Vinsamlegast notið þetta auðkenni þegar þið vitnið til verksins eða tengið í það: http://hdl.handle.net/1946/8783
Objective: Chronic pain is a complex state that affects a person’s physical and psychological well-being and may endure for many years. Psychological morbidity has been suggested as important contributing factor to chronic pain; increased knowledge on potential mechanisms might therefore facilitate preventive efforts.The focus of this study was on the impact of spousal loss on the development of chronic pain, more specifically, the aim was to investigate the effect of experiencing low preparedness before a wife’s death on the widower’s chronic pain 4-5 years after loss.
Methods: In a population-based study in the years 2004-2005, anonymous questionnaires were sent out to 907 men in Sweden who had lost a wife to cancer in 2000 and 2001. The questionnaires contained questions on circumstances around the death, such as the man’s preparedness at the time of his wife’s death and the men’s physical and psychological health at follow-up. Psychological morbidity was measured by the Hospital Anxiety and Depression Scale (HADS) and by direct questions on psychological health. Logistic regression was used to evaluate the risk of chronic pain within two age groups by level of preparedness taking into account the influence of various covariates. When exploring the association between chronic pain and psychological morbidity we calculated relative risk with 95% CI.
Results: Altogether 691/907 questionnaires were received (76%). 638 widowers answered a question on chronic pain, of those, 76 reported chronic pain (12%). Younger widowers were in general more likely to experience various pain symptoms; muscle tension (RR 1.38; CI 1.16-1.66), headache (RR 1.89; CI 1.49-2.41), burn out (RR 5.64; CI 2.08-15.32) compared with the older widowers. Younger widowers (38-61 years) who reported low degree of preparedness for their wife´s death had compared to widowers with high degree of preparedness increased risk of experiencing chronic pain (OR 6.67; CI 2.49-17.82) 4-5 years after loss. The same did not apply for older widowers (62-80 years) (OR 0.81; CI 0.32-2.05). Both age groups who experienced chronic pain were at increased risk for psychological morbidity. Younger widowers with chronic pain reported increased risk of depression (a single item question on depression: RR 2.44; CI 1.03-5.79), anxiety (RR 2.12; CI 1.10-4.09) and sleep disorders (RR 4.09; CI 2.02-8.26) and older widowers of depression (RR 2.45; CI 1.60-3.76 and a single-item question: RR 2.17; CI 1.11-4.21) and anxiety (RR 2.04; CI 1.05-3.96).
Conclusion: Younger men who are less prepared for their wife’s death are at higher risk for experiencing chronic pain and other various pain symptoms 4-5 years after loss. In addition, those who experience chronic pain have also greater likelihood of experiencing psychological morbidity. The findings emphasize the importance of preparedness for a wife’s death, identification on factors that might increase such preparedness are therefore called for. Our findings furthermore stress the importance of team work between health professionals when treating chronic pain and psychological morbidity among grieving individuals.