Journal of Qualitative Research in Health Sciences

Document Type : Original Article

Authors

1 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

5 Lung Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

6 Department of Anesthesiology and Critical Care, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

7 Alzahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran

8 Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

9 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan

10.34172/jqr.2024.18

Abstract

Background: Spirituality helps family caregivers of vegetative state patients to overcome the stressful conditions of patient care. However, the illness and caregiver burden may also negatively affect the caregiver’s spirituality. Accordingly, this study aimed to investigate the challenges of family caregivers of patients in a vegetative state.
Methods: The present qualitative study was conducted through conventional content analysis from August 2020 to September 2021 in two provinces of Iran (Sistan and Baluchestan and Khorasan Razavi). A total of 20 family caregivers of patients in a vegetative state were included in the study. Semi-structured interviews were employed to collect data. Data were analyzed using the method proposed by Graneheim and Lundman via MAXQDA2020 software. Data collection continued until data saturation and identification of main categories.
Results: Based on data analysis, spiritual disintegration and spiritual coherence were identified as the two main categories to describe the spiritual challenges of family caregivers of patients in a vegetative state. The experiences of family caregivers showed that spirituality is effective in accepting the conditions and adapting to the role of the patient caregiver. However, illness and caregiver burden lead to spiritual damage and the turning away of family caregivers from performing religious rites and rituals.
Conclusion: Considering the undeniable role of spirituality in dealing with the stressful situation of caring for a patient in a vegetative state, the spiritual needs of family caregivers and the implementation of nursing interventions to enhance the spiritual health of caregivers should be given more attention.

