Background: Responses to bereavement may be influenced by characteristics such as age or gender, but also by factors like culture and religion. Aim: A systematic review was undertaken to assess whether spiritual or religious beliefs alter the process of grief and/or bereavement. Methods: Fifteen computerized databases were searched. Thirty-two studies met the inclusion criteria. Evidence was graded according to the standard grading system of the Clinical Outcomes Group and by the SIGNAL score. Results: In total, 5715 persons were examined: 69% women, 87% white, 83% protestant. Ninety-four percent of studies show some positive effects of religious/spiritual beliefs on bereavement, but there was a great heterogeneity regarding included populations and outcome measurements. Conclusion: Available data do not allow for a definite answer on whether religious/spiritual beliefs effectively influence bereavement as most studies suffer from weaknesses in design and methodological flaws. Further research is needed. Recommendations for further research are given. Palliative Medicine 2007; 21: 207—217
Sloan RP, Bagiella E., Powell T.Religion, spirituality, and medicine. Lancet1999; 353: 664—67.
2.
Thoresen CESpirituality and health: Is there a relationship?J Health Psychol1999; 4: 291—300.
3.
Lukoff D., Provenzano R., Lu Ftr.Religious and spiritual case reports on Medline: A systematic analysis of records from 1980—1996. Altern Therap Health Med1999; 5: 64—70.
4.
Chochinov HMDying, dignity, and new horizons in palliative end-of-life care. CA Cancer J Clin2006; 56: 84—103.
5.
Sloan RR, Bagiella E.Claims about religious involvement and health outcomes. AnnalsBehav Med2002; 24: 14—21.
6.
Powell LH, Shahabi L., Thoresen CEReligion and spirituality. Linkages to physical health. Am Psychol2003; 58: 36—52.
7.
Seeman T., Dubin LF, Seemann M.Religiosity/spirituality and health: A critical review of the evidence for biological pathways. Am Psychol2003; 58: 53—63.
8.
National Institute for Clinical Excellence (ed.). Improving supportive and palliative care for adults with cancer. London, available at http://www.nice.org.uk.as cited in Speck P., Higginson I., Addington-Hall J.Spiritual needs in health care. Br Med J2004; 329: 123—24.
9.
World Health Organisation (ed.). National cancer control programmes: policies and managerial guidelines. Geneva, 2002: 84.
10.
Kissane DWBereavement. In Doyle D, Hanks G., Cherny NI, Calman K eds. Oxford textbook of palliative medicine. Oxford University Press, 2003 : 1137—50.
11.
Koffman J., Higginson IJReligious faith and support at the end of life: a comparison of first generation black Caribbean and white populations. Palliat Med2002; 16: 540—41.
12.
Feher S., Maly R.Coping with breast cancer in later life: the role of religious faith. Psychooncology1999; 8: 406—16.
13.
Johnston TE, Outlaw FB, Bernardo T., Roy A.Spiritual conflicts associated with praying about cancer. Psychooncology1999; 8: 386—94.
14.
Stroebe M., Hansson Rsw, Schut H.Handbook of bereavement: consequences, coping and care. American Psychologists Association, 2001.
15.
Stroebe MS, Stroebe W., Hansson ROHandbook of bereavement. Cambridge University Press, 1993.
16.
Consort-statement. QUOROM. Available at http://www.consort-statement.org/QUOROM.pdf (accessed 29 November, 2005).
17.
Mann T.Clinical guidelines: using clinical guidelines to improve patient care with theNHS. NHS Executive, 1996.
18.
Russell IT, Di Blasi Z., Lambert M., Russel D.Systematic reviews and meta-analyses: opportunities and threats. In Templeton AA, Cooke ID, O'Brien PMS eds. Evidence based fertility treatment. Royal College of Obstetricians & Gynaecologists, 1998.
19.
Finlay IG, Higginson IJ, Goodwin DM et al. Palliative care in hospital, hospice, at home: results from a systematic review. European Society for MedicalOncology2002: 257—64.
20.
Last JMA dictionary of epidemiology. Oxford University Press, 2001.
