Validation and Refinement of the Short Version of Perinatal Grief Scale in Chinese Women Who Experience Perianal Loss: A Psychometric Study.
Open accessAbstract
Background: The Short Version of the Perinatal Grief Scale (SVPGS) is a widely used scale of grief related to perinatal loss. This study aims to validate and refine the SVPGS among Chinese women experiencing perinatal loss by addressing its psychometric properties. Methods: After translating the SVPGS from English to Chinese and conducting a pre‐test with 20 end‐users, followed by an assessment of content validity involving 10 experts, a cross‐sectional study was conducted to assess its internal reliability and structure, concurrent, convergent, divergent, known‐group validities among 353 women who have experienced perinatal loss across eight hospitals in Hunan Province, China. A subset of 275 participants were reassessed over a 1‐month interval for the test–retest reliability. Results: The refined 15‐item SVPGS demonstrated excellent internal consistency (Cronbach's α = 0.92) and strong 1‐month test–retest reliability (κ = 0.83) compared to the original SVPGS. A three‐factor structure consisting of 15 items was confirmed through item analysis, exploratory factor analysis, and parallel analysis. Confirmatory factor analysis further validated this structure, indicating a good fit for the refined SVPGS. Concurrent validity was supported by a large correlation between the SVPGS and refined SVPGS (r = 0.90, p < 0.01). Convergent and divergent validities were confirmed through significant correlations with variables including depressive symptoms, anxiety symptoms, and post‐traumatic stress disorder, psychological flexibility, mindfulness, self‐compassion, perceived social support, and quality of life. Known‐group validation revealed significant differences in these variables between high and low levels of the refined SVPGS. Conclusions: These findings indicate that the refined SVPGS is a brief, reliable, and valid tool for measuring grief in women who have experienced perinatal loss. Future research is strongly recommended to test the refined SVPGS across diverse samples and cultural contexts to enhance its generalizability.
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3 of 23 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Study design and conductcitation
A minimum of 330 participants was required for the study.
“A minimum of 330 participants was required for inclusion in this study.”
- Also stated in: § 2.2 | Participants and Sample Size Estimation · plain
“Given that the Perinatal Grief Scale comprises 33 items, this necessitates a minimum of 330 respondents.”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Kyriazos 2018 source
Section 4.1 (page unavailable) discusses minimum sample-size rules of thumb, including a suggested sample of 300, but does not specify 330. The paper provides general guidance for factor analysis and SEM, not an inclusion requirement for the citing study. (LLM, conf=0.82)
Experimental — accuracy not yet measured - cites Pett et al. 2003 source
- Also stated in: § 2.2 | Participants and Sample Size Estimation · plain
- Premisecitation
This finding is consistent with the original SVPGS developed by Potvin et al. (1989) and other psychometric evaluations in different countries and regions, such as Greek, Persian, and Hong Kong.
“This finding is consistent with the original SVPGS developed by Potvin et al. (1989) and other psychometric evaluation in different countries and regions, such as Greek (Maniatelli et al. 2018), Persia (Khoori et al. 2024), and Hong Kong (Yan et al. 2010).”
Quote in the paperSubstantial claim1 of 3 sources checked- cites Potvin et al. (1989) source
- cites Maniatelli et al. 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Khoori et al. 2024 source
The Dear Editor section identifies the authors as creators of a Persian Perinatal Grief Scale and says it underwent translation and validation. But this 2024 paper is a letter about how a modification affects scoring, not the original Persian psychometric evaluation; its References identify that evaluation as a 2018 study. The unspecified finding said to be ‘consistent’ cannot be checked against this source. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Findingown data
No sociodemographic variables were significantly correlated with refined SVPGS scores.
“No sociodemographic variables were identified as having a significant correlation with the refined SVPGS scores.”
Quote in the paperNot a substantial claim - Findingown data
The refined SVPGS has a test-retest reliability kappa of 0.83 over an 8-week interval.
“strong 1-month test-retest reliability (κ = 0.83)”
- Also stated in: § 3.2 | Internal Consistency and Stability of the 6-PAQ-C · plain
“the kappa value of the eight-week test-retest reliability of the refined SVPGS was 0.83 (range 0.80 [domain: difficulty coping] to 0.88 [domain: active grief]).”
Quote in the paperSubstantial claim - Also stated in: § 3.2 | Internal Consistency and Stability of the 6-PAQ-C · plain
- Findingown data
The refined SVPGS and original SVPGS subscales are positively correlated (r = 0.73 to 0.77, p < 0.01).
“as well as among their subscales (r ranged from 0.73 to 0.77, all p < 0.01; Table A2).”
