autonomy, concept analysis theoretical definition and emperical referrents

Running head: AUTONOMY PART II









Concept Analysis: Autonomy


Brandy Cain

Washington State University


October 01, 2011

The acquisition of autonomy in any profession is afforded a high value as an indispensable enhancer of professional status. Though, the concept has a broad scope and is extremely abstract, it is considered as one of the core concepts in nursing theory. In terms of personal autonomy, literature based on autonomy is ridden with absent or ambiguous definitions. In order to arrive at the real definition of autonomy, the application of a concept analysis of autonomy is fundamental. Consequently, the establishment of a theoretical definition of the concept analysis of autonomy and the identification of the empirical referents linked to it are essential for this paper.


Keywords: autonomy; empirical referents; theoretical definition; nursing
Concept Analysis: Autonomy Brandy Cain

Autonomy is identified as the freedom linked to the making of binding and discretionary decisions, which are in constant consistency within a person’s scope of practice as well as the freedom attached to acting on the decisions arrived at(Ballou, 1998) (Christman, 2009) (Skår, 2010).In this case, For a human being to possess the ability of competently making a decision based on autonomy, he must hold principles established through a critical reflection on the laws and influences that surround him (Ballou, 1998). This ability allows him to act independently void of external influences. Essentially, this paper examines the theoretical definition of the concept of autonomy and the empirical referents for measuring autonomy.

Theoretical Definition

Under concept analysis, Autonomy encompasses the ability to self govern through making binding and discretionary decisions based on a person’s scope. In this case, a person can control the knowledge required to make the decisions at hand. This consists having the ability to utilize the information originating from external and internal sources, in establishing individual principles and morals to be adhered to in decision making. Binding and discretionary decisions translate to the lack of external influence in decision making (Christman, 2009). In this case a person does not require permission or approval from external sources during his individual decision making process. After the decisions are made, autonomy dictates that a person has the freedom to reflect critically on the factors linked to the decisions and act on them with competence in an independent manner. Autonomy translates to a positive attitude in embodying freedom during the decision making process. In essence, value should be attached to the freedom encompassed in autonomy.

Empirical Referents

Empirical Referents are identified as observable, verifiable and measurable components of a particular concept. In terms of this paper, it refers to the tools utilized in measuring the occurrence of the concept of autonomy. The first tool to be employed in measuring the occurrence of the concept of autonomy is ACS-30 (Bekker, Van Assen, 2006). It consists of an abridged edition of the original Autonomy Scale, which measures both connectedness and autonomy in terms of the world surrounding a person. This tool has been criticized, owing to its measurement of interrelated variables as well the questioning of construct and content validity. Other types of questionnaires and scales of measurement, for testing the strengths of individual insight and ability for decision making exist.

A good example of this is A Likert scale questionnaire, in form of The personal values clarification worksheet. It can be applied in the measurement of connectedness in terms of whether a person is using different values and principles at his disposal for autonomous decision making (Skår,2010). These tools however, are inappropriate for measuring such factors as the extent to which a person’s decisions are independent of external controls as well as the critical reflection injected into the establishment of the information taken in for the autonomous decision making process. Inherently, measuring the outcomes autonomous decision making is easy as compared to verifying that the decisions made were the actual products of individual internal values and thoughts.


The concept of autonomy is broad in spectrum and it is identified as a multidimensional concept that is complex in nature. It encompasses diverse definitions ridden with ambiguity and absence (Ballou, 1998). In this paper, the concept has been thoroughly reviewed by literary review. It has been defined in retroscope, through the theoretical definition based on concept analysis. Consequently, the Empirical referents based on concept analysis, for measuring the concept have been identified. This is regardless of the fact that the concept is philosophical in nature and not all aspects of autonomy are measurable under it. in conclusion, autonomy is a phenomenon that should be provided with considerably study due to its complexity



Ballou, K. A. (March/April 1998, March-April). A concept analysis of autonomy. Journal of Professional Nursing , 102-110.

Christman, J. (2009). The Stanford Encyclopedia of Philosophy.New York, NY: Stanford.

Skår, R. (2010). The Meaning of Autonomy in Nursing Practice. Journal of Clinical Nursing, 19(15-16), 2226-2234.

van Assen, M.A.L.M., & Bekker, M.H.J.(2009). Sex Differences in Autonomy-Connectedness: The Role of Personality Factors. Personality and Individual Differences, 47 (1), 12-17.


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