Date of Conferral



Doctor of Nursing Practice (DNP)




Dr. Andrea Jennings-Sanders


Terminally ill patients often have difficult choices at the end-of-life, and electing to receive hospice services is one of them. Hospice has been linked to improved quality of life and death and is accessible to terminally ill patients. Despite the accessibility, African American patients often make the decision to forgo hospice services. The purpose of this descriptive study was to explore perceptions and beliefs of nurse practitioners (NPs) regarding the lack of utilization of hospice for African American patients and the feasibility of NPs for initial referral for terminally ill African American patients. The research questions addressed whether an NP's perception, beliefs, and past experiences with hospice influence their decision to refer terminally ill African American patients to hospice. This project was guided by the theory of planned behavior to identify perceptions and beliefs of NPs about referrals for African American patients as well as knowledge to develop an awareness education program. Data were collected using a modified online survey administered to 8 NPs who practiced in Georgia or were members of a NPs' Facebook social group. Descriptive statistics demonstrated that the 8 NPs viewed hospice as a valuable service and cost-effective. Microsoft Excel was used to manage qualitative content, which demonstrated that NPs felt education was important for increasing African American patients' use of hospice. The implementation of an awareness education program can benefit NPs by educating them on the possible connection between their beliefs and perceptions about African American terminally ill patients and their decision to refer African American patients to hospice. Additionally, this project has the potential to improve end-of-life care.

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