Meaning-making in home-based end-of-life care: a qualitative study of wives’ experiences after the loss of their husbands to cancer

BACKGROUND: Caring for a spouse with cancer at home during the end-of-life period is emotionally demanding and can have lasting effects on bereaved partners. For some wives who assume the primary caregiving role, this experience becomes a source of meaning, personal growth, and relational reconstruction after loss. However, the longitudinal processes through which they derive positive meaning and rebuild their relationship over time remain unclear. This study builds on our previous research involving bereaved wives and husbands, who provided home-based end-of-life care for a partner with cancer between 6 months and 2 years after bereavement, and examines their positive interpretations of caregiving. In this follow-up study conducted approximately two years later, we re-interviewed the wives to explore how they interpreted their caregiving experiences. Through longitudinal comparison with the initial findings, we examined how caregiving meanings evolved. METHODS: We used a qualitative longitudinal design and conducted second interviews (approximately four years after bereavement) with wives who participated in the initial study and provided renewed consent. The semi-structured interviews were transcribed verbatim and analyzed using sequential comparative analysis. RESULTS: Five themes were identified: "the enduring bond of the married couple," "the importance of family members who spent time together until the end," "the meaning attached to caring for the husband in the terminal phase," "confronting life without the husband," and "reflection on one's way of life." Over time, wives gradually reconfigured their relationships with their husbands, shifting from viewing caregiving as a "concluded past" to experiencing it as a "continuing relationship in the present." This transition represents a conceptual shift, illustrating a dynamic process in which earlier interpretations are revisited and integrated into an evolving life narrative. CONCLUSIONS: The meaning-making process surrounding care for a dying husband did not remain fixed after bereavement; it evolved as a dynamic, ongoing reinterpretation. The findings indicate that positive meaning-making after loss deepens over time and is accompanied by relational growth. Through end-of-life care support, visiting nurses can understand how wives "make meaning of their marital relationship" and provide opportunities for narrative exchanges that lead to post-bereavement meaning construction.