Development and validation of the Neuro-Oncology Grief Index

Grief among neuro-oncology healthcare providers (NOPs) affects emotional resilience, professional performance, and patient care. This study adapted and validated the 30-item Neuro-Oncology Grief Index (NOGI) to assess grief experiences and coping strategies in NOPs after patient loss.

A cross-sectional design was used to adapt the NOGI through item generation, expert review, and field testing. Psychometric properties were evaluated via exploratory factor analysis, internal consistency using Cronbach's alpha, and stepwise regression was performed using variables that were significantly associated with provider grief to determine their predictive value and the amount of variance.

The sample comprised 80 NOPs (68% female, 75% white, 62% with >5 years' experience). An exploratory factor analysis identified a single factor for the grief scale. Internal consistency was acceptable with Cronbach's alpha = .92. High grief was linked to frequent patient deaths, burnout, and compassion fatigue. Adverse coping behaviors, like staying overly busy or isolating, were common; 58% of NOPs avoided emotional support due to workplace norms. Regression analysis identified past-year risk factors, provider protective factors, and adverse behavioral risks as significant predictors of grief.

The NOGI is a reliable, valid tool for assessing NOP grief, highlighting emotional grief, burnout, compassion fatigue, and coping strategies. Interventions addressing emotional support, burnout, and workplace norms are needed to enhance provider well-being and patient care. Future research should further validate the NOGI and address compassion fatigue and emotional support access.