title: Factors associated with psychological distress and grief resolution in surviving spouses of patients with advanced gastrointestinal cancer.
abstract: OBJECTIVE
  Patients with advanced gastrointestinal cancer often have a short survival time. This means that spouses only have a short time to adjust to the approaching death. The aim was to explore whether psychological distress at diagnosis, the course of the illness (anti-tumour treatment, respite period and survival time), the spouses' experience of the care and of losing a loved one were related to distress and grief resolution after the patient had deceased.
  
  
  METHODS
  Twenty-one spouses were followed prospectively from the patient's diagnosis of advanced gastrointestinal cancer to 6 months after the patient death. Spouses' experiences were measured with an interview, psychological distress with the Hospital Anxiety and Depression Scale and grief resolution with the Grief Resolution Index.
  
  
  RESULTS
  The spouses' anxiety at the time of diagnosis was related to their anxiety and grief resolution at follow-up. Two additional factors were associated with higher levels of anxiety at follow-up; the patient having received anti-tumour treatment and the spouse having experienced stress as a caregiver.
  
  
  CONCLUSIONS
  The study indicates that anti-tumour treatment, though it has the potential to prolong life, does not positively influence spouses' psychological distress and bereavement after the death of the patient.
authors: Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala Science Park, 751 83 Uppsala, Sweden. jeanette.winterling@pubcare.uu.se
authors: Jeanette
authors: J
authors: Winterling
authors: Elisabet
authors: E
authors: Wasteson
authors: Cecilia
authors: C
authors: Arving
authors: Birgitta
authors: B
authors: Johansson
authors: Bengt
authors: B
authors: Glimelius
authors: Karin
authors: K
authors: Nordin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D017028:Caregivers / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000523:psychology* / Q000628:therapy; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D013534:Survival