Nurses' collegiality: An evolutionary concept analysis.

Collegiality is one of the fundamental values of the nursing profession. During the nursing history, collegiality has been described as part of a nurse's relationship with their peers and it influences the quality of care they provide and job satisfaction and commitment to their work. Despite earlier definitions, the concept of collegiality in nursing has remained unclear. The aim of this study was to clarify the concept of collegiality in the nursing profession, using Rodger's evolutionary concept analysis. We carried out electronic searches using the CINAHL, PubMed, Scopus, Web of Science, SocINDEX, PsycINFO and Eric databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers published in English language from the inception of database to November 2022. This identified 25 papers. Based on our analysis, the attributes of the concept of collegiality were achieving mutual goals together with equality, reciprocity, trusted advocacy, powerful self-regulation and engaged belongingness. Antecedents of the concept included existing professional group, connection between professionals and professional self-esteem. The consequences were strengthening nurses' professional status, job satisfaction and their ability to provide the best possible patient care. We found that nurses' collegiality was a value-based concept, with a unique character based on professional connections. The concept brought together ethical and pragmatic strategies to achieve the best possible results for the nursing profession. Provided knowledge can be applied for further development of the concept and applying it in clinical research and practice. The concept of nurses' collegiality should also be studied in the future because both the profession and their working environment are constantly changing.

Resilience in nursing education: an evolutionary concept analysis.

OBJECTIVES: Resilience is a complex concept that is extensively drawn upon in higher education, nursing included. The objective is to examine the concept of resilience and its use within nursing education. METHODS: Rodgers' evolutionary concept analysis was used to explore this concept. RESULTS: The current focus on fostering resilience in undergraduate nursing education predominantly focuses on educational interventions to support one's ability to self-care continues to be pervasive within the nursing literature. More recent dialogue encourages a more holistic approach that examine interventions from both individual and structural perspectives. CONCLUSIONS: Recommendations for future research are to examine the synergy between individual, contextual, and structural factors to support resilience in nursing students. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Based on the concept analysis, resilience is contextual. Therefore, nurse educators may support and foster nursing students' resilience by having increased awareness of both individual and structural perspectives of resilience.

The Relationship Between Perception of Good Death With Clinical Competence of End-Of-Life Care in Critical Care Nurses.

Providing a good death can be one of the most important goals of end-of-life care. This study aimed to investigate the relationship between the concept of good death with clinical end-of-life care competence among intensive care nurses. The participants were 279 nurses in southeast Iran. The data were collected using the Nurses' Concept of Good Death Questionnaire and the Clinical Competency of End-of-Life Care Questionnaire. There was a positive, moderate, and significant correlation between nurses' concept of good death and their clinical competence in end-of-life care. Nurses who got higher scores on the concept of good death showed higher levels of clinical competence in end-of-life care. It is possible to take steps to improve nurses' concepts and knowledge through specialized educational interventions.

[Diving into the heart of the initial training of future nurses in Switzerland]. / Au cœur de la formation initiale des futurs infirmiers en Suisse.

Within the framework of the foreign internship program of his nursing school, a third year student was able to follow his fifth semester at the Haute École de santé du canton de Vaud, in Switzerland. He shares his experience and sheds light on the pedagogical orientations implemented in the initial training of nurses in this country neighbouring France.

The nurse without a nurse: the antecedents of presenteeism in nursing.

BACKGROUND: Presenteeism describes the state in which staff who lack the conditions for being present at work and need rest and leave for various reasons (such as illness, low spirits, fatigue, etc.) are present at the workplace. Due to the lack of knowledge about the antecedents of presenteeism in nurses and the context-based nature of this concept, the present study was conducted to explain the reasons for presenteeism in nurses. METHODS: This qualitative study was performed using the qualitative content analysis method. The study population consisted of 17 nurses working in different wards of hospitals. In this regard, data were collected from February to June 2020 using individual, face-to-face, in-depth, semi-structured interviews and were analyzed using qualitative content analysis. RESULTS: The nurse without a nurse was a category introduced as an antecedent of presenteeism. In this respect, nurses experienced limited power, injustice, compulsory presence, inadequate structural facilities, damaged professional identity, manager-nurse disconnect, insufficient knowledge, physical and mental health complications, job stress, job burnout, multitasking, and impaired communication. CONCLUSION: The nurse, who has been responsible for caring, supporting, advising, advocating, and educating the patient, has now been left without a nurse. In other words, not nursing the nurse has given rise to the emergence of presenteeism. It is recommended that the results of this study be used in making health policies. The results of this study can make nurses' voices heard by health leaders and managers. A voice that has never been heard as it deserves.

