title: The unrecognised cost of cancer patients' unrelieved symptoms:a nationwide follow-up of their surviving partners.
abstract: We investigated if a cancer patient's unrelieved symptoms during the last 3 months of life increase the risk of long-term psychological morbidity of the surviving partner. All women (n=506) living in Sweden under 80 years of age, who lost their husband/partner owing to cancer of the prostate in 1996 or of the urinary bladder in 1995 or 1996 were asked to answer an anonymous postal questionnaire, 2-4 years after their loss. The widows' psychological morbidity was associated with the patient's unrelieved mental symptoms. When the patient was perceived to have been very anxious during last three months of life (compared to no observed symptoms) the relative risks for the widows' psychological morbidity were: 2.5 (1.4-4.3) for depression and 3.4 (1.4-8.2) for anxiety. When comparing reports of the patient's pain (much vs no), the relative risks were 0.8 (0.5-1.2) for widowhood depression, and 0.8 (0.4-1.7) for widowhood anxiety. The patients were found to have had adequate access to physical pain control but poor access to psychological symptom control. Efficiency in diagnosing and treating psychological complications of terminally ill cancer patients may not only improve their quality of life but possibly also prevent long-term psychological morbidity of their surviving partners.
authors.affiliation: Department of Clinical Cancer Epidemiology, Inst. Oncology-Pathology, Karolinska Institute, Box 4402, 10268 Stockholm, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Valdimarsdóttir
authors.forename: A R
authors.initials: AR
authors.lastname: Helgason
authors.forename: C-J
authors.initials: CJ
authors.lastname: Fürst
authors.forename: J
authors.initials: J
authors.lastname: Adolfsson
authors.forename: G
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001601:Bereavement; D002277:Carcinoma / Q000503:physiopathology / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010361:Patients / Q000523:psychology; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012306:Risk; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013727:Terminal Care / Q000523:psychology*; D014149:Tranquilizing Agents; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000523:psychology; D017805:Widowhood / Q000523:psychology*
chemical_list: D006993:Hypnotics and Sedatives; D014149:Tranquilizing Agents