Date of Award


Document Type


Degree Name

Master of Arts (MA)




Kubler-Ross (1969) identified a progression through stages of denial, anger, bargaining, depression, and finally acceptance as a completion of the dying process. These stages are encompassed by feelings of hope which extend throughout the course of illness. The present study was designed to investigate the correspondence between the stage changes hypothesized by the Kubler-Ross theory and the perception of the course of illness by seriously ill patients and their spouse. An additional focus of the study was an evaluation of Q-methodology as a research procedure with the terminally ill.

A thirty-six item structured Q-sort was administered on two occasions to two couples, in each of which the wife had a potentially terminal medical diagnosis. Subjects described the patient's perception of the illness at the present time and as it had been at four other times since the diagnosis. The Q-sorts of each couple were intercorre- lated and submitted to Q-factor analysis.

The results supported the use of Q-methodology as a research procedure for investigations of terminal, illness. The subjects experienced no difficulty in using the instrument and the Q-factor analysis produced factors which organized patient and spouse perceptions of the present and recalled times since the diagnosis of the illness. The implications for the validity of the Kubler-Ross theory were ambiguous. Factors which emerged did not reveal the Kubler-Ross structure in the Q-sort nor was there evidence of stages. Pervasive feelings of hope may have masked any evidence of Kubler-Ross stages, the recall method may not have been accurate enough to reveal stages, the Kubler-Ross stages may be cyclical in these patients, or the theory may not be supported when further subjected to empirical validation.

Suggestions for further research regarding the presence of psychological stages in the dying process and the potential uses of Q-methodology were discussed.