Learning disability nurses’ experiences of promoting autonomy in adults with profound and multiple learning disabilities: A phenomenological study.

This thesis reports on a year-long study seeking to explore Learning Disability (LD) nurses lived experience of promoting autonomy for adults with profound and multiple learning disabilities
(PMLD) who live in England. Promoting autonomy constitutes a key component of LD nurses’ role within the current service provision for this client group. The question of how much autonomy is allowable while ensuring the safety of this client group remains an ethical problem and one for which no ultimate solution exist. Exploring LD nurses lived experiences produces a special kind of ‘practical’ knowledge that is beyond the dominance of medical knowledge and well-grounded in their day to day experiences. Findings will therefore be more meaningful to LD nurses regarding promoting autonomy for adults with PMLD as their experiences are explicated and illuminated. Consequently, potential exists for findings of this study to contribute to LD nursing discipline’s knowledge base and evidence-based-practice. A Heideggerian hermeneutic phenomenological framework of inquiry was used to guide the inquiry. Data were gathered from LD nurses using individual face-to-face unstructured interviews. Broad open ended questions were used to obtain participants’ concrete descriptions of their experiences in relation to promoting autonomy for adults with PMLD. Nine LD nurses from the north of England were interviewed and interviews were audio recorded and transcribed verbatim to create textual basis for data analysis. Data were analysed following a discursive and iterative seven step procedure as described by Diekelmann, Allen, and Tanner (1989). Analysis of participants’ interviews revealed three themes: (1) taking responsibility, (2) care delivery and (3) personhood. The findings illustrate how participants take pride in their role as learning disability nurses and the value they place on collaborative team working as well as the importance of knowing the person as an individual with own personality, behaviours and character in promoting autonomy for adults with PMLD. The results are relevant to LD nursing practice and also to cares and other health and social care professionals who work with adults needing support in most aspects of their lives such as those with progressed dementia and brain injury.