the second phase of the third age. The research was monitored by the social services of Bologna (Italy) in a support-care project. The results gathered led to considerations on…

Inter-generational micro-class mobility during and after socialism: The power, education, autonomy, capital, and horizontal (PEACH) model in Hungary.

PubMed

Lippényi, Zoltán; Gerber, Theodore P

2016-07-01

We propose a theoretical model of how occupational mobility operates differently under socialism than under market regimes. Our model specifies four vertical dimensions of occupational resources-power, education, autonomy, and capital-plus a horizontal dimension consisting of linkages among occupations in the same economic branch. Given the nature of state socialist political-economic institutions, we expect power to exhibit much stronger effects in the socialist mobility regime, while autonomy and capital should play greater stratifying roles after the market transition. Education should have stable effects, and horizontal linkages should diminish in strength with market reforms. We estimate our model's parameters using data from surveys conducted in Hungary during and after the socialist period. We adopt a micro-class approach, though we test it against approaches that use more aggregated class categories. Our model provides a superior fit to other mobility models, and our results confirm our hypotheses about the distinctive features of the state socialist mobility regime. Mobility researchers often look for common patterns characterizing mobility in all industrialized societies. Our findings suggest that national institutions can produce fundamentally distinct patterns of mobility. Copyright © 2016 Elsevier Inc. All rights reserved.

Mothers' autonomy and childhood stunting: evidence from semi-urban communities in Lao PDR.

PubMed

Kamiya, Yusuke; Nomura, Marika; Ogino, Hina; Yoshikawa, Kanako; Siengsounthone, Latsamy; Xangsayarath, Phonepadith

2018-05-22

Childhood stunting (height-for-age z-scores below - 2), a form of chronic undernutrition, remains a global health burden. Although a growing literature has examined the association between mothers' autonomy and childhood stunting, these studies have been limited to countries in South Asia or Sub-Saharan Africa where women have relatively lower social status than do men. Little research has analyzed the effect of mothers' autonomy on childhood stunting in Lao PDR, where women's social status is relatively high compared to that in other countries. We conducted a cross-sectional questionnaire and body scale measurement targeting 100 mothers and their 115 children (<5 years old) from semi-urban communities in Lao PDR, which is the country with the highest prevalence of childhood stunting in the Indochina region. As dimensions of women's autonomy, we measured self-esteem, self-efficacy, decision-making power, freedom of mobility, and control of money. We then analyzed how each dimension was associated with the likelihood of childhood stunting. The likelihood of childhood stunting was significantly lower if mothers had higher self-efficacy for health care (OR = 0.15, p = 0.007), self-esteem (OR = 0.11, p = 0.025), or control of money (OR = 0.11, p = 0.041). In contrast, mothers' decision-making power and freedom of mobility were not significantly associated with childhood stunting. We clarified which dimensions of women's autonomy were associated with childhood stunting in Lao PDR. A closer examination of mothers' autonomy will aid proper understanding of the determinants of childhood stunting.

An Application of the Reasoned Action Approach to Bystander Intervention for Sexual Assault.

PubMed

Lukacena, Kaylee M; Reynolds-Tylus, Tobias; Quick, Brian L

2017-10-25

The high prevalence of sexual assault in US college campuses has led to a widespread implementation of bystander intervention programs aimed at preventing sexual assault. The current study examines predictors of college students' intentions to engage in bystander intervention through the theoretical lens of the reasoned action approach. An online survey with college students (N = 186) was conducted at a large Midwestern university. Our results indicated experiential attitudes, instrumental attitudes, descriptive norms, autonomy, and capacity, each positively associated with participants' intentions to intervene to stop a sexual assault. Against expectations, injunctive norms were unrelated to bystander intervention intentions. Finally, in addition to these main effects, an experiential attitude by autonomy interaction was also observed. The results are discussed with a focus on the theoretical and practical implications of our findings.

Broadening the trans-contextual model of motivation: A study with Spanish adolescents.

PubMed

González-Cutre, D; Sicilia, Á; Beas-Jiménez, M; Hagger, M S

2014-08-01

The original trans-contextual model of motivation proposed that autonomy support from teachers develops students' autonomous motivation in physical education (PE), and that autonomous motivation is transferred from PE contexts to physical activity leisure-time contexts, and predicts attitudes, perceived behavioral control and subjective norms, and forming intentions to participate in future physical activity behavior. The purpose of this study was to test an extended trans-contextual model of motivation including autonomy support from peers and parents and basic psychological needs in a Spanish sample. School students (n = 400) aged between 12 and 18 years completed measures of perceived autonomy support from three sources, autonomous motivation and constructs from the theory of planned behavior at three different points in time and in two contexts, PE and leisure-time. A path analysis controlling for past physical activity behavior supported the main postulates of the model. Autonomous motivation in a PE context predicted autonomous motivation in a leisure-time physical activity context, perceived autonomy support from teachers predicted satisfaction of basic psychological needs in PE, and perceived autonomy support from peers and parents predicted need satisfaction in leisure-time. This study provides a cross-cultural replication of the trans-contextual model of motivation and broadens it to encompass basic psychological needs. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

What's in a Name? Expectations, Heuristics and Choice during a Period of Radical School Reform. CEP Discussion Paper No. 1477

ERIC Educational Resources Information Center

Bertoni, Marco; Gibbons, Stephen; Silva, Olmo

2017-01-01

Education policy worldwide has sought to incentivize school improvement and facilitate pupil-school matching by introducing reforms that promote autonomy and choice. Understanding the way in which families form preferences during these periods of reform is crucial for evaluating the impact of such policies. We study the effects on choice of a…

Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the English Longitudinal Study of Ageing (ELSA).

PubMed

Fleischmann, Maria; Carr, Ewan; Xue, Baowen; Zaninotto, Paola; Stansfeld, Stephen A; Stafford, Mai; Head, Jenny

2018-06-23

Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons. We used waves 2-7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50-60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease. For employees, on diagnosis of chronic disease autonomy marginally decreased (-0.10, 95% CI -0.20 to 0.00) and physical job demands significantly increased (0.13, 95% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (-0.36, 95% CI -0.64 to -0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (-2.78, 95% CI -6.03 to 0.48). Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of an intervention with teachers in the physical education context: A Self-Determination Theory approach

PubMed Central

2017-01-01

Framed within Self-Determination Theory, the purpose of the present study was to test the effects of a training program with physical education (PE) teachers. Participants were 21 high school PE teachers (experimental group, n = 10; control group, n = 11), and their 836 students, aged 12 to 16 years. Teachers in the experimental group received a training program consisting of strategies to support autonomy, competence, and relatedness need satisfaction. A repeated measures ANCOVA was carried out for each dependent variable. After the intervention, students in the experimental group significantly increased their scores on autonomy support, relatedness support, autonomy satisfaction, autonomous motivation, controlled motivation, and intention to be physically active, as compared to the control group. These findings emphasize the utility of a training program with PE teachers to promote the students’ psychological need satisfaction, and hence, self-determined motivation toward PE classes. PMID:29284027

Controlling and Autonomy-Supportive Parenting in the United States and China: Beyond Children's Reports.

PubMed

Cheung, Cecilia S; Pomerantz, Eva M; Wang, Meifang; Qu, Yang

2016-11-01

Research comparing the predictive power of parents' control and autonomy support in the United States and China has relied almost exclusively on children's reports. Such reports may lead to inaccurate conclusions if they do not reflect parents' practices to the same extent in the two countries. A total of 394 American and Chinese children (M age  = 13.19 years) and their mothers reported on mothers' controlling and autonomy-supportive parenting in the academic arena; trained observers coded such parenting in the laboratory. Children's reports were associated modestly with mothers' reports and weakly, if at all, with observers' reports in both the United States and China. Parenting predicted children's academic and emotional functioning similarly in the two countries, irrespective of reporter. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Maternal support for autonomy: relationships with persistence for children with Down syndrome and typically developing children.

PubMed

Gilmore, Linda; Cuskelly, Monica; Jobling, Anne; Hayes, Alan

2009-01-01

Maternal behaviors and child mastery behaviors were examined in 25 children with Down syndrome and 43 typically developing children matched for mental age (24-36 months). During a shared problem-solving task, there were no group differences in maternal directiveness or support for autonomy, and mothers in the two groups used similar verbal strategies when helping their child. There were also no group differences in child mastery behaviors, measured as persistence with two optimally challenging tasks. However, the two groups differed in the relationships of maternal style with child persistence. Children with Down syndrome whose mothers were more supportive of their autonomy in the shared task displayed greater persistence when working independently on a challenging puzzle, while children of highly directive mothers displayed lower levels of persistence. For typically developing children, persistence was unrelated to maternal style, suggesting that mother behaviors may have different causes or consequences in the two groups.

Examining maternal age, breastfeeding self-efficacy and health locus of control in psychological wellbeing of mothers.

PubMed

Lawal, Abiodun Musbau; Idemudia, Erhabor Sunday

2017-12-01

We investigated the direct and interaction influence of maternal age, breastfeeding self-efficacy (BSE), health locus of control (HLOC) on six dimensions of psychological wellbeing of breastfeeding mothers in Lagos, Nigeria. Data were collected from a convenience sample of 291 mothers attending health facilities in two suburb local government areas. The survey included socio-demographics (maternal age, marital status, ethnicity, education level and position of the baby currently breastfeeding), breastfeeding self-efficacy, health locus of control and psychological wellbeing scales. Independent variables were tested against sense of autonomy, positive relations with others, purpose in life, self-acceptance, environmental mastery and personal growth using factorial Multivariate Analysis of Variance. Results showed direct influence of BSE, HLOC and maternal age on various dimensions of psychological wellbeing. Interaction influences indicate BSE and HLOC on environmental mastery; BSE and maternal age on self-acceptance and HLOC and maternal age on sense of autonomy, positive relationship with others and self-acceptance respectively. In conclusion, maternal age, breastfeeding self-efficacy and health locus of control are vital for mothers to enjoy plenty dimensions of psychological wellbeing. Breastfeeding mothers need to be confident in their abilities to breastfeed and have control over their health-related behaviour in order to enjoy sufficient dimensions of psychological wellbeing.

Physical frailty, sarcopenia, and the enablement of autonomy: philosophical issues in geriatric medicine.

PubMed

Blasimme, Alessandro

2017-02-01

Physical frailty and loss of muscular mass (sarcopenia) are believed to be predictors of age-related conditions, such as disability and loss of autonomy. In this paper, I show that what in political and moral philosophy has come to be known as "the capability approach" may indeed provide much needed conceptual clarification in the area of frailty research. Other than being useful at the theoretical level, the capability approach can definitely help in the implementation of clinical guidelines and public health measures aimed at translating the results that are accumulating from frailty research. I will first briefly review the main philosophical tenets of the capability approach, and then analyze how they relate to current debates about frailty and sarcopenia by introducing the notion of "enablement". Finally, I will show how my analysis bears on both clinical research in this domain and public policy aimed at tackling some of the age-related issues in an aging society.

Quality care provision for older people: an interview study with patients and primary healthcare professionals.

PubMed

van de Pol, Marjolein Helena Johanna; Fluit, Cornelia Rita Maria Gertruda; Lagro, Joep; Niessen, Danielle; Rikkert, Marcellinus Gerardus Maria Olde; Lagro-Janssen, Antoinette Leonarda Maria

2015-08-01

In recent years, primary health care for the ageing population has become increasingly complex. This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people. This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands. All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached. Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another's perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: 'autonomy and independence', 'organisational barriers', and 'professional expertise'. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals. Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements. © British Journal of General Practice 2015.

Identifying the Potential for Robotics to Assist Older Adults in Different Living Environments

PubMed Central

Mitzner, Tracy L.; Chen, Tiffany L.; Kemp, Charles C.; Rogers, Wendy A.

2014-01-01

As the older adult population grows and becomes more diverse, so will their needs and preferences for living environments. Many adults over 65 years of age require some assistance [1, 2]; yet it is important for their feelings of well-being that the assistance not restrict their autonomy [3]. Not only is autonomy correlated with quality of life [4], autonomy enhancement may improve functionality [2, 5]. The goal of this paper is to provide guidance for the development of technology to enhance autonomy and quality of life for older adults. We explore the potential for robotics to meet these needs. We evaluated older adults' diverse living situations and the predictors of residential moves to higher levels of care in the United States. We also examined older adults' needs for assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and medical conditions when living independently or in a long-term care residence. By providing support for older adults, mobile manipulator robots may reduce need-driven, undesired moves from residences with lower levels of care (i.e., private homes, assisted living) to those with higher levels of care (i.e., skilled nursing). PMID:24729800

Parents' role in early adolescent self-injury: An application of self-determination theory.

PubMed

Emery, A Ann; Heath, Nancy L; Rogers, Maria

2017-06-01

We applied self-determination theory to examine a model whereby perceived parental autonomy support directly and indirectly affects nonsuicidal self-injury (NSSI) through difficulties in emotion regulation. 639 participants (53% female) with a mean age of 13.38 years (SD = 0.51) completed the How I Deal with Stress Questionnaire as a screener for NSSI, the Perceptions of Parents Scale, and the Difficulties in emotion Regulation Scale. Participants who indicated having ever hurt themselves on purpose without the intent to die (n = 116, 66% female) were classified in the NSSI lifetime group. A mediation analysis with bootstrapping procedure revealed that adolescents who reported their parents as being less supportive of their need for autonomy were more likely to have engaged in NSSI. Further, this relationship was partially mediated by emotion regulation. Adolescents who do not perceive autonomy support from their parents, have more difficulties regulating their emotions, and may turn to NSSI as a means to cope. Clinical implications of the findings suggest involving the family, and specifically, targeting parental autonomy support may be beneficial when working with young adolescents who self-injure. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Determinants of physical activity among patients with type 2 diabetes: the role of perceived autonomy support, autonomous motivation and self-care competence.

PubMed

Koponen, Anne M; Simonsen, Nina; Suominen, Sakari

2017-03-01

Based on self-determination theory (SDT), this study investigated, whether the three central SDT variables (perceived autonomy support, autonomous motivation and self-care competence), were associated with engagement in physical activity (PA) among patients with type 2 diabetes when the effect of a wide variety of other important life-context factors (perceived health, medication, duration of diabetes, mental health, stress and social support) was controlled for. Patients from five municipalities in Finland with registry-based entitlement to a special reimbursement for medicines used in the treatment of type 2 diabetes (n = 2866, mean age 63 years, 56% men) participated in this mail survey in 2011. Of all measured explanatory factors, autonomous motivation was most strongly associated with engagement in PA. Autonomous motivation mediated the effect of perceived autonomy support on patients' PA. Thus, perceived autonomy support (from one's physician) was associated with the patient's PA through autonomous motivation. This result is in line with SDT. Interventions for improved diabetes care should concentrate on supporting patients' autonomous motivation for PA. Internalizing the importance of good self-care seems to give sufficient energy to maintain a physically active lifestyle.

The Importance of Coaches' Autonomy Support in the Leisure Experience and Well-Being of Young Footballers.

PubMed

Balaguer, Isabel; Castillo, Isabel; Cuevas, Ricardo; Atienza, Francisco

2018-01-01

Drawing on the self-determination framework, the study examined the effect of coaches' autonomy support on the leisure experience of young male football players. Specifically, a model was tested analyzing the long-term predictive power of the players' perceptions of the coaches' autonomy support at the beginning of the season on the subjective vitality of young football players at the end of the season, through needs satisfaction and intrinsic motivation (IM). Moreover, we tested whether the effects of coaches' autonomy support on the aforementioned variables (needs satisfaction, IM, and subjective vitality) at the end of the season remained at the beginning of the following season. Because the coach in the second season was not the same one as in the first season, the perception of coaches' autonomy support at the beginning of the second season was used as a control variable. Three hundred and sixty football players ( M age = 12.60 years; SD = 0.52) completed a questionnaire on the variables of interest at the beginning of the first season (T1), at the end of the first season (T2), and at the beginning of the second season (T3). The results of the path analyses showed that players' perceptions of coaches' autonomy support at the beginning of the season (T1) positively predicted needs satisfaction at the end of the first season (T2), which in turn predicted IM at the end of the first season (T2). Additionally, IM significantly and positively predicted subjective vitality at the end of the first season (T2). Finally, needs satisfaction, IM, and subjective vitality at the end of the second season (T2) positively predicted these same variables at the beginning of the second season (T3). Results emphasized the importance of the autonomy support offered by the coach in promoting the quality of young people's leisure experience playing football and its benefits for their well-being.

The Importance of Coaches’ Autonomy Support in the Leisure Experience and Well-Being of Young Footballers

PubMed Central

Balaguer, Isabel; Castillo, Isabel; Cuevas, Ricardo; Atienza, Francisco

2018-01-01

Drawing on the self-determination framework, the study examined the effect of coaches’ autonomy support on the leisure experience of young male football players. Specifically, a model was tested analyzing the long-term predictive power of the players’ perceptions of the coaches’ autonomy support at the beginning of the season on the subjective vitality of young football players at the end of the season, through needs satisfaction and intrinsic motivation (IM). Moreover, we tested whether the effects of coaches’ autonomy support on the aforementioned variables (needs satisfaction, IM, and subjective vitality) at the end of the season remained at the beginning of the following season. Because the coach in the second season was not the same one as in the first season, the perception of coaches’ autonomy support at the beginning of the second season was used as a control variable. Three hundred and sixty football players (M age = 12.60 years; SD = 0.52) completed a questionnaire on the variables of interest at the beginning of the first season (T1), at the end of the first season (T2), and at the beginning of the second season (T3). The results of the path analyses showed that players’ perceptions of coaches’ autonomy support at the beginning of the season (T1) positively predicted needs satisfaction at the end of the first season (T2), which in turn predicted IM at the end of the first season (T2). Additionally, IM significantly and positively predicted subjective vitality at the end of the first season (T2). Finally, needs satisfaction, IM, and subjective vitality at the end of the second season (T2) positively predicted these same variables at the beginning of the second season (T3). Results emphasized the importance of the autonomy support offered by the coach in promoting the quality of young people’s leisure experience playing football and its benefits for their well-being. PMID:29896146

Self-Determination Theory Applied to Health Contexts: A Meta-Analysis.

PubMed

Ng, Johan Y Y; Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie; Deci, Edward L; Ryan, Richard M; Duda, Joan L; Williams, Geoffrey C

2012-07-01

Behavior change is more effective and lasting when patients are autonomously motivated. To examine this idea, we identified 184 independent data sets from studies that utilized self-determination theory (SDT; Deci & Ryan, 2000) in health care and health promotion contexts. A meta-analysis evaluated relations between the SDT-based constructs of practitioner support for patient autonomy and patients' experience of psychological need satisfaction, as well as relations between these SDT constructs and indices of mental and physical health. Results showed the expected relations among the SDT variables, as well as positive relations of psychological need satisfaction and autonomous motivation to beneficial health outcomes. Several variables (e.g., participants' age, study design) were tested as potential moderators when effect sizes were heterogeneous. Finally, we used path analyses of the meta-analyzed correlations to test the interrelations among the SDT variables. Results suggested that SDT is a viable conceptual framework to study antecedents and outcomes of motivation for health-related behaviors. © The Author(s) 2012.

[Long-term prognostic factors in Parkinson's disease (author's transl)].

PubMed

Guillard, A; Chastang, C

1978-05-01

Acturial methods are used to study the correlation between the initial condition and early therapeutic results, and the present condition of 164 parkinsonian patients treated with L. dopa for 4 to 8 years. There is an ineluctable deterioration in motility. There is a lower risk in patients who are autonomous and only slightly akinetic at the beginning of treatment. Intellectual deterioration is seen in some patients only. The risk factors are: males, the clinical forms of Parkinson's disease in which tremor is not predominant, onset of the disease before 60 years of age, and depression and transitory psychotic disorders during the first year of treatment. This deterioration appears 3 to 5 years after starting dopatherapy, which could be the cause. Life expectancy is still reduced by the disease at the present time. It is longer in patients in whom the disease started with isolated tremors, absence of Babinski's sign, and no loss of autonomy, and those in whom a good initial therapeutic result was obtained.

Professionalism and medicine's social contract with society.

PubMed

Cruess, Sylvia R

2006-08-01

Medicine's relationship with society has been described as a social contract: an "as if" contract with obligations and expectations on the part of both society and medicine, "each of the other". The term is often used without elaboration by those writing on professionalism in medicine. Based on the literature, society's expectations of medicine are: the services of the healer, assured competence, altruistic service, morality and integrity, accountability, transparency, objective advice, and promotion of the public good. Medicine's expectations of society are: trust, autonomy, self-regulation, a health care system that is value-driven and adequately funded, participation in public policy, shared responsibility for health, a monopoly, and both non-financial and financial rewards. The recognition of these expectations is important as they serve as the basis of a series of obligations which are necessary for the maintenance of medicine as a profession. Mutual trust and reasonable demands are required of both parties to the contract.

Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

2017-10-01

The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. A cross-sectional study based on two questionnaire surveys in 2014 and 2015. The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care. © 2017 John Wiley & Sons Ltd.

