This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Copp, G. Articles by Field, D. Search for Related Content Social Bookmarking                         What's this?

Open awareness and dying: The use of denial and acceptance as coping strategies by hospice patients

Middlesex University, London N193UA

David Field, PhD, MA, AM, BA

Centre for Cancer and Palliative Care Studies, Institute of Cancer Research, Royal Marsden NHS Trust, London

This paper examines the use of denial and acceptance as interdependent and fluctuating coping strategies by dying patients in a hospice, and discusses some of the reasons why denial and acceptance operate for these patients. 'Open awareness' of dying is now accepted as a central feature of palliative care, and full disclosure of prognosis and diagnosis is seen as a desirable element of care for patients who are dying. However, such openness is not without its tensions and conflicts. The study was conducted in a hospice where patients and nurses interact within an 'open awareness' context and where most patients live in the knowledge of 'certain death but at an unknown time'. The paper examines use of denial and acceptance by hospice patients at various times during their dying.

The data are derived from the findings of a prospective qualitative study on the experiences of 12 hospice patients and those of their nurses. Unstructured interviews and participant observation were used as the primary methods of collecting data. Data from interviews were coded and comparative analyses between cases were performed.

Denial and acceptance of dying among patients fluctuated during the period of dying and appeared to form an important aspect of their coping process. Denial and acceptance appeared to be used to avoid threats as well as to preserve existing relationships within the context of open awareness.

In contrast to some commonly held beliefs, which tend to view denial and acceptance as 'singular, either/or entities', denial and acceptance are best seen as interdependent and fluctuating strategies, used continually by dying patients.

Key Words: Dying • Denial • Acceptance • Awareness • Coping strategies • Hospices

Nursing Times Research, Vol. 7, No. 2, 118-127 (2002)
DOI: 10.1177/136140960200700206


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?