Construct validity of the 17-item Benefit Finding Scale in Chinese cancer patients and their family caregivers: a cross-sectional study

Interdependence relationships between unmet supportive care needs and its influencing factors in couples coping with colorectal cancer: a cross-sectional study

PURPOSE

To explore the unmet supportive care needs (USCNs) in colorectal cancer survivors and their spousal caregivers and identifying factors influencing USCNs from a dyadic perspective.

METHODS

In this cross-sectional survey, a total of 343 dyads consisting of Chinese colorectal cancer survivors and their spousal caregivers were recruited from a dyadic perspective. This study evaluated participants' USCNs, psychological distress of anxiety and depression, and benefit finding. The Actor-Partner Interdependence Mediation Model (APIMeM) as data analysis approaches was used to capture the bidirectional and mediating effects between the variables, revealing key factors influencing USCNs in colorectal cancer couples.

RESULTS

A total of 343 colorectal cancer couples were surveyed, reporting different USCNs. The analysis revealed that psychological distress and benefit finding play a central role in influencing USCNs. These factors affect the dyadic health outcomes of both cancer survivors and their spousal caregivers through bidirectional relationships. Specifically, psychological distress influences USCNs through its impact on benefit finding, which mediates the relationship between psychological distress and unmet care needs in the dyads.

CONCLUSIONS

This study highlights the USCNs and its influencing factors within colorectal cancer couples. The APIMeM findings suggest that USCNs can be enhanced by reducing psychological distress and strengthening the protective role of benefit finding. In response to the unique needs of colorectal cancer couples, tailored psycho-social supportive care interventions should be developed, focusing on alleviating psychological distress and reinforcing the positive aspects of benefit finding, thereby fostering stronger bi-directional relationships and improving USCNs in this population.

Benefit-finding in children with advanced cancer and their parents

OBJECTIVES

Although pediatric cancer often causes significant stress for families, most childhood cancer survivors are resilient and do not exhibit severe or lasting psychopathology. Research demonstrates some survivors may report benefit-finding or positive outcomes following this stressful life event. However, considerably less research has included families of children who are unlikely to survive their illness. Thus, this study investigated benefit-finding among parents and their children with advanced cancer, as well as associated demographic and medical factors.

METHODS

Families (N = 72) of children with advanced cancer (ages 5-25) were recruited from a large pediatric hospital. Advanced cancer was defined as relapsed or refractory disease, an estimated prognosis of <60%, or referral to end-of-life care. Participants completed a demographic survey and the Benefit Finding Scale at enrollment.

RESULTS

Children, mothers, and fathers reported moderate to high benefit-finding scores. Correlations between family members were weak and non-significant. Children reported significantly higher benefit-finding than fathers. Demographic and medical factors were not associated with benefit-finding in children, mothers, or fathers.

SIGNIFICANCE OF RESULTS

Families of children with advanced cancer reported moderate to high benefit-finding regardless of background or medical factors. Children identified benefits of their cancer experience independent of the experiences of their mothers and fathers. Larger studies should continue to examine factors associated with positive and negative outcomes in the context of childhood cancer to inform interventions.

Reliability and validity of the Chinese version of the Benefit Finding Questionnaire for people with mental disorders

BACKGROUND

Benefit finding (BF) is correlated with mental health and recovery, and its presence will contribute to the recovery of patients with mental disorders. Most of the current tools for assessing BF in patients with somatic disorders are not adequate for patients with mental disorders. The present study proposes to introduce the Benefit Finding Questionnaire for People with Mental Disorders and to validate its psychometric properties.

METHODS

The Beaton translation model was used to translate and cross-culturally adjust the Japanese version of the Benefit Finding Questionnaire for People with Mental Disorders. A survey of 514 people with mental disorders was conducted from January 2022 to October 2022 using a general information questionnaire and a translated Chinese version of the Benefit Finding Questionnaire for People with Mental Disorders (BFQ-C) using a convenience sampling method. The quality of the questionnaire was examined in terms of item analysis, reliability, and validity.

RESULTS

The results of the item analysis showed that all items met the requirements. The interrater agreement of the BFQ-C was good, with an interrater agreement = 0.714; the values of the item-level content validity index ranged from 0.75 to 1.00; and the average of all item-level content validity index on the scale = 0.958. Exploratory factor analysis extracted three main factors "change in relationship with others," "change in spirituality," and "change in values and thinking styles"-and the cumulative variance contribution rate was 57.70%. The results of the confirmatory factor analysis were χ2/df of 2.194, Root Mean Square Error of Approximation of 0.075, and comparative fit index of 0.919, indicating that the model fitted well. The questionnaire had a Cronbach' alpha of 0.936, a split reliability of 0.956, and a retest reliability of 0.939.

