Understanding Disenfranchised Grief in a Post–COVID-19 World—A Pilot Study of Advanced Practice Registered Nurses in Palliative Care

Abstract

Disenfranchised grief is a form of grief that remains unacknowledged and unsupportive. Building on Doka’s foundational concept of disenfranchised grief, the guiding framework for this pilot project was the Knowledge to Action framework. This study is a quantitative cross-sectional web-based survey, which included a validated questionnaire: the Witnessing Disenfranchised Grief Scale. The Witnessing Disenfranchised Grief Scale measures how participants feel their grief is recognized and validated by friends and family versus administrators or supervisors. A χ 2 analysis (P < .05) was completed with findings suggesting that palliative care advanced practice registered nurses broadly experienced higher levels of support from witness C types (colleagues, coworkers, family, or friends) when compared with witness A types (supervisors, bosses, or persons with administrative responsibility). A 2-sample t test also demonstrated significance when comparing both witness groups. Overall mean scores were significantly higher (P < .001) in the witness C group (mean, 68.7) versus the witness A group (mean, 51.2). Higher mean scores indicate a higher level of support reported by the participant. The findings affirm that advanced practice registered nurses working in palliative care continue to grieve both death and non–death-related losses and report a higher degree of witnessed grief by their friends, family members, and colleagues. Participants’ supervisors, bosses, or administrators provide less grief acknowledgment.