Quote in the paperSubstantial claim
- Findingown data
The standardized factor loadings for all 15 items in the three-factor model were greater than 0.69, ranging from 0.69 to 0.89.
“the standardized factor loadings for all 15 items were greater than 0.69, ranging from 0.69 to 0.89 (Table A1).”
Quote in the paperSubstantial claim - Findingown data
The content validity of the translated SVPGS was strong, with I-CVI and S-CVI of 1.
“All items received ratings of ≥3, yielding an item-level content validity index (I-CVI) and a scale-level content validity index (S-CVI) of 1 for the translated version, indicating strong content validity.”
Quote in the paperSubstantial claim - Findingown data
The three-factor model of the refined SVPGS exhibits good fit to the data (χ2/df = 1.78, GFI = 0.95, RMSEA = 0.047, SRMR = 0.044, CFI = 0.98, NFI = 0.95, NNFI = 0.97, TLI = 0.97).
“Confirmatory factor analysis further validated this structure, indicating a good fit for the refined SVPGS.”
- Also stated in: § 3.3 | Structure Validity · boosted
“The results indicated that the three-factor model exhibited excellent overall fit to the data ( χ 2 /df = 1.78, p < 0.0001, GFI = 0.95, RMSEA = 0.047, SRMR = 0.044, CFI = 0.98, NFI = 0.95, NNFI = 0.97, and TLI = 0.97).”
Quote in the paperSubstantial claim - Also stated in: § 3.3 | Structure Validity · boosted
- Findingown data
Concurrent validity was supported by a large correlation between the SVPGS and refined SVPGS (r = 0.90, p < 0.01).
“Concurrent validity was supported by a large correlation between the SVPGS and refined SVPGS (r = 0.90, p < 0.01).”
- Also stated in: § 3.4 | Concurrent Validity · plain
“A statistically significant positive correlation was observed between the total scores of the two scales (Pearson's r = 0.90, p < 0.01)”
Quote in the paperSubstantial claim - Also stated in: § 3.4 | Concurrent Validity · plain
- Findingown data
Known-group validation revealed significant differences in these variables between high and low levels of the refined SVPGS.
“Known-group validation revealed significant differences in these variables between high and low levels of the refined SVPGS.”
Quote in the paperSubstantial claim- Rests on an assumption: The Chinese versions of the comparator instruments (PHQ-9, GAD-7, IES-R, Psy-Flex, MAAS, SCS-SF, MSPSS, WHOQOL-BREF) are valid for measuring their respective constructs in women who have experienced perinatal loss.
- Findingown data
The refined 15-item SVPGS has excellent internal consistency (Cronbach's α = 0.92).
“The refined 15-item SVPGS demonstrated excellent internal consistency (Cronbach's α = 0.92)”
- Also stated in: § 3.2 | Internal Consistency and Stability of the 6-PAQ-C · plain
“The Cronbach's α for the refined SVPGS and its subscales-active grief, difficulty coping, and despair-were 0.92, 0.87, 0.87, and 0.89, respectively.”
Quote in the paperSubstantial claim - Also stated in: § 3.2 | Internal Consistency and Stability of the 6-PAQ-C · plain
- Findingown data
Refined SVPGS mean scores negatively correlated with SCS-SF scores (r = -0.53, p < 0.01) in the sample.
“SCS-SF (self-compassion; mean = 40.63,SD = 9.21, r = -0.53,p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores positively correlated with IES-R scores (r = 0.66, p < 0.01) in the sample.
“IES-R (PTSD; mean = 38.20,SD = 17.86, r = 0.66, p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in PHQ-9 scores between the high and low grief groups (t = -19.69, p < 0.001).
“Significant differences were observed in the scores of the PHQ-9 (t = -19.69,p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores negatively correlated with MAAS scores (r = -0.52, p < 0.01) in the sample.
“MAAS (mindfulness; mean = 66.42,SD = 17.48, r = -0.52,p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
The mean refined SVPGS score among women with low levels of grief (refined SVPGS ≤ 30) was 31.16 (SD 5.14; n = 25).
“The mean score of the refined SVPGS among women with low levels of grief (refined SVPGS ≤ 30) was 31.16 (SD: 5.14; n = 25)”
Quote in the paperSubstantial claim - Findingown data
The mean refined SVPGS score among women with high levels of grief (refined SVPGS ≥ 60) was 63.35 (SD 6.18; n = 166).
“while the mean score for women with high levels of grief (refined SVPGS ≥ 60) was 63.35 (SD 6.18; n = 166).”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in GAD-7 scores between the high and low grief groups (t = 10.19, p < 0.001).
