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Disclosure of Incurable Illness to Spouses: Do They Want to Know? A Swedish Population-Based Follow-Up Study

Hanna Dahlstrand, Arna Hauksdóttir, Unnur Valdimarsdóttir, Carl-Johan Fürst, Karin Bergmark, Gunnar Steineck

From the Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet; Stockholms Sjukhem Foundation, Stockholm; Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska Academy, Göteborg's University, Göteborg, Sweden; and the Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland

Corresponding author: Hanna Dahlstrand, MD, PhD, Radiumhemmet, Department of Oncology, Karolinska University Hospital, 171 76, Stockholm, Sweden; e-mail: hanna.dahlstrand{at}karolinska.se

Purpose Awareness of the cancer patient's terminal state decreases the risk of psychological morbidity of the bereaved. We wanted to determine whether male spouses of cancer patients who died from their disease had received information that the illness was incurable and to determine their preferences of disclosure.

Participants and Methods The study included 907 widowers whose wives had died of cancer. In an anonymous questionnaire, we asked whether the widower had received information that his wife's illness was incurable and about his attitudes towards receiving this information.

Results Six hundred ninety-one widowers (76%) participated. Eighty percent of the widowers reported that they were told that the wife's cancer was incurable, and 21% reported that they had been informed within 1 week before the patient's death. Although 14% of the widowers did not think the next of kin should be told immediately when the patient's cancer is beyond cure, 39% of the men did not want the patient to be immediately informed. Furthermore, 71% of the men who were never informed about the incurable illness believed that the next of kin should receive that information immediately.

Conclusion Although a large majority of men prefer an immediate disclosure about the incurable stage of their wife's illness, 41% of the husbands received this information during the last week of the patient's life or not at all. These findings indicate that there is room for improvement in the level of communication between health providers and the husbands of women with incurable cancer.

Supported by the Swedish Cancer Society, the Swedish Research Council, Stockholm City Council, Stockholm Cancer Foundation, and the Center for Health Care Sciences at Karolinska Institutet.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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