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Self-determination among community-dwelling older persons: explanatory factors

Journal article
Authors Isabelle Ottenvall Hammar
Synneve Dahlin-Ivanoff
Katarina Wilhelmson
Kajsa Eklund
Published in Scandinavian Journal of Occupational Therapy
Volume 23
Issue 3
Pages 198-206
ISSN 1103-8128
Publication year 2016
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Centre for Ageing and Health (Agecap)
Pages 198-206
Language en
Keywords Activities of daily living (ADL); aged 80 and over; capability; cross-sectional study; decision-making
Subject categories Gerontology, specializing in Medical and Health Sciences


Background Although it is acknowledged that exercising self-determination in daily activities affects older people’s health and well-being, few studies have focused on the explanatory factors for self-determination in daily life. Objective To investigate explanatory factors for self-determination in the context of community-dwelling older persons. Method: This cross-sectional study combined two sets of data that included community-dwelling persons 80 years and older (n = 456). A bivariate logistic regression was performed to analyse the association of self-determination and a set of explanatory factors. Results The final bivariate logistic regression model revealed five explanatory factors that were significantly associated with perceiving reduced self-determination: high education (OR = 2.83), frailty (OR = 2.70), poor self-rated health (OR = 2.54), dissatisfaction with physical health (OR = 6.50), and receiving help from public homecare service (OR = 2.46). Conclusion Several explanatory factors related to the ageing body and environmental aspects were associated with reduced self-determination. To help older people maintain self-determination, healthcare professionals should consider using a person-centred and capability approach to care.

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