“GAD-7 (t = 10.19,p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
The refined 15-item version of the SVPGS exhibited satisfactory internal reliability (α = 0.92).
“Consequently, we identified a refined 15-item version of the SVPGS, which exhibited satisfactory internal reliability (α = 0.92) and 8-week test-retest stability, confirming it as a reliable tool for accurately measuring perinatal grief over time.”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores negatively correlated with MSPSS scores (r = -0.52, p < 0.01) in the sample.
“MSPSS (quality of life; mean = 60.16,SD = 13.11,r = -0.52,p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in MSPSS scores between the high and low grief groups (t = 14.23, p < 0.001).
“MSPSS (t = 14.23, p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
The refined 15-item SVPGS demonstrated excellent internal consistency.
“The refined 15-item SVPGS demonstrated excellent internal consistency and stability, maintaining a consistent three-factor structure compared to the original scale.”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in IES-R scores between the high and low grief groups (t = 16.07, p < 0.001).
“IES-R (t = 16.07,p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores negatively correlated with Psy-Flex-C scores (r = -0.46, p < 0.01) in the sample.
“Psy-Flex-C (psychological flexibility; mean = 3.42, SD = 0.94, r = -0.46,p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in SCS-SF scores between the high and low grief groups (t = 15.20, p < 0.001).
“SCS-SF (t = 15.20,p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in WHOQOL-BREF scores between the high and low grief groups (t = 12.71, p < 0.001).
“WHOQOL-BREF (t = 12.71, p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
The refined 15-item SVPGS maintained a consistent three-factor structure compared to the original scale.
“The refined 15-item SVPGS demonstrated excellent internal consistency and stability, maintaining a consistent three-factor structure compared to the original scale.”
Quote in the paperSubstantial claim - Findingown data
The refined 15-item version of the SVPGS exhibited 8-week test-retest stability.
“Consequently, we identified a refined 15-item version of the SVPGS, which exhibited satisfactory internal reliability (α = 0.92) and 8-week test-retest stability, confirming it as a reliable tool for accurately measuring perinatal grief over time.”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores negatively correlated with WHOQOL-BREF scores (r = -0.61, p < 0.01) in the sample.
“WHOQOL-BREF (perceived social support; mean = 79.65,SD = 15.25, r = -0.61,p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
The refined SVPGS showed a stronger relationship with measures assessing similar constructs (PHQ-9, GAD-7, IES-R; r 0.56-0.66) compared to measures assessing entirely different constructs (Psy-Flex-C, MAAS, SCS-SF, MSPSS, WHOQOL-BREF; r 0.46-0.61).
“the refined SVPGS showed a stronger relationship with measures assessing similar constructs (i.e.PHQ-9, GAD-7, and IES-R; r ranged: 0.56-0.66,all ps < 0.01) compared to those measuring entirely different constructs (i.e.Psy-Flex-C, MAAS, SCS-SF, MSPSS, and WHOQOL-BREF; r ranged: 0.46-0.61,all ps < 0.01).”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores positively correlated with PHQ-9 scores (r = 0.64, p < 0.01) in the sample.
“statistically significant positive correlations between the mean scores of the refined SVPGS and the following measures: PHQ-9 (depressive symptoms; mean = 7.55, SD = 5.48, r = 0.64, p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
The refined 15-item SVPGS demonstrated stability.
“The refined 15-item SVPGS demonstrated excellent internal consistency and stability, maintaining a consistent three-factor structure compared to the original scale.”
Quote in the paperSubstantial claim - Findingown data
Refined SVPGS mean scores positively correlated with GAD-7 scores (r = 0.56, p < 0.01) in the sample.
“GAD-7 (anxiety symptoms; mean = 5.69, SD = 5.19, r = 0.56, p < 0.01)”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in MAAS scores between the high and low grief groups (t = 11.61, p < 0.001).
“MAAS (t = 11.61,p < 0.001)”
Quote in the paperSubstantial claim - Findingown data
Significant differences were observed in Psy-Flex-C scores between the high and low grief groups (t = 3.85, p < 0.001).
“Psy-Flex-C (t = 3.85, p < 0.001)”
Quote in the paperSubstantial claim - Interpretationcitation
The Chinese SVPGS has mixed or uncertain structural validity evidence.
“However, based on the results of these two studies, the psychometric evaluation of the Chinese SVPGS demonstrated unsatisfactory or uncertain reliability and validity.”
- Also stated in: § 1 | Introduction · hedged
“the evidence supporting the structural validation of the three-factor model is mixed, indicating a need for further research to clarify its structural validity and establish a clearer consensus.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Lai et al. 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Yan et al. 2010 source
- Also stated in: § 1 | Introduction · hedged
- Premisecitation
The 1-year test-retest results reported by Lai et al. (2013) indicated low test-retest stability for the Chinese SVPGS.
