title: Unrelieved symptoms of female cancer patients during their last months of life and long-term psychological morbidity in their widowers: a nationwide population-based study.
abstract: OBJECTIVE
  To investigate if a cancer patient's unrelieved symptoms during the last 3 months of life increase the risk of long-term psychological morbidity in the surviving widower.
  
  
  METHODS
  Men (n=907) younger than 80 years and living in Sweden, who had lost their wives due to cancer, were asked 4-5 years after their loss to answer an anonymous postal questionnaire that included questions about their current psychological morbidity and their wives' unrelieved symptoms during the last 3 months of life.
  
  
  RESULTS
  If the wife suffered unrelieved anxiety or pain during the last 3 months of her life, then the widowers had a higher risk of sleep-related problems 4-5 years after the loss. When the wife had suffered from anxiety, the relative risks (RR) for the widowers' sleep-related problems were: difficulty falling asleep (RR 1.7, 95% CI 1.0-3.0) and waking up at night with anxiety (RR 4.9, 95% CI 1.5-15.7). When the wife had unrelieved pain, the widowers years later had an increased risk of difficulty falling asleep at night (RR 1.8, 95% CI 1.0-3.3).
  
  
  CONCLUSIONS
  The unrelieved patients' end-of-life problems increase the risk of widowers' long-term mental suffering. Efficient and effective diagnoses and treatment of pain and anxiety in terminally ill cancer patients are critical for both patients and their surviving widowers.
authors.affiliation: Department of Oncology-Pathology, Division of Clinical Cancer Epidemiology, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. junmei.jonasson@oc.gu.se
authors.forename: Junmei Miao
authors.initials: JM
authors.lastname: Jonasson
authors.forename: Arna
authors.initials: A
authors.lastname: Hauksdóttir
authors.forename: Unnur
authors.initials: U
authors.lastname: Valdimarsdóttir
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Fürst
authors.forename: Erik
authors.initials: E
authors.lastname: Onelöv
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001601:Bereavement; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology; D013548:Sweden / Q000453:epidemiology; D013727:Terminal Care / Q000523:psychology* / Q000592:standards; D017805:Widowhood / Q000523:psychology*