Posttraumatic Growth Research Articles

Dyadic coping, resilience, and posttraumatic growth in spinal cord injury patients and their spouses: An actor-partner interdependence mediation model analysis.

Despite the recognized importance of posttraumatic growth (PTG) in the recovery process, the mechanisms that promote PTG in spinal cord injury (SCI) patients and their spouses, especially the roles of dyadic coping (DC) and resilience, have not been fully explored. This study aimed to assess the PTG of patients with SCI and their spouses and to investigate the interrelationships among DC, resilience, and PTG within the dyadic context. A total of 154 SCI patient-spouse dyads were recruited from a rehabilitation hospital in China. All participants completed questionnaires about DC, resilience, and PTG. Our study was based on the actor-partner interdependence mediation model (APIMeM). SCI patients and their spouses experienced comparable PTG level, M(patients) = 56.05 ± 14.09, M(spouses) = 54.74 ± 15.31. In the APIMeM, the patients' and their spouses' DC exerted actor effects on their own resilience, β(patients) = .418, p < .001; β(spouses) = .409, p < .01, and their own resilience also exerted actor effects on their own PTG, β(patients) = .416, p < .001; β(spouses) = .431, p < .001. The mediating effects of resilience on the impact of patients' and spouses' own DC on their own PTG were confirmed. Our research offers new insight into the PTG of SCI patients and their spouses at the individual and dyadic levels. Resilience partially mediates the relationship between DC and PTG in couples coping with SCI. Specifically, DC between SCI patient-spouse dyads can not only directly influence the level of PTG but also impact PTG through resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Do nurse spiritual responses to trauma explain nurse outcomes? A correlational observational study

BackgroundVarious facets of spirituality are associated with wellbeing. Given the current urgency to promote nurse wellbeing, nurse spirituality merits exploration. PurposeTo investigate how spiritual distress and growth (i.e., spiritual/religious struggle, moral injury, post-traumatic growth) contributed to nurse outcomes (i.e., burnout, job satisfaction, intent to leave). MethodsRNs providing direct patient care in three Southern California hospitals completed an online survey that included psychometrically robust measures. Hierarchical multiple regression analyses were used to test spiritual variables as predictors of nurse outcomes after accounting for demographic and work-related factors. FindingsIn this sample of 531 demographically diverse RNs, spiritual struggle contributed to burnout and turnover intention; posttraumatic growth and employer respect for nurse wellbeing contributed to all three nurse outcomes. DiscussionSpiritual distress and growth are understudied but potentially important influences on job outcomes for nurses. Results here suggest that continued development of interventions to address spiritual health is worth investment.

Posttraumatic Growth: The Role of Health and Financial Difficulties During a Pandemic.

Trauma can have a range of effects on individuals over time, including the potential for positive changes in favorable outcomes commonly referred to as posttraumatic growth. The posttraumatic growth literature has been criticized for various methodological limitations and has largely neglected the exploration of factors that may strengthen or weaken posttraumatic growth trajectories. The present study contributes to this literature by investigating trajectories of five dimensions of posttraumatic growth during the COVID-19 pandemic and the moderating effects of health and financial difficulties on these trajectories. Longitudinal data were collected monthly between July 2020 and December 2022 from a sample of employed adults in Germany, involving N = 1678 participants over 30 time points (Nobservations = 29,552). Results suggest that certain dimensions of posttraumatic growth showed significant increases (i.e., relationships) or decreases (i.e., spirituality and possibilities) over time and that trajectories of three dimensions (i.e., relationships, appreciation, and strength) demonstrated distinctive patterns of interaction with health and financial difficulties. Findings are discussed in the context of the pandemic as well as dynamic theories of personality and identity, with implications for advancing posttraumatic growth theory and research.

Moral Injury and Healing After the Great War: What G.A. Studdert Kennedy's Experience of Moral Injury Can Teach Us.

In this article, I chart the development of Moral injury in the life of Rev. G.A. Studdert Kennedy, a well-known British Chaplain who served in the First World War. Studdert Kennedy did not benefit from contemporary insights on Moral Injury but intuitively followed a path toward healing that involved reflection, confession, penance and post-traumatic growth. Chaplain Studdert Kennedy's experience of Moral Injury can inform our contemporary understanding and treatment of this debilitating malady.

