Hospice utilization by African Americans in Western North Carolina

This phenomenological study investigated hospice utilization by African Americans in Western North Carolina. In the United States, African Americans make up 9% of all hospice patients, far fewer than Whites who receive this care. Dealing with a terminal illness is a physical, emotional, and social experience. Hospice provides holistic care at the end of life using a bio-psycho-social-spiritual approach, and this study explored how African American adults receiving hospice care chose to enter this care. The ages of the patients ranged from 53 years to 89 years. Diagnoses included cancer of the lung, colon, prostate, and liver, as well as heart conditions, kidney failure, and debility unspecified. Moustakas' transcendental phenomenological model was followed for the data collection and analysis. Interviews were conducted using open-ended questions. Themes identified from the interviews and analysis that influence the decision for this group to enter hospice care include diagnosis, referral, collective decision-making, prior knowledge of hospice, trust of the doctor and healthcare professionals, and caregiving needs. Individual and group textural descriptions, structural descriptions, and a textural-structural synthesis are included. The last chapter explores implications and social relevance of the findings and offers suggestions for future research.