A study of miscarriage: development and validation of the Perinatal Grief Intensity Scale.

OBJECTIVE: This article outlines the development of the Perinatal Grief Intensity Scale (PGIS). It is based on a theoretical model developed to predict intensity of grief response to early pregnancy loss. DESIGN: Participants completed the PGIS by mail and made an overall assessment of their grief intensity by completing a single Likert-type item. PARTICIPANTS: A convenience sample of 186 women who had experienced a miscarriage before 16 weeks gestation in the previous 12-18 months. RESULTS: Fourteen items were retained after factor analyses, loading at .4 or greater. The 14 items loaded on a three-factor solution as predicted and accounted for 65% of the variance. Three factors were found to influence intensity of grieving: Reality of the pregnancy and baby within (Reality), congruence between the actual miscarriage experience and the woman's standard of the desirable (Congruence), and the ability of parents to make decisions or act in ways to increase this congruence (Confront Others). Chronbach's alpha for the entire instrument was .82, with subscale reliability scores of .89 (Reality), .84 (Confront Others), and .71 (Congruence). CONCLUSION: The PGIS demonstrates acceptable beginning reliability and validity in predicting grief intensity. Further testing of the instrument is needed with all types of pregnancy losses. The level of score needed to predict intense responses also needs to be determined.