title: Need for and access to bereavement support after loss of a husband to urologic cancers: a nationwide follow-up of Swedish widows.
abstract: OBJECTIVE
  Widowhood imposes difficult psychological, social and practical challenges. We investigated the prevalence and predictors of access to bereavement interventions during the first 6 months after the loss of a husband/male partner to prostate or urinary bladder cancer.
  
  
  METHODS
  All women (n = 506) aged < 80 years living in Sweden 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.
  
  
  RESULTS
  Thirty percent of the widows stated that they would not have needed psychological support by caregivers during the first 6 months of bereavement. Two-thirds of the others (162/242) (those who did not state that they had no need of support) did not have any access to psychological support, 10% (25/242) had little access, 11% (27/242) had moderate access and 12% (28/242) had a large amount of access to psychological support. Similar figures were observed for other bereavement interventions, such as information, economic counselling and support groups. Emotional relations during the last months prior to bereavement, intensity of faith, education, prior mental health problems and a diagnosis of prostate cancer were all positively correlated with access to psychological support by caregivers, whereas previously identified risk factors for excess morbidity in widowhood were not.
  
  
  CONCLUSIONS
  A large majority of Swedish widows who lost their husband to urologic cancers in 1995 or 1996 indicated a need for psychological support, information and economic counselling. This need was not met by caregivers and help was not aimed at important groups at risk of morbidity.
authors.affiliation: Department of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden. Unnur.Valdimarsdottir@meb.ki.se
authors.forename: Unnur
authors.initials: U
authors.lastname: Valdimarsdóttir
authors.forename: Asgeir R
authors.initials: AR
authors.lastname: Helgason
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Fürst
authors.forename: Jan
authors.initials: J
authors.lastname: Adolfsson
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000368:Aged; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D017051:Hospice Care; D006801:Humans; D008297:Male; D020380:Needs Assessment; D012944:Social Support; D018454:Spouses; D013315:Stress, Psychological; D013548:Sweden; D014571:Urologic Neoplasms / Q000401:mortality / Q000523:psychology*; D017805:Widowhood / Q000523:psychology*