Boosting Resilience Attentional Bias in Previously Bullied University Students with Low Post-Traumatic Growth: A Transcranial Direct Current Stimulation Study

Background/Objectives: Post-traumatic growth (PTG) has the potential to draw positive consequences from trauma. Hence, there is interest in finding ways to promote PTG. Research has identified an attentional bias towards positive resilience-related words (e.g., “persistence”, “purpose”) in university students who report high PTG after experiencing adversities. Although people can respond to these experiences by showing low PTG, this bias seems to help with their struggle by making purposeful contents more accessible. Therefore, boosting attentional bias towards positive resilience-related words could help people with low PTG. Methods: In this study, the participants were thirty-six university students who had experienced bullying before entering university. Using a Stroop emotional task, they identified the color of resilience and neutral words, either positive or negative, before and after being submitted to transcranial direct current stimulation. Stimulation was targeted at the right temporal area involved in intentionality processing. Results: In the anodal condition, the results support a stimulation effect on the resilience attentional bias that could benefit participants with low PTG. A significant moderation of approach motivation for this effect was also found. Specifically, only when participants had medium or high approach motivation did stimulation boost the attentional bias in students with low PTG. Conclusions: These results support that tDCS stimulation in this brain area is effective in enhancing resilience attentional bias in low-PTG students. However, for this effect to occur it is necessary to have approach motivation, which is motivation related to goals.

Post-Traumatic Growth Promoting and Inhibiting Factors Among Intimate Partner Violence Survivors: A Systematic Review.

Intimate partner violence (IPV) is a traumatic experience that is universally present across the globe. Undeniably, there are expected adverse outcomes. However, it is also conceivable that IPV survivors might see, feel, and experience a hopeful, positive future after their IPV experience. Notably experienced by IPV survivors is post-traumatic growth (PTG). PTG is a type of positive psychological change that occurs following the struggle with a traumatic experience. The changes are then reflected across five domains. As more studies on PTG among IPV survivors continue to rise, there must be a better understanding of the process. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, this systematic review consolidated findings from existing literature guided by the research questions: (a) What areas of PTG do IPV survivors most experience positive psychological growth? (b) What factors are associated with PTG among IPV survivors? A total of 22 studies met the criteria and were included. Spiritual growth and new possibilities domains were experienced the most by adult IPV survivors. Contributing and inhibiting factors toward PTG were identified and categorized as interpersonal, contextual, or intrapersonal. Targeted interventions aiding the process toward PTG for IPV survivors were also identified, including commonly maladaptive coping strategies. This systematic review contributes to the literature by increasing knowledge that can be used for more effective support, interventions, and policies that promote PTG for adult IPV survivors.

Patterns and transitions of posttraumatic stress symptoms and posttraumatic growth in trauma-exposed youth: A latent transition analysis.

The present study examined the transition patterns in latent classes of Post-traumatic stress disorder (PTSD) and post-traumatic growth among a sample of youth 4-13months after an explosion accident in China. Latent profile analyses identified consistent three classes (Resilient, Growing, and High-Symptom) at both waves. Latent transition analysis found most Resilient individuals remained stable while most Growing and High-symptom individuals transferred. Logistic regression predicting transition pathways suggests younger individuals, males, and those who lack social support are prone to experience reduced post-traumatic growth, whereas individuals with higher trauma exposure are prone to develop PTSD. Our study provides empirical evidence supporting qualitative transitions in PTSD and post-traumatic growth levels from a person-centred perspective. This adds to the current knowledge on the heterogeneity of post-traumatic responses of human beings and offers valuable guidance for post-traumatic interventions among youths.

Mindfulness affected post-traumatic stress symptoms and post-traumatic growth: Adaptive and maladaptive sides through trauma-related shame and guilt.

Mindfulness plays an important role in reducing post-traumatic stress symptoms (PTSS) and promoting posttraumatic growth (PTG) among traumatized populations. However, the mechanism at the emotional level has not been fully examined. Thus, we aimed to investigate the possible mediating roles of trauma-related shame and guilt. A total of 814 college students (Mage = 19.55, SD = 1.89) with traumatic experiences in China were recruited. Traumatic experiences, mindfulness, trauma-related shame, and trauma-related guilt were assessed in the first survey. Six months later, PTSS and PTG were assessed in the second survey. Structural equation modeling (SEM) analysis indicated that mindfulness was associated with less PTSS through shame and guilt. However, though directly associated with more PTG, mindfulness could also negatively predict PTG by evoking less guilt. Mindfulness can be a way to cope with traumatic experiences and related psychological consequences. However, although mindfulness can reduce PTSS by suppressing negative trauma-related shame and guilt, it can also limit the realization of PTG by inhibiting the adaptive sides of these emotions.