CONCLUSION

The BFQ-C demonstrated good reliability and validity, and can be used to assess the BF level of people with mental disorders (e.g., anxiety disorders, depressive disorders, schizophrenia, and bipolar disorders) in China.

The Chinese version of the general benefit finding scale (GBFS): Psychometric properties in a sample of college students

BACKGROUND

Benefit finding has become a central construct in the evolution of positive psychology and attracted attention in recent literature. This study aimed to translate and validate the General Benefit Finding Scale (GBFS) in Chinese college students.

METHODS

Forward- and back-translation of the GBFS was followed by the assessment of semantic equivalence and content validity. A sample of 589 college students was recruited in China to conduct reliability and validity analysis. The construct validity was assessed using exploratory (EFA) and confirmatory factor analysis (CFA). Concurrent validity was assessed using Pearson's correlation coefficients of the GBFS with the Perceived Stress Scale (PSS) and World Health Organization-Five Well-Being (WHO-5). Internal consistency and two-week test-retest reliability were also evaluated.

RESULTS

The content validity index for each item ranged from 0.83 to 1.00. EFA revealed a six-factor model, which exhibited acceptable goodness of fit in CFA (standardized root mean square residual = 0.031, root mean square error of approximation = 0.059, goodness-of-fit index = 0.860, comparative fit index = 0.904, Tucker-Lewis index = 0.890, chi-squared/degree of freedom = 2.07). The concurrent validity of the GBFS was supported by its statistically significant correlations with PSS (r = -0.271, p<0.001) and WHO-5 (r = 0.354, p<0.001). Moreover, the internal consistency for the overall scale was satisfactory, with Cronbach's α coefficient of 0.93 and McDonald's omega reliability of 0.94. The test-retest reliability was 0.82.

CONCLUSIONS

Although the Chinese version of GBFS was examined in a homogeneous convenience sample of college students, it provides a reliable and valid instrument for assessing benefit finding in the Chinese context.

Relationship Status and Quality Are Associated With Perceived Benefits of Caregiving for People With Heart Failure

BACKGROUND

"Benefit finding" is a strengths-based strategy for coping with medical illness that may be particularly useful for caregivers of people with heart failure given the highly fluctuating disease course.

OBJECTIVE

The aim of this study was to investigate benefit finding's association with the caregiver-care recipient relationship, depression, and burden at baseline and longitudinally.

METHODS

This is a longitudinal observational study of caregivers' benefit finding, relationship quality, depression, and burden. Correlation and multiple regression analyses identify baseline associations and predictors of 12-month change in benefit finding.

RESULTS

At baseline (n = 100; median, 60 years [interquartile range, 46-69]; 81% female, 70% partner/spouse), increased benefit finding correlated with higher relationship quality (r = 0.53; 95% confidence interval [CI], 0.38-0.67), lower depression (r = -0.33; 95% CI, -0.49 to -0.14), and lower burden (r = -0.31; 95% CI, -0.47 to -0.11). Twelve-month change in benefit finding was predicted by change in relationship quality (ß = 7.12; 95% CI, 0.62-13.61) but not depression or burden.

CONCLUSIONS

Relationship quality and benefit finding changed together over time. Interventions strengthening the caregiver-care recipient bond may be especially impactful for heart failure caregivers.

Determinants of Post-Traumatic Growth and Quality of Life in Ghanaian Breast Cancer Survivors

This study assessed the psychosocial factors associated with post-traumatic growth (PTG) and health-related quality of life (HRQoL) in women breast cancer survivors. Women (N = 128) completed questionnaires on social support, religiosity, hope, optimism, benefit-finding, PTG and HRQoL. Structural equation modeling was used to analyze the data. Results showed that perceived social support, religiosity, hope, optimism, and benefit finding were positively associated with PTG. Religiosity and PTG were positively associated with HRQoL. The results suggest that interventions aimed at increasing religiosity, hope, optimism, and perceived support can help survivors cope better with breast cancer.