The protective role of professional self-concept and job embeddedness on nurses' burnout: structural equation modeling.

BACKGROUND: Job embeddedness and professional self-concept are among the important nursing components, the existence of which help decrease occupational burnout among nurses. This study aimed to determine the protective role of Professional Self-concept and Job embeddedness on nurses'burnout. METHODS: This descriptive, correlational study had a predictive design and was conducted on nurses working in training and healthcare centers of Babol University of Medical Sciences in 2019. In total, 308 nurses participated in this study and were selected by stratified random sampling. In addition, data were collected using demographic characteristics questionnaire, Professional Self-concept questionnaire, Job embeddedness scale and nurses' burnout questionnaire. Moreover, data analysis was performed in SPSS version 25 and Smart PLS version 3.3 using correlational statistics and structural equation modeling. RESULTS: Both the variables of professional self-concept and job embeddedness, had a significant effect on nurses' burnout at 99% confidence level (P < 0.001) and the negative beta value for these two variables shows the inverse relationship between both professional self-concept and job embeddedness with nurses' burnout. The value of the coefficient of determination for burnout indicates that both the variables of professional self-concept and job embeddedness, together explain 78% of the changes in the variable of burnout. The beta coefficient for professional self-concept (- 0.50) is higher than the same coefficient for job embeddedness (- 0.42). As a result, the role of professional self-concept in predicting burnout of clinical nurses has been more than the role of job embeddedness. The indirect effect of professional self-concept on burnout of clinical nurses mediated by job embeddedness has been equal to - 0.347. As a result, it can be said that nurses' professional self-concept has a significant effect on nurses' burnout through mediation of job embeddedness. CONCLUSION: According to the results of the study, Professional Self-concept had an effective role in nurses' burnout. In other words, the higher the Professional Self-concept of nurses, the lower their burnout. Therefore, it is suggested that effective interventional strategies be designed by nursing managers through better planning and a supportive workplace be established to improve Professional Self-concept among nurses and decrease their burnout.

The relationship between professional self-concept and work-related quality of life of nurses working in the wards of patients with COVID-19.

BACKGROUND: Nurses are at the forefront of providing health care services and their performance is largely determinant of the quality of health care. This study aims to investigate associations between professional self-concept (PSC) and WRQoL among nurses from selected hospitals in Bushehr and Shiraz cities (south of Iran), during the period of COVD-19 pandemic. METHOD: This study is designed as a cross-sectional study. Available sampling was performed among active nurses in the care wards of patients with Covid-19 in public hospitals in Bushehr and Shiraz. Data were collected using demographic information form, along with the work-related quality of life and professional self-concept questionnaires. SPSS software and univariate and multivariate linear regression statistical methods with a significance level of 0.05 were used to analyze the data. RESULTS: The mean scores of the PSC and the WRQoL Scale in nurses were respectively 202.32 ± 38.19 and 68.81 ± 19.12. There was also a significant direct relationship between PSC and WRQoL. PSC together with work location and working experience could thus explain 34.6% of the variance in WRQoL, which was 26.5% for PSC. CONCLUSION: Considering the confirmation of the predictive role of nurses' PSC in their WRQoL in terms of planning and designing interventions to boost their WRQoL, attention to internal factors such as PSC is of utmost importance.

[The comparative evaluation of policy documents of the Russian Federation concerning personnel policy in health care].

