OP-15 Assessing grief in bereaved children and young people: validating the children’s attitude to grief scale (CAG)

<h3>Introduction</h3> The effective assessment of bereavement needs and outcomes is essential to deliver high-quality bereavement services. There is however limited evidence for child-specific grief measures. The Child Attitude to Grief (CAG) Scale is adapted from the Adult Attitude to Grief Scale (Sim et al.2014). The 9-item scale explores how a bereaved child/young person is experiencing and expressing their grief, based on the Range of Response to Loss model (Machin 2001). The CAG scale is being used with children aged 7<i>–</i>18, by some bereavement services, including Winston’s Wish. <h3>Aims</h3> This two-stage study aims to develop and determine the suitability of the CAG scale for use in clinical practice and research/evaluation. We present the first qualitative stage of the study, which assesses the face and content validity of the scale. <h3>Methods</h3> The original scale was discussed in three focus groups; bereaved young people (n=3); parents of bereaved children (n=3); and professional practitioners (n=10). The CAG was modified and piloted in 1:1 cognitive interviews with 8 bereaved young people and a practitioner focus group (n=10), then revised and discussed in a final focus group with bereaved young people (n=3). <h3>Results</h3> Participants valued the conversational therapeutic approach of the tool and viewed scale items and constructs(‘overwhelmed’, ‘controlled’ grief reactions and ‘resilient’ coping responses) as relevant and comprehensive. Ambiguity was perceived in some items, and the language considered too complex. Wording was simplified and a new response scale introduced. The final focus group confirmed the scale’s comprehensibility, acceptability and validity, with only minor modifications needed. <h3>Conclusions</h3> The revised CAG will be field-tested with c.250 children and young people receiving bereavement support to assess its validity and responsiveness. <h3>Impact</h3> This research will improve bereavement care for bereaved children and young people by developing a valid measure to assess need and outcomes, clinically and in research.