Mindfulness and mental health: the importance of a clinical intervention to prevent the effects of a traumatic event. A pilot study

Numerous research studies show that mindfulness can mitigate the negative impact of trauma on mental health by reducing symptoms of anxiety, mediating the relationship between trauma exposure and mental health, and treating symptoms resulting from traumatic events. During the COVID-19 pandemic, which was considered a traumatic event, the wellbeing of adults and children was severely compromised. Although children seem less vulnerable to the physical effects of the virus, this does not seem to be true for the psychological effects. Indeed, a prolonged period of loss of family activities and routines can have a negative impact on the mental health of children and adolescents. To investigate how mindfulness can help preschool children cope with the effects of COVID-19, a study was conducted on 46 children aged 4–5 years. The programme, based on the work of Jon Kabat-Zinn and adapted to the age of the participants, consisted of eight weekly 45-min sessions. Qualitative and quantitative results showed positive feedback, indicating that mindfulness helps children make sense of their experiences and achieve functional post-traumatic growth. This approach is seen as a challenge to guide children toward the restoration of psychological wellbeing, which is essential for good psychological balance.

Spiritual dryness and its predictors in Iranian Muslims

Abstract Illness, disability, and life-threatening events rank among the most significant crises that give rise to spiritual challenges. These challenges can lead to a dichotomy of spiritual dryness and cohesion, a phenomenon that can manifest in any demographic group due to illness or other crises. Within the Iranian Muslim community, various groups – healthy and sick, religious and non-religious – have consistently experienced spiritual dryness. This observation aligns with findings from other studies, particularly those involving Christians. However, the factors predicting spiritual dryness in these individuals have differed from those in other populations. Given that spirituality often serves as a potent strategy for navigating life’s crises, it is crucial to provide holistic support and spiritual care to those grappling with this phenomenon. This approach can help mitigate negative outcomes and foster positive ones, such as post-traumatic growth.

Characteristics and influencing factors of posttraumatic growth in young and middle-aged cancer patients: A cross-sectional latent profile analysis.

This cross-sectional study aimed to examine the subgroups of posttraumatic growth (PTG) among young and middle-aged cancer patients in China and to explore influencing factors. A total of 378 young and middle-aged cancer patients aged 18-60 were selected for the study at a hospital in Shanghai, China. Latent profile analysis identified four categories of PTG among young and middle-aged cancer patients: the "predicament group" (5.9%), the "struggle group" (36.8%), the "limited growth group" (44.1%) and the "remarkable growth group" (13.2%). Age, gender, time since diagnosis, cancer site, primary/recurrence, and meaning in life significantly influenced the distribution of PTG in young and middle-aged cancer patients. Targeted interventions should be developed to enhance the level of PTG among this population, considering the specific characteristics and influencing factors within each profile.

Mediation Effects of Self-Care Self-Efficacy and Health-Promoting Behaviors on Fear of Cancer Recurrence and Posttraumatic Growth in Postoperative Patients with Cervical Cancer: A Cross-Sectional Study

