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.
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.
Jonasson
Junmei Miao
JM
Department of Oncology-Pathology, Division of Clinical Cancer Epidemiology, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. junmei.jonasson@oc.gu.se
Hauksdóttir
Arna
A
Valdimarsdóttir
Unnur
U
Fürst
Carl Johan
CJ
Onelöv
Erik
E
Steineck
Gunnar
G
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*