Nowadays, in Russia number of problems is present in effective personnel policy in health care. The National Concept of personnel policy in health care (2002) expired in 2010 and no new one was developed. However, corresponding program documents were adopted at the level of subjects of the Russian Federation. The purpose of study was to compare evaluation of program documents of subjects of the Russian Federation related to issues of personnel policy in health care. The continuous sampling technique was applied to study these documents, which were valid in the territories of all subjects of the Russian Federation in 2002-2019. The comparative assessment was performed. It is demonstrated that the most informative document in this area is only the corresponding specialized Concept. However, this document was adopted only in 8.2% of the subjects of the Russian Federation, and they were valid only in two subjects. The concepts of health care development in the subjects of the Russian Federation, addressing medical personnel policy were adopted in 44.7% of the subjects of the Russian Federation. However, these legal documents operate only in 15.3% of territories. At the same time, the availability of appropriate specialized program document is a prerequisite of development of coherent and effective medical personnel policy in health care at all its levels.

Nurse's social responsibility: A hybrid concept analysis in Iran.

Background: Social responsibility in nursing is a complex concept that is completely associated with the context and healthcare system of every society. This study was conducted to analyze the concept of nurse's social responsibility in Iran. Methods: This analysis was done using a hybrid model, which consists of three phases: a literature review in the theoretical phase, semi-structured interviews in the fieldwork phase, and combination of the results of the two previous phases in a final analytical phase. Results: The four main themes extracted in the theoretical phase included: "Multi-dimensional and comprehensive approach", spirituality-based, learner-based and an evolutionary-process. In the fieldwork phase, all the themes obtained in the previous phase were confirmed, and one more theme emerged as "being relative". In the final phase, with the combination of the results of two previous phases, the final definition of the concept was presented. Conclusion: Clarifying the social responsibility of nurses and highlighting it in nursing will definitely lead to satisfaction in patients and clients, professional development and reduction of health care costs. Also, by identifying facilitators, inhibitors and social responsibility concepts, nursing managers and nursing educators will be able to design and implement their management and training activities based on scientific findings based on the findings that are necessary for the correct learning and implementation.

Workplace social capital in nursing: an evolutionary concept analysis.

AIM: To report an analysis of the concept of nurses' workplace social capital. BACKGROUND: Workplace social capital is an emerging concept in nursing with potential to illuminate the value of social relationships at work. A common definition is needed. DESIGN: Concept analysis. DATA SOURCES: The Cumulative Index to Nursing and Allied Health Literature, PubMed, PsychINFO and ProQuest Nursing. REVIEW METHODS: Databases were systematically searched using the keywords: workplace social capital, employee social capital, work environment, social capital and nursing. Sources published between January 1937-November 2012 in English that described or studied social capital of nurses at work were included. A total of 668 resources were found. After removing 241 duplicates, literature was screened in two phases: (1) titles and abstracts were reviewed (n = 427); and (2) remaining data sources were retrieved and read (n = 70). Eight sources were included in the final analysis. RESULTS: Attributes of nurses' workplace social capital included networks of social relationships at work, shared assets and shared ways of knowing and being. Antecedents were communication, trust and positive leadership practices. Nurses' workplace social capital was associated with positive consequences for nurses, their patients and healthcare organizations. CONCLUSION: Nurses' workplace social capital is defined as nurses' shared assets and ways of being and knowing that are evident in, and available through, nurses' networks of social relationships at work. Future studies should examine and test relationships between antecedents and consequences of nurses' workplace social capital to understand this important aspect of healthy professional practice environments better.

A concept analysis of nursing overtime.

