Validation of the Korean version of the Utrecht Grief Rumination Scale and its relationship with COVID-related hypochondriasis among healthcare workers who witnessed patient deaths

Abstract

Introduction: This study aimed to examine the reliability and validity of the Korean version of the Utrecht Grief Rumination Scale (UGRS) among healthcare workers who witnessed patient deaths. We also examined whether grief rumination may impact the cognitive-behavioral model of hypochondriasis.

Methods: This study was conducted via an anonymous online survey targeting healthcare workers who had worked at a tertiary hospital and had witnessed patient deaths over the previous 2 years. Demographic data and responses to the UGRS, the Pandemic Grief Scale (PGS) for healthcare workers, the Stress and Anxiety to Viral Epidemic-9 (SAVE-9), the Obsession with COVID-19 Scale (OCS), and the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS) were collected by requesting participants to recall their emotional state during the 2 weeks after witnessing a patient's death.

Results: The Korean version of the UGRS is reliable (Cronbach's alpha = 0.941) and valid (comparative fit index = 0.920, Tucker-Lewis index = 0.900, root-mean-square-error of approximation = 0.102, standardized root-mean-square residual = 0.050) for measuring grief rumination in healthcare workers. The OCS was predicted by CRBS (β = 0.19, p < 0.001), SAVE-9 (β = 0.45, p < 0.001), UGRS (β = 0.16, p = 0.010), and PGS (β = 0.16, p = 0.010, adjusted R2 = 0.49, F = 52.9, p < 0.001). In mediation analysis, grief rumination directly influenced coronavirus preoccupation; the relationship was mediated by viral anxiety and coronavirus reassurance-seeking behavior.

Conclusion: Grief rumination of healthcare workers who witnessed patient death requires further exploration as it may influence hypochondriacal responses.