The philosophy of a community-based hospice program involves care of terminally ill patients in their homes. However, some patients do not remain at home and are hospitalized. This descriptive study was conducted to determine reasons community-based hospice patients require hospitalization. Orem's Theory of Self-Care and Theory of Nursing Systems provided the theoretical framework. A convenience sample of 9 hospice patient primary caregivers from a community-based hospice program in West Central Alabama participated. These caregivers provided care to 9 hospice patients over the age of 40 years who required hospitalization in 1990 and had since expired. During scheduled home interview visits, the researcher completed the Stephens Survey of Hospice Patient's Primary Caregiver tool to determine reasons for the patient's hospitalization. The taped interviews were transcribed and reviewed by the researcher and two nurse experts. Quantitative data were analyzed using descriptive statistics. Qualitative data were evaluated by content analysis. The researcher concluded that uncontrolled pain was the most common cause for the patient's hospitalization. Also, interview analysis revealed two categories which amplify why patients were admitted to the hospital: caregiver stressors/demands and relationships with health care providers. In the roles of counselor, educator, and consultant, the Geriatric Nurse Clinician can assist patients/primary caregivers and other care providers to apply findings of this study to the development of policies, programs, and procedures to more effectively manage the pain of terminal illness and the stressors associated with caregiving. Recommendations for future study include conduction of research related to patlent/primary caregiver teaching compliance and responses to pain management in hospice patients and also replication of the study with a larger sample and further instrument development.


Master of Science in Nursing (MSN)


Graduate Nursing

Degree Date


Publication Number


First Advisor

Mary Patricia Curtis

Document Type


Included in

Nursing Commons