AIM: To report a concept analysis of nursing overtime. BACKGROUND: Economic constraints have resulted in hospital restructuring with the aim of reducing costs. These processes often target nurse staffing (the largest organizational expense) by increasing usage of alternative staffing strategies including overtime hours. Overtime is a multifaceted, poorly defined, and indiscriminately used concept. Analysis of nursing overtime is an important step towards development and propagation of appropriate staffing strategies and rigorous research. DESIGN: Concept analysis. DATA SOURCES: The search of electronic literature included indexes, grey literature, dictionaries, policy statements, contracts, glossaries and ancestry searching. Sources included were published between 1993-2012; dates were chosen in relation to increases in overtime hours used as a result of the healthcare structuring in the early 1990s. Approximately 65 documents met the inclusion criteria. REVIEW METHODS: Walker and Avant's methodology guided the analysis. DISCUSSION: Nursing overtime can be defined by four attributes: perception of choice or control over overtime hours worked; rewards or lack thereof; time off duty counts equally as much as time on duty; and disruption due to a lack of preparation. Antecedents of overtime arise from societal, organizational, and individual levels. The consequences of nursing overtime can be positive and negative, affecting organizations, nurses, and the patients they care for. CONCLUSION: This concept analysis clarifies the intricacies surrounding nursing overtime with recommendations to advance nursing research, practice, and policies. A nursing-specific middle-range theory was proposed to guide the understanding and study of nursing overtime.

Factors Related to Professional Self-Concept of Nursing Students and Nurses: A Systematic Review.

Background: Some nurses leave their job because of working conditions, which will affect nurse turnover. Patients perceive that those nurses are distrustful, and feel unsatisfied, with patients' complaints about nursing service. This study explored factors about the professional self-concept of nursing students and nurses. Materials and Methods: A systematic review of cross-sectional studies followed PRISMA guidelines. PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were used from 1982 to August 2020 with the terms "factors" AND "nurse" AND "professional" AND "self-concept." A total of 19 out of 4,349 articles were used for analysis. Joanna Brings Institute critical appraisal tools for the analytical cross-sectional studies were used in this study, and narrative synthesis was used to analyze data. Results: Professional self-concept of clinical nurses is influenced by including organizational or job factors, and individual and emotional factors. Job factors consist of organizational support, professional ethic, clinical ladder system, nursing experience, position, and time. Besides, sex, age, marital status, education, health status, healthy lifestyle, and experience were categorized as individual factors. Emotional factors were as follows: interpersonal relationships, spiritual growth, management stress, and self-description. Meanwhile, student nurses are influenced by including personal (degree of study and sex), emotions (emotional intelligence, and interest in the nursing profession), and external factors (nursing courses, peer-mentoring experience, and academic burnout). Conclusions: Thus, individual factors and emotions have a vital role in constructing clinical nurses' professional self-concept as student nurses. Improving individual and emotional/personal aspects will positively increase professional self-concept.

The effects of using the nurse self-concept mobile application on the retention of nursing students.

BACKGROUND: The high dropout rate among nursing students has become a global concern as it leads to a shortage of nurses on the one hand and a negative impact on the professional motivation of nursing students on the other. The present study was conducted to investigate the effects of using the Nurse Self-Concept Mobile Application (NSCMA) on the retention of nursing students. MATERIALS AND METHODS: The present study is an experimental work of research with a longitudinal design conducted from April to December 2021. The study population was second-year nursing students in a nursing school in the south of Iran who were randomly divided into an experimental (n = 49) and a control group (n = 50). The assessment was based on a pretest-posttest design and a one-month follow-up. The collected data were analyzed in SPSS v. 21 using descriptive statistics (frequency, percentage, mean, and standard deviation) and analytical statistics (repeated measures). The P value was set <0.05. RESULTS: The means of the students' ages and grades were 21.31 ± 2.43 and 15.30 ± 2.13, respectively. The results showed a statistically significant increase in the experimental group's intent-to-stay mean scores as measured in three stages (P = 0.029), indicating that the intervention enhanced the nursing students' inclination to stay in nursing programs. However, the changes in the control group's mean scores were not statistically significant (P = 0.132). CONCLUSION: The Nurse Self-Concept Mobile Application proved effective in enhancing nursing students' inclination to complete their education and follow a career as a nurse. Thus, it is essential that nursing students' education include programs designed to enhance the students' self-concept, especially in the first few years of their education. Also, nursing schools should use this software to encourage students to stay in the nursing major.

Nurses' Lived Experiences of Moral Courage Inhibitors: A Qualitative Descriptive Study.

