Alvita K. Nathaniel, Ph.D., RN and Tom Andrews, B.Sc., M.Sc., Ph.D., RN Abstract Grounded theories are powerful tools that fit empirical situations and provide “relevant predictions, explanations, interpretations, and applications” (Glaser & Strauss, 1967, p.1). Because of their real-world orientation, grounded theories are particularly appropriate for health care research. They can help professionals understand that certain patterns always seem to emerge, that particular people respond in predictable ways, and that actions produce predictable results (Nathaniel & Andrews, 2007). When physicians and nurses better understand patterns that affect patients, they can work towards altering harmful patterns to improve the quality of patient care. As time passes, one may ask, when do grounded theories become obsolete? When are they no longer useful? The purpose of this paper is to revisit the seminal grounded theory, Awareness of Dying, and compare it to contemporary conceptual and descriptive research on end-of-life care, asking the question, is the theory in need of modification? Introduction Modifiability is basic to grounded theory. Because they are generated through inductive logic, grounded theories are naturally modifiable. With induction, the analyst generalizes from a number of cases in which something is true and infers that the same thing is true of a whole class. In grounded theory, these inferences take the form of tentative hypotheses (Glaser, 1978). Hypotheses and the theories that they comprise demonstrate predictable patterns that can be observed. Glaser writes, “In GT, a concept is the naming of an emergent social pattern grounded in research data. For GT, a concept (category) denotes a pattern that is carefully discovered by constantly comparing theoretically sampled data until conceptual saturation of interchangeable indices. It is discovered by comparing many incidents, and incidents to generated concepts, which shows the pattern ….” (Glaser, 2002, p.4). The grounded theory method corrects for error or bias through constant comparison and abstraction, which further clarifies the underlying latent patterns (Glaser, 2002, rev.2007). After a theory is developed and published, time passes and new evidence becomes available. A basic strategy to ensure rigor, modifiability allows openness to correction and change as new evidence emerges, ensuring against “pet” hypotheses (Glaser, 1978). With that in mind, this paper revisits the original grounded theory, Awareness of Dying (Glaser & Strauss, 1965), compares it to contemporary research findings, and finds it to be in no need of modification. Awareness of Dying Revisited Awareness of Dying is a historical grounded theory—the first ever published. Today, a great deal of research focuses on death and dying, but in 1965, Awareness of Dying presented eye-opening revelations about how an awareness of the time and mode of death affects patient attitudes and the care delivered by nurses and physicians. The theory was developed by Barney Glaser and Anselm Strauss and was funded by a Public Health Service Research Grant from the Division of Nursing (Glaser & Strauss, 1965a). Glaser and Strauss spearheaded a six-year research program entitled Hospital Personnel, Nursing Care and Dying Patients. This research culminated in a number of publications including Awareness of Dying (Glaser & Strauss, 1965a), The Social Loss of Dying Patients (Glaser & Strauss, 1964), Time for Dying (Glaser & Strauss, 1968), Temporal Aspects of Dying as a Non-scheduled Status Passage (Glaser & Strauss, 1965b), and The Nurse and the Dying Patient (Quint, 1967). Awareness of Dying is the most well-known theory that emerged from the study. Glaser and Strauss, sociologists, and Jeanne Quint, a nurse, conducted intensive field work at a number of hospitals for six years (Glaser...