Concerns about death among severely ill people

Personal construct psychology was used to generate a set of questions about concerns about death among severely ill people. Answers to these questions were provided by content analyses of the responses of a large group of ill people to an open-ended question about their current experiences. Comparison of their responses with those of a similar group of well people indicated that they expressed more concerns about death. More death-related concerns were reported by those ill people who were facing surgery rather than those who were not, those whose illnesses were acute rather than chronic, and those who were interviewed while in the hospital rather than at home. Gender, age, marital status, and educational attainment were all considered predictors of death-related concerns; but none was found to be significant, nor were concerns about death observed to vary according to illness type. The psychological states found to accompany greater death-related concerns among ill people proved to represent both the adaptive and the dislocative processes of mourning. People who were not ill, but who had greater death-related concerns than other well people, on contrast, showed signs only of the more dislocative processes. Some of the implications of these findings for thanatological counseling of severely ill people are discussed.