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Autonomy
on Empowerment
Raquel McCarthy
GNRS 507: Scientific Writing
August 1, 2016
Background
Elderly with cancer patients face increased
barriers to exercising autonomy
PICOT
Does implementing autonomy-supportive palliative care
education versus no autonomy-supportive palliative care
education, increase empowerment as measured by the
Patient Empowerment Scale (PES) for geriatric, oncology
patients over 3 months?
Increase empowerment
Literature Review
All researchers sought to manipulate or expand upon
empowerment
Evidence Quality
Qualitative approaches relied upon
Nurse perspectives or patient experiences evaluated
Surveys (n=197, n=393)
Semi-structured interviews (n= < 20)
Questionnaires (n=76)
Evidence grading:
Level I
Level V
Level VI
Key Findings
Little agreement on empowerments definition
Standard, validated measure necessary
Clinical Findings
Nurses are more effective educators
Timing of intervention is key
Palliative care for health promotion
Family caregivers desire participatory
role
Change in Practice
UCSD Moores
Cancer Center
Improved
Program
Nurse-led
Physician-led
PAQ screening
No autonomy assessment
Focus: Autonomy
problems
Patient-centered
Family integration
disease course
standard treatment
3 dimensions absent
Incorporate 3 dimensions
Goal: Comfort
Goal: Increase
empowerment
UCSD, 2016
Potential Barriers
Physician preference by patient
Physician/organization opposition to change
Autonomy problems may not be present
Lack of readiness to receive or provide new
information
Outcome Measurement
Group 1: receives autonomy-supportive intervention
Group 2: receives standard PC from UCSD
Empowerment measured at 3 months
Patient Empowerment Scale (PES)
28-item Likert-type scale
Appraises empowerment, ability to make decisions
Four categories: 1 strongly disagree to 4 strongly
agree
10-15 minutes to complete
Non-upsetting, easy-to-answer questions
Bulsara et al., 2006
Conclusion
Empowerment-based interventions
Increase self-efficacy
Overcome autonomy problems
References
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