PurposeThe high recurrence risks significantly contribute to poor health outcomes among postoperative cervical cancer patients. This study aimed to determine the impact of fear of cancer recurrence (FCR) on the posttraumatic growth (PTG) in postoperative cervical cancer patients and to investigate the medicating effects of self-care self-efficacy and health-promoting behaviors within this relationship. MethodsA total of 334 cervical cancer patients who undergone surgery in three tertiary hospitals in Liaoning Province, China, were recruited using a convenience sampling method. Data were collected using the general information questionnaire, the Fear of Progression Questionnaire (fear of cancer recurrence), the Post-traumatic Growth Inventory (PTG), the Strategies Used by People to Promote Health (self-care self-efficacy), and the Health-Promoting Lifestyle Profile (health-promoting behaviors). Data analysis was performed using descriptive analysis, Pearson correlations, and multiple linear regression analysis. A structural equation model was conducted using Amos 24.0 software. ResultsPTG of cervical cancer patients after surgery was significantly and negatively associated with fear of cancer recurrence (r = -.54, P < .001), while positively correlated with self-care self-efficacy (r = .51, P < .001) and health-promoting behaviors (r = .59, P < .001). The mediation model revealed that self-care self-efficacy (Boots 95% CI [-0.39, -0.15]) and health-promoting behaviors (Boots 95% CI: [-0.51, -0.24]) independently served as mediating factors, respectively. Self-care self-efficacy and health-promoting behaviors played a significant chain mediating effect between fear of cancer recurrence and PTG (Boots CI: [-0.19, -0.07]), with an indirect effect of 11.6%. ConclusionsThis study demonstrated that self-care self-efficacy and health-promoting behaviors partially mediated the relationship between fear of cancer recurrence and PTG in cervical cancer survivors after surgery. Implementing tailored interventions focused on enhancing self-care self-efficacy and health-promoting behaviors among cervical cancer survivors may help alleviate concerns about cervical cancer recurrence and enhance PTG following surgery.

Narratives on disclosure of sexual violence: Survivors' responses to public testimony to a high-profile case.

Sexual violence is prevalent and associated with an elevated risk for physical health problems and psychological disorders. The social reactions survivors receive in response to disclosures of sexual violence can impact their postassault recovery. Many survivors do not disclose experiences of sexual violence, which can also complicate the course of recovery. The present study aims to further our understanding of survivors' experiences of sexual violence and their decisions to disclose or not disclose. The data set used is also of historical significance as it captures responses to one of the most public disclosures of sexual assault. Qualitative themes were identified from unsolicited, de-identified personal correspondence (n = 91) from a large archive sent to Dr. Christine Blasey Ford after her public testimony in front of the Senate Judiciary Committee describing an alleged sexual assault. Thematic analyses indicated five common negative reactions (i.e., dismissal, disbelief or denial, lack of repercussions for the perpetrator, retaliation, and victim blame) and two positive reactions (i.e., appropriate action and emotional support) in response to sexual violence disclosures. Reasons for nondisclosure included shame and fear of negative social reactions. Findings suggest that the interpersonal act of sexual violence disclosure is a dynamic process that can have lasting effects on survivors and has implications for fostering a sociocultural climate that facilitates posttraumatic growth in the aftermath of sexual violence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cross-cultural adaptation and reliability of the inventory of vicarious posttraumatic growth and research of its influencing factors: a cross-sectional study

ObjectiveThe purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables.MethodsThe Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG.ResultsThe Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett’s test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach’s α = 0.951), with dimensions’ Cronbach’s α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG.ConclusionThe Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.

Relationship between trauma, post-traumatic stress and post-traumatic growth for police officials: A path analysis

Background &amp; Objective: Police officials tend to face a high frequency of potentially traumatic incidents due to nature of their job. A dichotomous distinction among these traumatic incidents is witnessing of threat or harm to others and the experiencing of threat or harm directly to oneself. Previous research suggests that different types of traumas (direct and indirect) exposure can produce different levels of negative responses including posttraumatic stress disorder (PTSD) symptoms and positive outcomes such as posttraumatic growth (PTG) in police officials and other law enforcement agencies officials. Our objective was to study post-traumatic stress and post traumatic growth among police officials. Methods: In this cross-sectional study conducted from January 2019 to December 2022. The sample consisted of 400 police officials (having direct and indirect exposure of war trauma) who participated in war on terror in FATA Pakistan. Non probability purposive sampling technique was used for sample selection. Relationship among trauma, PTS (Post traumatic stress) and PTG (Post traumatic growth) was assessed. Results: Findings from the present study indicated that stress played vital role in paving pathway from trauma to growth (β =0.08). Study results also confirmed that moderate level of stress is linked with positive changes like posttraumatic growth. R-square change in linear relationship among stress and posttraumatic growth was 0.59 but in curvilinear relationship among stress and posttraumatic growth R-square change was 0.77 which is higher than linear relationship which confirmed the curvilinear relationship between stress and growth and these findings proved that moderate level of stress after war trauma exposure produced higher levels of post traumatic growth. Conditional indirect effect of exposure to trauma on growth is highly significant (***p &lt; .001) so the role of stress as mediator has been confirmed. Conclusion: The study provided initial evidence that after trauma exposure levels of posttraumatic stress which is experienced play a significant role in the promotion of PTG. Moreover, the results from the present study also revealed the possibility of positive changes in behaviors facilitated by moderate exposure of trauma and stress. doi: https://doi.org/10.12669/pjms.40.10.8897 How to cite this: Azeem A, Kiran N. Relationship between trauma, post-traumatic stress and post-traumatic growth for police officials: A path analysis. Pak J Med Sci. 2024;40(10):2223-2227. doi: https://doi.org/10.12669/pjms.40.10.8897 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Relationship between loneliness and post-traumatic growth in patients with gynecologic malignancies: the mediating role of self-disclosure and psychological resilience

