title: Impaired mental health among the bereaved spouses of cancer patients.
abstract: OBJECTIVE
  Few cancer physicians routinely provide bereavement follow-up in clinical practice. The purpose of this study was to identify the prevalence of impaired mental health among the bereaved spouses over several years and explore the indicators for early detection of high-risk spouses during end-of life (EOL) care.
  
  
  METHODS
  A cross-sectional mail survey was conducted for the bereaved spouses of patients who had died at the National Cancer Center Hospital of Japan. Bereaved spouses with potential psychiatric disorders were identified by the cut-off score of the 28-item General Health Questionnaire. Associated factors of potential psychiatric disorders were explored by logistic regression analysis.
  
  
  RESULTS
  A total of 821 spouses experiencing bereavement from 7 months to 7 years returned the questionnaires. Overall mean prevalence of potential psychiatric disorders was 44% (360/821). Bereaved spouses 'under 55 years' (71%) or '2 years after bereavement' (59%) revealed a significantly higher prevalence (p < 0.01). Associated factors during EOL care were several characteristics such as 'spouses' history of psychiatric disorder (odds ratio (OR) = 3.19), 'patients' with stomach cancer (OR = 1.87), and 'patients' using psychiatric consultation services (OR = 1.52) as well as spouses' dissatisfaction with EOL care such as 'physicians' treatment of physical symptoms' (OR = 3.44) and 'time spent communicating with patients' (OR = 1.55).
  
  
  CONCLUSIONS
  Nearly half the bereaved spouses showed potential psychiatric disorders even 7 years after bereavement. Patients' psychological distress, spouses' history of psychiatric disorder, and dissatisfaction with EOL care were indicators of high-risk spouses.
authors.affiliation: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. m.asai@thu. ac.jp
authors.forename: Mariko
authors.initials: M
authors.lastname: Asai
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.forename: Asao
authors.initials: A
authors.lastname: Ogawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsui
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Itoh
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohtsu
authors.forename: Kanji
authors.initials: K
authors.lastname: Nagai
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D017060:Patient Satisfaction; D015995:Prevalence; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology