Blackwell Reference Online

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In their 1965 landmark study Awareness of Dying , Barney Glaser and Anselm Strauss introduced awareness context as “what each interacting person knows of the patient's defined status, along with his recognition of the others’ awareness of his own definition … awareness context … is the context within which these people interact while taking cognizance of it.” Studying the process of dying in six San Francisco Bay area hospitals, Glaser and Strauss were struck by how little information patients possessed about their impending death, even though the staff were often aware that the patient might be dying. They analyzed the organizational-structural conditions for secrecy, its resulting interactions, changes in awareness, and consequences of the interactions for the participants and the setting. Drawing from the symbolic interactionist tradition, Glaser and Strauss intended to capture the work of managing and negotiating social change within the structural context of the hospital. Glaser and Strauss distinguished four awareness contexts: closed awareness , suspicion awareness , mutual-pretense awareness , and open awareness . In a closed awareness context the patient is unaware of pending death while the staff know. Glaser and Strauss found that most patients in the early 1960s died in closed awareness ( Glaser & Strauss 1968 ). Closed awareness reflects a patronizing approach ... log in or subscribe to read full text