21.
Austin D., Lennings C.Grief and religious belief: does belief moderate depression? Death Stud1993; 17: 487—96.
22.
Balk DESibling death, adolescent bereavement, and religion. Death Stud1991; 15: 1—20.
23.
Balk DEDeath, bereavement and college students: a descriptive analysis. Mortality1997; 2: 207—20.
24.
Bohannon JRReligiosity related to grief levels of bereaved mothers and fathers. Omega (Westport) 1991; 23: 153—59.
25.
Brown SL, Nesse RM, House JS, Utz RLReligion and emotional compensation: results from a prospective study of widowhood . Pers Soc Psychol Bull2004; 30: 1165—74.
26.
Carr DSBlack/white differences in psychological adjustment to spousal loss among older adults. Res Aging2004; 26: 591—622.
27.
Cartwright A.Is religion a help around the time of death?Public Health1991; 105: 79—87.
28.
Clarke SM, Hayslip BJ, Edmondson R., Guarnaccia CAReligiosity, afterlife beliefs, and bereavement adjustment in adulthood. J ReligGerontol2003; 14: 207—24.
29.
Davis CG, Nolen-Hoeksema S.Loss and meaning: How do people make sense of loss?Am Behav Sci2001; 44: 726—41.
30.
Easterling LW, Gamino LA, Sewell KW, Stirman LSSpiritual experience, church attendance, and bereavement. J Pastoral Care2000; 54: 263—75.
Fry PSThe unique contribution of key existential factors to the prediction of psychological well-being of older adults following spousal loss. Gerontologist2001; 41: 69—81.
33.
Gilbert KRReligion as a resource for bereaved parents. J Relig Health1992; 31: 19—30.
34.
Golsworthy R., Coyle A.Spiritual beliefs and the search for meaning among older adults following partner loss. Mortality1999; 4: 21—40.
35.
Higgins MPParental bereavement and religious factors. Omega (Westport) 2002; 45: 187—207.
36.
Levy IH, Martinkowski KS, Derby JFDifferences in patterns of adaptation in conjugal bereavement: their sources and potential significance. Omega (Westport ) 1994; 29: 71—87.
37.
McIntosh DN , Silver RC, Wortman CBReligion's role in adjustment to a negative life event: coping with the loss of a child. J Pers Soc Psychol1993; 65: 812—21.
38.
Michael ST, Crowther MR, Schmid B., Allen RSWidowhood and spirituality: coping responses to bereavement. J Women Aging2003; 15: 145—65.
39.
Murphy SA, Johnson LCFinding meaning in a child's violent death: a five-year prospective analysis of parents' personal narratives and empirical data. Death Stud2003; 27: 381—404.
40.
Oram D., Bartholomew K., Landolt MACoping with multiple AIDS-related loss among gay men. Journal of Gay & Lesbian Social Services2004; 16: 59—72.
41.
Pearce MJ, Chen J., Silverman GK, Kasl SV, Rosenheck R., Prigerson HGReligious coping, health, and health service use among bereaved adults. Int J Psychiatry Med2002; 32: 179—99.
42.
Richards TA , Folkman S.Spiritual aspects of loss at the time of a partner's death from AIDS. Death Stud1997 ; 21: 527—52.
43.
Scharlach AE , Fuller-Thomson E.Coping strategies following the death of an elderly parent. J Gerontol Soc Work1994; 21: 85—100.
44.
Schwab R.Paternal and maternal coping with the death of a child. Death Stud1990; 14: 407—22.
45.
Sherkat DE, Reed MDThe effects of religion and social support on self-esteem and depression among the suddenly bereaved. Soc Indic Res1992; 26: 259—75.
46.
Smith PC, Range LM, Ulmer A.Belief in afterlife as a buffer in suicidal and other bereavement. Omega (Westport) 1991— 1992; 24: 217—25.
47.
Smith SH `Fret no more my child for I'm all over heaven all day': religious beliefs in the bereavement of African American, middle-aged daughters coping with the death of an elderly mother. Death Stud2002; 26: 309—23.