“Moreover, the 1-year test-retest results reported by Lai et al. (2013) indicated low test-retest stability, suggesting that the scale may not produce consistent results over time.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Lai et al. 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisereasoning
The concurrent and known-group validities of the Chinese SVPGS remain unclear.
“Furthermore, the concurrent and known-group validities of the Chinese SVPGS remain unclear, complicating comparisons with other relevant scales and imposing limitations on its clinical and research applications.”
Quote in the paperSubstantial claim - Premisecitation
The Chinese SVPGS has satisfactory internal consistency (Cronbach's alpha = 0.94) in women who experienced miscarriage.
“Similarly, another study conducted by Lai et al. (2013) included 280 Chinese women who had experienced miscarriage and demonstrated satisfactory internal consistency for the Chinese SVPGS, with a Cronbach's alpha of 0.94.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Lai et al. 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
These findings indicate satisfactory known-group validity of the refined SVPGS.
“These findings indicate satisfactory known-group validity of the refined SVPGS (Table A3).”
Quote in the paperSubstantial claim - Interpretationown data
The psychometric robustness (reliability and validity) of the refined SVPGS was confirmed in assessing grief specific to perinatal loss among 353 Chinese women who experienced such loss within the past 6 months in mainland China.
“The psychometric robustness (i.e.reliability and validity) of the refined SVPGS was confirmed in assessing grief specific to perinatal loss among 353 Chinese women who experienced such loss within the past 6 months in mainland China.”
Quote in the paperSubstantial claim- Rests on an assumption: In the context of perinatal grief, individuals may experience prolonged grief disorder, particularly if societal support is lacking or if cultural norms discourage emotional expression.
- Premisecitation
The Chinese SVPGS has good internal consistency (Cronbach's alpha = 0.95 total, 0.83-0.90 subscales) in women with recent reproductive loss.
“The Chinese version of the SVPG was validated in women who have experienced recent reproductive loss, demonstrating satisfactory internal consistency with a Cronbach's α of 0.95 for the total score and between 0.83 and 0.90 for the three subscales (Yan et al. 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Yan et al. 2010 source
- Interpretationown data
The refined SVPGS is a reliable tool for accurately measuring perinatal grief over time.
“Consequently, we identified a refined 15-item version of the SVPGS, which exhibited satisfactory internal reliability (α = 0.92) and 8-week test-retest stability, confirming it as a reliable tool for accurately measuring perinatal grief over time.”
Quote in the paperSubstantial claim - Interpretationown data
The known-group validity of the refined SVPGS supports these findings by demonstrating significant differences in the aforementioned variables between individuals with high and low levels of grief.
“Furthermore, the known-group validity of the refined SVPGS supports these findings by demonstrating significant differences in the aforementioned variables between individuals with high and low levels of grief as measured by the refined SVPGS.”
Quote in the paperSubstantial claim - Interpretationown data
The refined SVPGS has the capacity to differentiate between varying levels of perinatal grief and its associated psychological outcomes.
“This further reinforces the instrument's capacity to differentiate between varying levels of perinatal grief and its associated psychological outcomes.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 18
- May combine two claims. 22
- The quote only partly states this claim. 2
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe WHOQOL-BREF has overall Cronbach's alpha 0.731 and subscale alphas 0.71-0.79.
“The overall Cronbach's alpha for the WHOQOL-BREF questionnaire was 0.731, while the Cronbach's alpha for the subscales ranged from 0.71 to 0.79 (Zhang et al. 2012).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Zhang et al. 2012 source
May combine two claims.
Findingown dataThe overall Cronbach's α of the original SVPGS was 0.69, indicating unacceptable internal consistency.
“The overall Cronbach's α of the SVPGS was 0.69, indicating an unacceptable level of internal consistency; therefore, further improvements were necessary.”
Quote in the paperSubstantial claimMay combine two claims. The quote only partly states this claim.
Findingown dataConvergent and divergent validities were confirmed through significant correlations with depressive symptoms, anxiety symptoms, PTSD, psychological flexibility, mindfulness, self-compassion, perceived social support, and quality of life.
“The SVPGS showed strong correlations with other mental health measures, including depressive symptoms, anxiety, post-traumatic stress disorder, psychological flexibility, mindfulness, self-compassion, perceived social support, and quality of life.”
Quote in the paperSubstantial claim- Rests on an assumption: The Chinese versions of the comparator instruments (PHQ-9, GAD-7, IES-R, Psy-Flex, MAAS, SCS-SF, MSPSS, WHOQOL-BREF) are valid for measuring their respective constructs in women who have experienced perinatal loss.
