Topic on autonomy

PROFESSIONAL ISSUES

Developing a concept analysis of
autonomy in nursing practice
Johit Wilkinson

The ability to define and categorize
concepts is essential in order to make
sense of an issue and effectively com-

municate it to others. Batey (1977) argues
that the greatest limitation of nursing
research is the vagueness with which key
terms are clarified. The process of conducting
a concept analysis is challenging. Critical
thinking is a desirable quality in nursing
(Kemp, 1985) and potentially leads to an
enhanced understanding of a topic. Rodgers
(19S9) offers a flexible method of concept
analysis which acknowledges the potential
for subjectivity in concept definition.

In undertaking a concept analysis of auton-
omy the author used Walker and Avant’s
(1988) strategy as it offers a structured
approach which assists in the achievement of
rigour in the process.

The issue of autonomy has received much
attention in the nursing literature. The empha-
sis has mainly focused on the desirabilit)’ of
autonomy for both practitioners and recipients
of care. Indeed, the concept of autonomous
nursing practice being delivered in partnership
with an autonomous patient/client has been
advocated as the panacea of modem profes-
sional nursing (Leddy and Pepper, 1993). The
concept of autonomy appears complex and yet
it is fundamental to human existence. The lack
of precision in its definition makes the search
for clarity and understanding a challenge.

A greater understanding of autonomy gives
insight into the following questions:
• Is autonomous nursing practice desirable?
• Is autonomous nursing practice possible?
• How may autonomous nursing practice (if

desirable and possible) be enhanced?

USES OF THE CONCEPT

A typical definition of autonomy is:

‘…the having or making of one’s own

laws, independence…’
(Tite Oxford English Dictionary, 1989).

Abstract
This article presents a concept analysis of autonomy and offers some
insights Into the quest for and operatlonallzation of autonomous nursing
practice. Recommendations are made regarding automony and nursing
practice at the level of the individuai practitioner. This concept is also
examined in reiation to the context in which nursing care is deiivered. The
conclusions drawn as a result of this anaiysis serve as a focus for debate
on the challenges that nurses and those invoived in their education face.

The word is derived from the Greek words
‘autos’ (self) and ‘nemien’ (to hold sway)
(Curtin, 1987).

At a physiological level, an autonomous
process is characterized by its independence
from rhe usual processes of regulation, e.g. the
autonomic nervous system functions largely
independently of conscious will (Marieb,
1992}. At a personal level, autonomy refers to
determining and defining self, which suggests
liberty to select and act according to one’s
will, inde