Postdischarge distress in surgically treated cancer patients and their spouses

Temporal patterns of distress among two groups of nonterminally ill, surgically treated cancer patients (n = 40) and their spouses (n = 40) during the immediate pre- and postdischarge period were studied. Data about problems encountered and standardized measures of distress (State Anxiety Index, Brief Symptom Index, and Vulnerability Index) were obtained before hospital discharge and at 10, 30, 60, 90, and 180 days postdischarge. The intensity of distress experienced by patients and spouses was remarkably similar, although the temporal pattern of occurrence was significantly different. Prior to discharge, spouse anxiety was significantly higher than that of the patients and above the norm for hospitalized persons. Spouses were least distressed after 10 days at home, but thereafter experienced a rise in vulnerability culminating in observable clinical depression at 90 and 180 days. Peak distress for the patients occurred 10 days after discharge as a function of physical symptoms that were unexpected or more severe than anticipated. Patients with ostomies (n = 20) were slower to return to pre-illness functional levels and had somewhat more psychological distress than nonostomy patients.