A Quantitative Meta-Analysis and Qualitative Meta-Synthesis of Aged Care Residents' Experiences of Autonomy, Being Controlled, and Optimal Functioning.

Autor:	Bradshaw EL; Faculty of Health Sciences, Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia., Anderson JR; Faculty of Health Sciences, Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia.; Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Victoria, Australia., Banday MAJ; Faculty of Health Sciences, School of Psychology, Australian Catholic University, Strathfield, New South Wales, Australia., Basarkod G; Faculty of Health Sciences, Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia., Daliri-Ngametua R; Faculty of Education and Arts, School of Education, Australian Catholic University, Banyo, Queensland, Australia., Ferber KA; Faculty of Health Sciences, Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia., Henry D; Faculty of Health Sciences, School of Psychology, Australian Catholic University, Fitzroy, Victoria, Australia., Ryan RM; Faculty of Health Sciences, Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia.; Ewha Womans University, Seoul, South Korea.
Jazyk:	angličtina
Zdroj:	The Gerontologist [Gerontologist] 2024 May 01; Vol. 64 (5).
DOI:	10.1093/geront/gnad135
Abstrakt:	Background and Objectives: The poor mental health of adults living in aged care needs addressing. Improvements to nutrition and exercise are important, but mental health requires a psychological approach. Self-determination theory finds that autonomy is essential to wellbeing while experiences of being controlled undermine it. A review of existing quantitative data could underscore the importance of autonomy in aged care, and a review of the qualitative literature could inform ways to promote autonomy and avoid control. Testing these possibilities was the objective of this research. Research Design and Methods: We conducted a mixed-methods systematic review of studies investigating autonomy, control, and indices of optimal functioning in aged care settings. The search identified 30 eligible reports (19 quantitative, 11 qualitative), including 141 quantitative effect sizes, 84 qualitative data items, and N = 2,668. Quantitative effects were pooled using three-level meta-analytic structural equation models, and the qualitative data were meta-synthesized using a grounded theory approach. Results: As predicted, the meta-analysis showed a positive effect of aged care residents' autonomy and their wellness, r = 0.33 [95% CI: 0.27, 0.39], and a negative effect of control, r = -0.16 [95% CI: -0.27, -0.06]. The meta-synthesis revealed seven primary and three sub-themes describing the nuanced ways autonomy, control, and help seeking are manifest in residential aged care settings. Discussion and Implications: The results suggest that autonomy should be supported, and unnecessary external control should be minimized in residential aged care, and we discuss ways the sector could strive for both aims. (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.)
Databáze:	MEDLINE
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