Liksom... att jag har en fri vilja : brukares självbestämmande i gruppbostad och personlig assistans inom LSS

Sammanfattning: The aim of this licentiate thesis is to investigate how self-determination for users with intellectual disabilities is experienced and described by users themselves, as well as by the personnel working within group homes and personal assistance regulated by the LSS. The essential meaning of self-determination is “the right to decide for oneself”. In international research, the term self-determination is used in the sense of being able to make choices regarding one’s life without undesired external influence or interference. The personnel have a central role in enabling and implementing the intentions of the LSS, a role which in this thesis is primarily focused on support for users in exercising self-determination. This thesis therefore comprises two sub-studies, one that focuses on the users´ experiences of self-determination and their reflections on it, and one that examines the personnel´s view of and attitude to the users´ selfdetermination. The study has a qualitative approach that is based on people´s everyday lives and places the individual at the center. Taken together, the sub-studies provide two distinct perspectives derived from the primary sources, which can contribute knowledge about the everyday reality of users´ self-determination. Two theoretical approaches were used to illustrate the users´ path to selfdetermination. One approach is based on the salutogenic view and the theory of sense of Coherence, whereas the other focuses on the perspective of power and selfdetermination, i.e. empowerment. This study shows that both users and staff identify self-determination as an important factor for users´ well-being. In an in-depth analysis, both possibilities and limitations for this self-determination are revealed. The study also shows that if the contact between users and personnel is characterized by a salutogenic approach based on the theory of sense of Coherence, the users are strengthened in their empowerment process. By gaining empowerment, the users ´ path towards self-determination in their daily life situation is facilitated. It became clear that the personnel are sometimes faced with a dilemma when this salutogenic approach is challenged. Examples of such situations are when the personnel´s responsibility for the care conflicts with the users´ self-determination, or when a third party, such as trustees or parents, has views that go against the user´s wishes. In a group home, rules and routines may also obstruct individually designed salutogenic support.

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