Translation and Psychometric Evaluation of the Professional Bereavement Scale - German Version (PBS-D) among Psycho-oncologists in Germany

Background: Professional grief – the emotional response to patient death among healthcare professionals – remains insufficiently understood. To gain better understanding psychometrically sound measures are crucial. The Professional Bereavement Scale (PBS) is the first instrument specifically designed to measure professional grief, but lacks validation beyond Chinese populations. This study aimed to translate, culturally adapt, and validate the PBS into German (PBS-D) and assess its psychometric properties among psycho-oncologists in Germany. Methods: First, the PBS was translated and culturally adapted following the TRAPD methodology. Then, to assess psychometric properties, data were collected using a cross-sectional online survey. Psychometric evaluation included item analysis, internal consistency, structural validity (confirmatory factor analysis), and convergent validity assessed using the Texas Revised Inventory of Grief and the Professional Quality of Life scale. Results: The PBS-D was developed through iterative translation, expert review, and cognitive testing, confirming the presence all three aspects of content validity (relevance, completeness, comprehensiveness). Among 258 eligible participants (91% female; mean age 48 years), the PBS-D demonstrated acceptable overall reliability for both major subscales. However, analyses of inter-item correlations revealed some internal inconsistencies within the scales, ranging from -.091 to .860, including negative correlations suggesting conceptual heterogeneity. The subscale concerning short term bereavement demonstrated robust convergent validity with another grief measure (r = .594). However, confirmatory factor analysis revealed insufficient structural validity. Conclusions: The PBS-D provides a solid foundation for assessing professional grief in German healthcare settings, demonstrating good reliability and convergent validity for core constructs. However, significant challenges regarding structural validity emerged. The instrument requires validation across diverse healthcare professions before it can be used routinely. Until then, subscale scores rather than total scores should be computed, with particular attention to professional role characteristics that influence the relevance of the grief dimension.