Grief care competence among nurses and nursing students: A scoping review

To synthesise how grief care competence is enacted, assessed, shaped and developed among nurses and nursing students and propose an evidence-informed conceptual framework.

Grief care is required across settings, yet competence is inconsistently defined, inferred from non-equivalent proxies and not integrated across practice, assessment, associated factors and education.

Scoping review.

Guided by the Arksey and O'Malley framework and reported according to PRISMA-ScR, seven databases were searched for evidence published from 1 January 2001-30 June 2026. Two reviewers independently screened records and charted data. Forty sources were synthesised using directed-inductive thematic analysis.

Five functions characterised enacted competence: recognising grief-related needs; compassionate communication; cultural, spiritual and meaning-oriented support; coordination and follow-up; and reflective emotional regulation. Instruments reported internal consistency coefficients of 0.70-0.981 but predominantly used self-report and measured isolated proxies rather than observed, cross-context competence. Competence was associated with individual resources, clinical experience, interpersonal relationships, education and organisational support; self-efficacy, reflection and emotional regulation emerged as potential learning mechanisms. Simulation, blended learning and reflective interventions reported mainly immediate improvements, whereas sustained clinical behaviour and patient- or family-centred outcomes were rarely evaluated. Cross-domain synthesis linked competence development with assessment and enactment in practice.

Grief care competence is a dynamic, context-sensitive capability rather than a collection of isolated attributes. Nursing curricula should combine staged experiential learning and multimethod assessment with organisational support for transfer into practice. Longitudinal, multicentre and cross-cultural studies are needed to test the framework and develop performance-based measures.