48.
Swanson PB, Pearsall-Jones JG, Hay DAHow mothers cope with the death of a twin or higher multiple. Twin Res2002; 5: 156—64.
49.
Tarakeshwar N., Stanton J., Pargament KIReligion: an overlooked dimension in cross-cultural psychology. J Cross-Cult Psychol2005; 34: 377—94.
50.
Thearle MJ, Vance JC, Najman JM, Embelton G., Foster WJChurch attendance, religious affiliation and parental responses to sudden infant death, neonatal death and still-birth. Omega (Westport) 1995; 31: 51—58.
51.
Thompson MP , Vardaman PJThe role of religion in coping with the loss of a family member to homicide. J Sci Study Relig2001; 36: 44—51.
52.
Walsh K., King M., Jones L., Tookman A., Blizard R.Spiritual beliefs may affect outcome of bereavement: a prospective study. Br Med J2002; 324: 1551—55.
53.
Harris Interactive Inc.Harris Poll: the religious and other beliefs of Americans. Available at http://www.harrisinteractive.com/harris_poll/index.asp?PID=3592003 (accessed 29 September 2005).
54.
Gallup GH, Lindsay DMSurveying the religious landscape: trends in U.S. beliefs. Morehouse Publishing, 1999.
55.
Marler PL, Hadaway CK “ Being religious” or being “spiritual” in America: a zero-sum proposition?J Sci Study Relig2002; 41: 289—300.
56.
Verweij J., Ester P, Nauta Rein.Secularization as an economic and cultural phenomenon: a cross-national analysis. J Sci Study Relig1997; 36: 309—24.
57.
Davie G.Believing without belonging: Is this the future of religion in Britain?Soc Compass1990; 37: 455—69.
58.
APD Schweiz. Available at www.nadeshda.org/foren/ cl.regionen.nordamerika/p933s939a (accessed 26 November 2005).
59.
Pollack D., Pickel G.Räumliche Aspekte für religiöse Bindungen in Ostdeutschland im Vergleich zu Westdeutschland, 2003. Available at http://www.kuwi.euv-frankfurt-o.de (accessed 29 September 2005 ).
60.
O'Connor TS , Meakes E., McCarroll-Butler P., Gadowsky S., O'Neill K.Making the most and making sense: Ethnographic research on spirituality in palliative care . J Pastoral Care1997; 51: 25—36.
61.
Oxford English Dictionary. ` Spirituality' in Oxford English Dictionary. Oxford University Press, 1989.
62.
Unruh AM, Versnel J., Kerr N.Spirituality unplugged: a review of commonalities and contentions, and a resolution . Can J Occupational Ther2002; 69: 5—19.
63.
Sinclair S. , Pereira J., Raffin S.A thematic review of the spirituality literature within palliative care. J Palliat Med2006 ; 9: 464—79.
64.
Mehnert A., Rieß S., Koch U.Die Rolle religiöser Glaubensüberzeugungen bei der Krankheitsbewältigung maligner Melanome. Verhaltenstherapie und Verhaltensmedizin2003; 24: 147—66.
65.
Allport GW, Ross JMPersonal religious orientation and prejudice. J Pers Soc Psychol1967; 5: 432—43.
66.
Stroebe MSReligion in coping with bereavement: confidence of convictions or scientific scrutiny?Int J Psychol Relig2004; 14: 23—36.
67.
Bowling A.Research methods in health. Open University Press, 2002.
68.
Stroebe MS, Schut H.Culture and grief. Bereavement Care1998; 17: 7—10.
69.
Walter T.On bereavement. Open University Press, 1999.
70.
Rosenblatt PCGrief: The social context of private feelings . In Stroebe MS, Stroebe W, Hansson RO eds. Handbook of bereavement. Theory, research, and intervention. Cambridge University Press, 1993: 102—11.
71.
Mantala-Bozos KIThe role of religion and culture on bereavement: the example of the Orthodox Christian tradition. Journal of Critical Psychology, Counselling andPsychotherapy2003; 3: 96—110.
