- Patient loss is a significant source of emotional and psychological distress among nurses, notably emotional exhaustion, anxiety, sleep disturbance, and burnout concerns.
- Common coping strategies reported were peer support, spiritual practices, and relaxation techniques used to manage grief in resource constrained settings.
- Institutions should implement structured grief support systems to strengthen resilience, promote psychological wellbeing, and sustain delivery of compassionate, high quality care.
BMC Palliat Care. 2026 Jul 10. doi: 10.1186/s12904-026-02229-3. Online ahead of print.
ABSTRACT
BACKGROUND: Nurses frequently develop close therapeutic relationships with patients and experience significant emotional distress when patients die. Despite extensive literature on caregiver burden in palliative care, there is limited data on how nurses in resource-constrained settings cope with grief and the downstream effects on their well-being and practice. This study aimed to examine grief coping strategies, emotional responses, and perceived mental health impacts among nurses following patient loss in a tertiary specialist hospital in Northern Nigeria.
METHODS: We conducted a cross-sectional survey between January and March 2025 at a high-volume (a high patient sort) Specialist hospital in Kano State, Nigeria. Using Yamane’s formula for finite population, 194registered nurses with at least one year of clinical experience (N = 194) were invited; all 194 (100%) completed a structured self‑administered questionnaire. Three domains were assessed using 4‑point Likert scales (1 = Strongly Disagree to 4 = Strongly Agree): (1) grief coping strategies (10 items), (2) attitudes and emotional responses after patient death (10 items), and (3) perceived impacts on mental health (10 items). We calculated descriptive statistics and mean domain scores; higher scores indicate stronger endorsement of the item or domain. Inferential statistics also explore gender differences and the years of clinical experiences across the three domains. Ethical approval was granted by the Kano State Ministry of Health Research Ethics Committee (NHREC/17/03/2018), and written informed consent was obtained from all participants.
RESULTS: A total of 194 nurses participated in the study. Emotional exhaustion, anxiety, sleep disturbances, and burnout concerns were commonly reported following patient loss. Peer support, spiritual practices, and relaxation techniques were the most frequently used coping strategies. Female nurses reported significantly higher coping strategy scores (p = 0.013), stronger emotional responses (p = 0.008), and greater mental health impacts (p = 0.003) than male nurses. No significant differences were observed across years of professional experience.
CONCLUSIONS: Patient loss remains a significant source of emotional and psychological distress among nurses. While peer support and spirituality are important coping mechanisms, healthcare institutions should implement structured grief-support systems to strengthen resilience, promote psychological well-being, and sustain the delivery of compassionate, high-quality care.
PMID:42432632 | DOI:10.1186/s12904-026-02229-3
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