May combine two claims. The quote only partly states this claim.
Findingown dataThe refined SVPGS has a three-factor structure (active grief, difficulty coping, despair) consisting of 15 items.
“A three-factor structure consisting of 15 items was confirmed through item analysis, exploratory factor analysis, and parallel analysis.”
- Also stated in: § 3.3 | Structure Validity · plain
“A CFA was conducted for the refined SVPGS to validate the three-factor structure”
Quote in the paperSubstantial claim- Also stated in: § 3.3 | Structure Validity · plain
May combine two claims.
Findingown data18 items were removed from the original SVPGS based on CITC results, resulting in a 15-item refined SVPGS.
“Consequently, based on the CITC results, 18 items were removed based on the selection criteria, resulting in a final version of the 15-item SVPGS (Table 2).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe refined SVPGS subscales have Cronbach's α values of 0.87 (active grief), 0.87 (difficulty coping), and 0.89 (despair).
“The Cronbach's α for the refined SVPGS and its subscales-active grief, difficulty coping, and despair-were 0.92, 0.87, 0.87, and 0.89, respectively.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe three-factor model was confirmed by CFA, demonstrating an excellent overall fit compared to the one-factor and two-factor models.
“Moreover, the three-factor model was confirmed by CFA, demonstrating an excellent overall fit compared to the onefactor and two-factor models.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Chinese version of the GAD-7 has excellent internal consistency (Cronbach's alpha = 0.91) in outpatient populations.
“The Chinese version of the GAD-7 was validated in outpatient populations from traditional Chinese internal medicine departments, indicating excellent internal consistency reliability, with a Cronbach's alpha of 0.91 (Zeng et al. 2013).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Zeng et al. 2013
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Chinese version of the PHQ-9 has good internal consistency (Cronbach's alpha = 0.86) in a community adult population.
“The Chinese version of the PHQ-9 has been validated in a community adult population, demonstrating good internal consistency reliability with a Cronbach's alpha of 0.86 (Wang et al. 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wang et al. 2014 source
Classified as probably not a substantial claim. May combine two claims.
Study design and conductown dataA total of 353 women participated, and 275 (77.90%) completed the 1-month reassessment.
“A total of 353 women who experienced perinatal loss participated in this survey and 275 responder (77.90%) completed the reassessment after 1-month interval.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataThe refined SVPGS is a brief, reliable, and valid tool for measuring grief in women who have experienced perinatal loss.
“These findings indicate that the refined SVPGS is a brief, reliable, and valid tool for measuring grief in women who have experienced perinatal loss.”
Quote in the paperSubstantial claim- Rests on an assumption: The convenience sample from eight hospitals in Hunan Province is representative of women who have experienced perinatal loss in mainland China.
- Rests on an assumption: The Chinese versions of the comparator instruments (PHQ-9, GAD-7, IES-R, Psy-Flex, MAAS, SCS-SF, MSPSS, WHOQOL-BREF) are valid for measuring their respective constructs in women who have experienced perinatal loss.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Chinese version of MSPSS has satisfactory internal consistency (Cronbach's alpha = 0.89).
“The Chinese version of the MSPSS has been validated in 12th-grade high school students, demonstrating satisfactory internal consistency with a Cronbach's alpha of 0.89 for the total score (Chou 2000).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Chou 2000 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Chinese version of the IES-R has acceptable internal consistency (α = 0.83-0.89) and test-retest stability (r = 0.52-0.76).
“The Chinese version of the IES-R (CIES-R) has been validated in patients from the Accident and Emergency Department, demonstrating acceptable internal consistency (with α values ranging from 0.83 to 0.89 for the three subscales) and test-retest stability (with r values ranging from 0.52 to 0.76) (Wu and Chan 2003).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wu and Chan 2003 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Turkish version, validated among 185 women, found the 32-item SVPGS had satisfactory internal reliability (α = 0.96) and 2-week test-retest reliability (0.91).
“In addition, the Tukey version, validated among 185 women who were living with perinatal loss up to 12 weeks past their loss, found that the 32-item SVPGS had satisfactory internal reliability (α = 0.96) and demonstrated 2-week test-retest reliability (0.91) (Kones et al. 2017).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kones et al. 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationYan et al. (2010) found that CFA rejected the original three-factor model and EFA suggested an alternative three-factor model for the Chinese SVPGS.
