DYING OF AWARENESS - THE THEORY OF AWARENESS CONTEXTS REVISITED

In this paper, I employ a grounded theory approach to extend an existi ng theory. My starting point is the theory of awareness contexts, firs t formulated in 1965 by Strauss and Glaser. Using introspective ethnog raphy, I illustrate that the way patients and relatives emotionally co pe with terminal information defines the kind of awareness context. I therefore suggest that the open awareness context should be split into three different contexts. In the suspended open awareness context, th e patient or kin ignores or disbelieves the message communicated by th e physician. In the uncertain open awareness context, the patient or f amily member dismisses the bad parts of the message and hopes for the best outcome. In the active open awareness context, the patient or rel ative accepts the impending death and prepares for it. This revision r eclaims the emotional power of terminal illness from the viewpoint of patients and relatives and adapts the theory to changed structural con ditions.