Introduction: Moral courage (MC) has been characterized among the vital strategies, adopted by nurses, for dealing with moral distress; even though there are some factors hindering the development of this behavior in clinical settings. Objective: The present study accordingly aimed to shed light on Iranian nurses' lived experiences regarding MC inhibitors. Methods: This qualitative descriptive study was fulfilled, using conventional content analysis. For this purpose, the participants comprised of 15 nurses were recruited purposively from teaching hospitals in Iran. As well, in-depth, individual semistructured interviews in a face-to-face mode were held for data collection. The data were further analyzed by Graneheim and Lundman's method. Results: The analysis of the interviews revealed some MC inhibitors, including the individual factors (viz., personality traits, fear of job loss, poor scientific/practical skills, lack of ethical knowledge, and phobia of unpleasant experience recurrence), and the organizational ones (namely, no reward system, lack of power at work and physician dominance, inadequate organizational support, and suppressive environment). Conclusion: The study findings demonstrated that the MC inhibitors in the nursing practice could be split into two general themes, that is, the individual and organizational ones. Accordingly, organizations could motivate nurses to make ethical decisions courageously, using supporting strategies, such as giving importance to nurses and empowering them, applying appropriate evaluation criteria, and appreciating ethical performance in these frontline healthcare workers.

Stakeholders' Perceptions of How Nurse-Doctor Communication Impacts Patient Care: A Concept Mapping Study.

There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions on how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. A total of 20 patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size, suggesting that each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) on 09.07.2020 (osf.io/9np8v/) prior to recruiting the first participant.

Reasoning like a doctor or like a nurse? A systematic integrative review.

When physicians and nurses are looking at the same patient, they may not see the same picture. If assuming that the clinical reasoning of both professions is alike and ignoring possible differences, aspects essential for care can be overlooked. Understanding the multifaceted concept of clinical reasoning of both professions may provide insight into the nature and purpose of their practices and benefit patient care, education and research. We aimed to identify, compare and contrast the documented features of clinical reasoning of physicians and nurses through the lens of layered analysis and to conduct a simultaneous concept analysis. The protocol of this systematic integrative review was published doi: 10.1136/bmjopen-2021-049862. A comprehensive search was performed in four databases (PubMed, CINAHL, Psychinfo, and Web of Science) from 30th March 2020 to 27th May 2020. A total of 69 Empirical and theoretical journal articles about clinical reasoning of practitioners were included: 27 nursing, 37 medical, and five combining both perspectives. Two reviewers screened the identified papers for eligibility and assessed the quality of the methodologically diverse articles. We used an onion model, based on three layers: Philosophy, Principles, and Techniques to extract and organize the data. Commonalities and differences were identified on professional paradigms, theories, intentions, content, antecedents, attributes, outcomes, and contextual factors. The detected philosophical differences were located on a care-cure and subjective-objective continuum. We observed four principle contrasts: a broad or narrow focus, consideration of the patient as such or of the patient and his relatives, hypotheses to explain or to understand, and argumentation based on causality or association. In the technical layer a difference in the professional concepts of diagnosis and the degree of patient involvement in the reasoning process were perceived. Clinical reasoning can be analysed by breaking it down into layers, and the onion model resulted in detailed features. Subsequently insight was obtained in the differences between nursing and medical reasoning. The origin of these differences is in the philosophical layer (professional paradigms, intentions). This review can be used as a first step toward gaining a better understanding and collaboration in patient care, education and research across the nursing and medical professions.

Lived experiences matter: The role of mental health professionals' psychological crises and vulnerability in shaping their health beliefs and concepts.

Background: Mental health professionals are often affected by mental health problems and disorders. Yet, the effects of these lived experiences on their causal beliefs and health concepts have not been investigated. The current study investigates how professionals' lived depressive experiences and their perceived vulnerability to mental illness affect their causal beliefs about mental disorders, their general concept of mental health and their specific concepts of depression and burnout. Methods: An online survey was conducted with 218 mental health professionals from 18 psychiatric clinic departments in the German federal states of Berlin and Brandenburg, investigating their experiences with depression, self-assessed vulnerability, their causal beliefs of mental illness, their general health concept and specific illness concepts of depression and burnout. A path model was calculated to examine the relationships between these variables. Participants with and without lived experience of depression were grouped. Results: Lived experience of depression was indicated by 126 participants. For participants with no experience of depression, perceived vulnerability negatively predicted beliefs in biological causation, which positively predicted higher differentiation between depression and burnout. For participants with previous depression experiences, perceived vulnerability positively predicted beliefs in psychological and social causation. Continuum belief was predicted only in this group by the three variables of causal beliefs. Psychological and social causation was positively associated, while biological causes were negatively associated with continuum beliefs. Conclusion: Mental health professionals are not external to the clinical situation. Their lived experiences do matter, shaping their beliefs and concepts and, thus, possibly also their actions toward patients.