“The authors noted that CFA rejected the original three-factor model, while EFA suggested an alternative three-factor model comprising a 12-item Sense of Worthlessness subscale, a 7-item Social Detachment subscale, and a 7-item Painful Recollection subscale.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Yan et al. 2010 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Chinese version of SCS-SF has good internal consistency (0.77 to 0.80).
“The Chinese version of SCS-SF has been validated in Chinese college students with a good internal consistency of 0.77 to 0.80 (Huang et al. 2023).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Huang et al. 2023
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationLai et al. (2013) identified and confirmed a two-factor structure for the Chinese SVPGS with good model fit.
“In contract, utilizing both EFA and CFA, Lai et al. (2013) identified and confirmed a two-factor structure for the Chinese SVPGS, reporting a good model fit (χ 2 [350] = 787.1,p < 0.01; root mean square error of approximation = 0.058; normed fit index = 0.90; goodness-of-fit index = 0.91; comparative fit index = 0.92).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Lai et al. 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe SVPGS has been translated into 17 languages and validated globally.
“The SVPGS has been widely used, translated into 17 languages, and validated globally for various types of loss related to pregnancy (Wright and Carpenter 2023).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wright and Carpenter 2023 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Chinese version of Psy-Flex has acceptable internal consistency (α = 0.84) and strong 2-week test-retest reliability (weighted kappa = 0.88).
“The Chinese version of Psy-Flex (Psy-Flex-C) demonstrated acceptable internal consistency, with a Cronbach's α of 0.84, and exhibited strong stability, reflected by a 2-week testretest reliability with a weighted kappa statistic of 0.88 (Li, Chien, et al. 2024).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Li, Chien, et al. 2024
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Spanish version of the SVPGS, validated by González et al. (2011) in 200 women, showed a refined 27-item version had satisfactory internal reliability (α = 0.95).
“For example, the Spanish version of the SVPGS, validated by González et al. (2011) in a sample of 200 women who had experienced one or more perinatal losses, showed that a refined 27-item version had satisfactory internal reliability (α = 0.95).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites González et al. (2011)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Interpretationown dataThe refined SVPGS exhibited good known-group validity, showing that parents with high and low levels of perinatal grief demonstrate significant differences in depressive symptoms, anxiety symptoms, PTSD, psychological flexibility, mindfulness, self-compassion, and perceived social support.
“Furthermore, the refined SVPGS exhibited good known-group validity, showing that parents with high and low levels of perinatal grief demonstrate significant differences in depressive symptoms, anxiety symptoms, PTSD, psychological flexibility, mindfulness, self-compassion, and perceived social support.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Chinese version of MAAS has good internal consistency (α = 0.89).
“The Chinese version of the MAAS was validated in Chinese college students and reported a good internal consistency reliability (α = 0.89) (Chen et al. 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Chen et al. 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningConvenience sampling with self-selected volunteers may have compromised the representativeness of the sample and limited the ability to assess potential demographic or clinical differences between respondents and non-respondents.
“First, to enhance practicality and efficiency, this study employed convenience sampling, with participants being self-selected volunteers.This approach may have compromised the representativeness of the sample and limited the ability to assess potential demographic or clinical differences between respondents and non-respondents.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
Interpretationown dataThis finding increases confidence in applying the three-factor model.
“This finding increases confidence in applying the three-factor model, which not only enhances our understanding of perinatal grief but also provides a robust framework for future research.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningFocusing exclusively on Chinese women who experienced perinatal loss, excluding partners and other population samples, raises questions regarding the validity of the revised SVPGS in accurately measuring paternal grief and may introduce selection bias, affecting the generalizability of the results.
“Second, this study focused exclusively on Chinese women who experienced perinatal loss, excluding their partners and other population samples.This omission raises questions regarding the validity of the revised SVPGS in accurately measuring paternal grief and may introduce selection bias, affecting the generalizability of the results.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataHigher levels of grief related to perinatal loss are associated with increased depressive symptoms, anxiety symptoms, and PTSD.
“Furthermore, a positive correlation was identified between the refined SVPGS and the PHQ-9, GAD-7, and IES-R, indicating that higher levels of grief related to perinatal loss are associated with increased depressive symptoms, anxiety symptoms, and PTSD.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataThe refined SVPGS presents a reliable, valid, and time-saving tool for assessing perinatal grief in Chinese women, addressing a critical gap in psychological research and practice within this demographic.
“In conclusion, the refined SVPGS presents a reliable, valid, and time-saving tool for assessing perinatal grief in Chinese women, addressing a critical gap in psychological research and practice within this demographic.”
Quote in the paperSubstantial claim- Rests on an assumption: The refined 15-item SVPGS is more effective in gathering data from this vulnerable population, enabling participants to complete the questionnaire with less strain and in a more timely manner.
