Posttraumatic growth in nursing home workers: differential associations of gratitude, meaning in life, and distress four years after the pandemic

PURPOSE/AIMS: To examine associations between posttraumatic growth, gratitude, meaning in life, and psychological distress among nursing home workers several years after the COVID-19 pandemic. METHODS: A cross-sectional study was conducted with 251 nursing home workers in Madrid, Spain, who had worked during the COVID-19 pandemic. Participants completed the Posttraumatic Growth Inventory-Short Form, the Purpose in Life Test-10, the Gratitude Questionnaire-6, and the Patient Health Questionnaire-4. Descriptive statistics, Pearson correlations, and multiple linear regression models were performed. RESULTS: Posttraumatic growth was present across the sample several years after the pandemic, although spiritual change showed lower scores than other growth dimensions. Gratitude and meaning in life were both positively associated with posttraumatic growth at the bivariate level. In adjusted models, gratitude remained significantly associated with all posttraumatic growth dimensions, whereas meaning in life did not retain independent associations. Psychological distress was also positively associated with posttraumatic growth, indicating that growth-related appraisals and distress coexisted in this sample. No significant differences in posttraumatic growth were observed across professional roles. CONCLUSION/IMPLICATIONS: This study contributes to the limited literature on nursing home workers by showing that posttraumatic growth remained present several years after the COVID-19 pandemic and was more closely associated with gratitude than with meaning in life in adjusted models. For research, the findings support a more differentiated view of positive post-adversity processes and their coexistence with distress. For geriatric nursing and long-term care, they underscore the value of considering not only emotional burden but also positive psychological appraisals when addressing staff well-being after major collective adversity.