Supporting Self-Direction in Social and Daily Life Contexts Among Vulnerable Older Adults: A Protocol for an Integrative Review and Concept Analysis

Objectives: This study aims to provide conceptual clarity on self-direction support in the care of vulnerable older adults, particularly those with dementia. It focuses on how self-direction is supported in meaningful daily activities and social participation. The goal is to define and operationalize the concept by identifying its key attributes, antecedents, and consequences across care contexts. Methods: A two-phase approach will be used. First, an integrative review will synthesize empirical evidence from gerontology, occupational therapy, psychology, nursing, and health ethics to examine current conceptualizations and practices. Second, a concept analysis will explore the theoretical structure of self-direction support. Findings will be synthesized into a conceptual framework. Expected outcomes: This study is expected to provide a clearer conceptual framework outlining the core components of self-direction as described in existing literature. This framework will define key attributes, identify influencing factors, and propose measurable indicators. The framework aims to guide professionals in balancing autonomy, safety, and care needs. Conclusions: As this is a study protocol, no results are presented; findings will be reported in the forthcoming review. The anticipated outcomes are expected to contribute to theory and practice by framing self-direction within social health. The framework may inform future research, policy, and intervention development to strengthen self-direction in meaningful activities and participation among vulnerable older adults. Further validation across settings and cultural contexts will be required.