Physicians’ perceptions of quality of care, professional autonomy, and job satisfaction in Canada, Norway, and the United States

PubMed Central

2013-01-01

Background We lack national and cross-national studies of physicians’ perceptions of quality of patient care, professional autonomy, and job satisfaction to inform clinicians and policymakers. This study aims to compare such perceptions in Canada, the United States (U.S.), and Norway. Methods We analyzed data from large, nationwide, representative samples of physicians in Canada (n = 3,083), the U.S. (n = 6,628), and Norway (n = 638), examining demographics, job satisfaction, and professional autonomy. Results Among U.S. physicians, 79% strongly agreed/agreed they could provide high quality patient care vs. only 46% of Canadian and 59% of Norwegian physicians. U.S. physicians also perceived more clinical autonomy and time with their patients, with differences remaining significant even after controlling for age, gender, and clinical hours. Women reported less adequate time, clinical freedom, and ability to provide high-quality care. Country differences were the strongest predictors for the professional autonomy variables. In all three countries, physicians’ perceptions of quality of care, clinical freedom, and time with patients influenced their overall job satisfaction. Fewer U.S. physicians reported their overall job satisfaction to be at-least-somewhat satisfied than did Norwegian and Canadian physicians. Conclusions U.S. physicians perceived higher quality of patient care and greater professional autonomy, but somewhat lower job satisfaction than their colleagues in Norway and Canada. Differences in health care system financing and delivery might help explain this difference; Canada and Norway have more publicly-financed, not-for-profit health care delivery systems, vs. a more-privately-financed and profit-driven system in the U.S. None of these three highly-resourced countries, however, seem to have achieved an ideal health care system from the perspective of their physicians. PMID:24330820

The impact of feedback valence and communication style on intrinsic motivation in middle childhood: Experimental evidence and generalization across individual differences.

PubMed

Mabbe, Elien; Soenens, Bart; De Muynck, Gert-Jan; Vansteenkiste, Maarten

2018-06-01

Prior research among adolescents and emerging adults has provided evidence for the beneficial effects of positive (relative to negative) feedback and an autonomy-supportive (relative to a controlling) communication style on students' intrinsic motivation. Unfortunately, similar experimental research in middle childhood is lacking. Moreover, little attention has been paid to the question of whether individual differences in personality and perceived parenting play a role in these effects. In the current experimental study (N = 110; M age  = 10.71 years), children completed puzzles at school under one of four experimental conditions, thereby crossing normative feedback valence (i.e., positive vs. negative) with communication style (i.e., autonomy supportive vs. controlling). Prior to the experiment, children filled out questionnaires tapping into the Big Five personality traits and into perceived maternal autonomy support and psychological control. After the experimental induction, children rated several motivational constructs (i.e., intrinsic motivation and need-based experiences). In addition, their voluntary behavioral persistence in a subsequent challenging puzzle task was recorded objectively. Providing positive normative feedback in an autonomy-supportive way yielded the most favorable motivational outcomes. Both feedback valence and communication style yielded an independent impact on children's experiences of competence and autonomy during task engagement, which in turn helped to explain children's elevated intrinsic motivation, as reflected by their perceived interest and behavioral persistence. A few effects were moderated by children's perceived parenting and personality traits, but the number of interactions was limited. The discussion focuses on the motivating role of positive normative feedback and an autonomy-supportive communication style for children. Copyright © 2018 Elsevier Inc. All rights reserved.

Physicians' perceptions of quality of care, professional autonomy, and job satisfaction in Canada, Norway, and the United States.

PubMed

Tyssen, Reidar; Palmer, Karen S; Solberg, Ingunn B; Voltmer, Edgar; Frank, Erica

2013-12-15

We lack national and cross-national studies of physicians' perceptions of quality of patient care, professional autonomy, and job satisfaction to inform clinicians and policymakers. This study aims to compare such perceptions in Canada, the United States (U.S.), and Norway. We analyzed data from large, nationwide, representative samples of physicians in Canada (n = 3,213), the U.S. (n = 6,628), and Norway (n = 657), examining demographics, job satisfaction, and professional autonomy. Among U.S. physicians, 79% strongly agreed/agreed they could provide high quality patient care vs. only 46% of Canadian and 59% of Norwegian physicians. U.S. physicians also perceived more clinical autonomy and time with their patients, with differences remaining significant even after controlling for age, gender, and clinical hours. Women reported less adequate time, clinical freedom, and ability to provide high-quality care. Country differences were the strongest predictors for the professional autonomy variables. In all three countries, physicians' perceptions of quality of care, clinical freedom, and time with patients influenced their overall job satisfaction. Fewer U.S. physicians reported their overall job satisfaction to be at-least-somewhat satisfied than did Norwegian and Canadian physicians. U.S. physicians perceived higher quality of patient care and greater professional autonomy, but somewhat lower job satisfaction than their colleagues in Norway and Canada. Differences in health care system financing and delivery might help explain this difference; Canada and Norway have more publicly-financed, not-for-profit health care delivery systems, vs. a more-privately-financed and profit-driven system in the U.S. None of these three highly-resourced countries, however, seem to have achieved an ideal health care system from the perspective of their physicians.

Report of 111 Consecutive Patients Enrolled in the International Serial Transverse Enteroplasty (STEP) Data Registry: A Retrospective Observational Study

PubMed Central

Jones, Brian A; Hull, Melissa A; Potanos, Kristina M; Zurakowski, David; Fitzgibbons, Shimae C; Ching, Y Avery; Duggan, Christopher; Jaksic, Tom; Kim, Heung Bae

2016-01-01

Background The International Serial Transverse Enteroplasty (STEP) Data Registry is a voluntary online database created in 2004 to collect information on patients undergoing the STEP procedure. The aim of this study was to identify preoperative factors significantly associated with 1) transplantation or death, or 2) attainment of enteral autonomy following STEP. Study Design Data were collected from September 2004 to January 2010. Univariate and multivariate logistic regression analyses were applied to determine predictors of transplantation/death or enteral autonomy post-STEP. Time to reach full enteral nutrition was estimated using a Kaplan-Meier curve. Results Fourteen of the 111 patients in the Registry were excluded due to inadequate follow-up. Of the remaining 97 patients, 11 patients died, and 5 progressed to intestinal transplantation. On multivariate analysis, higher direct bilirubin and shorter pre-STEP bowel length were independently predictive of progression to transplantation or death (p = .05 and p < .001, respectively). Of the 78 patients who were ≥7 days of age and required parenteral nutrition (PN) at the time of STEP, 37 (47%) achieved enteral autonomy after the first STEP. Longer pre-STEP bowel length was also independently associated with enteral autonomy (p = .002). The median time to reach enteral autonomy based on Kaplan-Meier analysis was 21 months (95% CI: 12-30). Conclusions Overall mortality post-STEP was 11%. Pre-STEP risk factors for progressing to transplantation or death were higher direct bilirubin and shorter bowel length. Among patients who underwent STEP for short bowel syndrome, 47% attained full enteral nutrition post-STEP. Patients with longer pre-STEP bowel length were significantly more likely to achieve enteral autonomy. PMID:23357726

Envisioning the Future for Older Adults: Autonomy, Health, Well-being, and Social Connectedness with Technology Support.

PubMed

Rogers, Wendy A; Mitzner, Tracy L

2017-03-01

Envisioning the future of older adults of 2050 is a challenging task given the heterogeneity of the older adult population. We consider primarily the domains of home, health, and social participation for individuals over age 65 and the potential role of information, communication, and robotic technology for enhanced independence, maintenance of autonomy, and enriched quality of life. We develop several scenarios to illustrate the diversity of circumstances, health, and living situations for older adults in the future. We discuss possible negative outcomes resulting from the proliferation of technology, including increased social isolation and a widening digital divide. However, we focus primarily on envisioning desired situations wherein older adults have autonomy and independence; are easily able to manage their health and wellness needs; have rich and rewarding opportunities for social connectedness, personal growth, continued life purpose, and overall high quality of life. To attain this future, we must be acting now: designing the technology with involvement by today's older adults who represent the needs and capabilities of tomorrow's older adults; developing the necessary infrastructure to support widespread availability and deployment of these technologies; and supporting the integration of technology into people's lives at younger ages with adaptive functionality to support changing needs and preferences.

Success in Weight Management Among Patients with Type 2 Diabetes: Do Perceived Autonomy Support, Autonomous Motivation, and Self-Care Competence Play a Role?

PubMed

Koponen, Anne M; Simonsen, Nina; Suominen, Sakari B

2018-01-01

Based on self-determination theory (SDT), this study investigated whether the three central SDT variables-perceived autonomy support (from a physician), autonomous motivation and self-care competence-were associated with success in weight management (SWM) among primary care patients with type 2 diabetes when the effect of other important life-context factors was controlled for. Patients participated in a mail survey in 2011. Those who had tried to change their health behavior during the past two years in order to lose weight, either with or without success (n = 1433, mean age 63 years, 50% men), were included in this study. The successors were more autonomously motivated and energetic than the non-successors. Moreover, male gender, younger age, taking oral medication only, and receiving less social support in diabetes care predicted better success. Autonomous motivation predicted SWM; self-care competence also played a role by partly mediating the effect of autonomous motivation on SWM. These results support the idea of SDT that internalizing the value of weight management and its health benefits is necessary for long-term maintenance of health behavior change. Perceived autonomy support was not directly associated with SWM. However, physicians can promote patients' weight management by supporting their autonomous motivation and self-care competence.

Health status, geriatric syndromes and prescription of oral anticoagulant therapy in elderly medical inpatients with atrial fibrillation.

PubMed

Bo, Mario; Sciarrillo, Irene; Maggiani, Guido; Falcone, Yolanda; Iacovino, Marina; Grisoglio, Enrica; Fonte, Gianfranco; Grosjean, Simon; Gaita, Fiorenzo

2017-03-01

The aim of the present study was to investigate the prevalence of geriatric syndromes among older medical inpatients with atrial fibrillation, and their association with use of vitamin K antagonists. A retrospective study of patients aged ≥65 years discharged with a diagnosis of atrial fibrillation from the Acute Geriatric Ward was carried out. Stroke and bleeding risk were evaluated according to the CHA 2 DS 2 -VASC and HAS-BLED scores. Comorbidity, cognitive status, functional autonomy and contraindications to vitamin K antagonists were also considered. Atrial fibrillation was documented in 1078 of 3650 patients (29.5%, mean age 83.4 ± 6.6 years, 60.3% women). Contraindications to vitamin K antagonists were documented in 24.9% of patients. Prescription of vitamin K antagonists at discharge was 37.8% and 47.9%, in the overall sample and in those without contraindications, respectively. In the overall sample, prescription of vitamin K antagonists was associated with younger age, permanent/persistent atrial fibrillation, home discharge, less comorbidity, higher hemoglobin levels, better functional independence, known atrial fibrillation at admission and lower HAS-BLED score. Among patients without contraindications to vitamin K antagonists, their use at discharge was independently associated with younger age, permanent/persistent atrial fibrillation, home discharge, higher hemoglobin levels and CHA2DS2-VASC score, better functional autonomy, and greater number of drugs. We showed a high prevalence of atrial fibrillation among older medical inpatients, who have a poor health status and a high prevalence of geriatric syndromes. Vitamin K antagonists were prescribed in less than half of the patients; underuse was mainly accounted for by a high prevalence of comorbidities/contraindications, poor health status and limited functional autonomy. Geriatr Gerontol Int 2017; 17: 416-423. © 2016 Japan Geriatrics Society.

The Future of Reproductive Autonomy.

PubMed

Johnston, Josephine; Zacharias, Rachel L

2017-12-01

In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy-they just don't talk about it. And while the decision whether to agree to prenatal screening and diagnostic testing is to be made with women's free and informed consent, many screening tests have been routinized in such a way that some women do not even recall agreeing to testing, while others feel that agreeing to testing is what their clinicians expect of them or that the testing is necessary to protect themselves and their families from the significant financial hardship of raising a child with a disability. In the face of these pressures, can one really say that women are freely choosing to undergo testing or are freely choosing to continue or terminate a pregnancy following receipt of test results? The reality of these pressures is requiring us to consider expanding the scope of our investigation beyond the clinical encounter to the broader context-to think harder about what reproductive autonomy means and how best to enhance it. © 2017 The Hastings Center.

Visual operations control in administrative environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carson, M.L.; Levine, L.O.

1995-03-01

When asked what comes to mind when they think of ``controlling work`` in the office, people may respond with ``overbearing boss,`` ``no autonomy,`` or ``Theory X management.`` The idea of controlling work in white collar or administrative environments can have a negative connotation. However, office life is often chaotic and miserable precisely because the work processes are out of control, and managers must spend their time looking over people`s shoulders and fighting fires. While management styles and structures vary, the need for control of work processes does not. Workers in many environments are being reorganized into self-managed work teams. Thesemore » teams are expected to manage their own work through increased autonomy and empowerment. However, even empowered work teams must manage their work processes because of process variation. The amount of incoming jobs vary with both expected (seasonal) and unexpected demand. The mixture of job types vary over time, changing the need for certain skills or knowledge. And illness and turnover affect the availability of workers with needed skills and knowledge. Clearly, there is still a need to control work, whether the authority for controlling work is vested in one person or many. Visual control concepts provide simple, inexpensive, and flexible mechanisms for managing processes in work teams and continuous improvement administrative environments.« less

Stimulated by Novelty? The Role of Psychological Needs and Perceived Creativity

PubMed Central

De Jonge, Kiki M. M.; Rietzschel, Eric F.; Van Yperen, Nico W.

2018-01-01

In the current research, we aimed to address the inconsistent finding in the brainstorming literature that cognitive stimulation sometimes results from novel input, yet other times from non-novel input. We expected and found, in three experiments, that the strength and valence of this relationship are moderated by people’s psychological needs for structure and autonomy. Specifically, the effect of novel input (vs. non-novel input), through perceived creativity, on cognitive stimulation was stronger for people who were either low in need for structure or high in need for autonomy. Also, when the input people received did not fit their needs, they experienced less psychological cognitive stimulation from this input (i.e., less task enjoyment and feeling more blocked) compared with when they did not receive any input. Hence, to create the ideal circumstances for people to achieve cognitive stimulation when brainstorming, input novelty should be aligned with their psychological needs. PMID:29405847

The role of staff in health promotion in community residences for people with intellectual disabilities: variation in views among managers and caregivers.

PubMed

Bergström, Helena; Wihlman, Ulla

2011-09-01

Managers and caregivers in community residences for people with intellectual disabilities are expected both to promote residents' health and to support their autonomy. The aim of this article was to explore variation in views among managers and caregivers on the role of staff in health promotion. A qualitative study was conducted using semi-structured interviews with six managers and six caregivers. The analysis used a phenomenographic approach to categorize variation in views. We identified five qualitatively different main categories of roles staff play in health promotion: the parent, the manipulator, the coach, the educator and the libertarian. In addition lifestyle-related risk factors for ill-health and barriers to a healthy lifestyle were analysed and described using qualitative content analysis. The results highlight the ethical conflict that faces staff trying to support a healthy lifestyle as well as the autonomy of the residents.

Sexuality and human rights in europe.

PubMed

Graupner, Helmut

2005-01-01

Written human rights law in Europe is as scanty as in the rest of the world. Case-law however provides considerable protection of sexual rights. It guarantees comprehensive protection of autonomy in sexual life, also for minors, and provides protection against discrimination based on sexual orientation. Negative attitudes of a majority may not justify interferences with the sexual rights of a minority and society could be expected to tolerate a certain inconvenience to enable individuals to live in dignity and worth in accordance with the sexual identity chosen by them. Compensation for interference with sexual autonomy and freedom is awarded. This high-level protection (as compared to other parts of the world) is however limited. It seems to be granted only in areas where it corresponds with public attitudes and social developments. And it is seldom secured on the national level but nearly exclusively by the European Court of Human Rights, whose case-law is often weakened by inconsistency.

Digital Media, Participatory Politics, and Positive Youth Development.

PubMed

Middaugh, Ellen; Clark, Lynn Schofield; Ballard, Parissa J

2017-11-01

Research on the social implications of adolescent technology use often focuses on identifying and preventing risk. However, adolescence is also a time of rapidly expanding capacities, expectations of autonomy, and identity exploration. In this article, we highlight findings from research in the field of youth civic development, which point to the importance of youth civic engagement during adolescence for later adult civic engagement as well as for promoting positive developmental outcomes. Researchers suggest that certain forms of Internet use (such as information seeking, social network site use, media production, and participation in online communities) promote civic engagement and that digital tools play an important role in youth empowerment efforts. In this article, we suggest a need for greater attention to efforts to promote digital media competencies among adolescents and for greater coordination of research on adolescent risk and adolescent autonomy and empowerment related to Internet use. Copyright © 2017 by the American Academy of Pediatrics.

Exploring Technological Frontiers: Autonomy in Legal Scholarship

ERIC Educational Resources Information Center

Moses, Lyria Bennett

2010-01-01

In 1999, Barton Beebe critiqued a "golden age" of space law in the 1950s and 1960s in which obscure legal issues concerning space exploration and aliens were addressed. This article describes a more recent "golden age" in legal scholarship, namely that relating to virtual worlds such as World of Warcraft and Second Life. The author examines the…

Ethical Dimensions of Quality of Life in Aging: Autonomy vs. Collectivism in the United States and Canada.

ERIC Educational Resources Information Center

Clark, Phillip G.

1991-01-01

Compares and contrasts value orientations of personal independence and collectivism in the United States and Canada and examines their relationship to concept of quality of life in aging. Explores implications of the analysis for expanding understanding of importance of value dimensions in comparative gerontology, and suggests ways of integrating…

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults' chronic pain experiences.

PubMed

Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet; Beyers, Wim

2017-12-01

This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults' healthy ageing process, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Female autonomy as a contributing factor to women's HIV-related knowledge and behaviour in three culturally contrasting States in India.

PubMed

Bloom, Shelah S; Griffiths, Paula L

2007-07-01

Factors contributing to India's vulnerability to the AIDS epidemic include pervasive poverty, low levels of education and high gender stratification. This study uses data collected in the 1998-99 National Family Health Survey-2 (NFHS-2) to investigate the relationship between aspects of women's autonomy and four measures of HIV-related knowledge and behaviour--awareness and knowledge of HIV/AIDS, condom awareness and condom use--in three culturally contrasting states in India: Kerala (n=2884), Karnataka (n=4357) and Uttar Pradesh (n=8981). The NFHS-2 is a nationally representative survey of India, with a sampling scheme that was designed such that each state sample can be generalized back to represent ever-married women aged 15-49 living in the state. Kerala scores highest in the four health outcome measures, followed by Karnataka and then Uttar Pradesh, but condom use is lowest in Karnataka. Kerala also leads in the four dimensions of autonomy examined and in socio-demographic status, followed again by Karnataka and Uttar Pradesh. Despite these observed differences, in all three states, women with greater autonomy as measured by this study were more likely to be knowledgeable about AIDS and condoms and to use condoms, after controlling for socio-demographic factors. These results concur with other studies focusing on women's autonomy and health outcomes around the world, and point to the importance of incorporating a gender-based approach to AIDS prevention programmes in India.

The opinions of radiographers, nuclear medicine technologists and radiation therapists regarding technology in health care: a qualitative study.

PubMed

Aarts, Sil; Cornelis, Forra; Zevenboom, Yke; Brokken, Patrick; van de Griend, Nicole; Spoorenberg, Miriam; Ten Bokum, Wendy; Wouters, Eveline

2017-03-01

New technology is continuously introduced in health care. The aim of this study was (1) to collect the opinions and experiences of radiographers, nuclear medicine technologists and radiation therapists regarding the technology they use in their profession and (2) to acquire their views regarding the role of technology in their future practice. Participants were recruited from five departments in five hospitals in The Netherlands. All radiographers, nuclear medicine therapists and radiation therapists who were working in these departments were invited to participate (n = 252). The following topics were discussed: technology in daily work, training in using technology and the role of technology in future practice. The recorded interviews were transcribed verbatim and analysed using open and axial coding. A total of 52 participants (57.7% radiographer) were included, 19 men and 33 women (age range: 20-63). Four major themes emerged: (1) technology as an indispensable factor, (2) engagement, support and training in using technology, (3) transitions in work and (4) the radiographer of the future. All participants not only value technological developments to perform their occupations, but also aspects such as documentation and physical support. When asked about the future of their profession, contradictory answers were provided; while some expect less autonomy, others belief they will get more autonomy in their work. Technology plays a major role in all three occupations. All participants believe that technology should be in the best interests of patients. Being involved in the implementation of new technology is of utmost importance; courses and training, facilitated by the managers of the departments, should play a major role. Only when a constant dialogue exists between health care professionals and their managers, in which they discuss their experiences, needs and expectations, technology can be implemented in a safe and effective manner. This, in turn, might positively influence quality of care. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Applicability of the principle of respect for autonomy: the perspective of Turkey.

PubMed

Kara, Mahmut Alpertunga

2007-11-01

Turkey has a complex character, which has differences from the Western world or Eastern Asia as well as common points. Even after more than a century of efforts to modernise and integrate with the West, Turkish society has values that are different from those of the West, as well as having Western values. It is worth questioning whether ordinary Turkish people show an individualistic character. The principle of respect for individual autonomy arises from a perception of oneself as an individual, and the person's situation may affect the applicability of the principle. Patients who perceive themselves to be members of a community rather than free persons and who prefer to participate in the common decisions of the community and to consider the common interest and the common value system of the community concerning problems of their life (except healthcare or biomedical research) rather than to decide as independent, rational individuals may not be competent to make an autonomous choice. Expectations that such patients will behave as autonomous individuals may be unjustified. The family, rather than the patient, may take a primary role in decisions. A flexible system considering cultural differences in the concept of autonomy may be more feasible than a system following strict universal norms.