Association between the patients' symptom burden and their family caregivers' benefit finding in non-small cell lung cancer receiving combined chemotherapy

PURPOSE

The aim of the study is to explore the relationship between the patients' symptom burden and their family caregivers' benefit finding in non-small cell lung cancer (NSCLC) receiving combined chemotherapy.

METHODS

A cross-sectional study on 181 NSCLC patients receiving combined chemotherapy and their family caregivers was conducted at two comprehensive hospitals from December 2021 to August 2022 in China. The patients completed the self-designed questionnaire, The Chinese Version of M.D. Anderson Symptom Inventory (MDASI) and Lung Cancer Module of the M.D. Anderson Symptom Inventory (MDASI-LC), while caregivers completed the self-designed questionnaire, Benefit Finding Scale (BFS).

RESULTS

The mean symptom burden score of NSCLC patients receiving combined chemotherapy was 71.55 (SD = 22.19), and the median score of fatigue was 6 (IQR, 4, 7). Fatigue was the most severe symptom. The mean benefit finding score of family caregivers was 56.09 (SD = 16.25). Among the dimensions of the benefit finding scale, the personal growth dimension scored the highest. The mean score of personal growth dimension was 18.31 (SD = 5.47). The scores of symptom burden of NSCLC patients and the benefit finding of family caregivers were significantly different in patients' clinical data: stage of tumor, tumor metastasis, duration of illness, self-care ability, leukocyte count (WBC), blood platelet (PLT), hemoglobin content (Hb), Na⁺ concentration, and K⁺ concentration (P < 0.05). The symptom burden of NSCLC patients with combined chemotherapy was adversely correlated with the benefit finding of family caregivers (r =  - 0.609 ~  - 0.151, P < 0.05).

CONCLUSIONS

The symptom burden of patients is adversely correlated with the benefit finding of family caregivers in NSCLC receiving combined chemotherapy; the lighter the symptom burden of patients, the higher the benefit finding of family caregivers. Therefore, appropriate nursing measures should be taken for fatigue, lack of appetite, and other symptoms. A variety of ways should be taken to promote family caregivers to participate in patient symptom management, so as to achieve the goal of reducing the burden of patients' symptoms and improving the level of family caregivers' benefit finding.

Current status and influencing factors of care burden of pancreatic cancer caregivers under COVID-19

Objective

To explore the level of care burden and its influencing factors of caregivers of pancreatic cancer patients during hospitalization under the background of COVID-19.

Methods

From September 2021 to December 2021, in Jiangsu Province Hospital, the convenience sampling method was used to investigate the care burden level of family caregivers of pancreatic cancer patients, and univariate and multivariate analysis methods were used to analyze the influencing factors. The survey tools included the General Information Questionnaire, the Family Caregiver Care Burden Scale, the Hospital Anxiety and Depression Scale, the Benefit Discovery Rating Scale, and the General Self-Efficacy Scale.

Results

A total of 100 subjects were included in this study, of which 45% were male and 55% were older than 50 years. In the Context of COVID-19, the care burden of caregivers of pancreatic cancer patients was at a mild level, and the main influencing factors were family economic status (p < 0.001), anxiety and depression level (p < 0.001) and self-efficacy (p < 0.001).

Conclusion

Medical staff should pay attention to the caregivers of pancreatic cancer with a heavy family burden, and pay attention to their anxiety and depression, and take corresponding measures to improve the self-efficacy of the caregivers, so as to reduce the care burden.

Development and Psychometric Assessment of the Benefit Finding Scale for Chinese Older Adults With Chronic Diseases

The current study sought to develop an instrument for measuring benefit finding in Chinese older adults with chronic diseases and establish its psychometric characteristics. Scale items were drafted based on a literature review, theoretical learning, the Benefit Finding Scale (BFS), the Post-Traumatic Growth Inventory, and results of interviews with 24 older adults with chronic diseases. The preliminary scale draft was constructed by performing a Delphi expert consultation and pretest with a small sample. Using the first draft of the scale, we surveyed 380 older adults with chronic diseases. The BFS for older adults with chronic diseases comprised 26 items. Using exploratory factor analysis, we identified six common factors that explained 66.86% of the variance. Item content validity index ranged from 0.818 to 1.000 and scale content validity index was 0.91. Cronbach's alpha of the scale was 0.924 and test-retest reliability was 0.902. The BFS for older adults with chronic diseases showed good validity and reliability and can be used as a measurement tool for benefit finding in the aforementioned population. [Research in Gerontological Nursing, 16(1), 44-52.].

