A Hermeneutic Phenomenological Study: Living With The Certainty of Death
Open Access
- Author:
- Farcus, Nedra
- Graduate Program:
- Nursing
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- February 28, 2012
- Committee Members:
- Janice Lee Penrod, Dissertation Advisor/Co-Advisor
Janice Lee Penrod, Committee Chair/Co-Chair
Judith E Hupcey, Committee Member
Susan Jayne Loeb, Committee Member
Timothy Slekar, Committee Member - Keywords:
- certainty of death
nursing
end of life
Hermeneutic Phenomenology - Abstract:
- Supporting individuals through their end-of-life transitions is an integral part of nursing practice. One particular transition relates to the final weeks and months of the individual’s life and their shift from an attitude of uncertainty about the anticipated time of their death to a sense of certainty about the limited time that remains. Van Manen’s hermeneutic phenomenological method was used to explore the lived experience and associated meanings of living with the certainty of death among a number of individuals enrolled in hospice care. Phase I of the study took place in central Pennsylvania in 2007 with interviews of five individuals enrolled in hospice care to assess the feasibility of conducting a research investigation with end-of-life patients enrolled in hospice. Phase II was conducted during 2011 with five additional hospice patients in the same area of central Pennsylvania, who participated in two interviews at their home. An audio-recorded protocol was implemented whereby the participants were asked to record their thoughts and experiences for three days after the first interview. Following the thematic analysis of the Phase II transcribed data, the Phase I and Phase II data sets were merged and the following essential features of living with the certainty of death were identified and described: (a) Beating the Odds, (b) Living With, Not Dying From, (c) Separating and Connecting: Shifting Relations, (d) Transcending the Everyday World Through Spirituality, (e) Getting My House In Order, and (f) Living With Pain. A critical reading of related texts was conducted to gain additional insights and perspectives on the research. The lifeworld existentials of lived body, lived space, lived relations, and lived time, as delineated by Max van Manen (1990), guided the researcher’s reflection on these essential features. Among the findings in the study were that the hospice patients interviewed were living with purpose and actively engaging life even though they knew their death was imminent. Finally, the methodological, nursing practice, and research implications are presented with a view towards developing better end-of-life care.