A quantitative meta-analysis and qualitative meta-synthesis of aged care residents’ experiences of autonomy, being controlled, and optimal functioning
Journal article
Bradshaw, Emma L., Anderson, Joel R., Banday, Ma A. J., Basarkod, Geetanjali, Daliri-Ngametua, Rafaan, Ferber, Kelly A., Henry, Dylan and Ryan, Richard M.. (2023). A quantitative meta-analysis and qualitative meta-synthesis of aged care residents’ experiences of autonomy, being controlled, and optimal functioning. The Gerontologist. 64(5), pp. 1-12. https://doi.org/10.1093/geront/gnad135
Authors | Bradshaw, Emma L., Anderson, Joel R., Banday, Ma A. J., Basarkod, Geetanjali, Daliri-Ngametua, Rafaan, Ferber, Kelly A., Henry, Dylan and Ryan, Richard M. |
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Abstract | 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. |
Keywords | self-determination theory; systematic review; motivation; nursing home |
Year | 2023 |
Journal | The Gerontologist |
Journal citation | 64 (5), pp. 1-12 |
Publisher | Oxford University Press |
ISSN | 1758-5341 |
Digital Object Identifier (DOI) | https://doi.org/10.1093/geront/gnad135 |
PubMed ID | 37798134 |
Web address (URL) | https://academic.oup.com/gerontologist/article/64/5/gnad135/7293006 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 1-12 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 05 Oct 2023 |
Publication process dates | |
Deposited | 30 Nov 2023 |
Additional information | © The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. |
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
https://acuresearchbank.acu.edu.au/item/90034/a-quantitative-meta-analysis-and-qualitative-meta-synthesis-of-aged-care-residents-experiences-of-autonomy-being-controlled-and-optimal-functioning
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Publisher's version
OA_Bradshaw_2023_A_quantitative_meta_analysis_and_qualitative.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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