title: Bereavement life review improves spiritual well-being and ameliorates depression among American caregivers.
abstract: 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.
  
  
  METHODS
  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."
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Nursing,St. Mary's College,Fukuoka,Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Ando
authors.affiliation: St. Francis Hospice,Honolulu,Hawaii.
authors.forename: Felicia
authors.initials: F
authors.lastname: Marquez-Wong
authors.affiliation: St. Francis Hospice,Honolulu,Hawaii.
authors.forename: Gary B
authors.initials: GB
authors.lastname: Simon
authors.affiliation: Graduate School,Kurume University,Kurume,Japan.
authors.forename: Haruko
authors.initials: H
authors.lastname: Kira
authors.affiliation: Kokoro Research Center,Kyoto University,Kyoto,Japan.
authors.forename: Carl
authors.initials: C
authors.lastname: Becker
mesh_terms: D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D006254:Hawaii; D006801:Humans; D008297:Male; D008875:Middle Aged; D029181:Spirituality; D011795:Surveys and Questionnaires
keywords: Depression