Applicability of the principle of respect for autonomy: the perspective of Turkey

PubMed Central

Kara, Mahmut Alpertunga

2007-01-01

Turkey has a complex character, which has differences from the Western world or Eastern Asia as well as common points. Even after more than a century of efforts to modernise and integrate with the West, Turkish society has values that are different from those of the West, as well as having Western values. It is worth questioning whether ordinary Turkish people show an individualistic character. The principle of respect for individual autonomy arises from a perception of oneself as an individual, and the person's situation may affect the applicability of the principle. Patients who perceive themselves to be members of a community rather than free persons and who prefer to participate in the common decisions of the community and to consider the common interest and the common value system of the community concerning problems of their life (except healthcare or biomedical research) rather than to decide as independent, rational individuals may not be competent to make an autonomous choice. Expectations that such patients will behave as autonomous individuals may be unjustified. The family, rather than the patient, may take a primary role in decisions. A flexible system considering cultural differences in the concept of autonomy may be more feasible than a system following strict universal norms. PMID:17971462

Preschool Children (Ages 2 to 4 Years) - NCS Dietary Assessment Literature Review

Cancer.gov

The preschool years are characterized as a time of increasing autonomy, expanding language skills, increasing ability to control behavior, and broadening social circumstances, such as attending preschool or staying with friends or relatives.

Characteristics of the work environment related to older employees' willingness to continue working: intrinsic motivation as a mediator.

PubMed

van den Berg, Peter T

2011-08-01

The relationships between older employees' willingness to continue working and characteristics of the work environment for older workers were investigated, as well as a possible mediation by intrinsic motivation. 103 employees ages 50 to 65 years, from various sectors of the Dutch labor market, completed questionnaires that measured willingness to continue working, intrinsic motivation, organizational stimulation, work variety, work challenge, and job autonomy. Hierarchical regression analyses showed organizational stimulation, as well as the various job characteristics, were positively related to employees' willingness to continue working. Moreover, intrinsic motivation fully mediated the relationship of work variety with willingness to continue working and partially mediated the relationships of organizational stimulation, work challenge, and job autonomy with willingness to continue working. It was concluded that organizations can encourage older workers to work until age 65 and beyond by shifting their focus from extrinsic to intrinsic rewards.

Health information law in the context of minors.

PubMed

Rosenbaum, Sara; Abramson, Susan; MacTaggart, Patricia

2009-01-01

This article presents a legal overview of privacy and autonomy considerations related to children in the context of health information technology adoption and use. All uses of health-related technologies take place within a legal framework that guides health care generally; the privacy laws and autonomy principles long predate health information technology and can be expected to shape its design and use. Furthermore, it is a legal tenet that technology advances shape the law, and this can be expected as health information technology use evolves. Most laws related to health care, medical practice, and the right to privacy are state-based and subject to high variability. As the health information revolution increasingly eliminates the importance of geographic boundaries to health care, interstate tensions can be expected to grow. Health information privacy law is even more complex in the case of children, because the relationship between privacy law and children is itself complex. The law considers minor children to be deserving of special protection against harm and risk exposure, and this concern extends to privacy. Regardless of whether minors can shield health information from parents, it is clear that parents and children have the power to control the flow of information to and among entities. Although information protections may pose a higher standard where information about children is concerned, this fact should not overshadow the extent to which information can be used under existing legal principles. Over time, as the security and safety of information sharing are established, the law may yet evolve to permit a freer flow of information.

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification

PubMed Central

Ribisl, Kurt M; Mayer, Deborah K; Tate, Deborah F

2018-01-01

Background Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback. Objective The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions. Methods We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up. Results For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who were in the standard priming condition and received both autonomy supportive and exemplar messages. In the PA module, autonomy supportive messages had a stronger effect on self-efficacy for PA in the standard priming condition. For PA, eating habits, and weight-related behaviors, the main effect of exemplar messages on behavioral intentions was in the hypothesized direction but did not reach statistical significance (P=.08). When comparing the main effects of different message conditions, there were no differences in engagement and message perceptions. Conclusions Findings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, PA, eating habits, and weight control. Combining standard priming and autonomy supportive message components shows potential for optimizing tailored feedback for tobacco cessation and PA behaviors. PMID:29496652

Integration of the Remote Agent for the NASA Deep Space One Autonomy Experiment

NASA Technical Reports Server (NTRS)

Dorais, Gregory A.; Bernard, Douglas E.; Gamble, Edward B., Jr.; Kanefsky, Bob; Kurien, James; Muscettola, Nicola; Nayak, P. Pandurang; Rajan, Kanna; Lau, Sonie (Technical Monitor)

1998-01-01

This paper describes the integration of the Remote Agent (RA), a spacecraft autonomy system which is scheduled to control the Deep Space 1 spacecraft during a flight experiment in 1999. The RA is a reusable, model-based autonomy system that is quite different from software typically used to control an aerospace system. We describe the integration challenges we faced, how we addressed them, and the lessons learned. We focus on those aspects of integrating the RA that were either easier or more difficult than integrating a more traditional large software application because the RA is a model-based autonomous system. A number of characteristics of the RA made integration process easier. One example is the model-based nature of RA. Since the RA is model-based, most of its behavior is not hard coded into procedural program code. Instead, engineers specify high level models of the spacecraft's components from which the Remote Agent automatically derives correct system-wide behavior on the fly. This high level, modular, and declarative software description allowed some interfaces between RA components and between RA and the flight software to be automatically generated and tested for completeness against the Remote Agent's models. In addition, the Remote Agent's model-based diagnosis system automatically diagnoses when the RA models are not consistent with the behavior of the spacecraft. In flight, this feature is used to diagnose failures in the spacecraft hardware. During integration, it proved valuable in finding problems in the spacecraft simulator or flight software. In addition, when modifications are made to the spacecraft hardware or flight software, the RA models are easily changed because they only capture a description of the spacecraft. one does not have to maintain procedural code that implements the correct behavior for every expected situation. On the other hand, several features of the RA made it more difficult to integrate than typical flight software. For example, the definition of correct behavior is more difficult to specify for a system that is expected to reason about and flexibly react to its environment than for a traditional flight software system. Consequently, whenever a change is made to the RA it is more time consuming to determine if the resulting behavior is correct. We conclude the paper with a discussion of future work on the Remote Agent as well as recommendations to ease integration of similar autonomy projects.

Work characteristics predict the development of multi-site musculoskeletal pain.

PubMed

Oakman, Jodi; de Wind, Astrid; van den Heuvel, Swenne G; van der Beek, Allard J

2017-10-01

Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups. This study is based on 5136 employees from the Study on Transitions in Employment, Ability and Motivation (STREAM) who reported no MSP at baseline. Measures included physical, emotional, mental, and psychological job demands, social support and autonomy. Predictors of MSP were studied by logistic regression analyses. Univariate and multivariate analyses with age stratification (45-49, 50-54, 55-59, and 60-64 years) were done to explore differences between age groups. All work characteristics with the exception of autonomy were predictive of the development of MSP, with odds ratios varying from 1.21 (95% CI 1.04-1.40) for mental job demands to 1.63 (95% CI 1.43-1.86) for physical job demands. No clear pattern of age-related differences in the predictors of MSP emerged, with the exception of social support, which was predictive of MSP developing in all age groups except for the age group 60-64 years. Adverse physical and psychosocial work characteristics are associated with MSP. Organisations need to comprehensively assess work environments to ensure that all relevant workplace hazards, physical and psychosocial, are identified and then controlled for across all age groups.

Positive and negative influences of social participation on physical and mental health among community-dwelling elderly aged 65-70 years: a cross-sectional study in Japan.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2017-05-19

Although numerous investigations have indicated that social participation (SP) has positive effects on the health of older adults, there have been few studies on its negative health consequences. We examined the cross-sectional associations of the type, frequency, and autonomy for SP with physical and mental health. The analytical subjects were 5126 males and 7006 females who were functionally independent, born between 1945 and 1949, and covered by A City's medical insurance system. Physical and mental health were measured using the SF-8 Health Survey. SP was measured through six types of social groups. These social groups included volunteer groups, sports groups, hobby clubs, senior citizens' clubs, neighborhood community associations, and cultural groups. Analysis of covariance was conducted to compare adjusted physical health component summary scores (PCS) and mental health component summary scores (MCS) by the frequency and autonomy of SP. Age, family size, body mass index, chronic conditions, smoking, alcohol intake, depression and cognitive functioning were included as covariates. To examine whether the associations between SP and PCS/MCS are different between genders, we performed analyses stratified by gender. Overall, positive associations of the frequency and autonomy of SP with PCS and MCS were stronger in females than males. As to frequency, frequent participation in sports groups and hobby clubs had significantly better PCS among both genders and better MCS among females than non-participation. None of the groups differed significantly in the MCS among males. As to autonomy, among both genders, voluntary participation in sports groups and hobby clubs had significantly better PCS than non-participation, and better MCS than not only non-participation, but also obligatory participation. Among females, obligatory participation in all groups had significantly poorer MCS than voluntary participation, and obligatory participation in sports groups had significantly poorer MCS than non-participation. Obligatory SP had significantly poorer MCS than voluntary participation, occasionally than non-participation; there is a possibility that obligatory SP has harmful influences on mental health of community-dwelling elderly. Measures to promote SP with consideration for individuals' autonomy may be effective in the public health approach to maintaining mental health.

Sociocultural influences and body image in 9- to 12-year-old girls: the role of appearance schemas.

PubMed

Clark, Levina; Tiggemann, Marika

2007-03-01

This study tested whether an individual's beliefs about the importance of appearance in their life is a mediator of sociocultural influences on body dissatisfaction in young girls. Participants were 265 girls in Grades 4 to 7 (M age = 10.71 years) from 5 private primary schools in metropolitan Adelaide, South Australia. Girls completed questionnaire measures of appearance television and magazine exposure, peer appearance conversations, autonomy, appearance schemas, and body dissatisfaction. Appearance media exposure and peer appearance conversations were negatively related to body esteem, and autonomy positively predicted body esteem. Most important, appearance schemas mediated between all sociocultural variables and body dissatisfaction.

Identifying Meta-Clusters of Students' Interest in Science and Their Change with Age

ERIC Educational Resources Information Center

Baram-Tsabari, Ayelet; Yarden, Anat

2009-01-01

Nearly 6,000 science questions collected from five different web-based, TV-based and school-based sources were rigorously analyzed in order to identify profiles of K-12 students' interest in science, and how these profiles change with age. The questions were analyzed according to their topic, thinking level, motivation for and level of autonomy in…

JPRS Report, East Asia, Southeast Asia

DTIC Science & Technology

1988-05-25

seek employment is expected to lighten Malaysia’s unemployment problem. Deputy Labor Min- ister Datuk Wan Abu Bakar pointed out today that if they can...680,000 people. The deputy minister of labor, Datuk Wan Abu Bakar , is fully aware of this projection, and is encouraging our citizens to seek...autonomy to both the Muslims and Christians in Mindanao similar to a federal system as in the United States and Malaysia. Sultan Macapanton Abbas Jr

Quantification of upper limb skills in elderly rehabilitative inpatients: a controlled study.

PubMed

Bejor, M; Mandrini, S; Caspani, P; Comelli, M; Chiappedi, M

2015-08-01

Aging has a recognized degenerative effect on the functionality of the hand in terms of strength and dexterity. Despite this, there are few studies in literature that quantify the upper limb skills in the elderly. The aim was to present quantitative data regarding upper limb functionality in the elderly and to quantify the effect of aging on them, considering the influence of the comorbidities, of the global level of autonomy, of the cognitive status and of the mood, which are typically compromised in the elderly. It was a controlled study. It was settled in the Rehabilitation Unit of the "Santa Maria alle Fonti" Medical Center, part of the Don Carlo Gnocchi ONLUS Foundation. Thirty-five elderly inpatients (aged 78.6±7.5 years) compared to 30 healthy young adults (aged 30±3.9 years). A task consisting in 12 trials of grasping of rulers was administered to each subject and studied with a video analysis software. To assess the comorbidities, the global level of autonomy, the cognitive status and the mood, we respectively used the Cumulative Illness Rating Scale (CIRS), the Functional Independence Measure (FIM™), the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale in the 15-items version (GDS-15). The scores obtained in these scales were correlated to the mean times of trials execution. The motor performance was significantly worse in the inpatients group compared to the control group in terms of time to complete single tasks (which was on average three times higher in the inpatients group) and of respect of the starting sound stimulus, with more subjects from the inpatients group anticipating the starting signal. This worsening of the motor performance was significantly correlated to the severity of comorbidities and to the global level of autonomy. No significant differences emerged for the correctness of the performance and significant differences were not correlated with depression or cognitive impairment. This study provides quantifiable data regarding upper limb skills in the elderly inpatient, allowing comparisons with other future studies of the rehabilitative environment. It suggests the relevance of considering the severity of comorbidities and the global level of autonomy in the assessment of upper limb skills in the elderly.

Impact of liposomal doxorubicin-based adjuvant chemotherapy on autonomy in women over 70 with hormone-receptor-negative breast carcinoma: A French Geriatric Oncology Group (GERICO) phase II multicentre trial.

PubMed

Brain, Etienne G C; Mertens, Cécile; Girre, Véronique; Rousseau, Frédérique; Blot, Emmanuel; Abadie, Sophie; Uwer, Lionel; Bourbouloux, Emmanuelle; Van Praagh-Doreau, Isabelle; Mourey, Loic; Kirscher, Sylvie; Laguerre, Brigitte; Fourme, Emmanuelle; Luneau, Sylvia; Genève, Jean; Debled, Marc

2011-10-01

Breast cancer is a disease of ageing. Functional independence in elderly patients, measured with the Katz activities of daily living (ADL) scale, predicts overall survival and the need for welfare support. Few prospective studies have examined the feasibility of adjuvant chemotherapy and its impact on autonomy in women over 70 years of age with high-risk breast cancer. This multicentre phase II trial was designed to assess the impact of adjuvant anthracycline-based chemotherapy on these patients' autonomy. In a two-stage Fleming design, women aged ≥70 years with histologically proven hormone-receptor-negative early breast cancer and a significant risk of recurrence (pN+ or "high risk" pN0) received 4 cycles of nonpegylated liposomal doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) every 3 weeks postoperatively, on an outpatient basis. The primary endpoint was the change in the ADL score during chemotherapy. Secondary endpoints include comprehensive geriatric, quality-of-life and acceptability assessments, tolerability, and long-term outcome. The results for the primary endpoint and other scales at completion of adjuvant chemotherapy are reported here, while long-term follow-up is not yet complete. Forty patients (median age 75 [70-82]) were enrolled between February 2006 and November 2007. Chemotherapy had no deleterious impact on ADL, cognition, mental status, or the frequency of comorbidities. In contrast, the number of patients at risk of malnutrition, based on the Mini Nutritional Assessment, more than doubled between baseline and the end of chemotherapy, rising from 15% to 38%. Quality-of-life deteriorated in terms of social and role functioning, likely owing to fatigue, loss of appetite, nausea and vomiting. Treatment acceptability was good. The main adverse effect was neutropenia, 15% of the patients experiencing febrile neutropenia. No cardiac toxicity or toxic deaths occurred. This study demonstrates the feasibility of an adjuvant chemotherapy regimen combining nonpegylated liposomal doxorubicin and cyclophosphamide in fit elderly women <85 years with breast cancer. Although chemotherapy had an impact on social and role functioning, autonomy was not impaired and toxicity was acceptable. Special attention should be paid to nutritional status before and after treatment. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[Influence of autonomy support, social goals and relatedness on amotivation in physical education classes].

PubMed

Moreno Murcia, Juan A; Parra Rojas, Nicolás; González-Cutre Coll, David

2008-11-01

The purpose of this study was to analyze some factors that influence amotivation in physical education classes. A sample of 399 students, of ages 14 to 16 years, was used. They completed the Perceived Autonomy Support Scale in Exercise Settings (PASSES), the Social Goal Scale-Physical Education (SGS-PE), the factor of the Basic Psychological Needs in Exercise Scale (BPNES) adapted to physical education and the factor of the Perceived Locus of Causality Scale (PLOC). The psychometric properties of the PASSES were analyzed, as this scale had not been validated to the Spanish context. In this analysis, the scale showed appropriate validity and reliability. The results of the structural equation model indicated that social responsibility and social relationship goals positively predicted perception of relatedness, whereas the context of autonomy support did not significantly predict it. In turn, perception of relatedness negatively predicted amotivation. The findings are discussed with regard to enhancing students' positive motivation.

Women's autonomy in decision making for health care in South Asia.

PubMed

Senarath, Upul; Gunawardena, Nalika Sepali

2009-04-01

This article aims to discuss women's autonomy in decision making on health care, and its determinants in 3 South Asian countries, using nationally representative surveys. Women's participation either alone or jointly in household decisions on their own health care was considered as an indicator of women's autonomy in decision making. The results revealed that decisions of women's health care were made without their participation in the majority of Nepal (72.7%) and approximately half of Bangladesh (54.3%) and Indian (48.5%) households. In Sri Lanka, decision making for contraceptive use was a collective responsibility in the majority (79.7%). Women's participation in decision making significantly increased with age, education, and number of children. Women who were employed and earned cash had a stronger say in household decision making than women who did not work or worked not for cash. Rural and poor women were less likely to be involved in decision making than urban or rich women.

Goals and everyday problem solving: manipulating goal preferences in young and older adults.

PubMed

Hoppmann, Christiane A; Blanchard-Fields, Fredda

2010-11-01

In the present study, we examined the link between goal and problem-solving strategy preferences in 130 young and older adults using hypothetical family problem vignettes. At baseline, young adults preferred autonomy goals, whereas older adults preferred generative goals. Imagining an expanded future time perspective led older adults to show preferences for autonomy goals similar to those observed in young adults but did not eliminate age differences in generative goals. Autonomy goals were associated with more self-focused instrumental problem solving, whereas generative goals were related to more other-focused instrumental problem solving in the no-instruction and instruction conditions. Older adults were better at matching their strategies to their goals than young adults were. This suggests that older adults may become better at selecting their strategies in accordance with their goals. Our findings speak to a contextual approach to everyday problem solving by showing that goals are associated with the selection of problem-solving strategies.

The relationship between negative life events and suicidal behavior: moderating role of basic psychological needs.

PubMed

Rowe, Catherine A; Walker, Kristin L; Britton, Peter C; Hirsch, Jameson K

2013-01-01

Individuals who experience negative life events may be at increased risk for suicidal behavior. Intrapersonal characteristics, such as basic psychological needs, however, may buffer this association. To assess the potential moderating role of overall basic psychological needs, and the separate components of autonomy, competence, and relatedness, on the association between negative life events and suicidal behavior. Our sample of 439 college students (311 females, 71%) completed the following self-report surveys: Life Events Scale, Basic Psychological Needs Scale, Beck Depression Inventory - II, and the Suicide Behaviors Questionnaire-Revised. In support of our hypotheses, negative life events were associated with greater levels of suicidal ideation and attempts, and satisfaction of basic psychological needs, including autonomy, relatedness, and competence, significantly moderated this relationship, over and above the effects of the covariates of age, sex, and depressive symptoms. Suicidal behavior associated with the experience of negative life events is not inevitable. Therapeutically bolstering competence, autonomy, and relatedness may be an important suicide prevention strategy for individuals experiencing life stressors.

Apocalyptic thinking, autonomy, and sociotropy.

PubMed

Morris, Neil; Johnson, Martin P

2002-06-01

As the millennium approached there was a unique opportunity to examine beliefs about impending apocalyptic events. In March, 1998 60 English participants, 20 to 35 years of age, including 20 Jehovah's Witnesses, 20 Roman Catholics, and 20 Methodists, completed a four-dimension scale of Positive and Negative Autonomy and Positive and Negative Sociotropy and a questionnaire, Apocalyptic Thinking, on the millennium containing questions on apocalyptic beliefs. The aim of the study was to investigate the apocalyptic beliefs of a number of Christian denominations and examine the relationship between scores on apocalyptic thinking about the millennium and group cohesion. Jehovah's Witnesses scored highest on all scales except Positive Autonomy, and the Catholics had higher Negative Sociotropy and Apocalyptic Thinking scores than the Methodists. Negative Sociotropy scores correlated positively with Apocalyptic Thinking scores for all groups. These data suggest significant positive relationship between these Christian endorsements of the likelihood of apocalyptic events at the millennium and the extent to which they perceive nonmembers of their denomination as 'outsiders'.

Do Some People Need Autonomy More Than Others? Implicit Dispositions Toward Autonomy Moderate the Effects of Felt Autonomy on Well-Being.

PubMed

Schüler, Julia; Sheldon, Kennon M; Prentice, Mike; Halusic, Marc

2016-02-01

The present studies examined whether implicit or explicit autonomy dispositions moderate the relationship between felt autonomy and well-being. Study 1 (N = 187 undergraduate students) presents an initial test of the moderator hypothesis by predicting flow experience from the interaction of autonomy need satisfaction and autonomy dispositions. Study 2 (N = 127 physically inactive persons) used vignettes involving an autonomy (un)supportive coach to test a moderated mediation model in which perceived coach autonomy support leads to well-being through basic need satisfaction. Again, the effects of need satisfaction on well-being were hypothesized to be moderated by an implicit autonomy disposition. Study 1 showed that individuals with a strong implicit autonomy (but not power or achievement) motive disposition derived more flow experience from felt autonomy than individuals with a weak implicit autonomy disposition. Study 2 revealed that perceived autonomy support from sports coaches, which we experimentally induced with a vignette method, leads to autonomy satisfaction, leading in turn to positive effects on well-being. This indirect effect held at high and average but not low implicit autonomy disposition. The results indicate that the degree to which people benefit from autonomy need satisfaction depends on their implicit disposition toward autonomy. © 2014 Wiley Periodicals, Inc.

Parent-Adolescent Discrepancies in Adolescents’ Competence and the Balance of Adolescent Autonomy and Adolescent and Parent Well-Being in the Context of Type 1 Diabetes

PubMed Central

Butner, Jonathan; Berg, Cynthia A.; Osborn, Peter; Butler, Jorie M.; Godri, Carine; Fortenberry, Katie T.; Barach, Ilana; Le, Hai; Wiebe, Deborah J.

