Psychometric Validation of the Grief State Scale for Nurses

Abstract

To assess the reliability and validity of the Grief State Scale for Nurses (GSSN) at a Military Hospital in Saudi Arabia. This questionnaire-based cross-sectional psychometric validation study was conducted between December 2023 and February 2024 among nurses working at a military hospital in Jeddah, Saudi Arabia. Eligible participants were nurses from different clinical wards who had experienced patient death during working hours. Data were collected using the GSSN, a 31-item self-report instrument assessing grief traits and grief states. The scale has been previously used in research examining grief and coping strategies among nurses dealing with patient deaths. A total of 382 nurses completed the survey, of whom 342 were included in the final analysis. Data were analysed using the Statistical Package for the Social Sciences and analysis of moment structures (AMOS) version 28.0. Internal consistency reliability was assessed using Cronbach’s alpha. Construct validity was examined using confirmatory factor analysis within structural equation modeling. Convergent and divergent validity were also assessed to evaluate the psychometric properties of the scale. Of the 342 nurses who experienced patient death, 56.7% were aged 25–35 years, 86.5% were female, and 55% were married. Cronbach’s alpha if item deleted ranged from 0.879 to 0.896, while the overall Cronbach’s alpha was 0.888. Confirmatory factor analysis demonstrated mixed model-fit indices, with acceptable incremental fit indices but a marginal RMSEA (0.093). The GSSN demonstrated acceptable reliability and construct validity among nurses who experienced patient death at a military hospital in Saudi Arabia. Further validation in larger, multicentre and culturally diverse samples is recommended.