The struggle for the soul of hospice: stress, coping, and change among hospice workers.

This article reports preliminary findings from an ongoing study of occupational stress, coping, and change among employees at a hospice in New York state. The study sought to identify those aspects of hospice work that direct-service and middle-management staff considered unique and rewarding, and also to examine those conditions that created problematic levels of stress. A qualitative methodology was employed, based on heuristic principles of grounded theory and action research. Techniques included field observation and participation, 38 semi-structured interviews, and group discussion and review of data by research participants. The authors elaborate upon established models of occupational stress and coping, and identify hospice-specific stressors and resources for coping. The research highlights "support" as a critically important, multidimensional element for successful coping. A re-examination and reinterpretation of "coping" as it applies to stress in hospice work is suggested.