African American women's perceptions of hospice for end-of-life care

The purpose of this generic qualitative study was to determine why African American's utilization of hospice care is lower than that of European Americans by examining 30 African American women's perceptions of hospice services. Previous studies did not elicit responses from females of childbearing age only, nor did other studies consider that African American women were culturally the primary caregivers in the home. Through focus groups and semi-structured interview questions, results of the study showed that among African American women, spirituality and family obligations were contributing factors to how the women perceived hospice services. The women reported that hospice usage was a personal choice, with 33% stating they would definitely utilize the services provided. The remaining 67% of the women said they would not use hospice or would use it only as a last alternative. Nearly75% of the women had a negative or less than favorable perception of hospice, and 57% of the women associated hospice care with lonliness, isolation, and the feeling of a bad death. Socioeconomic status did not change the participants' opinions of hospice. None of the women interviewed stated their socioeconomic status influenced their perceptions of hospice. Future studies are necessary to determine whether factors of spirituality, family obligations, and socioeconomic status would alter the perceptions of African American women of non-childbearing age concerning hospice care in an effort to present hospice services in a positive light and to increase awareness of the benefits of a comfortable, peaceful death with dignity and spirituality.