2009-01-01

We examined whether intra-family discrepancies in perceptions of the adolescent’s competence and independence were associated with autonomy and also well-being for adolescents and parents. The latent discrepancy model was used to examine the ways that mothers and fathers consistently differed from their adolescent across measures of independence and competence regarding type 1 diabetes, a stressful context for families. One-hundred and eighty-five mothers, fathers, and adolescents (M age= 12.5 SD= 1.3) completed measures of the adolescent’s independence in completing diabetes tasks, problems with diabetes management, adherence to the medical regimen, measures of well-being, and metabolic control. The latent discrepancy model was conducted via structural equation modeling that generated latent discrepancies from the adolescent for mothers and fathers. Both mothers and fathers viewed the adolescent’s competence more negatively than did the adolescent. These discrepancies related to more parental encouragement of independence and adolescent autonomy, but also poorer metabolic control, and poorer parental psychosocial well-being. The results are interpreted within a developmental perspective that views discrepancies as reflecting normative developmental processes of autonomy, but associated with disruptions in well-being in the short term. PMID:19413435

Parent-adolescent discrepancies in adolescents' competence and the balance of adolescent autonomy and adolescent and parent well-being in the context of Type 1 diabetes.

PubMed

Butner, Jonathan; Berg, Cynthia A; Osborn, Peter; Butler, Jorie M; Godri, Carine; Fortenberry, Katie T; Barach, Ilana; Le, Hai; Wiebe, Deborah J

2009-05-01

This study examined whether intrafamily discrepancies in perceptions of the adolescent's competence and independence were associated with autonomy and well-being for adolescents and parents. The ways in which mothers and fathers consistently differed from their adolescent across measures of independence and competence regarding Type 1 diabetes, a stressful context for families, were examined with the latent discrepancy model. A sample of 185 adolescents (mean age = 12.5 years, SD = 1.3), their mothers, and participating fathers completed measures of the adolescent's independence in completing diabetes tasks, problems with diabetes management, adherence to the medical regimen, measures of well-being, and metabolic control. The latent discrepancy model was conducted via structural equation modeling that generated latent discrepancies from the adolescent for mothers and fathers. Both mothers and fathers viewed the adolescent's competence more negatively than did the adolescent. These discrepancies related to more parental encouragement of independence and adolescent autonomy but also to poorer metabolic control and poorer parental psychosocial well-being. The results are interpreted within a developmental perspective that views discrepancies as reflecting normative developmental processes of autonomy but as being associated with disruptions in well-being in the short term. Copyright 2009 APA, all rights reserved

Exercisers' perceptions of their fitness instructor's interacting style, perceived competence, and autonomy as a function of self-determined regulation to exercise, enjoyment, affect, and exercise frequency.

PubMed

Puente, Rogelio; Anshel, Mark H

2010-02-01

The primary purpose of the present investigation was to test the hypothesis, derived from Self-Determination Theory (SDT), that an individual's perceived competence and autonomy mediate the relationship between the exercisers' perception of their instructor's interaction style and the exercisers' motivation to exercise. A secondary purpose was to identify the affective and behavioral outcomes derived from self-determined regulation. It was hypothesized that SDT would significantly explain and predict exercise behavior. Participants consisted of 238 college students, 103 males and 135 females (M age = 20.4 years, SD = 2.16), who volunteered to participate in the study. They were asked to complete a battery of questionnaires measuring instructor's interacting style, self-regulation to exercise, perceived autonomy and competence, enjoyment, positive and negative affect, and exercise frequency. Using structural equation modeling with observed variables, the results showed that perceived competence and autonomy mediated the relationship between perceived instructor's interacting style and self-determined regulation. It was also found that self-determined regulation was significantly related to exercise enjoyment, positive affect, and exercise frequency. It was concluded that understanding the motivational factors and emotional and behavioral consequences of physical activity will partially explain an individual's motives to engage regularly in exercise.

The Portuguese formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): a preliminary validation study.

PubMed

Matos, Marta; Bernardes, Sónia F

2013-09-01

Development and preliminary validation of a Portuguese measure of perceived Formal Social Support for Autonomy and Dependence in Pain (FSSADI_PAIN). One hundred and fifty-one older adults (88.1% women), between 56 and 94 years of age (M = 75.41; SD = 9.11), who attended one of the following institutions--day care centre (33.1%), nursing home (36.4%) and senior university (30.5%)--were recruited for this study. Along with the FSSADI_PAIN, participants filled out the Portuguese versions of the Brief Pain Inventory (Azevedo et al., 2007, Dor, 15, 6) and the Social Support Scale of Medical Outcomes Survey (Pais-Ribeiro & Ponte, 2009, Psicologia, Saúde & Doença, 10, 163). The factorial structure reflected the functions of perceived promotion of (1) dependence and (2) autonomy, showing good internal consistency (α > .70) and sensitivity indices. The FSSADI_PAIN showed good content, discriminant and criterion validity; it differentiated the perceptions of promotion of dependence/autonomy according to individual's pain severity and disability, as well as the type of institution. These preliminary findings suggest that the FSSADI_PAIN is an innovative and promising measure of perceived formal social support adapted to pain-related contexts. © 2012 The British Psychological Society.

Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus.

PubMed

Petersen, Jakob; Hellström, Per; Wikkelsø, Carsten; Lundgren-Nilsson, Asa

2014-10-01

To investigate the impact of shunt surgery on the activity, participation, autonomy, and health-related quality of life (HRQOL) of patients with idiopathic normal-pressure hydrocephalus (iNPH) as well as the effect on caregiver burden. Thirty-seven patients (median age 70 years, range 50-89 years) with iNPH were evaluated before and 6 months after surgery. Symptoms and signs were assessed by the iNPH scale, activities of daily living (ADL) with the Functional Independence Measure (FIM) and Assessment of Motor and Process Skills (AMPS), autonomy and participation with Impact on Participation and Autonomy (IPA), and caregiver burden with the Caregiver Burden Scale (CBS). HRQOL was evaluated with the EQ-5D (EuroQol Group-5 Dimension health survey). Twenty-four patients (65%) improved clinically (iNPH scale score) and 31 (86%) improved their HRQOL after surgery, almost to the same level as found in the normal population. The patients became more independent in physical and cognitive activities, and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level. After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal.

Organizational climate and self-efficacy as predictors of staff strain in caring for dementia residents: A mediation model.

PubMed

Karantzas, Gery C; McCabe, Marita P; Mellor, David; Von Treuer, Kathryn; Davison, Tanya E; O'Connor, Daniel; Haselden, Rachel; Konis, Anastasia

2016-01-01

To date, no research has investigated how the organizational climate of aged care influences the self-efficacy of staff in caring for residents with dementia, or, how self-efficacy is associated with the strain experienced by staff. This study sought to investigate the extent to which the self-efficacy of aged care staff mediates the association between organizational climate variables (such as autonomy, trusting and supportive workplace relations, and the recognition of competence and ability, and perceptions of workplace pressure) and staff strain. A cross-sectional survey design was implemented in which 255 residential aged care staff recruited across aged care facilities in Melbourne, Australia. Staff completed self-report measures of organizational climate, self-efficacy, and strains in caring for residents with dementia. Indirect effects analyses using bootstrapping indicated that self-efficacy of staff mediated the association between the organizational climate variables of autonomy, trust, support, pressure, and staff strain. The findings of this study emphasize that the aged care sector needs to target organizational climate variables that enhance the self-efficacy of staff, and that this in turn, can help ameliorate the strain experienced by staff caring for residents experiencing dementia. Copyright © 2016. Published by Elsevier Ireland Ltd.

Elective oocyte cryopreservation for deferred childbearing.

PubMed

Goldman, Kara N; Grifo, Jamie A

2016-12-01

Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation. Despite an inevitable decline in fertility and increase in miscarriage with increasing female age, there is a growing worldwide trend to delay childbearing. Patients and providers alike demonstrate large gaps in knowledge surrounding age-related fertility decline. Oocyte cryopreservation is clinically approved for medically indicated fertility preservation, but a growing number of women are using oocyte cryopreservation to defer childbearing and maintain reproductive autonomy. Mounting data support the efficacy and safety of oocyte cryopreservation when used to electively defer childbearing, with recent studies demonstrating rates of euploidy, implantation and live birth rates equivalent to in-vitro fertilization (IVF) with fresh oocytes. Oocyte cryopreservation provides women with an option to defer childbearing and maintain reproductive autonomy, with IVF success rates on par with fresh IVF. However, it is critical that patients understand the limitations of oocyte cryopreservation. Greater education regarding age-related fertility decline should be geared toward patients and providers to prevent unintended childlessness.

Psychological need satisfaction, control, and disordered eating.

PubMed

Froreich, Franzisca V; Vartanian, Lenny R; Zawadzki, Matthew J; Grisham, Jessica R; Touyz, Stephen W

2017-03-01

Unfulfilled basic psychological needs have been associated with disordered eating behaviours, but the mechanisms underlying that associations are not well understood. This study examined a two-stage path model linking basic psychological need satisfaction to disordered eating behaviours via issues of control. Female university students (N = 323; M age  = 19.61), community participants (N = 371; M age  = 29.75), and women who self-reported having been diagnosed with an eating disorder (ED; N = 41; M age  = 23.88) completed measures of psychological need satisfaction (i.e., autonomy and competence), issues of control (i.e., feelings of ineffectiveness and fear of losing self-control [FLC]), and ED pathology. Path analysis revealed that unsatisfied needs of autonomy and competence were indirectly related to disordered eating behaviours through feelings of ineffectiveness and FLC. The results indicate that issues of control might be one of the mechanisms through which lack of psychological need satisfaction is associated with disordered eating. Although the model was constructed using cross-sectional data, these findings suggest potential targets for prevention and treatment efforts aimed at reducing disordered eating in young females. Our results indicate that young women with chronically unfulfilled basic psychological needs might be vulnerable to developing disordered eating behaviours. The observed patterns suggest that persistent experience of need frustration may engender an internal sense of ineffectiveness and lack of control, which then compels individuals to engage in disordered eating behaviours in an attempt to regain autonomy and competence. Interventions for eating disorders may be most effective when emphasizing the promotion of people's needs for autonomy and competence. Limitations The model was constructed using cross-sectional data. Future experimental and longitudinal studies are needed to confirm the temporal sequence from basic psychological needs to issues of control. The sample only consisted of young women. Further research should explore how thwarting of psychological need satisfaction functions in men. Our clinical sample was small and diagnosis was not confirmed through clinical interview; therefore, those data should be interpreted with caution. © 2016 The British Psychological Society.

Autonomy support and control in weight management: what important others do and say matters.

PubMed

Ng, Johan Y Y; Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie

2014-09-01

Drawing from self-determination theory (Ryan & Deci, 2002, Overview of self-determination theory: An organismic-dialectical perspective. In E. L. Deci & R. M. Ryan (Eds.), Handbook of self-determination research (pp. 3-33). Rochester, NY: The University of Rochester Press.), we examined how individuals' psychological needs, motivation, and behaviours (i.e., physical activity and eating) associated with weight management could be predicted by perceptions of their important others' supportive and controlling behaviours. Using a cross-sectional survey design, 235 participants (mean age = 27.39 years, SD = 8.96 years) completed an online questionnaire. Statistical analyses showed that when important others were perceived to be more supportive, participants reported higher levels of more optimal forms of motivation for weight management, which in turn predicted more physical activity and healthy eating behaviours. In contrast, when important others were perceived to be controlling, participants reported higher levels of less optimal forms of motivation, which in turn predicted less physical activity and healthy eating behaviours, as well as more unhealthy eating behaviours. Significant indirect effects were also found from perceived support and control from important others to physical activity and eating behaviours, all in the expected directions. The findings support the importance of important others providing support and refraining from controlling behaviours in order to facilitate motivation and behaviours conducive to successful weight management. What is already known on this subject? Autonomy support is related to basic need satisfaction and autonomous motivation in the context of weight management. In turn, these variables are related to adaptive outcomes for weight management. What does this study add? Measurement of perceived controlling behaviours by important others. Measurement of perceived need thwarting. Structural model on how important others affect weight management behaviours of the individual. © 2013 The British Psychological Society.

Quality care provision for older people: an interview study with patients and primary healthcare professionals

PubMed Central

van de Pol, Marjolein Helena Johanna; Fluit, Cornelia Rita Maria Gertruda; Lagro, Joep; Niessen, Danielle; Rikkert, Marcellinus Gerardus Maria Olde; Lagro-Janssen, Antoinette Leonarda Maria

2015-01-01

Background In recent years, primary health care for the ageing population has become increasingly complex. Aim This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people. Design and setting This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands. Method All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached. Results Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another’s perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: ‘autonomy and independence’, ‘organisational barriers’, and ‘professional expertise’. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals. Conclusion Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements. PMID:26212845

Second-Order Dimensions of the Work Values Inventory (WVI).

ERIC Educational Resources Information Center

Bolton, Brian

1980-01-01

Stimulating work, interpersonal satisfaction, economic security, responsible autonomy, comfortable existence, and esthetic concerns provide a summary of clients' work motivation at a higher level of generality. They are independent of age, education, and intelligence and can be hand-scored. (Author)

Autonomy of the child in the South African context: is a 12 year old of sufficient maturity to consent to medical treatment?

PubMed

Ganya, Wandile; Kling, Sharon; Moodley, Keymanthri

2016-11-02

A child is a developing person with evolving capacities that include autonomy, mental (decisional) capacity and capacity to assume responsibility. Hence, children are entitled to participatory (autonomy) rights in South Africa as observed in the Children's Act 38 of 2005. According to section 129 of the Act a child may consent to his or her own medical treatment provided that he or she is over the age of 12 years and is of sufficient maturity and decisional capacity to understand the various implications of the treatment including the risks and benefits thereof. However, the Act does not provide a definition for what qualifies as 'sufficient maturity' nor does it stipulate how health professionals ought to assess the decisional capacity of a child. In addition, South Africa is a culturally diverse country. The Western liberal notion of autonomy may not necessarily find equal prominence in the mores of people with a different worldview. Hence we demonstrate a few salient comparisons between legal liberal moral theory and African communitarianism as pertinent to the autonomy of the child. Children are rights-holders by virtue of their humanity. Their dignity as individual human persons affords them the entitlement to human rights as contemplated under the Constitution of the Republic of South Africa. However, contrary to the traditional Western notion of individual autonomous persons African societies hold a communalistic notion of person hence there is less regard for individual autonomy and rights with more emphasis on the communal good and maintaining the continuity of relationships and interdependencies shared within a community. A child considered in this view is not regarded as a full person. This implies that decisions concerning the child, including consent to medical treatment are discussed and determined by the community to which the child belongs. Lastly, in this article, we draw on the notion of capacity for responsibility to produce a pragmatic definition of sufficient maturity. It seems reasonable to suggest a move away from a general legal age of consent for medical treatment toward more individualised, context-specific approaches in determining the maturity of a child patient to consent to medical treatment. Perhaps, decision-making with respect to consent to the medical treatment of a child belonging to a traditional African community where the notion of a person is embedded in communitarianism ought to involve the child's parents/guardians/caregivers where possible provided that the best interests of the child are awarded priority.

The More, the Better? Curvilinear Effects of Job Autonomy on Well-Being From Vitamin Model and PE-Fit Theory Perspectives.

PubMed

Stiglbauer, Barbara; Kovacs, Carrie

2017-12-28

In organizational psychology research, autonomy is generally seen as a job resource with a monotone positive relationship with desired occupational outcomes such as well-being. However, both Warr's vitamin model and person-environment (PE) fit theory suggest that negative outcomes may result from excesses of some job resources, including autonomy. Thus, the current studies used survey methodology to explore cross-sectional relationships between environmental autonomy, person-environment autonomy (mis)fit, and well-being. We found that autonomy and autonomy (mis)fit explained between 6% and 22% of variance in well-being, depending on type of autonomy (scheduling, method, or decision-making) and type of (mis)fit operationalization (atomistic operationalization through the separate assessment of actual and ideal autonomy levels vs. molecular operationalization through the direct assessment of perceived autonomy (mis)fit). Autonomy (mis)fit (PE-fit perspective) explained more unique variance in well-being than environmental autonomy itself (vitamin model perspective). Detrimental effects of autonomy excess on well-being were most evident for method autonomy and least consistent for decision-making autonomy. We argue that too-much-of-a-good-thing effects of job autonomy on well-being exist, but suggest that these may be dependent upon sample characteristics (range of autonomy levels), type of operationalization (molecular vs. atomistic fit), autonomy facet (method, scheduling, or decision-making), as well as individual and organizational moderators. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Affective Motives for Smoking Among Early Stage Smokers

PubMed Central

Wahlquist, Amy E.; Garrett-Mayer, Elizabeth; Gray, Kevin M.; Saladin, Michael E.; Carpenter, Matthew J.

2014-01-01

Background: As most smokers initiate smoking during adolescence, assessment of smoking motives that underlie trajectories of dependence is critical for both prevention and cessation efforts. In the current study, we expected participants with higher nicotine dependence would smoke (a) less for positive reinforcement (PR) and (b) more for negative reinforcement (NR) motives. We secondarily assessed the relative contribution of PR to NR motives across levels of dependence. Methods: Data were drawn from a study on cue-elicited craving among occasional versus daily adolescent smokers aged 16–20 years (N = 111). Smoking motives were assessed in relation to 3 commonly used measures of nicotine dependence: (a) Fagerström Test for Nicotine Dependence (FTND), (b) Autonomy over Smoking Scale (AUTOS), and (c) Nicotine Dependence Syndrome Scale (NDSS). Results: Compared to occasional smokers, daily smokers had significantly higher scores on each dependence measure and endorsed more prominent NR smoking motives. Each measure of nicotine dependence was strongly associated with NR motives for smoking, although measures differed in their association with PR motives. As expected, the FTND, AUTOS, and NDSS each significantly predicted smoking motive difference score (PR − NR), such that higher dependence was associated with more prominent NR motives for smoking. Conclusions: Results are consistent with our understanding of dependence and provide further support for 3 common measures of nicotine dependence among early stage smokers. PMID:24924155

Knowledge, Autonomy and Maturity: Developmental and Educational Concerns as Rhetorical Resources in Adolescents' Discussions regarding the Age of Electoral Majority in England

ERIC Educational Resources Information Center

Gibson, Stephen; Hamilton, Lorna

2013-01-01

Recent debates concerning the age of electoral majority in the UK have focused on the levels of knowledge and maturity of young people. However, little research has explored the ways in which adolescents orient to these concerns themselves. In this article, we present analyses from a qualitative interview investigation in Northern England, and…

Educational attainment, gender and health inequalities among older adults in Catalonia (Spain).

PubMed

Solé-Auró, Aïda; Alcañiz, Manuela

2016-08-04

Health expectancies vary worldwide according to socioeconomic status (SES), with health disadvantages being evident among lower SES groups. Using educational attainment as a proxy of SES, we seek to identify trends in SES differentials in health by gender, with a particular focus on individuals with low educational attainment in the adult Catalan population (Spain) aged 55 or older. Using cross-sectional data for 1994 and 2010-2014 drawn from the Catalan Health Survey, we examined three health indicators to document social health inequalities: self-perceived health, functional limitations, and restrictions on activities of daily living (ADL). We applied logistic models for each indicator, controlling for sociodemographic characteristics, health coverage and health behaviours. Among the less-educated, females presented a greater improvement in their self-perceived health over time than did their male counterparts, there being no significant variations among the medium/high educated. Regardless of education, males showed an increase in the prevalence of functional problems (as did the women, but the increase was not statistically significant). Both genders presented a higher prevalence of limitations when performing ADL in the second time period. The gender health gap was reduced slightly both for the low and the medium/high educated, expect in the case of ADL restrictions. Health and functioning differences by education level persisted, but showed significant signs of reduction. Less-educated females constitute the most disadvantaged group in terms of health and personal autonomy, though there are encouraging signs that the gap is closing both in terms of gender and level of education. Health policymakers need to devote particular attention to the aging population with low SES, especially to women. Public programmes promoting greater protection and equity, while fostering preventive and healthy practices, need to target the most underprivileged.

Aerobic capacity explains physical functioning and participation in patients with multiple sclerosis-related fatigue.

PubMed

Rosalie Driehuis, Emma; van den Akker, Lizanne Eva; de Groot, Vincent; Beckerman, Heleen

2018-02-13

To investigate whether aerobic capacity explains the level of self-reported physical activity, physical functioning, and participation and autonomy in daily living in persons with multiple sclerosis-related fatigue. A cross-sectional study. Sixty-two participants with multiple sclerosis-related fatigue. Aerobic capacity was measured with a leg ergometer and was expressed as maximal oxygen uptake (VO2max, in ml/kg/min). Physical activity was measured with the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), physical functioning with the Short Form 36 - physical functioning (SF36-pf), and participation and autonomy in daily living with the Impact on Participation and Autonomy questionnaire (IPA). Multiple regression analyses were performed, adjusted for potential confounders (gender, age, body mass index, educational level, and employment status). Mean maximal oxygen uptake (VO2max) was 23.9 ml/kg/min (standard deviation (SD) 6.3 ml/kg/min). There was no significant relationship between VO2max and physical activity (PASIPD): β = 0.320, 95% confidence interval (95% CI) = -0.109 to 0.749, R2 = 10.8%. Higher VO2max correlated with better physical functioning (SF36-pf): β = 1.527, 95% CI = 0.820-2.234, R2 = 25.9%, and was significantly related to IPA domains "autonomy indoors" (β = -0.043, 95% CI = -0.067 to -0.020, R2 = 20.6%), "autonomy outdoors" (β = -0.037, 95% CI = -0.062 to -0.012, R2 = 18.2%) and "social life and relationships" (β=-0.033, 95% CI = -0.060 to -0.007, R2 = 21.3%). Maximum aerobic capacity was severely reduced in persons with multiple sclerosis-related fatigue. This partly explains the limited physical functioning and restrictions in participation and autonomy indoors, outdoors and in social life and relationships in these persons.

