Bereavement life review improves spiritual well-being and ameliorates depression among American caregivers.

OBJECTIVE: The aim of our study was to investigate the utility of bereavement life review (BLR) to elevate spiritual well-being and alleviate depression among Hawaiian-American caregivers, and to identify changes that occur when caring for their loved ones up to the time of death. METHOD: Bereavement life review therapy was provided for 20 bereaved Hawaiian Americans. In the first session, subjects reviewed memories of the deceased with a therapist, who recorded their narratives and collected them into a personal history book. During the second session, subjects discussed the contents of this book. Caregivers completed the Functional Assessment Chronic Illness Therapy-Spiritual (FACIT-Sp) questionnaire and the Beck Depression Inventory, Second Edition (BDI-II) pre- and post-intervention. Subjects also described changes in their views that occurred during the caring process in response to questions. RESULTS: FACIT-Sp scores significantly increased from 34.1 ± 9.63 to 36.3 ± 10.6 (t = -2.6, p < 0.05, and BDI scores significantly decreased from 11.7 ± 7.7 to 8.8 ± 7.0 (t = 2.27, p < 0.05). Five categories were chosen from the narratives on changes that had occurred during caregiving and due to the deceased death: "Learning from practical caring experience," "Positive understanding of patients," "Recognition of appreciation," "Self-change or growth," and "Obtaining a philosophy." SIGNIFICANCE OF RESULTS: These findings show the applicability of bereavement life review therapy for Hawaiian families, including efficacy for spiritual well-being and depression. The comments of the caregivers also indicate the potential of the therapy for identifying the positive aspects of caring for terminally ill patients.

Development of a Japanese Benefit Finding scale (JBFS) for patients with cancer.

The primary aim of this study was to develop a scale to evaluate benefits for patients with cancer under treatment in Japan (the Japan Benefit Finding scale [JBFS]). The participants were 98 patients with cancer who completed the JBFS, which has 26 items, the General Health Questionnaire short version (GHQ 12). Factor analysis, structural equation modeling (SEM), and correlation analysis were performed. Three key domains were identified: ''Recognition of one's role in the family and priorities,'' ''Appreciation for life,'' and ''Faith.'' Validity was confirmed by SEM. There was a significant correlation between the JBFS and GHQ 12. The reliability and validity are adequate, and the JBFS shows that Japanese patients who found benefits in cancer were able to adjust to their disease.

Factors that influence the efficacy of bereavement life review therapy for spiritual well-being: a qualitative analysis.

PURPOSE: We have previously shown that bereavement life review therapy improves the spiritual well-being of a bereaved family, but the factors that influence the efficacy of this therapy have not been determined. Therefore, this study was performed to identify factors associated with improvement of spiritual well-being of bereaved families. METHODS: The participants were 21 bereaved family members who lost a relative who had been treated in a palliative care unit in Japan. The family members received the Bereavement Life Review over two sessions of about 60 min each. In the first session, the bereaved family member reviewed their memories of the deceased relative with a clinical psychologist and answered several questions. After the first session, the psychologist made an album. In the second session, the family member and the psychologist confirmed the accuracy of the contents of the album. Assessment was performed using the Functional Assessment Chronic Illness Therapy-Spiritual score, based on which the participants were separated into effective and non-effective groups. Factors were extracted from the narrative of the therapy using a text-mining software. RESULTS: Factors such as "good memories of family," "loss and reconstruction," and "pleasant memories of last days" were commonly found in the effective group, whereas factors such as "suffering with memories," "regret and sense of guilt," and "disagreement on funeral arrangements" were more common in the non-effective group. CONCLUSIONS: Factors like "good memories of families," "loss and reconstruction," and "pleasant memories of last days" were associated with the improvement of spiritual well-being of bereaved families.

Effects of bereavement life review on spiritual well-being and depression.

CONTEXT: Some bereaved families experience low spiritual well-being, such as lack of meaning of life or purpose and psychological distress like severe depression. OBJECTIVES: The primary aim of this study was to investigate the effects of the Bereavement Life Review on the spiritual well-being of bereaved family members. The secondary aim was to investigate the effects of this therapy on depression. METHODS: Participants were 21 bereaved family members who lost loved ones in various palliative care units in Japan. They received the Bereavement Life Review, which consisted of two sessions for about 60 minutes each. In the first session, a bereaved family member reviewed memories with a clinical psychologist and answered some question. After the first session, the clinical psychologist made an album. In the second session, the family member and the clinical psychologist confirmed the accuracy of the contents of the album. The duration of the therapy was two weeks. The family member was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale and the Beck Depression Inventory-II (BDI-II) pre- and postintervention. RESULTS: FACIT-Sp scores increased from 19.9+/-5.8 to 22.8+/-5.1 (Z=-2.2, P=0.028 by Wilcoxon signed-rank test) and BDI scores decreased from 10.8+/-7.7 to 6.8+/-5.8 (Z=-3.0, P=0.003). CONCLUSIONS: The Bereavement Life Review has the potential to improve spiritual well-being and decrease depression of bereaved family members. A further study with more participants is required to confirm the present findings.