Optimism and symptoms of anxiety and depression among Chinese women with breast cancer: the serial mediating effect of perceived social support and benefit finding

OBJECTIVE

This research examines the direct and indirect relationships between optimism, perceived social support (PSS), benefit finding (BF), and anxiety and depressive symptoms among Chinese women with breast cancer (BC).

METHODS

We recruited 512 patients, aged averagely 47.46(SD = 8.51) years from two hospitals located in Hunan province, China. The variables were assessed using the Optimism-Pessimism Scale (OPS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Benefit Finding Scale (BFS), and the Hospital Anxiety and Depression Scale (HADS). Path analyses were conducted by Amos version 24.0 for Windows to test the hypothesized serial mediation model.

RESULTS

Path analyses suggest a significant negative association between optimism and symptoms of anxiety and depression. The relationship was mediated by BF (β = -0.085, SE = 0.015, 95% CI [-0.126, -0.055]), and by BF together with PSS (β = -0.027, SE = 0.007, 95% CI [-0.047, -0.017]). The difference comparison between the two indirect effects was significant (β = 0.057, SE = 0.015, 95% CI [0.034,0.101]).

CONCLUSIONS

Our findings suggest that PSS, and BF are important mediators through which optimism may buffer symptoms of anxiety and depression among Chinese BC patients. Clinicians and healthcare practitioners should be aware of the importance of patients' emotional health and endeavor to offer emotional support, facilitate their capacity to improve their quality of life.

The Dyadic Effects of Self-Efficacy on Quality of Life in Advanced Cancer Patient and Family Caregiver Dyads: The Mediating Role of Benefit Finding, Anxiety, and Depression

Objectives. To explore the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in cancer patient (CP) and family caregiver (FC) dyads, and to ascertain the dyadic effects of self-efficacy on quality of life (QOL) in CP-FC dyads. Methods. Conducted from November 2014 to December 2015, participants comprised 772 CP-FC dyads. The study surveyed participant characteristics, self-efficacy, benefit finding, anxiety, depression, and QOL. Data were analyzed using Pearson’s correlation, T-test, and actor-partner interdependence mediation model (APIMeM). Results. CPs’ self-efficacy was positively correlated with both their own and FCs’ benefit finding and mental component summary (MCS), and negatively associated with anxiety and depression (all Ps < 0.01, |r| = 0.144∼0.432). However, CPs’ self-efficacy was only positively correlated with their own physical component summary (PCS) (r = 0.193), but not FCs’ PCS. The same profile was identified in FCs’ self-efficacy (all Ps < 0.01, |r| = 0.100∼0.468). FCs reported higher levels of self-efficacy and PCS compared to CPs (both Ps < 0.001). Significant positive correlations (r = 0.168–0.437) were identified among all paired variables in CP-FC dyads (all Ps < 0.001). To some extent, dyads’ self-efficacy influences dyads’ MCS and PCS through improving positive emotions (benefit finding) and relieving negative emotions (anxiety and depression). Conclusions. Study findings not only support the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in CP-FC dyads but confirm the hypothesis that dyads’ self-efficacy may impact their MCS/PCS via an indirect approach to improve benefit finding and relieve anxiety and/or depression in CP-FC dyads.

The 22-Item Benefit Finding Scale: Validation and Application among Patients with Cervical Cancer in Ethnic Minority Areas of Southwestern China

Recently, the Benefit Finding Scale (BFS) has been translated and culturally adapted for use in China. However, further validation of the instrument is required before it can be used in the management of patients with cervical cancer in China. In this study, we conducted the questionnaire survey and examined its properties. This methodological study was conducted at a tumor hospital located in southwestern China. Patients with cervical cancer who had been reexamined in the outpatient department of the hospital and hospitalized from June to August 2019 were selected. The item analysis, exploratory factor analysis (EFA), and reliability analysis were tested. The relationships between benefit finding and sociodemographic and disease-related variables were analyzed by ANOVA and regression models. A total of 247 patients were assessed (mean age: 48.0 ± 13.3 years). Educational level, self-perceived disease severity, and physical exercise were the predictors of benefit finding. The correlation coefficient between 22 items and their dimensions was the best. EFA analysis supported a five-factor model for structure validity. All Cronbach's alpha for the Chinese version of the BFS (BFS-C) was greater than 0.80. The results demonstrated the good reliability and validity of BFS-C. It appears to be a useful scale to assess experience of benefit finding among patients with cervical cancer in China.