BackgroundTo explore the relationship between loneliness and post-traumatic growth, with a focus on the mediating role of psychological resilience and self-disclosure.MethodsThis study was a cross-sectional survey using the Loneliness Scale for Cancer Patients, the Distress Expression Index Scale (for measuring self-disclosure), the Psychological Resilience Scale, and the Posttraumatic Growth Scale on 215 inpatients with gynecologic malignancies at a tertiary care hospital in Guangzhou. Subsequently, Correlation, regression, and mediation analyses were performed using SPSS to test the relationships between the variables.ResultsThe results showed that loneliness was negatively correlated with posttraumatic growth (r = -0.261, P < 0.001), self-disclosure was positively correlated with posttraumatic growth (r = 0.360, P < 0.001), and psychological resilience was positively correlated with posttraumatic growth (r = 0.475, P < 0.001); loneliness was correlated with self-disclosure (r = -0.194, P < 0.01), loneliness was negatively correlated with psychological resilience (r = -0.287, P < 0.001), self-disclosure was correlated with psychological resilience (r = 0.287, P < 0.001); loneliness was significantly correlated with self-disclosure (r = -0.314, P < 0.001); loneliness was not a direct predictor of posttraumatic growth (β = -0.108, t = 1.734, P > 0.05), but could influence posttraumatic growth through the mediated effect of self-disclosure and psychological resilience, where the total indirect effect of self-disclosure and psychological resilience was − 0.155 (95% CI: -0.236, -0.081, P < 0.001).ConclusionsThe mechanism of loneliness on post-traumatic growth in patients with gynecologic malignancies is mainly through the indirect effect of self-disclosure and the indirect impact of psychological resilience. Great attention should be paid to patients’ loneliness, to find factors promoting patients’ self-disclosure, to improve the level of patients’ psychological resilience, and promote post-traumatic growth of gynecologic malignant tumors.

Enduring strengths: How childhood adversity shapes adult resilience in Kosovo

This study investigates how adults who faced childhood adversity develop resilience, using the Resilience Portfolio Model to assess the impact of early victimization on adult well-being and posttraumatic growth. A sample of 689 adults aged 18 to 60 (average age 25.2 years, SD = 9.62) was recruited online in Kosovo, a collectivist and post-conflict society. Participants completed a survey on youth victimization, psychosocial strengths, subjective well-being and posttraumatic growth. Findings from the study show that 93% experienced some form of victimization, including 40% who were exposed to parental violence. Blockwise logistic regressions indicated that poly-strengths (an indicator of the breadth of one's resilience portfolio), sense of purpose, optimism, and religious meaning making were associated with higher levels of posttraumatic growth, controlling for polyvictimization and demographics (total R2 = 0.39). Poly-strengths, sense of purpose, optimism, and psychological endurance were associated with higher subjective well-being (total R2 = 0.34). Unexpectedly, some strengths were associated with lower posttraumatic growth, including coping, anger management, and moral-based meaning making. Findings from this highly victimized sample show that several strengths seem promising in promoting resilience. Intervention and prevention programs should consider focusing on promoting a sense of purpose or broadening resilience portfolios. More research is needed in other collectivist and post-conflict societies.

Post-traumatic reactions and quality of life after pelvic exenteration for gynecologic cancer: a retrospective cohort study.

