Finding Benefit in Bereavement among Family Cancer Caregivers Youngmee Kim, PhD 1 Charles S. Carver, PhD, 1 Richard Schulz, PhD, 2 Aurelie Lucette, MA, 1 and Rachel S. Cannady, BS 3 Abstract Background and Objective: Even though cancer is the second most common cause of death, little is known about the extent to which family caregivers find meaning and benefit in the loss, and associated demographic char- acteristics and caregiving experiences. This study addressed this gap in our knowledge. Design and Subjects: Family caregivers participated in a nationwide survey for cancer caregivers two years after the relative’s diagnosis (T1). Of those, 121 were identified as bereaved by five years postdiagnosis (T2) and provided valid data for the study variables. Participants were primarily middle-aged, spouse of the deceased, and bereaved for an average of 2.9 years. Measurements: Perceived caregiving stress, caregiver esteem, and patient’s cancer severity as indicators of initial caregiving stressors and caregivers’ demographics were measured at T1. Social support and time since bereave- ment as indicators of current resources and benefit finding in bereavement as an outcome were measured at T2. Results: Reports of personal growth from bereavement emerged in multiple domains, although some caregivers were less likely to find benefit: nonspousal caregivers who had greater caregiving stress and spousal caregivers with lack of social support. Conclusions: Findings suggest that bereavement programs designed to help bereaved caregivers find meaning in the loss should be personalized reflecting individual differences in caregiving stress and caregiver esteem. Such programs should also be tailored differently for spousal versus nonspousal caregivers. Introduction C ancer is the second leading cause of death: more than 570,000 die from cancer each year in the United States. 1 A cancer diagnosis immediately evokes existential apprehen- sions and concerns both among the patients and their family members and close friends. Family members not only expe- rience heightened levels of psychological distress, but also find benefit in the challenges associated with the cancer in the family. Different terminologies (e.g., benefit finding, post- traumatic growth, stress-related growth) have been used to describe the phenomenon of personal growth or positive changes following an encounter with a challenging or trau- matic life experience. 2–4 We will use the term benefit finding here to refer to this phenomenon. Most studies of benefit finding in the experience of cancer have focused on the patients, 5–8 but a few studies have ex- amined benefit finding among family members, 9,10 mostly spouses of breast cancer patients assessed while the patients were alive. For example, husbands reported benefit finding one to five years after their wives’ breast cancer diagnosis. 4,11 Caregivers reported personal growth from providing care to a family member with various types of cancer 12 and other ill- nesses, such as HIV/AIDS 13 and multiple sclerosis. 14 What happens when caregiving gives way to bereavement? Existing bereavement studies are mostly mixed with regard to cause of death. These studies have found that bereaved family members often search for new hope, meaning, and purpose in life, both in qualitative 15–17 and quantitative studies. 18–21 Only a few studies examined benefit finding in bereavement fo- cused on cancer caregivers and prospectively investigated the effects of initial caregiving experiences on benefit finding in bereavement, however. Predictors of benefit finding in bereavement The main goal of this study was to examine predictors of benefit finding after the relative’s death. Both theory 22 and evidence suggest that greater challenges may promote greater benefit finding. For bereaved caregivers, prior caregiving 1 Department of Psychology, University of Miami, Coral Gables, Florida. 2 Department of Psychiatriy, University of Pittsburgh, Pittsburgh, Pennsylvania. 3 American Cancer Society, Atlanta, Georgia. Accepted March 26, 2013. JOURNAL OF PALLIATIVE MEDICINE Volume 16, Number 9, 2013 ª Mary Ann Liebert, Inc. DOI: 10.1089/jpm.2013.0049 1040