Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Arts in Nursing (MAN)




Prognosis for terminally ill patients is intended to serve the purpose of educating patients on the expected clinical outcome of their illness. This information is generally communicated to a patient by their primary physician when options for fufiher treattnent or "cure" are limited. Learning a prognosis may be helpful to some patients, while burdensome to others. A review of the literature reveals many barriers to effective communication of prognosis. The purpose of this project is to develop a metaphor for enhanced communication of prognosis to be used by hospice nurses that incorporates a caring perspective on living with hope during end of life. Jean Watson's Theory of Human Caring is used as a framework to guide the spirit of this project. The concepts of caring presence, compassion, and hope are integrated into the communication metaphor. The goal of the project is to educate hospice nurses on the essence and use of the metaphor as they initiate conversations with patients regarding their prognosis. Caring conversations about prognosis may transform potential feelings of finality into an opportunity for living with hope at end of life.


SC 11.MAN.2013.Hanks.D