In this study we examined the meaning of being the wife of a vegetative patient over time. The research was based on semistructured interviews with 12 wives of husbands who were diagnosed with persistent vegetative state between 1 year 2 months and 10 years prior to the interview. We found that there were two contradicting forces common to all of the wives across time. First, there was a process of finding significance in the situation based on acceptance of the husband’s condition and focusing on positive emotions and values such as love, commitment, and loyalty. Second, the wives described an increase in negative emotions such as sadness, pain, loneliness, loss, and grief. These findings are discussed in the context of research and theoretical literature about coping processes and the meaning of caring for patients in a persistent vegetative state.
AcitelliL. K.YoungA. M. (1996). Gender and thought in relationships. In FitnessG. Fletcher (Ed.), Knowledge structures and interactions in close relationships: A social psychological approach (pp.147-168). Hillsdale, NJ: Lawrence Erlbaum.
2.
BirdC. E.RiekerP. P. (1999). Gender matters: An integrated model for health. Social Science & Medicine, 48, 745-755. doi:10.1016/so277-9536(98)00402-x
3.
BraekhusA.OksengardA.EngedalK.LaakeK. (1998). Social and depressive stress suffered by spouses of patients with mild dementia. Scandinavian Journal of Primary Health Care, 16, 242-246. doi:10.1080/028134398750003034
4.
BurgessE.DrotarD.TaylorG.WadeS.StancinT.YeatesK. (1999). Family burden of injury interview: Reliability and validity studies. Journal of Head Trauma Rehabilitation, 14, 394-405. doi:10.1097/00001199-199908000-0008
5.
ChiambrettoP.Rossi FerrarioS.ZottiA. M. (2001). Patients in a persistent vegetative state: Caregiver attitudes and reactions. Acta Neurologica Scandinavica, 104, 364-368. doi:10.1034/j.1600-0404.2001.00107.x
6.
CollinsC.JonesR. (1997). Emotional distress and morbidity in dementia carers: A matched comparison of husbands and wives. International Journal of Geriatric Psychiatry, 12, 1168-1173. doi:10.1002/(sici)1099-1166(199712)
7.
CommissarisC.JollesJVerheyJ. R.KokG. J. (1995). Problems of caregiving spouses of patients with dementia. Patient Education and Counseling, 25, 143-149. doi:10.1016/0738-391(95)00718-F
8.
DavisM. C.MatthewsK. A.TwamleyE. W. (1999). Is life more difficult on Mars or Venus? A meta-analytic review of sex differences in major and minor life events. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 21(1), 83-97. doi:10.1007/BF02895038
9.
EmersonR.FretzR.ShawL. (1995). Writing ethnographic fieldnotes. Chicago: University of Chicago Press.
10.
FlorianV.DroryY. (1990). The mental health inventory: Psychometric characteristics and normative data from Israeli population. Psychologia, 2, 26-35. (Hebrew)
11.
FriedmanA. (1996). Intimacy and power in female identity. Tel Aviv, Israel: Hakibbutz Hameuchad. (Hebrew)
12.
GillenR.TennenH.AffleckG.SteinpreisR. (1998). Distress, depressive symptoms, and depressive disorder among caregivers of patients with brain injury. Journal of Head Trauma Rehabilitation, 13, 31-43. doi:10.1097/00001199-199806000-00004
13.
GilliganC. (1982). In a different voice: Psychological theory and women’s development. Cambridge, MA: Harvard University Press.
14.
GoldzweigG.AndritschEHubertA.WalachN.PerryS.BrennerB.BaiderL. (2009). How relevant is marital status and gender variables in coping with colorectal cancer? A sample of middle aged and older cancer survivors. Psycho-Oncology, 18, 866-874. doi:10.1002/pon.1499
15.
HammersleyM. (1995). Theory and evidence in qualitative research. Quality and Quantity, 29, 55-66. doi:10.1007/BFo1107983
16.
KaplanA. (2002). Attenders, absentees in “Oasis”—Existential paradoxes in modern residential center. In BrickY. (Ed.), The politics of aging, the elderly population in Israel and the national set priorities (203-219). Tel Aviv, Israel: Hakibbutz Hameuchad. (Hebrew)
17.
KimY.LoscalzoM. J.WellischD. K.SpillersR. L. (2006). Gender differences in caregiving stress among caregivers of cancer survivors. Psycho-Oncology, 15, 1086-1092. doi:10.1002/pon.1049
18.
KvaleS. (1996). Interviews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage.
19.
LazarusR.FolkmanS. (1984a). Coping and adaptation. In GentryW. D. (Ed.), The handbook of behavioral medicine. New York: Guilford Press.
20.
LazarusR. S.FolkmanS. (1984b). Stress, appraisal and coping. New York: Springer.
