Dear Editor,

The Perinatal Grief Scale (PGS) is the most widely used standardized measure to assess and detect grief after perinatal loss in all parents who have experienced any type of perinatal loss.1 It has been translated into at least 17 languages (https://judithlasker.com/perinatal-grief-scale/). In some of these translations, items that did not work in that culture through translation had to be omitted. This poses implications for scoring in research utilizing these amended versions.

As creators of the PGS-Persian (PGS-P) version, which has already been utilized in a few Iranian studies, we find it necessary to remind researchers who employ the PGS-P that this modification exists and should be considered in their analysis and reporting. After preparing the PGS-P and publishing the results of the translation process in 2018,2 the PGS-P underwent a modification after translation and validation. Specifically, one item was removed from the ‘despair’ subscale, reducing it from 11 items to 10 items. Consequently, the total number of items in the original PGS was reduced from 33 to 32 in the Persian version. This adjustment led to variations in the total PGS-P scores and its ‘despair’ subscale score compared to the original version.

Following the publication of two articles in 2020 and 2022,3,4 in which the PGS-P was used, the presentation of results adhered to the original English version of the PGS, overlooking the changes introduced in the Persian version.

This oversight by the authors carries several consequences:

1. Other researchers who refer to these studies perpetuate the distortion.
2. It misleads researchers comparing results obtained from this version of the scale across different countries.

It is strongly recommended that researchers, when employing a tool in their studies, carefully examine the source used, analyze their data based on it, and subsequently interpret the results. This is especially crucial for tools where, during the translation process into a specific culture and language, changes have been identified compared to the original version, leading to potential variations in interpretations and outcomes.

references

1. 1. Setubal MS, Bolibio R, Jesus RC, Benute GG, Gibelli MA, Bertolassi N, et al. A systematic review of instruments measuring grief after perinatal loss and factors associated with grief reactions. Palliat Support Care 2021 Apr;19(2):246-256.
2. 2. Siadatnezhad S, Ziaei T, Khoori E, Vakili MA, Lasker J. Translation and validation of the persian version of the perinatal grief scale in Iranian mothers with an experience of pregnancy loss. Middle East J Famil Med 2018;16(1):55-61.
3. 3. Barat S, Yazdani S, Faramarzi M, Khafri S, Darvish M, Rad MN, et al. The effect of brief supportive psychotherapy on prevention of psychiatric morbidity in women with miscarriage: a randomized controlled trial about the first 24-hours of hospitalization. Oman Med J 2020 Jun;35(3):e130.
4. 4. Nournorouzi L, Nourizadeh R, Hakimi S, Esmaeilpour K, Najmi L. The effect of a coping program on mothers’ grief following perinatal deaths. J Educ Health Promot 2022 Aug;11:248.