Nurses as Gifted Artists in Caring: An Analysis of Nursing Care Concept.

Background: Nursing care happens with the artistic presence of the nurse in the care setting. Despite its importance in nursing, yet many ambiguities surround its definition and characteristics. The aim of this study was to analyze the concept of nursing care. Materials and Methods: This concept analysis was conducted using Walker and Avant's approach. An extensive literature search was done in the Medline, CINAHL, Embase and SID databases to find articles published in English between 1988 and 2019. The search keywords were "care", "nursing care", "concept", "concept analysis", and similar words. According to Walker and Avant's approach, after selecting the concept and determining the aim of analysis, 3742 references were reviewed and 68 articles and 2 books were selected to determine and extract the defining attributes, antecedents, consequences, and empirical referents of the nursing care concept. Results: The three main defining attributes of the concept were relationship, compassion, and professional action. The antecedents were nurse-related, client-related and environment-related, and the consequences were for nurses, clients and community. Conclusions: The defining attributes, antecedents, and consequences determined in the present study help better understand the concept of nursing care. This study highlights the importance of the communicative, caring, and advocacy roles of nurses and their compassionate professional action in the promotion of individual and community health.

A systematic concept analysis of healthcare team resilience in times of pandemic disasters.

BACKGROUND: The concept of resilience has been used as a descriptor for individuals and organizations with the dominant themes of bouncing back and moving forward. AIMS: To examine the concept of resilience in providers and healthcare teams during pandemic disasters. RESEARCH DESIGN: Walker and Avant's eight-step concept analysis method. DATA SOURCE: CINAHL, EBSCO Host, PubMed, and SCOPUS were searched using the combined terms "resilience" or "resiliency" or "resilient" and "healthcare professionals," or "healthcare worker" or "healthcare team" or "physician" or "nurse" or "doctor" and "pandemic" or "disaster." METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Checklist was used to review the literature and apply findings using the eight-step Walker and Avant method for concept analysis. RESULTS: Three clusters emerged as attributes of individual resilience that may be applied to healthcare teams in times of pandemic disasters: (1) resilience is a dynamic contextual process, (2) resilience stabilizes the team to maintain a routine level of function, and (3) resilience is a catalyst for the actualization of innate or acquired skills and ability within the healthcare team. CONCLUSION: This analysis suggests that resilience enhances the healthcare team's ability to maintain function during acute changes created by pandemic disasters. Resilience in healthcare teams during pandemics requires future research to explore the phenomenon.

Concept of older person autonomy: phenomenological study of the opinion of specialist nurses.

Background: The concept of autonomy is composed of several components, making it a multidimensional concept. This includes cognitive ability, intellectual ability, emotional intelligence, social situation, and physical ability skills. This study aimed to describe the experiences attributed to the meaning of the concept of autonomy, by specialist nurses. Methods: A descriptive phenomenological study was carried out, according to the Giorgi method. Eighteen nurses were recruited at a hospital in Portugal. Data were collected through individual interviews. Results: The 18 specialist nurses work on average as nurses for 16years and are specialist nurses; for an average of 5.9years, most are specialist nurses in rehabilitation nursing. From the data analysis, six themes emerged: ability to do, ability to resolve, decision ability, cognitive ability, social integration, and emotional intelligence. Conclusions: Most professionals perceive the concept as the ability to perform activities of daily living and the ability to make decisions, especially concerning informed consent. It is necessary to raise awareness of the breadth of this concept since the quality of life and dignity of the elderly person depends on autonomy.