LincolnS. Y.GubaG. E. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.
23.
LoboPrabhuS.MolinariV.ArlinghausK.BarrE.LomaxJ. (2005). Spouses of patients with dementia: How do they stay together “till death do us part”?Journal of Gerontological Social Work, 44, 161-174. doi:10.1003/J083v44n03_10
24.
MaesS.LeventhalH.De RidderD. T. (1996). Coping with chronic diseases. In ZeidnerM.EndlerN. S. (Eds.), Handbook of coping: Theory, research, applications (pp. 221-251). New York: John Wiley.
25.
ManD. W. K. (2002). Family caregivers’ reactions and coping for persons with brain injury. Brain Injury, 16, 1025-1037. doi:10:1080/0269905021000010087
26.
MarshN. V.KerselD. A.HavillJ. H.SleighJ. W. (1998). Caregiver burden at 7 months following severe traumatic brain injury. Brain Injury, 12, 225-238. doi:10.1080/026990598122700
27.
McDonoughP.WaltersV. (2001). Gender and health: Reassessing patterns and explanations. Social Science and Medicine, 52, 547-559. doi:orgq10.1016/s0277-9536(00)00159-3
28.
McLeodJ. (2001). Qualitative research in counseling and psychotherapy. London: Sage.
29.
MishlerE. G. (1986). Research interviewing: Context and narrative. Cambridge, MA: Harvard University Press.
30.
MorseJ. M.FieldP. A. (1998). Nursing research: The application of qualitative approaches (2nd ed.). Cheltenham, UK: Stanley Thornes.
31.
NeimeyerR. A. (1995). Limits and lessons of constructivism: Some critical reflections. Journal of Constructivist Psychology, 8, 339-361. doi:10.1080/10720539508405914
32.
NeimeyerR. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies, 24, 541-558. doi:10.1080/07481180050121480
33.
NeimeyerR. A.KeeseeN. J.FrotnerB. V. (2000). Loss and meaning reconstruction: Propositions and procedures. In MalkinsonR.RubinS. S.WitztumE. (Eds.), Traumatic and non traumatic loss and bereavement (pp. 197-230). Madison, CT: Psychological Press.
34.
NigelM.KerselD.HavillJ.SieighJ. (1998). Caregiver burden at 1 year following severe traumatic brain injury. Brain Injury, 12, 1045-1059. doi:10.1080/026990598121954
35.
PattonM. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA: Sage.
36.
PhillipsonM. (1972). Phenomenological philosophy and sociology. In FilmerP.PhillipsonM.SilvermanD.WalshD. (Eds.), New directions in sociological theory (pp. 119-163). London: Collier & Macmillan.
37.
RandoT. A. (2000). Clinical dimensions of anticipatory mourning: Theory and practice in working with the dying, their loved ones, and their caregivers. Champaign, IL: Research Press.
38.
Rose-RegoS. K.StraussM. E.SmythK. A. (1998). Differences in the perceived well-being of wives and husbands caring for persons with Alzheimer’s disease. Gerontologist38, 224-230. doi:10.1093/geront/38.2.224
39.
Royal College of Physicians. (2003). The vegetative state: Guidance on diagnosis and management. Clinical Medicine, 3, 249-254.
40.
SchofieldJ. W. (1993). Increasing the generalizability of qualitative research. In HammersleyM. (Ed.), Social research: Philosophy, politics and practice (pp. 200-225). London: Sage.
41.
ShilanskyA.WeitzR. (2002). Treating families of patients in vegetative state: Adjustment and interaction with hospital staff. In DolceG.SazbonL. (Eds.), Post-traumatic vegetative state (pp. 124-130). Stutgart, Germany: Thieme.
42.
ShkediA. (2005). Multiple case narrative. Amsterdam: John Benjamins.
43.
SimonR W. (1992). Parental role strains, salience of parental identity and gender differences in psychological distress. Journal of Health and Social Behavior, 33(1), 25-35. doi:10.2307/2136855
44.
SternJ. M.SazbonL.BeckerE.CosteffH. (1988). Severe behavioral disturbance in families of patients with prolonged coma. Brain Injury2, 259-262. doi:10.3109/02699058809150951
45.
TreschD.SimsF.DuthieE.GoldsteinM. (1991). Patients in a persistent vegetative state: Attitudes and reactions of family members. Journal of the American Geriatric Society, 39, 17-21.
46.
van ManenM. (1997). Researching lived experiences. London, ON, Canada: Althouse Press.
47.
WeissR. S. (1994). Learning from strangers: The art and method of qualitative interview studies. New York: Free Press.
48.
WordenJ. W. (1991). Grief counseling and grief therapy: A handbook for the mental health practitioner (2nd ed.). London: Springer.
