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The Grief Support in Healthcare Scale: Development and Testing

Anderson, Keith A.; Ewen, Heidi H.; Miles, Elizabeth A.

doi: 10.1097/NNR.0b013e3181fca9de

Background: Social support is an important factor to consider in understanding the grief process. However, existing measures of social support fail to account adequately for the unique characteristics of grief experienced by healthcare workers in relation to the deaths of patients or nursing home residents.

Objective: The purposes of this study were to develop and to test a grief support measure specific to the experiences of healthcare workers.

Methods: Using a cross-sectional design, 380 nursing assistants completed self-administered surveys focusing on grief and loss in the nursing home setting. Exploratory factor analysis and regression analysis were conducted to test the psychometric properties of the Grief Support in Healthcare Scale (GSHCS) and to investigate the scale's relationships with grief outcomes.

Results: Reflective of the theory of disenfranchised grief, the 15 items of the GSHCS were loaded onto three distinct factors: recognition of the relationship, acknowledgement of the loss, and inclusion of the griever. Reliability was acceptable to high across these factors (Cronbach's α of .89, .86, and .78, respectively). Regression analysis indicated that the three subscales of the GSHCS were related significantly to both distress from grief and growth from grief, yet these relationships were unique for each factor.

Discussion: This research demonstrated that the GSHCS has acceptable reliability and face validity for understanding grief in healthcare workers and may aid in the development of interventions targeted at enfranchising grief in this population. Additional testing is needed to estimate the validity and the reliability of the scale with other groups of healthcare workers.

Keith A. Anderson, PhD, is Assistant Professor, College of Social Work, The Ohio State University, Columbus.

Heidi H. Ewen, PhD, is Assistant Professor, Department of Sociology and Gerontology, Miami University, Oxford, Ohio.

Elizabeth A. Miles, MSW, is Graduate Student, College of Social Work, The Ohio State University, Columbus.

Accepted for publication September 3, 2010.

Corresponding author: Keith A. Anderson, PhD, College of Social Work, The Ohio State University, 1947 College Rd., Columbus, OH 43210-1162 (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.