Tehran University of Medical Sciences Nursing Practice Today 2383-1154 13 1 2026 01 01 74 83 Azam Eshaghian Dorcheh Department of Pediatric and Neonatal Nursing, Isfahan University of Medical Sciences, Isfahan, Iran Hadis Ashrafizadeh Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Dezful, Iran Fatemeh Khademi Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Salman Barasteh Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Arndt Büssing Department of Health, Witten Herdecke University, Herdecke, North Rhine-Westphalia, Germany Klaus Baumann Faculty of Theology, Freiburg University, Germany Mahmood Salesi Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Mohadese Babaie Department of Anesthesiology, School of Allied Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran Maryam Karami Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mitra Jaras Department of Nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran Maryam Rassouli Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND School of Nursing, College of Health Sciences, University of Nizwa, Nizwa, Sultanate of Oman 2025 07 12 2025 11 02 Background & Aim: Understanding predictive factors for complicated grief after COVID-19 losses is critical for developing targeted support strategies. This study aimed to examine predictors of complicated grief among Iranians who lost a family member during the pandemic. Materials & Methods: This descriptive-correlational study was conducted from December 2022 to August 2023. A total of 150 relatives of COVID-19 victims were recruited via convenience sampling. Data were collected using the Inventory of Complicated Grief, the Burdened by Grief and Loss questionnaire, the WHO-5 Well-being Index, and a measure of pandemic-related burden. Data were analyzed using SPSS v. 26, employing chi-square, Fisher's exact test, and multiple logistic regression to identify predictors. Results: The likelihood of developing complicated grief among women compared to men was 3.77 times higher (p<0.001, OR=3.77), and the chance of complicated grief in close family members compared to distant relatives was 4.55 times higher (p<0.001, OR=4.55). An increase in psychological well-being score significantly lowered the likelihood of complicated grief in bereaved companions (p<0.001, OR=0.86); however, an increase in being burdened by grief and loss scale significantly augmented the likelihood of complicated grief in bereaved companions (p<0.001, OR=1.11). However, an increase in the Burdened by Grief and Loss score significantly increased the likelihood of complicated grief in bereaved companions (p<0.001, OR=1.11). The prevalence of complicated grief in Iranian people who have lost their family members because of COVID-19 was higher compared to similar studies. Conclusion: Female gender, close kinship with the deceased, and a heavier psychological burden of loss were significant risk factors for complicated grief, while stronger mental health served as a protective factor. Given the crucial role of nurses in bereavement care, there is an urgent need for structured, supportive interventions and psychological services, ideally delivered through clinical guidelines tailored for these vulnerable groups. https://npt.tums.ac.ir/index.php/npt/article/view/4255 https://npt.tums.ac.ir/index.php/npt/article/download/4255/684