Motivational and evolutionary aspects of a physical exercise training program: a longitudinal study

PubMed Central

Rosa, João P. P.; de Souza, Altay A. L.; de Lima, Giscard H. O.; Rodrigues, Dayane F.; de Aquino Lemos, Valdir; da Silva Alves, Eduardo; Tufik, Sergio; de Mello, Marco T.

2015-01-01

Several studies have indicated that motivational level and prior expectations influence one’s commitment to physical activity. Moreover, these aspects are not properly described in terms of proximal (SDT, Self Determination Theory) and distal (evolutionary) explanations in the literature. This paper aims to verify if level of motivation (BREQ-2, Behavioral Regulation in Exercise Questionnaire-2) and expectations regarding regular physical exercise (IMPRAF-54) before starting a 1-year exercise program could determine likelihood of completion. Ninety-four volunteers (53 women) included a completed protocol group (CPG; n = 21) and drop-out group (n = 73). The IMPRAF-54 scale was used to assess six different expectations associated with physical activity, and the BREQ-2 inventory was used to assess the level of motivation in five steps (from amotivation to intrinsic motivation). Both questionnaires were assessed before starting a regular exercise program. The CPG group presented higher sociability and lower pleasure scores according to IMPRAF-54 domains. A logistic regression analysis showed that a one-point increment on sociability score increased the chance of completing the program by 10%, and the same one-point increment on pleasure score reduced the chance of completing the protocol by 16%. ROC curves were also calculated to establish IMPRAF-54 cutoffs for adherence (Sociability – 18.5 points – 81% sensibility/50% specificity) and dropout (Pleasure – 25.5 points – 86% sensibility/20% specificity) of the exercise protocol. Our results indicate that an expectation of social interaction was a positive factor in predicting adherence to exercise. Grounded in SDT and its innate needs (competence, autonomy, relatedness), physical exercise is not an end; it is a means to achieve autonomy and self-cohesion. The association of physical activity with social practices, as occurs in hunter-gathering groups, can engage people to be physically active and can provide better results in adherence exercise programs for the general population. PMID:26042076

The Chains on All My People Are the Chains on Me: Restrictions to Collective Autonomy Undermine the Personal Autonomy and Psychological Well-Being of Group Members.

PubMed

Kachanoff, Frank J; Taylor, Donald M; Caouette, Julie; Khullar, Thomas H; Wohl, Michael J A

2018-01-11

Four studies assessed the potentially detrimental effects that restrictions to collective autonomy (i.e., a group's freedom to determine and practice its own identity) may have for the personal autonomy and psychological well-being of group members. In Study 1, using 3 distinct samples (NSample1a = 123, NSample1b = 129, NSample1c = 370), correlational and cross-cultural evidence indicates that perceived restrictions to the collective autonomy of one's group is directly associated with reduced personal autonomy, and indirectly associated with diminished well-being through personal autonomy. In Study 2 (N = 411), a longitudinal assessment of group members over 3 time-points during a 4-month period found that group members who perceived greater collective autonomy restriction also experienced reduced personal autonomy, and in turn, reduced psychological well-being over time. In Study 3 (N = 255), group members described a time during which their ingroup had (or did not have) its collective autonomy unduly restricted by other groups. Participants who were primed to think that their group lacked collective autonomy reported reduced feelings of personal autonomy, and reduced psychological well-being (compared with those primed to think their group had collective autonomy). In Study 4 (N = 389), collective autonomy was manipulated within the context of an intensive laboratory simulation. Collective autonomy-restricted group members experienced less personal autonomy than those who did not have their collective autonomy restricted. Together these findings suggest that restrictions to a group's collective autonomy may have detrimental consequences for the personal autonomy and psychological well-being of group members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effects of gender, age, and diabetes duration on dietary self-care in adolescents with type 1 diabetes: a Self-Determination Theory perspective.

PubMed

Austin, Stéphanie; Senécal, Caroline; Guay, Frédéric; Nouwen, Arie

2011-09-01

This study tests a model derived from Self-Determination Theory (SDT) (Deci and Ryan, 2000) to explain the mechanisms by which non-modifiable factors influence dietary self-care in adolescents with type 1 diabetes (n = 289). SEM analyses adjusted for HbA1c levels revealed that longer diabetes duration and female gender were indicative of poorer dietary self-care. This effect was mediated by contextual and motivational factors as posited by SDT. Poorer autonomy support from practitioners was predominant in girls with longer diabetes duration. Perceived autonomous motivation and self-efficacy were indicative of greater autonomy support, and led to better dietary self-care.

Operator Informational Needs for Multiple Autonomous Small Vehicles

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Fan, Henry; Cross, Charles D.; Hempley, Lucas E.; Cichella, Venanzio; Puig-Navarro, Javier; Mehdi, Syed Bilal

2015-01-01

With the anticipated explosion of small unmanned aerial vehicles, it is highly likely that operators will be controlling fleets of autonomous vehicles. To fulfill the promise of autonomy, vehicle operators will not be concerned with manual control of the vehicle; instead, they will deal with the overall mission. Furthermore, the one operator to many vehicles is becoming a constant meme with various industries including package delivery, search and rescue, and utility companies. In order for an operator to concurrently control several vehicles, his station must look and behave very differently than the current ground control station instantiations. Furthermore, the vehicle will have to be much more autonomous, especially during non-normal operations, in order to accommodate the knowledge deficit or the information overload of the operator in charge of several vehicles. The expected usage increase of small drones requires presenting the operational information generated by a fleet of heterogeneous autonomous agents to an operator. NASA Langley Research Center's Autonomy Incubator has brought together researchers in various disciplines including controls, trajectory planning, systems engineering, and human factors to develop an integrated system to study autonomy issues. The initial human factors effort is focusing on mission displays that would give an operator the overall status of all autonomous agents involved in the current mission. This paper will discuss the specifics of the mission displays for operators controlling several vehicles.

Genetic screening and testing in an episode-based payment model: preserving patient autonomy.

PubMed

Sutherland, Sharon; Farrell, Ruth M; Lockwood, Charles

2014-11-01

The State of Ohio is implementing an episode-based payment model for perinatal care. All costs of care will be tabulated for each live birth and assigned to the delivering provider, creating a three-tiered model for reimbursement for care. Providers will be reimbursed as usual for care that is average in cost and quality, while instituting rewards or penalties for those outside the expected range in either domain. There are few exclusions, and all methods of genetic screening and diagnostic testing are included in the episode cost calculation as proposed. Prenatal ultrasonography, genetic screening, and diagnostic testing are critical components of the delivery of high-quality, evidence-based prenatal care. These tests provide pregnant women with key information about the pregnancy, which, in turn, allows them to work closely with their health care provider to determine optimal prenatal care. The concepts of informed consent and decision-making, cornerstones of the ethical practice of medicine, are founded on the principles of autonomy and respect for persons. These principles recognize that patients' rights to make choices and take actions are based on their personal beliefs and values. Given the personal nature of such decisions, it is critical that patients have unbarred access to prenatal genetic tests if they elect to use them as part of their prenatal care. The proposed restructuring of reimbursement creates a clear conflict between patient autonomy and physician financial incentives.

Developmental coordination disorder in children with specific language impairment: co-morbidity and impact on quality of life.

PubMed

Flapper, Boudien C T; Schoemaker, Marina M

2013-02-01

Co-morbidity of Developmental Coordination Disorder (DCD) in children with specific language impairment (SLI) and the impact of DCD on quality-of-life (QOL) was investigated in 65 5-8 year old children with SLI (43 boys, age 6.8±0.8; 22 girls, age 6.6±0.8). The prevalence of DCD was assessed using DSM-IV-TR criteria (American Psychiatric Association (APA), 2000) operationally defined in the clinical practice guideline (CPG): movement ABC scores below 15th percentile, scores on DCDQ and/or MOQ-T below 15th percentile, absence of medical condition according to paediatric-neurological exam. Quality of life (QOL) was measured with the TNO-AZL-Child-Quality-Of-Life (TACQOL) Questionnaire filled out by parents for the SLI group with and without DCD, and compared to a reference group (N=572; age 6.9±0.9). The TACQOL covers 7 QOL domains: physical, motor, cognitive and social functioning, autonomy, positive and negative moods. Prevalence of DCD in children with SLI was 32.3%. In children with SLI, mean QOL scores were significantly lower in the autonomy, cognitive, social and positive moods domains compared to the reference group. Children with SLI and DCD differed from children with SLI without DCD by significantly lower mean overall-, motor-, autonomy-, and cognitive domain-QOL scores. Clinicians should be aware that about one third of children with SLI can also be diagnosed with DCD. Assessment of QOL is warranted in order to assess which domains are affected in children with SLI with or without DCD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Surgical patients' and nurses' opinions and expectations about privacy in care.

PubMed

Akyüz, Elif; Erdemir, Firdevs

2013-09-01

The purpose of this study was to determine the opinions and expectations of patients and nurses about privacy during a hospital admission for surgery. The study explored what enables and maintains privacy from the perspective of Turkish surgical patients and nurses. The study included 102 adult patients having surgery and 47 nurses caring for them. Data were collected via semistructured questionnaire by face-to-face interviews. The results showed that patients were mostly satisfied by the respect shown to their privacy by the nurses but were less confident of the confidentiality of their personal data. It was found that patients have expectations regarding nursing approaches and attitudes about acknowledging and respecting patient autonomy and confidentiality. It is remarkable that while nurses focused on the physical dimension of privacy, patients focused on informational and psychosocial dimensions of privacy, as well as its physical dimension.

Disclosure of incidental constituents of psychotherapy as a moral obligation for psychiatrists and psychotherapists.

PubMed

Trachsel, Manuel; Gaab, Jens

2016-08-01

Informed consent to medical intervention reflects the moral principle of respect for autonomy and the patient's right to self-determination. In psychotherapy, this includes a requirement to inform the patient about those components of treatment purported to cause the therapeutic effect. This information must encompass positive expectancies of change and placebo-related or incidental constituent therapy effects, which are as important as specific intervention techniques for the efficacy of psychotherapy. There is a risk that informing the patient about possible incidental constituents of therapy may reduce or even completely impede these effects, with negative consequences for overall outcome. However, withholding information about incidental constituents of psychotherapy would effectively represent a paternalistic action at the expense of patient autonomy; whether such paternalism might in certain circumstances be justified forms part of the present discussion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[How free is free will? Neuro-scientific and philosophical aspects of motivation and decision-making].

PubMed

Hinterhuber, Hartmann

2012-01-01

The question concerning the postulated freedom of will continues to occupy the neuro-sciences, psychiatry, law and neuro-philosophy. Do current research results really show that freedom and responsibility were only illusions, since previously supposed free decisions were only accompanying features of long held neuronal activations? Did Julien de La Mettrie have a great vision, when, already in the Eighteenth Century, he expected a "monsieur Machine"?This article attempts to summarize and evaluate findings that are currently available. The autonomy of human action is not only founded in a subjectively perceived act of will but far more in the ability of the human being to act according to an inner drive which is steered consciously and rationally. The autonomy of human action is not only restricted to the perceived ego, but comprises body and soul, brain and spirit and consequently the whole human being with all their characteristics, values and aims. Modern science thereby supports the old philosophical theory of a conditional freedom of will.

Determinants of working until retirement compared to a transition to early retirement among older workers with and without chronic diseases: Results from a Dutch prospective cohort study.

PubMed

Sewdas, Ranu; van der Beek, Allard J; de Wind, Astrid; van der Zwaan, Lennart G L; Boot, Cécile R L

2018-05-01

The ageing society and recent policy changes may lead to an increase of older workers with chronic diseases in the workforce. To date, it is unclear whether workers with chronic diseases have specific needs while employed. The aim of this study is to explore the differences in determinants of working until retirement compared to a reference group who have transitioned to early retirement among workers with and without chronic diseases. Dutch workers aged 57-62 years ( n = 2445) were selected from an existing prospective cohort study, 'STREAM'. The potential determinants were categorized into: individual, health, work-related and social factors. Logistic regression analyses were performed to determine the associations between these determinants and working until retirement - once for workers with and once for those without chronic diseases. To test differences, we included an interaction term between the determinant and the covariate 'having a chronic disease yes/no' in the analyses of the total population. In total, 1652 (68%) persons were employed from 2011 to 2013. The majority of the determinants appeared to be similar for workers with or without a chronic disease; the interaction terms for these determinants and the covariate 'having a chronic disease' showed a p-value higher than 0.05, except for one individual factor (i.e. mastery) and one work-related factor (i.e. autonomy), which showed a p-value below 0.05. Higher mastery and higher autonomy were statistically significantly associated with working until retirement for those with chronic diseases, whereas they were not for those without chronic diseases. Differences between workers with and without chronic diseases may exist for working until a statutory retirement age. Interventions aimed at encouraging work participation of older workers should make a distinction between the two groups. Autonomy at work and mastery were found to be factors that may promote work participation until higher age, specifically for older workers with chronic diseases.

Integrative Perspectives of Academic Motivation

NASA Astrophysics Data System (ADS)

Chittum, Jessica Rebecca

My overall objective in this dissertation was to develop more integrative perspectives of several aspects of academic motivation. Rarely have researchers and theorists examined a more comprehensive model of academic motivation that pools multiple constructs that interact in a complex and dynamic fashion (Kaplan, Katz, & Flum, 2012; Turner, Christensen, Kackar-Cam, Trucano, & Fulmer, 2014). The more common trend in motivation research and theory has been to identify and explain only a few motivation constructs and their linear relationships rather than examine complex relationships involving "continuously emerging systems of dynamically interrelated components" (Kaplan et al., 2014, para. 4). In this dissertation, my co-author and I focused on a more integrative perspective of academic motivation by first reviewing varying characterizations of one motivation construct (Manuscript 1) and then empirically testing dynamic interactions among multiple motivation constructs using a person-centered methodological approach (Manuscript 2). Within the first manuscript (Chapter 2), a theoretical review paper, we summarized multiple perspectives of the need for autonomy and similar constructs in academic motivation, primarily autonomy in self-determination theory, autonomy supports, and choice. We provided an integrative review and extrapolated practical teaching implications. We concluded with recommendations for researchers and instructors, including a call for more integrated perspectives of academic motivation and autonomy that focus on complex and dynamic patterns in individuals' motivational beliefs. Within the second manuscript (Chapter 3), we empirically investigated students' motivation in science class as a complex, dynamic, and context-bound phenomenon that incorporates multiple motivation constructs. Following a person-centered approach, we completed cluster analyses of students' perceptions of 5 well-known motivation constructs (autonomy, utility value, expectancy, interest, and caring) in science class to determine whether or not the students grouped into meaningful "motivation profiles." 5 stable profiles emerged: (1) low motivation; (2) low value and high support; (3) somewhat high motivation; (4) somewhat high empowerment and values, and high support; and (5) high motivation. As this study serves as a proof of concept, we concluded by describing the 5 clusters. Together, these studies represent a focus on more integrative and person-centered approaches to studying and understanding academic motivation.

Chickering's Vectors and the Adult Child Experience.

ERIC Educational Resources Information Center

Sitten, Robin J.

This document looks at the college student who is an adult child from a dysfunctional family, applying Chickering's seven vectors of college-age student development to that student's experiences at college. Each of Chickering's seven vectors (developing competence, managing emotions, developing autonomy, establishing identity, freeing…

PREDOMOS study, impact of a social intervention program for socially isolated elderly cancer patients: study protocol for a randomized controlled trial.

PubMed

Crétel-Durand, Elodie; Nouguerède, Emilie; Le Caer, Hervé; Rousseau, Frédérique; Retornaz, Frédérique; Guillem, Olivier; Couderc, Anne-Laure; Greillier, Laurent; Norguet, Emmanuelle; Cécile, Maud; Boulahssass, Rabia; Le Caer, Francoise; Tournier, Sandrine; Butaud, Chantal; Guillet, Pierre; Nahon, Sophie; Poudens, Laure; Kirscher, Sylvie; Loubière, Sandrine; Diaz, Nadine; Dhorne, Jean; Auquier, Pascal; Baumstarck, Karine

2017-04-12

Cancer incidence and social isolation increase along with advanced age, and social isolation potentiates the relative risk of death by cancer. Once spotted, social isolation can be averted with the intervention of a multidisciplinary team. Techniques of automation and remote assistance have already demonstrated their positive impact on falls prevention and quality of life (QoL), though little is known about their impact on socially isolated elderly patients supported for cancer. The primary objective of the PREDOMOS study is to evaluate the impact of establishing a Program of Social intervention associated with techniques of Domotic and Remote assistance (PS-DR) on the improvement of QoL of elderly isolated patients, treated for locally advanced or metastatic cancer. The secondary objectives include treatment failure, tolerance, survival, and autonomy. This trial is a multicenter, prospective, randomized, placebo-controlled, open-label, two-parallel group study. The setting is 10 French oncogeriatric centers. Inclusion criteria are patients aged at least 70 years with a social isolation risk and a histological diagnosis of cancer, locally advanced or metastatic disease. The groups are (1) the control group, receiving usual care; (2) the experimental group, receiving usual care associating with monthly social assistance, domotic, and remote assistance. Participants are randomized in a 1:1 allocation ratio. Evaluation times involve inclusion (randomization) and follow-up (12 months). The primary endpoint is QoL at 3 months (via European Organization for Research and Treatment of Cancer (EORTC) QLQ C30); secondary endpoints are social isolation, time to treatment failure, toxicity, dose response-intensity, survival, autonomy, and QoL at 6 months. For the sample size, 320 individuals are required to obtain 90% power to detect a 10-point difference (standard deviation 25) in QoL score between the two groups (20% loss to follow-up patients expected). The randomized controlled design is the most appropriate design to demonstrate the efficacy of a new experimental strategy (Evidence-Based Medicine Working Group classification). National and international recommendations could be updated based on the findings of this study. ClinicalTrials.gov, NCT02829762 . Registered on 29 June 2016.

Parenting and Independent Problem-Solving in Preschool Children With Food Allergy

PubMed Central

Power, Thomas G.; Hahn, Amy L.; Hoehn, Jessica L.; Thompson, Caitlin C.; Herbert, Linda J.; Law, Emily F.; Bollinger, Mary Elizabeth

2015-01-01

Objective To examine autonomy-promoting parenting and independent problem-solving in children with food allergy. Methods 66 children with food allergy, aged 3–6 years, and 67 age-matched healthy peers and their mothers were videotaped while completing easy and difficult puzzles. Coders recorded time to puzzle completion, children’s direct and indirect requests for help, and maternal help-giving behaviors. Results Compared with healthy peers, younger (3- to 4-year-old) children with food allergy made more indirect requests for help during the easy puzzle, and their mothers were more likely to provide unnecessary help (i.e., explain where to place a puzzle piece). Differences were not found for older children. Conclusions The results suggest that highly involved parenting practices that are medically necessary to manage food allergy may spill over into settings where high levels of involvement are not needed, and that young children with food allergy may be at increased risk for difficulties in autonomy development. PMID:25326001

Parental mind-mindedness but not false belief understanding predicts Hong Kong children's lie-telling behavior in a temptation resistance task.

PubMed

Wang, Lamei; Zhu, Liqi; Wang, Zhenlin

2017-10-01

Children can tell lies before they understand the concept of false belief. This study investigated the relationship between parental mind-mindedness, defined as the propensity of parents to view their children as mental agents with independent thoughts and feelings, and the lie-telling behavior of Hong Kong children aged 3-6years. The results confirmed earlier findings indicating that Hong Kong children's understanding of false belief is delayed; nevertheless, the participants appeared to lie just as well as children from other cultures. The lie-telling behavior of Hong Kong children was predicted by parental mind-mindedness and children's age but was unrelated to children's false belief understanding. It is suggested that children of mind-minded parents are more likely to exercise autonomy in socially ambiguous situations. Future studies should focus on the roles of parenting and children's multifaceted autonomy when addressing children's adaptive lie telling. Copyright © 2017 Elsevier Inc. All rights reserved.

Adolescent-parent attachment as a mediator of relations between parenting and adolescent social behavior and wellbeing in China.

PubMed

Cai, Mengfei; Hardy, Sam A; Olsen, Joseph A; Nelson, David A; Yamawaki, Niwako

2013-01-01

The purpose of this study was to examine links between parenting dimensions (authoritative parenting, psychological control, and parental authority) and adolescent wellbeing (self-esteem, autonomy, and peer attachments) as mediated by parent-teen attachment, among Chinese families. The sample included 298 Chinese adolescents, ages 15-18 years (M(age) = 16.36, SD = .68; 60% female). The mediation model was examined using path analyses (one model with parental authority as overprotection, and one with it as perceived behavioral control). To improve model fit a direct path was added from authoritative parenting to autonomy. Authoritative parenting was positively predictive of attachment, while psychological control and overprotection (but not behavioral control) were negative predictors. In turn, adolescent-parent attachment was positively related to the three outcomes. Lastly, the model paths did not differ by adolescent gender. These findings suggest that parenting behaviors may play a crucial role in adolescent social behaviors and wellbeing via adolescent-parent attachment.

Children's Decision-Making Involvement About Research Participation: Associations With Perceived Fairness and Self-Efficacy.