The Experienced Benefits of the 17-Item Benefit Finding Scale in Chinese Colorectal Cancer Survivor and Spousal Caregiver Couples

The specific aims of the present study were twofold: (i) to examine the psychometric properties of a Chinese version of the 17-item Benefit Finding Scale (BFS-C), and (ii) to explore the experienced benefits in colorectal cancer (CRC) survivors and their spousal caregivers (SCs). A total of 286 CRC survivors and SCs participated in the investigation, which assessed participant variables of demographic characteristics and benefit finding (BF). Statistical methods applied were confirmatory factor analysis (CFA), Cronbach’s α, Pearson’s correlation, Kappa coefficient, paired t-tests, and one-way ANOVAs. CFA analysis supported a three-factor model for structure validity. All Cronbach’s α for BFS-C was greater than 0.870 in both CRC survivors and SCs. The test–retest correlations at the scale level ranged from good to excellent for CRC survivors (r = 0.752–0.922), and from moderate to good for SCs (r = 0.469–0.654). There were moderate to high correlations between CRC survivors and SCs in all of the paired BFs (all Ps < 0.001, r = 0.332–0.575). This report provided the satisfactory psychometric properties of the BFS-C in such aspects as construct validity, internal, and test–retest reliability among couples coping with CRC in China. Healthcare professionals need to treat couples as a unit and develop dyadic interventions to improve dyadic BF when supporting CRC survivors.

Validating the Chinese version of the Cancer Survivors' Partners Unmet Needs measure (C-CaSPUN) and exploring unmet needs in Chinese cancer survivor-family caregiver dyads

OBJECTIVES

To evaluate the psychometric properties of the C-CaSPUN in Chinese family caregivers (FCs) of cancer survivors (CaS) and to compare the unmet needs of CaS-FC dyads.

METHODS

A questionnaire survey, consisting of five Chinese version measurement scales, was used to collect data from CaS-FC dyads. Statistical methods used included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's α, intraclass correlation coefficient (ICC) and Pearson's correlation.

RESULTS

Participants consisted of 610 survivor-caregiver dyads. EFA and CFA established the four-factor construct C-CaSPUN, comprising relationship impact and life perspective, information and health care, quality of life (QoL) and survivorship care. All of the C-CaSPUN scales had good internal reliability (Cronbach's α ≥ 0.752). The ICC for test-retest ranged from 0.645 to 0.782 at the scale level, with an average ICC value of 0.653. The concurrent validity was evidenced by C-CaSPUN being negatively associated with SF-12 MCS and positively related to anxiety and/or depression. In addition, the correlation coefficient scores between C-CaSPUN factors and the C-CaSUN total scale ranged from moderate to good (r = 0.505-0.671).

CONCLUSIONS

Study findings may support the reliability and validity of the C-CaSPUN in measuring the unmet needs of FCs of Chinese CaS.

The Benefit Finding Questionnaire (BFQ): Scale Development, Validation, and Its Psychometric Properties Among People with Mental Illness

Benefit finding has been defined as positive life changes that result from a stressful event, such as the diagnosis of chronic illness. The present study aimed to develop a benefit finding questionnaire (BFQ) and examine its psychometric property among people with chronic mental illness in Japan. This study adopted a mixed method composed of three phases, including Phase 1: To draft the item pool and design the BFQ based on literature review and discussion among the authors, Phase 2: To revise and refine the drafted items through feedback from focus group interviews and further consideration, and Phase 3: To examine the psychometric properties of the BFQ following the questionnaire survey for people with chronic mental illness and validation of the questionnaire. In Phase 3, a cross-sectional, self-administered questionnaire survey was conducted for mental health service users. Among the 373 eligible participants, we used data from 265 respondents for the analyses (valid response rate = 71.0%). About 65% were male, and the average age was 45.3 years (SD = 12.9). Around 70% were diagnosed with schizophrenia. Factorial, concurrent, and divergent validities, as well as reliability were explored. The 21-item BFQ demonstrated good factorial validity, concurrent and divergent validities, and sufficient internal consistency reliability among people with chronic mental illness. It appears to be a useful scale to assess experience of benefit finding among people with chronic mental illness. Further large-scale research will ensure verification of the scale among people with other illnesses or difficulties.

