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The Spiritual Nature of Uncertainty Among Hospice Patients

Stephenson, Pam Shockey PhD, RN, AOCNS; Sheehan, Denice PhD, RN; Hansen, Dana PhD, APRN; Mayo, M. Murray PhD, RN

Journal of Hospice & Palliative Nursing: October 2017 - Volume 19 - Issue 5 - p 480–486
doi: 10.1097/NJH.0000000000000376
Feature Articles

People with protracted and life-limiting illness engage in end-of-life transitions as they prepare for death. The end of life is a time of mystery that elicits uncertainties in the form of questions, worries, and doubts. If not managed properly, uncertainties can contribute to emotional distress and feelings of lost control. Currently, uncertainty occurring at the end of life is underresearched. Phenomenology was used to explore the experience of uncertainty for 6 hospice patients using semistructured interviews. A 4-member, interpretive team analyzed the data. The participants were asked to describe the uncertainties that they had while they were dying. Interestingly, most of the stories about uncertainty were spiritual in nature. An overall theme of “uncertainty as a bridge” emerged from the data as the way uncertainties affected their dying. Two subthemes of “uncertainties about dying” and “uncertainties about important relationships” also emerge as the areas of greatest concern for participants. These findings support uncertainty as an important phenomenon for people preparing for death and one that providers of end-of-life care should understand.

Pam Shockey Stephenson, PhD, RN, AOCNS, is assistant professor, College of Nursing, Kent State University, Ohio.

Denice Sheehan, PhD, RN, is associate professor, College of Nursing, Kent State University, Ohio.

Dana Hansen, PhD, APRN, is assistant professor, College of Nursing, Kent State University, Ohio.

M. Murray Mayo, PhD, RN, is assistant professor, School of Nursing, Ursuline College, Pepper Pike, Ohio.

Address correspondence to Pam Stephenson, PhD, RN, AOCNS, 113 Henderson Hall, College of Nursing, Kent State University, Kent, OH 44242 (

This research was funded by the University Research Council at Kent State University, Ohio.

The authors have no conflicts of interest to disclose.

© 2017 by The Hospice and Palliative Nurses Association.