Date of Award

Spring 2007

Document Type

Dissertation - Restricted

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Wilson, Sarah A.

Second Advisor

Ramey, Sandra

Third Advisor

Stohrer, Walter


This chapter is divided into three sections. The first section provides a general introduction to the area of study, end of life health care; and it briefly outlines the problem under investigation; the purpose of the study, and the significance of the problem as well as justification for investigating it. The second section defines important terms and concepts; and the third section discusses the choice of research paradigm for the study, and the philosophical assumptions that make this paradigm appropriate. Providing quality care to dying persons in the United States and elsewhere has become a major health and social concern in the last two decades (Arnold, 2004; Asch et al., 2005; Field & Cassel, 1997; Lunney et al., 2003; Zaner, 2004) Quality care at the end of life is care that assists dying persons and their loved ones in their transition from dying to death with personal dignity, relief from suffering, and with opportunities to find meaning and self-understanding in life's ending. Quality care must also be within acceptable professional and ethical standards (Chochinov, 2002; Field & Cassel, 1997; Patrick, 2003). Professional caregivers are unprepared to provide end of life care in ways that meet the needs of persons dying and those anticipating bereavement (Booth et al., 1996; Fallowfield et al., 2002; Field & Cassel, 1997; Heaven & Maguire, 1996; Institute of Medicine, 1997; Maguire & Pitceathly, 2002; Wilkinson, 1991). Consequently the basic needs of patients and family members remain notably unidentified and unmet. (Andershed, 2000; Bottorff, 2000; Kruijver, 2000; Lunney, 2004; SUPPORT Investigators, 1995)...



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