title: Middle-aged female spouses of patients with metastatic cancer: lived experiences.
abstract: BACKGROUND
  Although the survival rate for cancer is increasing because of advances in treatment technology, cancer still comes as a great shock to the families of patients who are in the advanced stages of this disease. When a married, middle-aged man is diagnosed with advanced cancer, his spouse most often becomes his primary caregiver. However, few studies have studied the lived experience of these middle-aged spouses.
  
  
  OBJECTIVE
  This study explores the lived experience of middle-aged female spouses of husbands diagnosed with advanced cancer.
  
  
  METHODS
  A qualitative design was used. In-depth interviews were conducted with participants whose spouses were being treated at the oncology outpatient department of a teaching hospital in northern Taiwan. The data were collected with purposive sampling over a 12-month period.
  
  
  RESULTS
  A content analysis of 11 participant interviews revealed four themes: simultaneously bearing all layers of stress, changing of attitudes and values, developing the effective skills of caregiving, and gaining support from the family and from religion.
  
  
  CONCLUSIONS
  A middle-aged female spouse faces many layers of stress and many crises in caring for her husband with advanced cancer. Female spouses in Taiwan tend to rely significantly more on internal resources (family) than external resources (friends and medical professionals). It is recommended that these families use external resources such as medical and social welfare systems more actively to facilitate their successful passage through these crises. Understanding the lived experiences of these female spouses helps nurses provide appropriate nursing interventions.
authors.affiliation: 1PhD, RN, Associate Professor and Chair, Department of Nursing, National Taipei University of Nursing and Sciences 2MSN, RN, Associate Professor, Department of Nursing, National Taipei University of Nursing and Health Sciences 3PhD, RN, Associate Professor, Department of Nursing, National Taipei University of Nursing and Health Sciences.
authors.forename: Hung-Ru
authors.initials: HR
authors.lastname: Lin
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Lin
authors.forename: Wen-Chuan
authors.initials: WC
authors.lastname: Lin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological; D013624:Taiwan