Emancipation in decision-making in women's health care.

Background: Emancipation as a nursing concept is derived from a long-standing history of social oppression and is easily addressed by both critical social theory and feminist theory. It is the apparent concept to describe a phenomenon witnessed in nursing when caring for women in the decision-making process about health care issues. Emancipation has been recognized by expert clinical observation.

Aim: The aim of this paper is to define the concept of emancipation for possible future application to nursing practice for the promotion of humanistic nursing care in women's health, specifically applied to the decision-making process.

Method: A literature search was carried out using the CINAHL database and the keywords nursing and emancipation, and covering the period 1985-2003. The Rodgers and Knafl (2000) method of concept analysis was then used to derive a conceptual meaning of emancipation that benefits patient care as well as professional nursing development. Emancipation is broken down into antecedents, attributes and consequences. Related concepts are also explored, compared and discussed to synthesize relevant characteristics.

Findings: This concept analysis identifies emancipation in decision-making as a nursing phenomenon by discussing the antecedent of oppression and exploring the identified attributes: (a) empowerment, (b) personal knowledge, (c) social norms, (d) reflection and (e) flexible environment. The consequence of emancipation is free choice. It is a futuristic concept with strong historical ties in need of exploration and development within the context of women's health care in relation to decision-making.

Conclusions: The concept model illustrates emancipated decision-making, with its five attributes in relation to oppression as a non-linear phenomenon. Areas for further study include the exploration of the contribution of each critical attribute and its relationship to emancipated decision-making, and the decision-making process in relation to patient satisfaction and how long the person continues to adhere to the decision. Also the professional nursing role in promotion of emancipated decision-making is virtually unexplored, but is an important concept in the paradigm of shared decision-making about health care alternatives.