PubMed

Miller, Victoria A; Feudtner, Chris; Jawad, Abbas F

2017-04-01

The primary objective of this study was to examine the associations of children's involvement in decisions about research participation with their perceptions of the decision-making process and self-efficacy. Participants were children (ages 8-17) who enrolled in research studies in the prior 2 months. Children completed a questionnaire that yielded three decision-making involvement subscales: Researcher Engages Child, Researcher Supports Autonomy, and Child Participates. Children reported on fairness of the decision-making process and health-related decision self-efficacy. After adjusting for age, higher scores on Researcher Engages Child were associated with greater self-efficacy, and higher scores on Researcher Supports Autonomy were associated with greater perceived fairness. These data underscore the potential importance of researcher-child interactions about research participation when assent is sought, including proactively involving children in the decision by asking for their opinions and communicating their central role in the decision, which are likely to be more meaningful to children than receiving information or signing a form.

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.

PubMed

Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

2016-09-01

Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.

Ebb and Flow in Parent-Child Interactions: Shifts from Early through Middle Childhood

PubMed Central

Bradley, Robert H.; Pennar, Amy; Iida, Masumi

2015-01-01

Objective This study documents the strength of relations between key parent and child behaviors as they occur during typical encounters for both mothers and fathers and determines whether there were shifts in the strength of relations between parent and child behaviors during early and middle childhood. Design Multivariate multi-level modeling was used to examine associations between three parent behaviors (respect for autonomy, stimulation of development, hostility) and two child behaviors (agency, negativity) as they occurred in typical parent-child activities at four time points from 54 months through 5th grade for 817 families. Results For mothers and fathers, respect for autonomy and stimulation were associated with child agency. Paternal hostility was negatively associated with child agency, but for mothers the relation became more positive with age. Parental respect for autonomy and hostility were associated with child negativity for both mothers and fathers; however, for mothers, relations between autonomy support and child negativity became more positive, and relations between hostility and child negativity became less positive. Conclusions There are clear shifts in the strength of relations between some parenting behaviors and child behaviors from early to middle childhood, indicative of a changing dialectic as children become more independent and different dialectics for mothers and fathers. Parenting behavior links to child competence and adaptive behavior, and the findings may help resolve some uncertainties about relations between parental behavior and children's developmental trajectories. PMID:26877717

The relationship between female genital cutting and women's autonomy in Eritrea.

PubMed

Besera, Ghenet; Roess, Amira

2014-09-01

To investigate the relationship between women's autonomy and attitudes toward female genital cutting (FGC) and having a daughter with FGC in Eritrea. Data from a nationally representative sample of 8754 women aged between 15 and 49 years from the 2002 Eritrea Demographic and Health Survey were analyzed. Multivariate logistic regression was used to determine significant predictors of the practice of and attitudes toward FGC, including women's autonomy. Sixty-three percent (n = 3168) of women sampled had at least one daughter who had undergone FGC and 50.1% (n = 4848) of women believed FGC should continue. When controlling for sociodemographic characteristics, the odds of supporting the continuation of FGC were greater among women who justified wife beating (adjusted odds ratio [aOR] 1.43; 95% confidence interval [CI] 1.23-1.66). Among women who participated in household decisions, the odds of them supporting the continuation of FGC were less than among women who did not participate in household decisions (aOR 0.87; 95% CI, 0.75-0.99). Interventions addressing women's autonomy, specifically attitudes toward gender norms and increasing women's involvement in household decisions that carry a greater responsibility, may be a useful approach to reduce the support for and practice of FGC. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Multigenerational links between mothers' experiences of autonomy in childhood and preschoolers' respiratory sinus arrhythmia: Variations by maltreatment status.

PubMed

Noll, Laura K; Clark, Caron A C; Skowron, Elizabeth A

2015-11-01

Despite burgeoning evidence linking early exposure to child maltreatment (CM) to deficits in self-regulation, the pathways to strong regulatory development in these children are not well understood, and significant heterogeneity is observed in their outcomes. Experiences of autonomy may play a key role in transmitting self-regulatory capacity across generations and help explain individual differences in maltreatment outcomes. In this study, we investigated multigenerational associations between Generation 1 (G1)-Generation 2 (G2) mothers' early experience of warmth and autonomy in relation to their own mothers and their Generation 3 (G3) children's autonomic physiological regulation in CM (n = 85) and non-CM (n = 128) families. We found that G2 mothers who recalled greater autonomy in their childhood relationship with their G1 mothers had preschool-age G3 children with higher respiratory sinus arrhythmia at baseline when alone while engaged in individual challenge tasks, during social exchanges with their mother in joint challenge tasks, and during the portions of the strange situation procedure when the mother was present. Although no clear mediators of this association emerged, multigenerational links among G1-G2 relations, maternal representations of her child, child behavior, and child respiratory sinus arrhythmia differed by maltreatment status, thus possibly representing important targets for future research and intervention.

Adolescent and parental perceptions of medical decision-making in Hong Kong.

PubMed

Hui, Edwin

2011-11-01

To investigate whether Chinese adolescents in Hong Kong share similar perceptions with their Western counterparts regarding their capacity for autonomous decision-making, and secondarily whether Chinese parents underestimate their adolescent children's desire and capacity for autonomous decision-making. 'Healthy Adolescents' and their parents were recruited from four local secondary schools, and 'Sick Adolescents' and their parents from the pediatric wards and outpatient clinics. Their perceptions of adolescents' understanding of illnesses and treatments, maturity in judgment, risk-taking, openness to divergent opinions, pressure from parents and doctors, submission to parental authority and preference for autonomy in medical decision-making are surveyed by a 50-item questionnaire on a five-point Likert scale. Findings indicate that Chinese adolescents aged 14-16 perceive themselves to possess the necessary cognitive abilities and maturity in judgment to be autonomous decision-makers like their Western counterparts. Paradoxically, although they hesitate to assert their autonomy, they are also unwilling to surrender that autonomy to their parents even under coercion or intimidation. Parents tend to underestimate their adolescents' preferences for making autonomous decisions and overestimate the importance of parental authority in decision-making. '14-and-above' Chinese adolescents in Hong Kong perceive themselves as capable of autonomous decision-making in medically-related matters, but hesitate to assert their autonomy, probably because of the Confucian values of parental authority and filial piety that are deeply embedded in the local culture. © 2010 Blackwell Publishing Ltd.

Multigenerational links between mothers’ experiences of autonomy in childhood and preschoolers’ respiratory sinus arrhythmia: Variations by maltreatment status

PubMed Central

NOLL, LAURA K.; CLARK, CARON A. C.; SKOWRON, ELIZABETH A.

2017-01-01

Despite burgeoning evidence linking early exposure to child maltreatment (CM) to deficits in self-regulation, the pathways to strong regulatory development in these children are not well understood, and significant heterogeneity is observed in their outcomes. Experiences of autonomy may play a key role in transmitting self-regulatory capacity across generations and help explain individual differences in maltreatment outcomes. In this study, we investigated multigenerational associations between Generation 1 (G1)–Generation 2 (G2) mothers’ early experience of warmth and autonomy in relation to their own mothers and their Generation 3 (G3) children’s autonomic physiological regulation in CM (n = 85) and non-CM (n = 128) families. We found that G2 mothers who recalled greater autonomy in their childhood relationship with their G1 mothers had preschool-age G3 children with higher respiratory sinus arrhythmia at baseline when alone while engaged in individual challenge tasks, during social exchanges with their mother in joint challenge tasks, and during the portions of the strange situation procedure when the mother was present. Although no clear mediators of this association emerged, multigenerational links among G1–G2 relations, maternal representations of her child, child behavior, and child respiratory sinus arrhythmia differed by maltreatment status, thus possibly representing important targets for future research and intervention. PMID:26535936

Progression in children with intestinal failure at a referral hospital in Medellín, Colombia.

PubMed

Contreras-Ramírez, M M; Giraldo-Villa, A; Henao-Roldan, C; Martínez-Volkmar, M I; Valencia-Quintero, A F; Montoya-Delgado, D C; Ruiz-Navas, P; García-Loboguerrero, F

2016-01-01

Patients with intestinal failure are unable to maintain adequate nutrition and hydration due to a reduction in the functional area of the intestine. Different strategies have the potential to benefit these patients by promoting intestinal autonomy, enhancing quality of life, and increasing survival. To describe the clinical characteristics of children with intestinal failure and disease progression in terms of intestinal autonomy and survival. A retrospective study was conducted, evaluating 33 pediatric patients with intestinal failure that were hospitalized within the time frame of December 2005 and December 2013 at a tertiary care referral center. Patient characteristics were described upon hospital admission, estimating the probability of achieving intestinal autonomy and calculating the survival rate. Patient median age upon hospital admission was 2 months (interquartile range [IQR]: 1-4 months) and 54.5% of the patients were boys. Intestinal autonomy was achieved in 69.7% of the cases with a median time of 148 days (IQR: 63 - 431 days), which decreased to 63 days in patients with a spared ileocecal valve. Survival was 91% during a median follow-up of 281 days (IQR: 161 - 772 days). Medical management of patients with intestinal failure is complex. Nutritional support and continuous monitoring are of the utmost importance and long-term morbidity and mortality depends on the early recognition and management of the associated complications. Copyright © 2016. Published by Masson Doyma México S.A.

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification.

PubMed

Valle, Carmina G; Queen, Tara L; Martin, Barbara A; Ribisl, Kurt M; Mayer, Deborah K; Tate, Deborah F

2018-03-01

Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback. The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions. We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up. For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who were in the standard priming condition and received both autonomy supportive and exemplar messages. In the PA module, autonomy supportive messages had a stronger effect on self-efficacy for PA in the standard priming condition. For PA, eating habits, and weight-related behaviors, the main effect of exemplar messages on behavioral intentions was in the hypothesized direction but did not reach statistical significance (P=.08). When comparing the main effects of different message conditions, there were no differences in engagement and message perceptions. Findings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, PA, eating habits, and weight control. Combining standard priming and autonomy supportive message components shows potential for optimizing tailored feedback for tobacco cessation and PA behaviors. ©Carmina G Valle, Tara L Queen, Barbara A Martin, Kurt M Ribisl, Deborah K Mayer, Deborah F Tate. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.03.2018.

Social network, autonomy, and adherence correlates of future time perspective in patients with head and neck cancer.

PubMed

Baldensperger, Linda; Wiedemann, Amelie U; Wessel, Lauri; Keilholz, Ulrich; Knoll, Nina

2018-06-01

Socioemotional selectivity theory proposes that, with more limited future time perspective (FTP), the meaning of individual life goals shifts from instrumental and long-term goals, such as autonomy, to emotionally meaningful and short-term life goals, especially concerning meaningful social relationships. Adverse side effects of cancer therapy may conflict with the realization of emotionally meaningful goals leading to nonadherence. In line with the theoretical assumptions, this study aimed to investigate (a) associations among disease symptoms, physical and cognitive limitations, and FTP and (b) among FTP, family network size, striving for autonomy, and treatment adherence. One hundred fifty-seven patients (43-90 years; 75% male) with head and/or neck cancer of a German University Medical Centre completed a questionnaire measuring FTP, age, disease symptoms, physical and cognitive functioning, family network size, and treatment adherence. Autonomy was assessed with a card sort task. A structural equation model yielded an acceptable fit χ 2 (28) = 44.41, P = .025, χ 2 /df = 1.59, root mean square error of approximation = 0.06 (90% CI = 0.02, 0.09), Tucker-Lewis Index = 0.92, and Comparative Fit Index = 0.96. An increased level of disease symptoms and physical and cognitive limitations was related to a shorter subjective FTP. Furthermore, individuals with a limited FTP reported a smaller family network, a lowered quest for autonomy, and lower treatment adherence. Hypotheses derived from socioemotional selectivity theory were supported by the data. Longitudinal investigations should follow to corroborate findings and to focus on underlying mechanisms as improving patients FTP may play a crucial role in future disease management programs. Copyright © 2018 John Wiley & Sons, Ltd.

The Effects of Satisfaction of Basic Psychological Needs at School on Children’s Prosocial Behavior and Antisocial Behavior: The Mediating Role of School Satisfaction

PubMed Central

Tian, Lili; Zhang, Xiao; Huebner, E. Scott

2018-01-01

Grounded in Basic Psychological Need Theory, we examined the direct effects of the satisfaction of three basic psychological needs at school (i.e., satisfaction of autonomy needs at school, satisfaction of relatedness needs at school, and satisfaction of competence needs at school) on prosocial behavior and antisocial behavior as well as the mediation effects of school satisfaction on the relations between the satisfaction of three basic psychological needs at school and prosocial behavior as well as antisocial behavior. We employed a sample of 801 Chinese children (429 males; Mage = 9.47) in a three-wave longitudinal study, with each wave occurring 6 months apart. Direct and indirect effects were estimated by Structural Equation Modeling. Results indicated that: (1) Satisfaction of relatedness needs at school and competence needs at school, but not satisfaction of autonomy needs at school, displayed direct effects on prosocial behavior. Also, satisfaction of relatedness needs at school, but not satisfaction of autonomy needs at school or competence needs at school, displayed direct effects on antisocial behavior. (2) Both satisfaction of relatedness needs at school and competence needs at school displayed indirect effects on prosocial behavior and antisocial behavior via school satisfaction as a mediator. However, satisfaction of autonomy needs at school failed to have indirect effects on prosocial behavior or antisocial behavior via school satisfaction. These findings suggest differential predictors of children’s prosocial and antisocial behavior, supporting the separability of the two constructs. The findings also suggest developmental differences in need satisfaction, with the satisfaction of autonomy needs playing a relatively less important role in school-age children. We also discussed limitations and practical applications of the study. PMID:29719523

The development of science achievement in middle and high school. Individual differences and school effects.

PubMed

Ma, Xin; Wilkins, Jesse L M

2002-08-01

Using data from the Longitudinal Study of American Youth (LSAY), hierarchical linear models (HLMs) were used to model the growth of student science achievement in three areas (biology, physical science, and environmental science) during middle and high school. Results showed significant growth in science achievement across all areas. The growth was quadratic across all areas, with rapid growth at the beginning grades of middle school but slow growth at the ending grades of high school. At the student level, socioeconomic status (SES) and age were related to the rate of growth in all areas. There were no gender differences in the rate of growth in any of the three areas. At the school level, variables associated with school context (school mean SES and school size) and variables associated with school climate (principal leadership, academic expectation, and teacher autonomy) were related to the growth in science achievement. Initial (Grade 7) status in science achievement was not associated with the rate of growth in science achievement among either students or schools in any of the three areas.

Individual differences in satisfaction with activity-based work environments

PubMed Central

Ernst, Anja F.; Albers, Casper J.; Mobach, Mark P.; Van Yperen, Nico W.

2018-01-01

Satisfaction with activity-based work environments (ABW environments) often falls short of expectations, with striking differences among individual workers. A better understanding of these differences may provide clues for optimising satisfaction with ABW environments and associated organisational outcomes. The current study was designed to examine how specific psychological needs, job characteristics, and demographic variables relate to satisfaction with ABW environments. Survey data collected at seven organizations in the Netherlands (N = 551) were examined using correlation and regression analyses. Significant correlates of satisfaction with ABW environments were found: need for relatedness (positive), need for privacy (negative), job autonomy (positive), social interaction (positive), internal mobility (positive), and age (negative). Need for privacy appeared to be a powerful predictor of individual differences in satisfaction with ABW environments. These findings underline the importance of providing work environments that allow for different work styles, in alignment with different psychological need strengths, job characteristics, and demographic variables. Improving privacy, especially for older workers and for workers high in need for privacy, seems key to optimizing satisfaction with ABW environments. PMID:29518104

Evaluation of quality of life and description of the sociodemographic state in adolescent and young adult patients with phenylketonuria (PKU).

PubMed

Simon, Eva; Schwarz, Martin; Roos, Judith; Dragano, Nico; Geraedts, Max; Siegrist, Johannes; Kamp, Gudrun; Wendel, Udo

2008-03-26

Normal intellectual and personal development can be expected in early-diagnosed and treated PKU patients. Aim of the study was to analyse quality of life and social status, which are important parameters for an overall estimation of success of treatment apart from intellectual outcome in adult PKU patients. 67 patients completed a questionnaire on quality of life and social status. Data was compared to the German census on an age matched control collective. Quality of life measured with the Profile of Quality of Life in the Chronically Ill (PLC) revealed mean values for capacity of performance in the patient group in the same range as in the control collective. The analysis of the social state of PKU patients revealed a tendency towards lower or delayed autonomy, and a low rate of forming normal adult relationships in which to have children. Schooling and professional career corresponded approximately to the control collective. Though every chronic disorder must be regarded as restraining, it shows that PKU does not preclude healthy emotional adjustment when the disease is diagnosed early and treated well.

"Without bodily autonomy we are not free": exploring women's concerns about future access to contraception following the 2016 US presidential election.

PubMed

Judge, Colleen P; Wolgemuth, Tierney E; Hamm, Megan E; Borrero, Sonya

2017-11-01

Following the 2016US presidential election, social media posts and news stories amplified concerns about the potential for reduced access to contraception under the incoming administration and urged women to seek long-acting reversible contraception. We aimed to describe women's concerns about future access to contraception, in their own words. A social-media-based, anonymous online survey assessing thoughts and concerns about future access to contraception was distributed to reproductive-aged US women for 1 week in mid-January 2017. Participants who were concerned about future access to contraception could share their thoughts and feelings in an open-ended comments box. We qualitatively analyzed 449 written responses for content and themes, with the goal of characterizing key concerns. Women who provided written comments had a mean age of 28years; 85% were white, 88% had at least a college degree, and 93% identified as Democratic or Democratic-leaning. Women were highly concerned about future affordability of contraceptive methods due to potential loss of insurance, reduced insurance coverage for contraceptive methods and reduced access to low-cost care at Planned Parenthood. Many also worried about increased restrictions on abortion. Participants' concerns regarding access to contraception and abortion centered around themes of reproductive and bodily autonomy, which women described as fundamental rights. Women in this study expressed considerable fear and uncertainty regarding their future access to contraception and abortion following the 2016US presidential election. The potential for restricted access to affordable contraception and abortion was viewed as an unacceptable limitation on bodily autonomy. As the future of US health care policy is debated, many women are concerned about the impact of policy changes on their ability to access affordable contraception and abortion, which many view as essential to the preservation of bodily and reproductive autonomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Dentists versus auto mechanics: are there ethical differences?

PubMed

Riley, Crystal

2013-01-01

The different ethical perspectives of dentists and auto mechanics include primary concern, billing procedures, advertising, emergency care, the level of autonomy granted to their patients/ clients, the amount of disclosure given to their patients/clients, the ability to judge the work of others, and the freedom to pursue romantic relationships with their patients/clients. In analyzing these differences, one finds dentists to have much greater ethical obligations than auto mechanics. There are subtle differences between the ethical expectations of Canadian and United States dentists.

The times, they are a changin'.

PubMed

Dwyer, C E

1996-07-01

Significant changes are taking place and will continue to take place in U.S. health care and medicine. Many of these changes are not, and will not be, to the benefit of physicians. Reduced personal autonomy, probably lower compensation than expected, fewer and less adequate resources, and overall significantly reduced power are some of the likely outcomes of the changes underway. Perhaps of greatest personal interest is the high likelihood of lack of employment in medicine for upwards of 200,000 physicians over the next 20 years.

The art of delegation.

PubMed

Linney, B J

1998-01-01

Effective delegation is a large of a manager's position. Physician executives are expected to be skilled delegators and able to lead team efforts to meet larger organizational goals. Delegation should be a five-step process: (1) Describe the results you want; (2) Listen for suggestions about how the task should be done; (3) Give autonomy and freedom to accomplish the task; (4) Follow up; and (5) Give feedback and credit. This column explores the art of delegating and how to assess your skills in this key management area.

Respect for patient autonomy in forensic psychiatric nursing.

PubMed

Rose, Donald N

2005-01-01

A fundamental issue that forensic psychiatric nurses struggle with is respect for patient autonomy, as the two liberal prerequisites for autonomy, liberty and rationality, are either absent or compromised in forensic psychiatric settings. In this paper, a contemporary feminist perspective of autonomy, relational autonomy, will be advanced as an alternative approach to the traditional liberalist, Kantian, perspective of autonomy. The concepts of autonomy, paternalism, and justice will be discussed in relation to forensic psychiatric nursing.

Family support in the transition to adulthood in Portugal--its effects on identity capital development, uncertainty management and psychological well-being.

PubMed

Oliveira, José Egídio; Mendonça, Marina; Coimbra, Susana; Fontaine, Anne Marie

2014-12-01

In a familistic southern European society such as the Portuguese, the family has historically played a prominent role in supporting the negotiation of transition pathways into adulthood. The present study aimed at capturing (1) the relative weight of parental financial support and autonomy support in contributing to the youngsters' psychological well-being (PWB), and (2) the mediating role of identity capital and uncertainty management in this relationship. A total of 620 participants completed measures of parental support, identity capital, uncertainty management and PWB. Autonomy support was found to be the strongest predictor of PWB, both directly and indirectly through its effects on identity capital and the use of target focused uncertainty management strategies. Conversely, financial support evidenced only a minor indirect impact through the mediation of tangible identity capital. Autonomy stimulation may constitute one of the most developmentally determinant family challenges in assisting the process of coming of age in Portugal. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Power to the People: Data Citizens in the Age of Precision Medicine

PubMed Central

Evans, Barbara J.

