Spiritual beliefs may affect outcome of bereavement: prospective study

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Abstract
Objective: To explore the relation between spiritual beliefs and resolution of bereavement. Design: Prospective cohort study of people about to be bereaved with follow up continuing for 14 months after the death. Setting: A Marie Curie centre for specialist palliative care in London. Participants: 135 relatives and close friends of patients admitted to the centre with terminal illness. Main outcome measure: Core bereavement items, a standardised measure of grief, measured 1, 9, and 14 months after the patients' death. Results: People reporting no spiritual belief had not resolved their grief by 14 months after the death. Participants with strong spiritual beliefs resolved their grief progressively over the same period. People with low levels of belief showed little change in the first nine months but thereafter resolved their grief. These differences approached significance in a repeated measures analysis of variance (F=2.42, P=0.058). Strength of spiritual belief remained an important predictor after the explanatory power of relevant confounding variables was controlled for. At 14 months the difference between the group with no beliefs and the combined low and high belief groups was 7.30 (95% confidence interval 0.86 to 13.73) points on the core bereavement items scale. Adjusting for confounders in the final model reduced this difference to 4.64 (1.04 to 10.32) points. Conclusion: People who profess stronger spiritual beliefs seem to resolve their grief more rapidly and completely after the death of a close person than do people with no spiritual beliefs. What is already known on this topic Religious belief affects outcome of bereavement in families coping with the death of a child and in older people who are bereaved of a spouse Research is often retrospective, and causal connections are difficult to establish What this study adds People who profess stronger spiritual beliefs seem to resolve their grief more rapidly and completely after the death of a person close to them than do people with no spiritual beliefs Most palliative care units involve the family members and friends of the person dying; attention to spiritual matters may be an important component of this work