• Kiri Walsh, Michael King, Louise Jones, Adrian Tookman, and Robert Blizard.
• Department of Psychiatry and Behavioural Science, Royal Free Campus, Royal Free and University College Medical School, London NW3 2PF.
• BMJ. 2002 Jun 29; 324 (7353): 1551.

ObjectiveTo explore the relation between spiritual beliefs and resolution of bereavement.DesignProspective cohort study of people about to be bereaved with follow up continuing for 14 months after the death.SettingA Marie Curie centre for specialist palliative care in London.Participants135 relatives and close friends of patients admitted to the centre with terminal illness.Main Outcome MeasureCore bereavement items, a standardised measure of grief, measured 1, 9, and 14 months after the patients' death.ResultsPeople 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.ConclusionPeople 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.

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