2017-01-01

Twentieth-century bioethics celebrated individual autonomy but framed autonomy largely in terms of an individual’s power to make decisions and act alone. The most pressing challenges of big data science in the twenty-first century can only be resolved through collective action and common purpose. This Article surveys some of these challenges and asks how common purpose can ever emerge on the present bioethical and regulatory landscape. The solution may lie in embracing a broader concept of autonomy that empowers individuals to protect their interests by exercising meaningful rights of data citizenship. This Article argues that twentieth-century bioethics was a paternalistic, top-down affair in which self-proclaimed ethics experts set standards to protect research subjects portrayed as autonomous yet too vulnerable and disorganized to protect themselves. The time may be ripe for BioEXIT, a popular uprising of regular people seeking a meaningful voice in establishing citizen-led ethical and privacy standards to advance big-data science while addressing the concerns people feel about the privacy of their health data. PMID:29118898

HIV vulnerabilities of sex-trafficked Indian women and girls.

PubMed

Gupta, Jhumka; Raj, Anita; Decker, Michele R; Reed, Elizabeth; Silverman, Jay G

2009-10-01

To qualitatively explore potential mechanisms that may confer heightened risk for HIV infection among survivors of sex trafficking in India. Case narratives of 61 repatriated women and girls who reported being trafficked into sex work and were receiving services at an NGO in Mysore, India, were reviewed. Narratives were analyzed to examine potential sources of HIV risk related to sex trafficking. Participants were aged 14-30 years. Among the 48 women and girls tested for HIV, 45.8% were HIV positive. Narratives described very low levels of autonomy, with control exacted by brothel managers and traffickers. Lack of control appeared to heighten trafficked women and girls' vulnerability to HIV infection in the following ways: use of violent rape as a means of coercing initiation into sex work, inability to refuse sex, inability to use condoms or negotiate use, substance use as a coping strategy, and inadequate access to health care. Sex trafficked women and girls lack autonomy and are rendered vulnerable to HIV infection through several means. Development of HIV prevention strategies specifically designed to deal with lack of autonomy and reach sex-trafficked women and girls is imperative.

From autonomy to creativity: a multilevel investigation of the mediating role of harmonious passion.

PubMed

Liu, Dong; Chen, Xiao-Ping; Yao, Xin

2011-03-01

Building on self-determination theory, we theorized about and demonstrated, through 2 multilevel field studies, the pivotal role of harmonious passion in translating organizational autonomy support and individual autonomy orientation into job creativity. Results based on 3-level data from 856 members in 111 teams within 23 work units of a porous metal company (Study 1) and from 525 employees in 98 teams of 18 branches of a large commercial bank (Study 2) revealed 2 major findings. First, organizational autonomy support from a higher organizational level (unit or branch) compensated for the effect of autonomy support from a lower organizational level (team) or individual autonomy orientation on employees' harmonious passion. Second, harmonious passion mediated the interactive effects of unit (branch) autonomy support and team member autonomy orientation, of team autonomy support and team member autonomy orientation, and of unit (branch) autonomy support and team autonomy support on individual creativity. We discuss the theoretical and practical implications of these findings in the organizational context. PsycINFO Database Record (c) 2011 APA, all rights reserved.

The Evolution of Autonomy.

PubMed

Stammers, Trevor

2015-01-01

There can be little doubt, at least in the Western world, that autonomy is theruling principle in contemporary bioethics. In spite of its 'triumph' however,the dominance of the utilitarian concept of autonomy is being increasinglyquestioned. In this paper, I explore the nature of autonomy, how it came todisplace the Hippocratic tradition in medicine and how different conceptsof autonomy have evolved. I argue that the reduction of autonomy to'the exercise of personal choice' in medicine has led to a 'tyranny of autonomy' which can be inimical to ethical medical practice rather than conducive to it.I take the case of Kerrie Wooltorton as an illustration of how misplacedadherence to respect for patient autonomy can lead to tragic consequences.An analysis of autonomy based on the work of Rachel Haliburton isdescribed and applied to the role of autonomy in a recent bioethicaldebate--that arising from Savulescu's proposal that conscientious objection by health-care professionals should not be permitted in the NHS. Inconclusion, I suggest Kukla's concept of conscientious autonomy as onepromising pathway to circumvent both the limitations and adverse effectsof the dominance of current (mis)understandings of autonomy in biomedical ethics.

Is arthroplasty preferable to internal fixation for the treatment of extracapsular fracture of the upper femur in the elderly?

PubMed

Duriez, P; Devaux, T; Chantelot, C; Baudrier, N; Hery, J-Y; Mainard, D; Favier, T; Massin, P

2016-10-01

Although internal fixation is the reference treatment for extracapsular fracture of the upper femur, indications for arthroplasty are broadening, especially in unstable comminutive fracture in fragile bone. The present study hypothesis was that arthroplasty reduces early mortality and morbidity and provides better recovery of autonomy in over-80 year-old patients than does internal fixation. A prospective multicenter study was conducted on 8 sites. Internal fixation was systematically used in 5 centers; arthroplasty was used systematically in 1 center, and reserved for unstable fracture in 2 centers. A total of 697 patients aged over 80 years (mean age, 85±5 years), presenting with extracapsular fracture, were included; 521 were treated by internal fixation and 176 by arthroplasty. Results were studied on multivariate analysis of ASA score, blood loss, transfusion, and also of treatment modality as an independent factor for early (first 6 months) mortality and morbidity (mechanical, general and nutritional complications) and functional outcome (autonomy and dependence). Overall mortality was 19.2%. Autonomy deteriorated in 56% of patients alive at 6 months and dependence worsened in 44%. Two percent of those managed by internal fixation underwent revision for disassembly (n=8) or infection (n=1). Eight percent of those managed by arthroplasty underwent revision for dislocation (n=4), implant loosening (n=3) or infection (n=7). On univariate analysis, mortality was higher in the arthroplasty group (25%) than with internal fixation (17%; P=0.002), as were blood loss (425±286mL versus 333±223mL; P<0.0001), transfusion rate (61% versus 32%; P<0.0001) and infection (4% versus 0.2%; P<0.001). On multivariate analysis, however, treatment modality no longer showed impact on mortality or on morbidity and autonomy at 6 months. Nutritional status was better conserved at 6 months following arthroplasty, but dependence worsened. Poor preoperative autonomy, ASA score, and nutritional status and time to treatment were independent factors for mortality. Transfusion, associated with onset of mechanical complications, significantly increased dependence. Type of treatment had little impact on mortality, morbidity or functional outcome. Differences seemed more related to preoperative functional and nutritional status. III, prospective case-control study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Factors associated with the self-perceived ability of nursing staff to remain working until retirement: a questionnaire survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; van der Hoek, Lucas S; Francke, Anneke L

2015-09-02

It is important to learn how employers in European countries can prevent nursing staff from changing occupation or taking early retirement in order to counteract expected nursing shortages. However, to date research on nursing staff's ability to remain working until retirement age has been limited. The purpose of this study was to gain insight into the associations between different job and organisational characteristics, job satisfaction, occupational commitment and the self-perceived ability to continue working in the current line of work until the official retirement age. The questionnaire-based, cross-sectional study included 730 nursing staff members employed in Dutch hospitals, nursing homes, organisations for psychiatric care, homes for the elderly, care organisations for disabled people and home care organisations (mean age: 48; 89% female). Linear and logistic regression analyses and mediation analyses were applied to test hypothesised associations. Reducing work pressure and increasing appreciation by senior management in particular have positive consequences for nursing staff's self-perceived ability to continue working until the official retirement age. The job and organisational characteristics of autonomy, work pressure, supportive leadership, educational opportunities, communication within the organisation and appreciation of nursing staff by senior management together have substantial impact on nursing staff's job satisfaction. Job satisfaction in turn is related to the self-perceived ability to continue working until the retirement age. However, job satisfaction mainly summarises the joint effect of job and organisational characteristics and has no supplementary effect on the self-perceived ability to continue working. Employers should primarily focus on work pressure and the appreciation of nursing staff by senior management in order to retain nursing staff even as they get older.

Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD

PubMed Central

Stenner, Paul

2010-01-01

Background Most measures of quality of life (QoL) are based on ‘expert’ opinions. This study describes a new measure of QoL in older age, the Older People's QoL Questionnaire (OPQOL), which is unique in being derived from the views of lay people, cross-checked against theoretical models for assessment of comprehensiveness. Its performance was assessed cross-sectionally and longitudinally. It was compared with two existing QoL measures in the cross-sectional studies in order to identify the optimal measure for use with older populations. Methods Data were taken from three surveys of older people living at home in Britain in 2007–2008: one population survey of people aged 65+, one focused enumeration survey of ethnically diverse older people aged 65+, one follow-up of a population survey of people aged 65+ at baseline in 1999/2000. Measures were QoL (using OPQOL, Control, Autonomy, Satisfaction, Pleasure - 19 items (CASP-19), World Health Organization Quality of Life questionnaire - version for older people (WHOQOL-OLD)), health, social and socioeconomic circumstances. The CASP-19 and WHOQOL-OLD were not administered to the longitudinal sample in order to reduce respondent burden. Results Psychometric tests were applied to each QoL measure. The OPQOL, CASP-19 and WHOQOL-OLD performed well with the cross-sectional samples; however, only the OPQOL met criteria for internal consistency in the Ethnibus samples. Conclusion The OPQOL is of potential value in the outcome assessment of health and social interventions, which can have a multidimensional impact on people's lives. Further research is needed to examine whether differences by ethnicity reflect real differences in QoL, methodological issues, variations in expectations or cultural differences in reporting. PMID:20719807

Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD.

PubMed

Bowling, Ann; Stenner, Paul

2011-03-01

Most measures of quality of life (QoL) are based on 'expert' opinions. This study describes a new measure of QoL in older age, the Older People's QoL Questionnaire (OPQOL), which is unique in being derived from the views of lay people, cross-checked against theoretical models for assessment of comprehensiveness. Its performance was assessed cross-sectionally and longitudinally. It was compared with two existing QoL measures in the cross-sectional studies in order to identify the optimal measure for use with older populations. Data were taken from three surveys of older people living at home in Britain in 2007-2008: one population survey of people aged 65+, one focused enumeration survey of ethnically diverse older people aged 65+, one follow-up of a population survey of people aged 65+ at baseline in 1999/2000. Measures were QoL (using OPQOL, Control, Autonomy, Satisfaction, Pleasure--19 items (CASP-19), World Health Organization Quality of Life questionnaire--version for older people (WHOQOL-OLD)), health, social and socioeconomic circumstances. The CASP-19 and WHOQOL-OLD were not administered to the longitudinal sample in order to reduce respondent burden. Psychometric tests were applied to each QoL measure. The OPQOL, CASP-19 and WHOQOL-OLD performed well with the cross-sectional samples; however, only the OPQOL met criteria for internal consistency in the Ethnibus samples. The OPQOL is of potential value in the outcome assessment of health and social interventions, which can have a multidimensional impact on people's lives. Further research is needed to examine whether differences by ethnicity reflect real differences in QoL, methodological issues, variations in expectations or cultural differences in reporting.

Job satisfaction of the oral health labour force in Australia.

PubMed

Luzzi, L; Spencer, A J

2011-03-01

Job satisfaction among registered clinical dentists in Australia was measured to identify issues influencing recruitment and retention. A questionnaire was mailed to a random sample of 2202 dentists, stratified by state and gender, selected from the 2005 Australian Dental Association directory. A total of 61.9% of dentists responded. Analyses showed significant differences in levels of satisfaction for various dimensions of job satisfaction by gender, age group, practice type and geographic area. Differences in satisfaction between male and female dentists related to the relationships with colleagues and administrative responsibilities dimensions. Dentists of different age groups differed on eight dimensions: relationships with colleagues, patients, staff; personal time; intrinsic satisfaction; community; administrative responsibilities and resources. Differences among private and public dentists related to autonomy, relationships with patients, staff, community, compensation and resources dimensions. Dentists working in different geographic areas differed on relationships with staff and community dimensions. Differences existed between private and public dentists, metropolitan and non-metropolitan dentists, male and female dentists and dentists of different ages. Such differences should be addressed in order to improve recruitment and retention rates of dentists. Workplaces that offer job autonomy, competitive pay, flexible working hours and minimal administrative burden may improve dentist job satisfaction. © 2010 Australian Dental Association.

Impact on Participation and Autonomy: Test of Validity and Reliability for Older Persons.

PubMed

Hammar, Isabelle Ottenvall; Ekelund, Christina; Wilhelmson, Katarina; Eklund, Kajsa

2014-11-06

In research and healthcare it is important to measure older persons' self-determination in order to improve their possibilities to decide for themselves in daily life. The questionnaire Impact on Participation and Autonomy (IPA) assesses self-determination, but is not constructed for older persons. The aim of this study was to examine the validity and reliability of the IPA-S questionnaire for persons aged 70 years and older. The study was performed in two steps; first a validity test of the Swedish version of the questionnaire, IPA-S, followed by a reliability test-retest of an adjusted version. The validity was tested with focus groups and individual interviews on persons aged 77-88 years, and the reliability on persons aged 70-99 years. The validity test result showed that IPA-S is valid for older persons but it was too extensive and the phrasing of the items needed adjustments. The reliability test-retest on the adjusted questionnaire, IPA- Older persons (IPA-O), showed that 15 of 22 items had high agreement. IPA-O can be used to measure older persons' self-determination in their care and rehabilitation.

QUALITY OF LIFE AND HEALTH SELF-PERCEPTION IN CHILDREN WITH POOR SCHOOL PERFORMANCE.

PubMed

Rezende, Bárbara Antunes; Lemos, Stela Maris Aguiar; Medeiros, Adriane Mesquita de

2017-01-01

To examine the association between quality of life and health self-perception of children with poor school performance, considering sociodemographic factors. An analytical, observational, cross-sectional study was conducted with 99 children aged 7 to 12 years receiving specialized educational assistance. Parents and legal guardians answered questions concerning the sociodemographic profile. For an assessment of the quality of life and proposed domains (autonomy, functioning, leisure, and family), the children completed the Autoquestionnarie Qualité de Vie Enfant Imagé (AUQEI) and answered a question concerning their self-perceived health. Data were analyzed using multiple linear regression, considering a 5% significance level. Among the evaluated children, 69 (69.7%) male participants with mean age of 8.7±1.5, 27% self-assessed their health status as poor/very poor, and 36.4% of the children reported having impaired quality of life. As for the domains assessed by AUQEI, there was statistical significance in the associations between family with age, autonomy with economic classification, and leisure and functioning with self-perceived health. The quality of life of children with academic underachievement is associated with their health self-perception and sociodemographic characteristics.

[Issues related to consent to healthcare decisions in children and adolescents].

PubMed

Bailly, D

2010-02-01

The process of consent to healthcare decisions in children and adolescents often set physicians difficult problems. From what age is a child able to understand the information given to him or her about illness and treatment? Is an ill child indeed in the capacity to give his or her voluntary consent to treatment? How to define and to assess the capacity of an ill child to take part in treatment decisions? More than the age of the child, it is his or her level of cognitive, emotional and social development and its interactions with illness that will determine his or her degree of involvement in the decision-making process. There is a moral and ethical need to respect the rights and autonomy of every individual, regardless of age. This does not mean viewing children and adolescents as rational and autonomous decision-makers. This implies that we must promote their developmentally appropriate participation in shared decision-making with parents and physicians. Therefore, instead of asking, "should children and adolescents be granted absolute autonomy in decision making?" we ought to ask, "should we treat children and adolescents like people?" Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

Defining Mental Health in Later Life.

ERIC Educational Resources Information Center

Qualls, Sara Honn

2002-01-01

Traditional models for defining mental health have used statistical definitions and symptom-based definitions. In a lifespan psychological approach, mental health in later life is defined as acceptance of the aging self as an active being who creates meaning, maintains maximum autonomy, and sustains positive relationships. (Contains 12…

Parental Involvement in Adolescent Romantic Relationships: Patterns and Correlates

ERIC Educational Resources Information Center

Kan, Marni L.; McHale, Susan M.; Crouter, Ann C.

2008-01-01

This study examined dimensions of mothers' and fathers' involvement in adolescents' romantic relationships when offspring were age 17. Using cluster analysis, parents from 105 White, working and middle class families were classified as positively involved, negatively involved, or autonomy-oriented with respect to their adolescents' romantic…

Emotion Regulation in Children with Down Syndrome.

ERIC Educational Resources Information Center

Smith, Maureen C.; Walden, Tedra A.

This study presents a preliminary exploration of emotion regulation in a sample of 20 children (ages 3-18 years) with Down Syndrome. Three aspects of emotion regulation (modulation, organization, flexibility) were predicted from emotion variables (affect intensity, affective expression, and autonomy-curiosity and motivation) in backward regression…

Autonomy-How much is too much

DTIC Science & Technology

2007-06-22

throughout the ages Hero of Alexandria designed a number of water- and air-powered automata[3][4] Leonardo da Vinci designed and built a number...Verlag, 2006. [6] Benedict Sweeney. “Leonardo’s Hands.” http://www.leonardoshands.com/artman2/publish/ leonardos - robot-knight/index.shtml [7] Peter

Adolescents' health-related quality of life (HRQoL) changes over time: a three year longitudinal study.

PubMed

Meade, Tanya; Dowswell, Elizabeth

2016-01-25

Adolescence is a significant developmental stage marked by physical, psychological and social changes. While adolescents are generally perceived to be healthy, this stage of development is also associated with an emergence of risk factors that may have long-term consequences for their wellbeing. The aim of this study was to assess health related quality of life (HRQoL), and possible gender and age differences, in a sample of secondary school-aged adolescents over a three-year time period. Australian adolescents (n = 403, aged 12-15 at baseline) across six New South Wales high schools completed the KIDSCREEN-27 Questionnaire at three time points. The KIDSCREEN-27 measures five HRQoL domains (physical wellbeing, psychological wellbeing, autonomy and parents relations, social support and peers, and school environment). Mixed-between-within-subjects ANOVA analyses were employed to examine HRQoL over time and across age and gender. HRQoL rates were comparable to the European-based KIDSCREEN norms with the exception of psychological wellbeing, which was considerably lower in this study's sample. Over time, for the total sample, there were significant changes on only one of the five dimensions (social support and peers). However, gender differences were found to be significant across three dimensions (physical wellbeing, psychological wellbeing, and autonomy and parents relations), with females reporting lower scores than males (i.e. lower HRQoL). Females' scores also declined over the three time points across two of the five HRQoL dimensions (social support and peers, and school environment), indicating reductions in HRQoL over time. Age differences were found across all but one dimension (autonomy and parents relations). Although statistically significant, the changes in HRQoL may not be clinically significant, as the effect sizes were small and therefore those changes would not be readily noticeable. Those changes, however, suggest that, while HRQoL is predominantly stable over time, fluctuations and declines, such as those found for females, may be early indicators of physical and psychological vulnerabilities. If such vulnerabilities are detected timely; they may be addressed with preventative measures or appropriate interventions.

Autonomy: Life and Being

NASA Astrophysics Data System (ADS)

Williams, Mary-Anne

This paper uses robot experience to explore key concepts of autonomy, life and being. Unfortunately, there are no widely accepted definitions of autonomy, life or being. Using a new cognitive agent architecture we argue that autonomy is a key ingredient for both life and being, and set about exploring autonomy as a concept and a capability. Some schools of thought regard autonomy as the key characteristic that distinguishes a system from an agent; agents are systems with autonomy, but rarely is a definition of autonomy provided. Living entities are autonomous systems, and autonomy is vital to life. Intelligence presupposes autonomy too; what would it mean for a system to be intelligent but not exhibit any form of genuine autonomy. Our philosophical, scientific and legal understanding of autonomy and its implications is immature and as a result progress towards designing, building, managing, exploiting and regulating autonomous systems is retarded. In response we put forward a framework for exploring autonomy as a concept and capability based on a new cognitive architecture. Using this architecture tools and benchmarks can be developed to analyze and study autonomy in its own right as a means to further our understanding of autonomous systems, life and being. This endeavor would lead to important practical benefits for autonomous systems design and help determine the legal status of autonomous systems. It is only with a new enabling understanding of autonomy that the dream of Artificial Intelligence and Artificial Life can be realized. We argue that designing systems with genuine autonomy capabilities can be achieved by focusing on agent experiences of being rather than attempting to encode human experiences as symbolic knowledge and know-how in the artificial agents we build.

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education

PubMed Central

Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

2016-01-01

Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation. Key points The SDT is a relevant theoretical framework for elementary school physical education. Using the quasi-experimental research design, this study is one of the earlies studies supporting that elementary school PE teachers can manipulate the instructional context using the SDT to increase students’ perceived autonomy and intrinsic motivation. Increasing students’ perceived autonomy may not lead to significant changes in other SDT constructs (i.e., amotivation, external regulation, introjected regulation, and identified regulation). PMID:27803624

[Decision making in the elderly: which tools for its evaluation by the clinician?].

PubMed

Hommet, Caroline; Constans, Thierry; Atanasova, Boriana; Mondon, Karl

2010-09-01

Numerous decision-making situations occur in the activities of daily living. The consequences of the decision-making capacity disturbances may have a great impact on the patient's autonomy, financial management, and his or her reaction to a diagnosis as well as the ability to accept a therapeutic option or give informed consent. Decision-making is a complex and multi-dimensional process and brings into play attention, memory and executive functions, which are processed in the prefrontal cortex, particularly vulnerable in aging. A better comprehension of the mechanisms of decision-making, and of the resulting social consequences of their dysfunction may improve autonomy of the elderly. Unfortunately, we still lack appropriate tools to explore decision-making in routine practice.

[Considerations for the Definition of a Interval of Vulnerability/Possibility in Adolescence].