Highlights

  1. Monti MM, Laureys S, Owen AM. The vegetative state. BMJ. 2010;341:c3765. doi: 10.1136/bmj.c3765.
  2. Gosseries O, Vanhaudenhuyse A, Bruno MA, Demertzi A, Schnakers C, Boly MM, et al. Disorders of consciousness: coma, vegetative and minimally conscious states. In: Cvetkovic D, Cosic I, eds. States of Consciousness: Experimental Insights into Meditation, Waking, Sleep and Dreams. Berlin, Heidelberg: Springer; 2011. p. 29-55. doi: 10.1007/978-3- 642-18047-7_2.
  3. Keykha A, Ramezani M, Amini S, Karimi Moonaghi H, Saki A. Educational challenges of family caregivers of vegetative state patients for home care preparedness: a qualitative content analysis. J Educ Health Promot. 2022;11:345. doi: 10.4103/ jehp.jehp_1647_21.
  4. Tzidkiahu T, Sazbon L, Solzi P. Characteristic reactions of relatives of post-coma unawareness patients in the process of adjusting to loss. Brain Inj. 1994;8(2):159-65. doi: 10.3109/02699059409150967.
  5. Imani-Goghary Z, Noohi E, Peyrovi H, Kazemi M. Exploring the role of spirituality in coping process of family caregivers of patients in vegetative state. Br J Med Med Res. 2016;17(2):1- 11. doi: 10.9734/bjmmr/2016/26300.
  6. Hefti R. Integrating religion and spirituality into mental health care, psychiatry and psychotherapy. Religions. 2011;2(4):611- 27. doi: 10.3390/rel2040611.
  7. Heidarzadeh M, Rassouli M, Mohammadi Shahbolaghi F, Alavi Majd H, Karam AM, Mirzaee H, et al. Posttraumatic growth and its dimensions in patients with cancer. Middle East J Cancer. 2014;5(1):23-9.
  8. Kim Y, Carver CS, Spillers RL, Crammer C, Zhou ES. Individual and dyadic relations between spiritual well-being and quality of life among cancer survivors and their spousal caregivers. Psychooncology. 2011;20(7):762-70. doi: 10.1002/pon.1778.
  9. Krok D. The role of meaning in life within the relations of religious coping and psychological well-being. J Relig Health. 2015;54(6):2292-308. doi: 10.1007/s10943-014-9983-3.
  10. Ramezani M, Ahmadi F, Mohammadi E, Kazemnejad A. The grounded theory of “trust building”. Nurs Ethics. 2019;26(3):753-66. doi: 10.1177/0969733017734411.
  11. Nemati S, Rassouli M, Ilkhani M, Baghestani AR. The spiritual challenges faced by family caregivers of patients with cancer: a qualitative study. Holist Nurs Pract. 2017;31(2):110-7. doi: 10.1097/hnp.0000000000000198.
  12. Rezaei H, Fathi M, Roshani D, Kalhor MM. Correlation between spiritual well-being and family caregiver burden in patients with cancer. Iran J Rehabil Res Nurs. 2019;6(2):115- 24. [Persian].
  13. Shirinkam F, Shamsalinia A, Torabi Chafjiri R, Ghaffari F. Spiritual attitude of family caregivers in elder with stroke. Journal of Caspian Health and Aging. 2019;4(2):37-44. doi: 10.22088/cjhaa.4.2.37. [Persian].
  14. Abasnejad Mousavi SM, Arzani A, Galeshi M, Afsari A. Evaluation of spiritual health and social support in family caregivers of cancer patients in north of Iran. J Gorgan Univ Med Sci. 2022;24(2):75-81. [Persian].
  15. Vigna PM, de Castro I, Fumis RR. Spirituality alleviates the burden on family members caring for patients receiving palliative care exclusively. BMC Palliat Care. 2020;19(1):77. doi: 10.1186/s12904-020-00585-2.
  16. Hadian M, Jabbari A, Sheikhbardsiri H. Exploring challenges of health system in Iranian traditional medicine: a qualitative study. Ethiop J Health Sci. 2020;30(6):1027-36. doi: 10.4314/ ejhs.v30i6.22.
  17. Sheikhbardsiri H, Doustmohammadi MM, Mousavi SH, Khankeh H. Qualitative study of health system preparedness for successful implementation of disaster exercises in the Iranian context. Disaster Med Public Health Prep. 2022;16(2):500-9. doi: 10.1017/dmp.2020.257.
  18. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88. doi: 10.1177/1049732305276687.
  19. Lindgren BM, Lundman B, Graneheim UH. Abstraction and interpretation during the qualitative content analysis process. Int J Nurs Stud. 2020;108:103632. doi: 10.1016/j. ijnurstu.2020.103632.
  20. Lincoln YS. Naturalistic inquiry. In: Ritzer G, ed. The Blackwell Encyclopedia of Sociology. Wiley-Blackwell; 2007.
  21. Lee V. The existential plight of cancer: meaning making as a concrete approach to the intangible search for meaning. Support Care Cancer. 2008;16(7):779-85. doi: 10.1007/ s00520-007-0396-7.
  22. Park CL. Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychol Bull. 2010;136(2):257-301. doi: 10.1037/a0018301.
  23. Eton DT, Lepore SJ, Helgeson VS. Psychological distress in spouses of men treated for early-stage prostate carcinoma. Cancer. 2005;103(11):2412-8. doi: 10.1002/cncr.21092.
  24. Malhotra M, Thapa K. Religion and coping with caregiving stress. Int J Multidiscip Curr Res. 2015;3:613-9.
  25. Grubbs JB, Exline JJ. Why did God make me this way? Anger at God in the context of personal transgressions. J Psychol Theol. 2014;42(4):315-25. doi: 10.1177/009164711404200401.
  26. Yeater EA, Austin JL, Green MJ, Smith JE. Coping mediates the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol use in homeless, ethnically diverse women: a preliminary study. Psychol Trauma. 2010;2(4):307- 10. doi: 10.1037/a0021779.
  27. Exline JJ, Prince-Paul M, Root BL, Peereboom KS. The spiritual struggle of anger toward God: a study with family members of hospice patients. J Palliat Med. 2013;16(4):369-75. doi: 10.1089/jpm.2012.0246.
  28. Pashaei F, Taleghani F, Tavakol K, Rezaei A. Family experiences from caregivering of patient with coronary artery bypass graft surgery: a qualitative study. Iran J Nurs Res. 2010;5(16):61-71. [Persian].
  29. Barrett JL, Lanman JA. The science of religious beliefs. Religion. 2008;38(2):109-24. doi: 10.1016/j.religion.2008.01.007.
  30. Maghsoudi J, Soltani F, Pahlavanzade S, Tavakol K. Family experiences of patients admitted in intensive care unit (ICU). Iran J Nurs Midwifery Res. 2008;12(4):139-45.
  31. Rahmani F, Ranjbar F, Hosseinzadeh M, Razavi SS, Dickens GL, Vahidi M. Coping strategies of family caregivers of patients with schizophrenia in Iran: a cross-sectional survey. Int J Nurs Sci. 2019;6(2):148-53. doi: 10.1016/j.ijnss.2019.03.006.
  32. Krok D. The mediating role of coping in the relationships between religiousness and mental health. Arch Psychiatry Psychother. 2014;2(1):5-13. doi: 10.12740/app/26313.
  33. Ano GG, Vasconcelles EB. Religious coping and psychological adjustment to stress: a meta-analysis. J Clin Psychol. 2005;61(4):461-80. doi: 10.1002/jclp.20049.
  34. Corallo F, Bonanno L, Lo Buono V, De Salvo S, Rifici C, Bramanti A, et al. Coping strategies in caregivers of disorders of consciousness patients. Neurol Sci. 2018;39(8):1375-81. doi: 10.1007/s10072-018-3431-1.
  35. Nemati S, Rassouli M, Ilkhani M, Baghestani AR, Nemati M. Development and validation of ‘caring ability of family caregivers of patients with cancer scale (CAFCPCS)’. Scand J Caring Sci. 2020;34(4):899-908. doi: 10.1111/scs.12797.

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