The Practical Use of Awareness Theory

Abstract

Editor’s note: Through examples found in their seminal theory, Awareness of Dying, Glaser and Strauss (1965) demonstrated how to develop and write a classic grounded theory in a way that is applicable to practice. Awareness of Dying was one of four monographs that culminated from a six-year funded research program titled Hospital Personnel, Nursing Care and Dying Patients (Glaser & Strauss, 1968). In Awareness of Dying, Glaser and Strauss identified different levels of awareness of impending death and the effects these have on patients, families, nurses, and physicians. They discovered four distinctly different awareness contexts: closed awareness, suspected awareness, mutual pretense awareness, and open awareness. In other words, to what degree does the patient know that he or she is dying and how do others participate in that knowledge. Glaser and Strauss found that awareness contexts affected many elements of medical and nursing care and relationships among staff, patients, and families. In discussing their theory, Glaser and Strauss emphasized the importance of usefulness, clarity, and parsimony in the development of grounded theories. Indeed, through a review of the literature, Andrews and Nathaniel in 2009 confirmed that the theory continues to be useful in practice. Glaser and Strauss’s chapter has been edited and reprinted several times. In various forms, this paper was published as a chapter in in Awareness of Dying (1965) and subsequently in The Discovery of Grounded Theory: Strategies for Qualitative Research (1967). As reprinted here, the chapter has been gently edited for clarity and context from the version found in Applying Grounded Theory: A Neglected Option (Glaser, 2014) and includes Glaser and Strauss’s original footnotes. It is included in this issue of Grounded Theory Review as an example of the practical usefulness of a substantive grounded theory.