PubMed

Orón Semper, José Víctor; Echarte Alonso, Luis Enrique

2017-01-01

This article explores the hypothesis that while maturation related cognitive abilities reaches maturity around the age of fifteen, maturation related social skills is delayed until well into the twenties. Our goal is to try to define what is the window of opportunity/vulnerability and what is the maturational status of the young in this interval. In this context, we argue how the maturational time of the closing of adolescence has an impact on the valuation of autonomy in decision-making of the person. Particularly, we figure out implications for the assessment of the autonomy of youth in health issues, and also criminal liability. In the conclusion, we offer some educational criteria that may provide guidance for implementing both social policy and educational programs.

Factors associated with institutional delivery in Ghana: the role of decision-making autonomy and community norms.

PubMed

Speizer, Ilene S; Story, William T; Singh, Kavita

2014-11-27

In Ghana, the site of this study, the maternal mortality ratio and under-five mortality rate remain high indicating the need to focus on maternal and child health programming. Ghana has high use of antenatal care (95%) but sub-optimum levels of institutional delivery (about 57%). Numerous barriers to institutional delivery exist including financial, physical, cognitive, organizational, and psychological and social. This study examines the psychological and social barriers to institutional delivery, namely women's decision-making autonomy and their perceptions about social support for institutional delivery in their community. This study uses cross-sectional data collected for the evaluation of the Maternal and Newborn Referrals Project of Project Fives Alive in Northern and Central districts of Ghana. In 2012 and 2013, a total of 2,527 women aged 15 to 49 were surveyed at baseline and midterm (half in 2012 and half in 2013). The analysis sample of 1,606 includes all women who had a birth three years prior to the survey date and who had no missing data. To determine the relationship between institutional delivery and the two key social barriers-women's decision-making autonomy and community perceptions of institutional delivery-we used multi-level logistic regression models, including cross-level interactions between community-level attitudes and individual-level autonomy. All analyses control for the clustered survey design by including robust standard errors in Stata 13 statistical software. The findings show that women who are more autonomous and who perceive positive attitudes toward facility delivery (among women, men and mothers-in-law) were more likely to deliver in a facility. Moreover, the interactions between autonomy and community-level perceptions of institutional delivery among men and mothers-in-law were significant, such that the effect of decision-making autonomy is more important for women who live in communities that are less supportive of institutional delivery compared to communities that are more supportive. This study builds upon prior work by using indicators that provide a more direct assessment of perceived community norms and women's decision-making autonomy. The findings lead to programmatic recommendations that go beyond individuals and engaging the broader network of people (husbands and mothers-in-law) that influence delivery behaviors.

"I've Had a Pretty Tough Life but That's Not Why I Do This": Narratives of Autonomy and Control among Alcohol and Drug Service-Engaged Early Teenagers

ERIC Educational Resources Information Center

MacLean, Sarah J.; Bruun, Andrew; Mallett, Shelley

2013-01-01

The provision of alcohol and other drug (AOD) programmes in Australia targeting a broad age range of young people may inadvertently obscure the particular service needs of early teenagers. In this study, we describe four main accounts of substance use identified through interviews with 20 AOD service-engaged participants in Victoria, aged from 13…

The effects of autonomy support on salivary alpha-amylase: The role of individual differences.

PubMed

Sieber, Vanda; Schüler, Julia; Wegner, Mirko

2016-12-01

The empirical evidence for the relationship between autonomy-supportive environments and physiological stress is inconsistent. Whereas some studies report a decrease in stress in autonomy-supportive environments, other studies show a negative effect of autonomy on physiological stress. As previous research has not considered individual differences within this relationship, the present research aims to close this empirical gap by proposing that an implicit autonomy disposition, which is defined as a dispositional preference for self-determination, serves as a moderator. In an experiment, we tested whether the autonomy disposition moderates the effect of different teaching styles (controlling, autonomy-supportive, and neutral) on the acute physiological stress response (salivary alpha-amylase) in adolescents (N=69). The study revealed that participants with a high implicit autonomy disposition displayed lower salivary alpha-amylase responses when exposed to autonomy-supportive vignettes compared to when they were exposed to controlling or neutral teaching styles. The opposite pattern was found in students with a low implicit autonomy disposition. The results illustrate that experimentally induced variations in autonomy support lead to different physiological stress responses, depending on individual differences in the implicit autonomy disposition. Copyright © 2016 Elsevier Ltd. All rights reserved.

Burnout in Hospital Social Workers Who Work with AIDS Patients.

ERIC Educational Resources Information Center

Oktay, Julianne S.

1992-01-01

Surveyed 128 hospital social workers who worked with Acquired Immune Deficiency Syndrome (AIDS) patients. Found that hospital AIDS social workers had slightly higher rates of emotional exhaustion and depersonalization on Maslach Burnout Inventory but also felt substantially higher level of personal accomplishment. Age, autonomy, and belonging to…

Who "Owns" the University? Institutional Autonomy and Academic Freedom in an Age of Knowledge Capitalism

ERIC Educational Resources Information Center

Shore, Cris; Taitz, Mira

2012-01-01

The neoliberal reframing of universities as economic engines and the growing emphasis on "third stream" commercial activities are global phenomena albeit with significant local variations. This article uses the concept of "ownership" to examine how these processes are impacting on institutional self-understandings and…

Testing Self-Determination Theory via Nigerian and Indian Adolescents

ERIC Educational Resources Information Center

Sheldon, Kennon M.; Abad, Neetu; Omoile, Jessica

2009-01-01

We tested the generalizability of five propositions derived from Self-Determination Theory (SDT; Deci & Ryan, 2000) using school-aged adolescents living in India (N = 926) and Nigeria (N = 363). Consistent with past U.S. research, perceived teacher autonomy-support predicted students' basic need-satisfaction in the classroom and also predicted…

Connectivism and Dimensions of Individual Experience

ERIC Educational Resources Information Center

Tschofen, Carmen; Mackness, Jenny

2012-01-01

Connectivism has been offered as a new learning theory for a digital age, with four key principles for learning: autonomy, connectedness, diversity, and openness. The testing ground for this theory has been massive open online courses (MOOCs). As the number of MOOC offerings increases, interest in how people interact and develop as individual…

Development to Learning: Semantic Shifts in Professional Autonomy and School Leadership

ERIC Educational Resources Information Center

Stevenson, Michael; Hedberg, John G.; O'Sullivan, Kerry-Ann; Howe, Cathie

2015-01-01

In the digital age, technology is playing an important role in changing the nature of professionalism. Newer forms of "professional learning" stand in contrast to more traditional forms of "professional development." The shifting paradigm has implications for school leaders in all contexts. This study sought to qualitatively…

Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

PubMed

Heins, Marianne; Hofstede, Jolien; Rijken, Mieke; Korevaar, Joke; Donker, Gé; Francke, Anneke

2018-04-17

In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision. Patients also rated whether they received these aspects. Questionnaires were based on the CQ index palliative care. Almost all patients rated information provision and respect for their autonomy as important. The majority also rated support when suffering from specific symptoms as important, especially support when in pain. In general, patients received the care they considered important. However, 49% of those who considered it important to receive support when suffering from fatigue and 23% of those who wanted to receive information on the expected course of their illness did not receive this or only did so sometimes. For most patients with advanced cancer, the palliative care that they receive matches what they consider important. Support for patients experiencing fatigue may need more attention. When symptoms are difficult to control, GPs and nurses may still provide emotional support and practical advice. Furthermore, we recommend that GPs discuss patients' need for information about the expected course of their illness.

From solidarity to autonomy: towards a redefinition of the parameters of the notion of autonomy.

PubMed

Fainzang, Sylvie

2016-12-01

Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use.

[Managerial autonomy in primary care: position of health professionals in Mallorca].

PubMed

Tamborero, Gaspar; Esteva, Magdalena; March, Sebastià; Guillén, Mireia

2015-02-01

To assess the knowledge, perceptions, expectations and attitudes of Primary Care (PC) professionals in Mallorca on managerial autonomy. Cross-sectional study based on an ad hoc, anonymous questionnaire, distributed online, from June-July 2013. PC Mallorca. PC healthcare professionals (n=1,097). Knowledge of self-management skills, requirements, and future scenarios of the centers with management autonomy (CMA); impact of self-management, commitment and willingness to take risks, and to become a CMA. Response rate: 49.8% (546/1097), with 10.9% showing a high level of knowledge of self-management. The core competencies of a CMA were internal organizational capacity (87.5%) and selection of staff (81.1%). The CMA future was envisaged with motivated and involved professionals (72.6%), efficient results (66%), better quality of care (59.4%), and better training (52.8%). The benefits of self-management were considered important, for individual practitioners and for the improvement of PC in Mallorca (46.8%). The main requirements of the CMA were to have: trained managers (92.6%), budget allocation systems (87.5%), and appropriate management contracts (86.1%). They preferred that the CMA should depend on the Administration (62.7%), and had a personal interest in becoming a CMA (56.9%), but without taking on excessive commitments (waiving statutory regime, financial risk). These data provide hitherto unknown information of great importance, which could contribute to a more rational planning and participatory implementation of CMA in our midst. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Gendered Help at the Workplace: Implications for Organizational Power Relations.

PubMed

Chernyak-Hai, Lily; Waismel-Manor, Ronit

2018-01-01

One of the most thoroughly studied aspects of prosocial workplace behavior is organizational citizenship behavior (OCB). Yet, the definition of OCB seems to overlook the fact that help-giving acts may be of different types with different consequences for both giver and recipient. The present research explores workplace help-giving behavior by investigating the importance of gender as a factor that facilitates or inhibits specific types of help that empower and disempower independent coping: autonomy- and dependency-oriented help, respectively. A pilot and two following studies were conducted. The pilot study empirically assessed which acts would be clearly perceived by participants as representing both types of help. Then, using the descriptions of these acts, Study 1 examined which type of help would be perceived as most likely to be given by a male or female employee to a male or female colleague in a sample of 226 participants (78% women). Study 2 explored which type of help participants perceived as one they would rather receive from a male or female helper in a sample of 170 participants (65% women). Our findings indicate that male and female respondents who rated men giving help were more likely to expect them to give autonomy-oriented help, especially to women. There were no significant differences in dependency-oriented help. Further, women preferred to receive more autonomy-oriented help than men did, regardless of the help-giver's gender; no significant results were found for men. Implications for OCB and workplace power relations are discussed.

From self-assessment to frustration, a small step toward autonomy in robotic navigation

PubMed Central

Jauffret, Adrien; Cuperlier, Nicolas; Tarroux, Philippe; Gaussier, Philippe

2013-01-01

Autonomy and self-improvement capabilities are still challenging in the fields of robotics and machine learning. Allowing a robot to autonomously navigate in wide and unknown environments not only requires a repertoire of robust strategies to cope with miscellaneous situations, but also needs mechanisms of self-assessment for guiding learning and for monitoring strategies. Monitoring strategies requires feedbacks on the behavior's quality, from a given fitness system in order to take correct decisions. In this work, we focus on how a second-order controller can be used to (1) manage behaviors according to the situation and (2) seek for human interactions to improve skills. Following an incremental and constructivist approach, we present a generic neural architecture, based on an on-line novelty detection algorithm that may be able to self-evaluate any sensory-motor strategies. This architecture learns contingencies between sensations and actions, giving the expected sensation from the previous perception. Prediction error, coming from surprising events, provides a measure of the quality of the underlying sensory-motor contingencies. We show how a simple second-order controller (emotional system) based on the prediction progress allows the system to regulate its behavior to solve complex navigation tasks and also succeeds in asking for help if it detects dead-lock situations. We propose that this model could be a key structure toward self-assessment and autonomy. We made several experiments that can account for such properties for two different strategies (road following and place cells based navigation) in different situations. PMID:24115931

A cross-cultural comparison of the coexistence and domain superiority of individuating and relating autonomy.

PubMed

Yeh, Kuang-Hui; Bedford, Olwen; Yang, Yung-Jui

2009-06-01

The consensus definition of autonomy in the psychological literature emphasizes self-governance through free volition, not separation or independence from others. Since the concept of self may differ cross-culturally, several researchers have tried to incorporate types of self into the notion of autonomy; however, only the dual model of autonomy has been able to do this while retaining an emphasis on volition. The dual model describes two distinct forms of autonomy-individuating and relating-each with superior function in a specific domain of individual functioning. Individuating autonomy represents a volitional capacity to act against social constraints and offers a route to achieve an independent self-identity by expressing individualistic attributes and distinctions. Relating autonomy represents a volitional capacity to act by emphasizing the harmony of self-in-relation-to-others, the quality of interpersonal relationships, and self-transcendence. These two forms of autonomy have been shown to coexist at the individual level in a Taiwanese sample. This study takes the next step, with a cross-cultural test of the coexistence and domain superiority hypotheses of individuating and relating autonomy. Participants included 306 college students from Taiwan and 183 college students from the United States. Structural equation modelling by multigroup analyses confirmed the cross-cultural equivalence of the two-factor individuating autonomy and relating autonomy measurement model. Across both samples the two forms of autonomy were shown to be mutually inclusive and not exclusive or independent. The domain-superior function of each form of autonomy was also confirmed cross-culturally; each form of autonomy has a dominant, but not necessarily exclusive, domain of functioning. Specifically, individuating autonomy was more associated with intrapersonal than interpersonal domain dependent variables, while relating autonomy was more associated with interpersonal than intrapersonal domain dependent variables. Limitations of the study and considerations for future research are discussed.

Effect of Women's autonomy on maternal health service utilization in Nepal: a cross sectional study.

PubMed

Adhikari, Ramesh

2016-05-13

Women's role has been a priority area not only for sustainable development, but also in reproductive health since ICPD 1994. However, very little empirical evidence is available about women's role on maternal health service utilization in Nepal. This paper explores dimensions of women's autonomy and their relationship to utilization of maternal health services. The analysis uses data from the Nepal Demographic and Health Survey, 2011. The analysis is confined to women who had given birth in the 5 years preceding the survey (n = 4,148). Women's autonomy related variables are taken from the standard DHS questionnaire and measured based on decision in household about obtaining health care, large household purchases and visit to family or relative. The net effect of women's autonomy on utilization of maternal health services after controlling for the effect of other predictors has been measured through multivariate logistic regression analysis. The findings indicate only about a half of the women who had given birth in the past 5 years preceding the survey had 4 or more ANC check up for their last birth. Similarly, 40 % of the women had delivered their last child in the health facilities. Furthermore, slightly higher than two-fifth women (43 %) had postnatal check up for their last child. Only slightly higher than a fourth woman (27 %) had utilized all the services (adequate ANC visit, delivered at health institution and post natal check up) for their last child. This study found that many socio-demographic variables such as age of women, number of children born, level of education, ethnicity, place of residence and wealth index are predicators of utilizing the maternal health services of recent child. Notably, higher level autonomy was associated with higher use of maternal health services [adjusted odds ratio (aOR) =1.40; CI 1.18-1.65]. Utilization of maternal health services for the recent child among women is very low. The study results suggest that policy actions that increase women's autonomy at home could be effective in helping assure good maternal health.

Impact of a supervised exercise program supporting autonomy on the adoption of an active lifestyle among obese adolescents: a Self-Determination Theory perspective.

PubMed

Gourlan, M; Sant, F; Boiche, J

2014-12-01

Regular physical activity (PA) practice represents a key component of obesity treatment. Drawing upon Self-Determination Theory, the purpose of this study was twofold. The first aim was to evaluate among obese adolescents the impact of a supervised exercise program supporting autonomy on their motivation to practice PA at the end of the intervention. The second aim was to evaluate the impact of the program on their level of PA one month after the end of the intervention. Eighteen obese adolescents (mean age=14.3 years, mean BMI=33.47 kg/m²) were recruited to participate in an 11-week residential obesity treatment program. They received a 45-minute supervised exercise session each week. Motivational regulations were assessed at baseline and at the end of the intervention (via the Exercise Motivation Scale). PA practice was assessed at baseline and one month after the end of the intervention (via the 7-day PA recall interview). The analyses revealed that adolescents' levels of autonomy increased, that their levels of intrinsic motivation tended to increase, and that their level of external regulation tended to decrease. In addition, the participants increased their habitual PA practice one month after the end of the intervention in comparison to baseline. This study highlights that supporting autonomy during supervised exercise sessions appears as an effective strategy to promote PA among obese adolescents because it fosters internalization of the behavior.

Talk the talk and walk the walk. Evaluation of autonomy in aging and Alzheimer disease by simulating instrumental activities of daily living: the S-IADL

PubMed Central

Gounden, Yannick; Lacot, Emilie; Couvillers, Frédérique; Lions, Amandine; Hainselin, Mathieu

2016-01-01

Objective The autonomy of individuals is linked to the achievement of instrumental activities of daily living that require complex behavior. In the elderly, the assessment of autonomy is usually based on questionnaires that have strong subjective constraints. Considering this fact, we tested elderly healthy adults and Alzheimer disease patients using a new measure, the S-IADL (Simulation of Instrumental Activities for Daily Living), to assess the ability to perform effectively activities of daily living. Method The S-IADL shares many items with the well-known IADL questionnaire proposed by Lawton & Brody (1969). However, as opposed to the IADL, the assessment of autonomy is not based on the completion of a questionnaire but requires the realization or simulation of various activities of daily living. Eighty-three participants (69 healthy elderly, and 14 Alzheimer Disease patients) completed the IADL and performed the S-IADL assessment. Results Results revealed that, like the IADL, the S-IADL is able to identify AD patients who are likely to encounter difficulties in performing everyday activities, and no major differences were found between the IADL and the S-IADL. Conclusions We outlined some advantages for prefering, in certain situation, this new tool based on simulation of activities in functional evaluation. Finally, we discuss the main limits of the S-IADL that should be investigated prior to its utilization by clinicians. PMID:27672491

Affective motives for smoking among early stage smokers.

PubMed

Mathew, Amanda R; Wahlquist, Amy E; Garrett-Mayer, Elizabeth; Gray, Kevin M; Saladin, Michael E; Carpenter, Matthew J

2014-10-01

As most smokers initiate smoking during adolescence, assessment of smoking motives that underlie trajectories of dependence is critical for both prevention and cessation efforts. In the current study, we expected participants with higher nicotine dependence would smoke (a) less for positive reinforcement (PR) and (b) more for negative reinforcement (NR) motives. We secondarily assessed the relative contribution of PR to NR motives across levels of dependence. Data were drawn from a study on cue-elicited craving among occasional versus daily adolescent smokers aged 16-20 years (N = 111). Smoking motives were assessed in relation to 3 commonly used measures of nicotine dependence: (a) Fagerström Test for Nicotine Dependence (FTND), (b) Autonomy over Smoking Scale (AUTOS), and (c) Nicotine Dependence Syndrome Scale (NDSS). Compared to occasional smokers, daily smokers had significantly higher scores on each dependence measure and endorsed more prominent NR smoking motives. Each measure of nicotine dependence was strongly associated with NR motives for smoking, although measures differed in their association with PR motives. As expected, the FTND, AUTOS, and NDSS each significantly predicted smoking motive difference score (PR - NR), such that higher dependence was associated with more prominent NR motives for smoking. Results are consistent with our understanding of dependence and provide further support for 3 common measures of nicotine dependence among early stage smokers. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Why are rural Indian women so thin? Findings from a village in Maharashtra

PubMed Central

Chorghade, GP; Barker, M; Kanade, S; Fall, CHD

2009-01-01

Objective: To identify social, behavioural and cultural factors that explain the thinness of young women relative to their men in rural Maharashtra, India. Design: Twelve focus group discussions were conducted to explore the villagers' understanding of why women in their area might be thinner than men. Setting: Pabal village and surrounding hamlets, in the Pune district of Maharashtra, India. Subjects: Samples of young mothers and fathers, grandmothers and grandfathers were selected from families in the village with children below 10 years of age. Results: Four factors were identified that the villagers felt contributed to the disparity in thinness. First, marriage isolated girls from their own families and villages, and brought the expectation of early motherhood. Young brides were often unable to relax and eat adequately. Second, marriage increased the workload of young women. They were expected to do the heaviest household chores as well as farm work in this predominantly agricultural community. Third, women had no financial autonomy or freedom of movement, and were therefore denied access to supplementary food sources available to men. Fourth, young women felt responsible for their household's health and success. They were encouraged to fast regularly to ensure this. Despite feeling responsible, young women had no control over factors that might affect the household's well being. This made them anxious and worried a great deal of the time. Conclusions: Interventions to improve the nutritional status of young women in this region need to recognise the roles and responsibilities taken up by young brides. PMID:16480528

Accepting or declining dialysis: considerations taken into account by elderly patients with end-stage renal disease.

PubMed

Visser, Annemieke; Dijkstra, Geke J; Kuiper, Daphne; de Jong, Paul E; Franssen, Casper F M; Gansevoort, Ron T; Izaks, Gerbrand J; Jager, Kitty J; Reijneveld, Sijmen A

2009-01-01

Elderly patients with end-stage renal disease have to make a difficult decision whether or not to start dialysis. This study explores the considerations taken into account by these patients in decision-making regarding renal replacement therapy. In-depth interviews were conducted to gain an enhanced understanding of the considerations in treatment decision-making. Fourteen patients aged 65 years or older participated in the interviews, of whom 8 patients had made the decision to start, and 6 patients the decision to decline, dialysis. All participating patients had a variety of health problems, but appeared to have normal cognitive functions. Patients who declined dialysis were older and more often men and widow(er)s compared with patients who accepted dialysis. Patients chose to start dialysis because they enjoyed life, were not prepared to face the end of life, felt they had no other choice or had care-giving responsibilities for family members. Patients declined dialysis because of the speculated loss of autonomy, their age-associated decrease in vitality, distance from dialysis center and reluctance to think about the future. Results suggest that patients' decisions to decline or accept dialysis are not based on the effectiveness of the treatment, but rather on personal values, beliefs and feelings toward life, suffering and death, and the expected difficulties in fitting the treatment into their life.