There is great variation in individuals' adjustments to the death of a loved one from an illness. Some recently bereaved individuals show marked declines in physical and emotional health, whereas others do not. The proposed study is designed to investigate the influence of several psychosocial factors on individuals' who have a terminally ill loved one, and who are associated with local hospices. Our choice of the variables we believe will predict which individuals show long term physical and emotional illness has been based on general psychosocial models of the relationship between stress and health. According to these models, persons who are at highest risk for long-term physical and emotional disturbance following stress are characterized by a maladaptive, pessimistic style of explaining the events in their lives, poor social supports, and inactive, emotion-focused coping styles. Thus, we shall assess these characteristics in subjects before the death of their loved one, and then use them to predict which subjects will show the poorest physical and emotional health at one, six, thirteen, and eighteen months following the death. In addition, we shall assess several other variables that may mediate subjects' abilities to adjust to bereavement. These include the financial resources available to subjects and the financial burden incurred as a result of the patient's illness and death, the amount of responsibility each subject had for the care of the ill patient, the number of other stressor experienced around the time of the death, and pre-existing physical or emotional illness in the subjects. Each of these factors should contribute to subjects' subjective experience of stress, but the effects of these factors on emotional and physical health outcomes should be mediated by social supports, coping styles, and explanatory styles.
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