The dyadic relationship of benefit finding and its impact on quality of life in colorectal cancer survivor and spousal caregiver couples

OBJECTIVES

To explore the benefit finding (BF) relationship between colorectal cancer (CRC) survivors and their spousal caregivers, and to discover the dyadic impact of BF on quality of life (QOL) in CRC survivor and spousal caregiver couples.

METHODS

Conducted from May 2018 to December 2018, the study included 286 couples consisting of CRC survivors and their spousal caregivers. The study survey evaluated participants' BF, anxiety, depression, and QOL. Data analysis methods included Pearson's correlation, paired t test, and the actor-partner interdependence mediation model (APIMeM).

RESULTS

CRC survivors and spousal caregivers reported comparable moderate to high BF experience (ranging from 68.9 to 80.8%). Moderate to high correlations were found between CRC survivors and their spousal caregivers in all of the paired BFs (including the overall BF scale and three factors) (all Ps < 0.001, r = 0.461-0.612). We found significant positive correlations of the same measures between dyads of CRC survivors and spousal caregivers (r = 0.331-0.612), including BFS-C (overall BF scale and three subscales), HADS-C (anxiety and depression), PCS, and MCS. To a certain degree, BF exerts an impact on couples' QOL through the mediating effect of psychological distress (anxiety and depression).

CONCLUSIONS

The present study further confirms the dyadic interdependence between BF, anxiety, depression, and QOL in couples coping with CRC. In addition, the APIMeM findings may support the proposed mechanism, in that buffering against negative emotions (psychological distress) is an approach in which BF plays an important role, e.g., improves QOL, in the context of a stressful process.

Psychometric properties of the Chinese version of the cancer survivors' unmet needs measure

PURPOSE

Recognition has been growing that when developing effective and affordable survivorship care programmes, it is crucial to assess cancer survivors' unmet needs. The purpose of this study was to evaluate the psychometric properties, including construct validity, internal consistency, test-retest reliability, and concurrent validity, of the Chinese version of the Cancer Survivors' Unmet Needs measure (C-CaSUN) using a sample of Chinese adult cancer survivors.

METHOD

A test battery, consisting of a self-developed information sheet and four Chinese version measurement scales [CaSUN, the Benefit Finding Scale, Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 12-item Short Form (SF-12)], was applied to collect data from Chinese adult cancer survivors. Statistics methods used included exploratory factor analysis, confirmatory factor analysis, Cronbach's coefficient α, Pearson's correlation, and Kappa coefficient.

RESULTS

There were 610 cancer survivors. Factor analysis confirmed the five-factor model of C-CaSUN, including information and medical care, life perspective, relationship, comprehensive support, and quality of life. Cronbach's α for all of the C-CaSUN scales was greater than 0.845. The test-retest correlations at the scale level, including the total and the five factors between the two time points, ranged from good to excellent (r = 0.713-0.833). The average Kappa coefficient at the item level was 44%. Evidence of significant negative correlations with SF-12 MCS, and positive correlations with anxiety and depression, established the concurrent validity of the C-CaSUN.

CONCLUSIONS

Evidence indicates that the C-CaSUN is a reliable and valid measure of unmet needs in Chinese cancer survivors. Findings support the five-factor construct of C-CaSUN.

Making sense of loss through spirituality: Perspectives of African American family members who have experienced the death of a close family member to cancer

OBJECTIVE

Among African Americans, spirituality is meaning or purpose in life and a faith in God who is in control of health and there to provide support and guidance in illness situations. Using qualitative methods, we explored the use of spirituality to make sense of the end-of-life and bereavement experiences among family members of a deceased cancer patient.

METHOD

Data in this report come from 19 African Americans who experienced the loss of a family member to cancer. A qualitative descriptive design was used with criterion sampling, open-ended semistructured interviews, and qualitative content analysis.

RESULTS

Participants made sense of the death of their loved one using the following five themes: Ready for life after death; I was there; I live to honor their memory; God's wisdom is infinite; and God prepares you and brings you through. These five themes are grounded in conceptualizations of spirituality as connectedness to God, self, and others.Significance of resultsOur findings support the results that even during bereavement, spirituality is important in the lives of African Americans. African American family members might struggle with issues related to life after death, their ability to be physically present during end-of-life care, and disentangling beliefs around God's control over the beginning and ending of life. The findings in this report can be used to inform healthcare providers to better support and address the needs for support of African American family members during end-of-life and bereavement experiences.