- Rests on an assumption: There is a critical gap in psychological research and practice for assessing perinatal grief in Chinese women.
May combine two claims.
Interpretationown dataHigher levels of grief are linked to lower levels of psychological flexibility, mindfulness, self-compassion, perceived social support, and overall quality of life.
“In addition, a negative correlation was found between the refined SVPGS and the Psy-Flex-C, MAAS, SCS-SF, MSPSS, and WHOQOL-BREF, suggesting that higher levels of grief are linked to lower levels of psychological flexibility, mindfulness, self-compassion, perceived social support, and overall quality of life.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenReliance on self-reported data may introduce biases, such as social desirability bias or inaccurate recall.
“Finally, the reliance on self-reported data may introduce biases, such as social desirability bias or inaccurate recall.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
No research has been conducted to examine the psychometric properties of the SVPGS in women who have experienced perinatal loss in mainland China.
“no research has been conducted to examine the psychometric properties of the SVPGS in women who have experienced perinatal loss in mainland China, where varying policies and cultural contexts may significantly affect both the experience and expression of perinatal grief.”
The paper relies on this without support.
The convenience sample from eight hospitals in Hunan Province is representative of women who have experienced perinatal loss in mainland China.
“A convenience sample was recruited from eight hospitals across seven cities in Hunan Province, China.”
The paper relies on this without support.
The Chinese versions of the comparator instruments (PHQ-9, GAD-7, IES-R, Psy-Flex, MAAS, SCS-SF, MSPSS, WHOQOL-BREF) are valid for measuring their respective constructs in women who have experienced perinatal loss.
“The convergent validity of the refined SVPGS was assessed by calculating the Pearson product-moment correlation coefficient between the refined SVPGS and tools measuring similar constructs (i.e.PHQ-9, GAD-7, and IES-R).”
The paper relies on this without support.
In the context of perinatal grief, individuals may experience prolonged grief disorder, particularly if societal support is lacking or if cultural norms discourage emotional expression.
“In the context of perinatal grief, individuals may experience prolonged grief disorder, particularly if societal support is lacking or if cultural norms discourage emotional expression.”
The paper relies on this without support.
The refined 15-item SVPGS is more effective in gathering data from this vulnerable population, enabling participants to complete the questionnaire with less strain and in a more timely manner.
“The refined version proved to be more effective in gathering data from this vulnerable population, as it addressed both the physical and psychological challenges they face, enabling participants to complete the questionnaire with less strain and in a more timely manner.”
The paper relies on this without support.
There is a critical gap in psychological research and practice for assessing perinatal grief in Chinese women.
“addressing a critical gap in psychological research and practice within this demographic.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
The low-grief group's mean exceeds its inclusion cutoff
MajorA group restricted to refined SVPGS scores of 30 or less cannot have a mean score of 31.16.
“The mean score of the refined SVPGS among women with low levels of grief (refined SVPGS ≤ 30) was 31.16 (SD: 5.14; n = 25)”
“Low level of perinatal grief (n = 25; mean = 31.16;SD = 5.14)”
The two-factor fit summary disagrees with Table 3
MajorThe prose puts all two-factor models' χ2/df values between 5.82 and 6.75 and their GFI values between 0.76 and 0.80. Table 3 instead reports χ2/df of 4.75 and GFI of 0.89 for model 3, among other out-of-range indices.
“the three two-factor models also performed inadequately ( χ 2 /df ranged from 5.82 to 6.75, all ps < 0.0001, GFI ranged from 0.76 to 0.80, RMSEA ranged from 0.14 to 0.16”
“| Two-factor model (3) c | 4.75 | <0.0001 | 0.89 | 0.23 | 0.054 | 0.89 | 0.91 | 0.92 | 0.91 |”
Most reported losses fall outside the paper's perinatal-loss definition
MajorThe paper defines perinatal loss as beginning at gestational week 20, but reports that 183 participants' most recent losses occurred during weeks 1-12.
“Perinatal loss, defined as the death of a foetus or infant during the perinatal period-ranging from the 20th week of gestation to the 28th day after birth”
“Gestational age at most recent pregnancy loss (week[s]) 1-12 weeks 183 (65.13) 13-24 weeks 135 (38.24) ≥25 weeks 35 (9.92)”
Significant demographic associations are both denied and reported
MajorThe results say no sociodemographic variables were significantly correlated with refined SVPGS scores, but the Table 1 note says three were.
“No sociodemographic variables were identified as having a significant correlation with the refined SVPGS scores.”
“a These three sociodemographic variables exhibited a significant correlation with the refined SVPGS scores, with absolute values of correlation coefficient (r) ranging from 0.10 to 0.11.”
