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Author ORCID Identifier


Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Cynthia Jacelon

Subject Categories

Other Nursing


The majority of deaths in the United States occur in the hospital (Xu, Kochanek, Murphy, & Tejada-Vera, 2010). Because there is little understanding of the meaning behind this delicate social process for the patient, the purpose of this study was to develop a theory that describes the social processes one undergoes during the in-hospital end-of-life phase. Grounded theory methodology was chosen to understand this phenomenon and then explain it theoretically (Charmaz, 1990). The data used to develop the theoretical model was previously collected by StoryCorps and therefore components of secondary analysis were taken into consideration. Stories that are housed at the American Folklife Center at the Library of Congress were obtained, transcribed, and coded. Constant comparative analysis of the data allowed a preliminary conceptual model to emerge. The conceptual model of hospitalization at end-of-lifeis built off assumptions found in the literature and then moves through perspective groups to form a model of needs. Needs were both shared and individual. From needs, came social process. The social process was identified as Being out of controland described the deeper psychological existence of each group who was experiencing end-of-life care. Persons from each perspective group describe their journey in the hospital, over time, as being influenced by each of the other perspectives but not their own. In reviewing the relevant literature on the social process during end-of-life, it was found that many social process models are grounded in the concept of needs. These comparable studies help strengthen the link between social processes and needs during end of life. Limitations of this study pertain to the use of secondary analysis. Each piece of the model was derived from bits of stories instead of understanding the entire process from each individual’s perspective. Because of the preliminary nature of this study, there are many opportunities for future validation of findings and deeper understanding of the conceptual components.


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