The retest interval is reported as both one month and eight weeks
MajorThe results describe the reassessment as occurring after one month, whereas the procedure and reliability result specify eight weeks.
“275 responder (77.90%) completed the reassessment after 1-month interval.”
“For stability, the kappa value of the eight-week test-retest reliability of the refined SVPGS was 0.83”
The percentage for losses at weeks 1-12 uses the wrong denominator
MajorThe reported 183 participants are 51.84% of the sample of 353, not 65.13%. This affects the stated distribution of gestational ages.
Reported 65.13 · recomputed 51.84136
“Gestational age at most recent pregnancy loss (week[s]) 1-12 weeks 183 (65.13) 13-24 weeks 135 (38.24) ≥25 weeks 35 (9.92)”
Two known-group t-statistic signs disagree with the table
MinorThe results give positive t-statistics for anxiety and PTSD, while Table A3 gives negative statistics of the same magnitudes.
“GAD-7 (t = 10.19,p < 0.001), IES-R (t = 16.07,p < 0.001)”
“Anxiety symptoms (GAD-7) 1.48 ± 1.16 6.33 ± 5.26 -10.19***PTSD (IES-R) 13.32 ± 6.42 41.95 ± 15.914 -16.07***”
The quality-of-life response scale has conflicting category counts
MinorThe WHOQOL-BREF description calls its response scale five-point but states endpoints of 1 and 7. Its stated maximum total of 182 also corresponds to 26 items scored up to 7.
“Respondents were asked to rate the questions regarding their perceptions of quality of life, health, and other aspects of life described in the items on a 5-point Likert scale, ranging from 1 ('Very poor/Very dissatisfied/Not at all') to 7 ('An extreme amount/Very good/Very satisfied/Extremely').”
“The World Health Organization Quality of Life -Brief Version (WHOQOL-BREF) is a 26-item (total score possible range: 26 to 182)”
Social support and quality-of-life measures are mislabeled
MinorThe correlation results call MSPSS a quality-of-life measure and WHOQOL-BREF a perceived-social-support measure, reversing the constructs assigned to those instruments in the measures section.
“MSPSS (quality of life; mean = 60.16,SD = 13.11,r = -0.52,p < 0.01), and WHOQOL-BREF (perceived social support; mean = 79.65,SD = 15.25, r = -0.61,p < 0.01)”
“The Multidimensional Scale of Perceived Social Support (MSPSS) is a 12-item (total score possible range: 12 to 84) self-reported questionnaire evaluating perceived social support”
The reported Psy-Flex mean is below its possible range
MinorThe results give a Psy-Flex-C mean of 3.42, although the measure's stated total-score range starts at 6. Table 4 separately gives its mean as 21.70.
“Psy-Flex-C (psychological flexibility; mean = 3.42, SD = 0.94, r = -0.46,p < 0.01)”
“The Psy-Flex is a six-item (total score possible range: 6 to 30) selfreport questionnaire measuring psychological flexibility”
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Research works printed but not linked: 6
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Cited by
Sorted by citations
A COSMIN Systematic Review Exploring the Psychometric Properties of Perinatal Grief Instruments
Rose, V., & Robertson, N. (2026) · Journal of Loss and Trauma · doi:10.1080/15325024.2026.2723898
He, L., Liu, J., Sun, R., Tan, Y. Y., Qiu, L., & Shaochuan, C. (2026) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2026.2650195
- Authors
- Li, S. N., Yang, L., Wang, Q. Y., Xie, J., Cao, H., Zhao, W., & Tang, S. Q.
- Affiliations
- School of Psychology Shenzhen University Shenzhen People's Republic of China
- Central South University (CN)
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital Central South University Changsha China
- Second Xiangya Hospital of Central South University (CN)
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital Central South University Changsha Hunan China
- Corresponding author
- Yang, Li
- Venue
- Clinical Psychology & Psychotherapy
- Publisher
- Wiley
- Published
- 2025-03
- Volume
- 32
- Issue
- 2
- Pages
- e70067-e70067
- ISSN
- 1063-3995 (ISSN-L)
- 1099-0879
- OpenAlex
- W4408997650
- Cited by
- 2
- References
- 52
- Citations by year
- 2026: 2
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Update notices
- correction (2025-07-01)
- Open access
- bronze
- doi.org
- Locations
- Clinical Psychology & Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- Perinatal Grief Scale, perinatal loss, grief measurement, Chinese women, scale validation, psychometric properties, factor structure, test-retest reliability
- MeSH terms
- East Asian People, Adult, China, Cross-Sectional Studies, Female
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