We examined post-traumatic reactions and quality of life in women with recurrent gynecologic cancer who underwent a pelvic exenteration (PE), a potentially life-saving radical surgery associated with life-altering sequelae. Twenty-one women who had completed PE at least 6months prior completed the Impact of Event Scale-Revised, a measure of post-traumatic stress, the Post-Traumatic Growth Inventory, a measure of post-traumatic growth, the Center for Epidemiologic Studies-Depression Scale, and the European Organization for Research and Treatment of Cancer 30-item core Quality of Life Questionnaire. We examined the associations between these outcome variables, and quality of life scores were compared to normative values for the general and gynecologic cancer populations. Thirty percent of women reported clinically significant post-traumatic stress symptoms and 71% endorsed clinically significant depressive symptoms. More post-traumatic stress was associated with less post-traumatic growth, more depressive symptoms, and worse quality of life. In general, women's quality of life was worse than the general population but comparable to women with stage III-IV ovarian cancer and women with cervical cancer. Social functioning was markedly lower in our sample and women reported more pain, diarrhea, and financial difficulties post-PE compared to published norms for the general population and women with ovarian or cervical cancer. There were no differences in quality of life based on age, type of PE, type of urinary diversion, or cancer type. Findings support long-term continued symptom management and the ongoing rehabilitation of patients to optimize physical, psychological, and social well-being in PE survivorship.

Prolonged exposure to a public health event: the mediating role of resilience between social support and post-traumatic growth among frontline nurses

Background Inthe early days of December 2022, the Chinese government ended its restrictive quarantine measures (e.g. nationwide lockdown) against COVID-19, which started in December 2019. Three years of prolonged exposure to the COVID-19 pandemic and restrictive quarantine policy had a notable impact on the mental health of frontline nurses. Traumatic events can have negative effects on people as well as positive ones, such as post-traumatic growth (PTG). Studies have revealed that frontline nurses’ self-perceived quality of life had not changed significantly when the pandemic’s effects lessened. The Chinese model of fighting the pandemic provided a valuable opportunity for studying the effects of prolonged exposure traumatic events on PTG in individuals.ObjectiveThis cross-sectional study attempted to investigate PTG and its relationship with social support and resilience among frontline nurses during COVID-19 pandemic.MethodsA sample of 378 frontline nurses from tertiary hospitals in China participated in this study. The study took place two weeks after the government announced the end of the quarantine policy in December 2022 in China. Participants’ PTG, resilience and social support were assessed using the Post-traumatic Growth Inventory, Social Support Rate Scale and 14-Item Resilience Scale, respectively. PROCESS Procedure Model 4 was employed to examine the mediating role of resilience between social support and PTG.ResultsThe results of mediating effect analysis showed that social support could significantly predict resilience (a = 0.752, SE = 0.079, P < 0.001). Social support could significantly predict PTG (c’ = 0.366, SE = 0.103, P < 0.001), and resilience could also significantly predict PTG (b = 0.226, SE = 0.060, P < 0.001). Bootstrap test identified a significant mediating effect of resilience between social support and PTG (ab = 0.170, BootSE = 0.077, 95% CI [0.031, 0.330]). The mediating effect contributed 31.72% of the total effect ([a×b]/c=[0.752 × 0.226]/0.536 = 0.3172), indicating a partial mediating role of resilience between social support and PTG.ConclusionResilience partially mediated the relationship between social support and PTG among frontline nurses during COVID-19 pandemic. Improving social support and resilience might be effective intervention strategies for promoting PTG among frontline nurses during traumatic events.

Posttraumatic Growth after Spontaneous Coronary Artery Dissection: A Mixed-Methods Study

Abstract Background: Heart attacks caused by spontaneous coronary artery dissection (SCAD) are traumatic events. While stressful, traumatic events can also be catalysts for positive growth. Aims: This study investigated the nature, prevalence, and correlates of posttraumatic growth (PTG) after SCAD. Methods: A mixed-methods approach was used. Part 1 involved seven focus groups with SCAD survivors (n = 30), the findings of which were analyzed thematically. Part 2 involved an online survey of SCAD survivors (n = 263), which included the PTG inventory (PTGI). Bivariate and multivariable analyses determined the significant correlates of PTG after SCAD. Results: Part 1 revealed four key themes, namely appreciating life and living in the moment, personal agency, new work-life balance, and spiritual clarity. Part 2 demonstrated that 79% of participants reported some degree of PTG. The mean total PTGI score was 46.4; standard deviation = 25.5. In terms of PTGI factors, the most common aspects of growth were appreciation of life and personal strength. PTG was significantly associated (P &lt; 0.05) with education, partner status, living arrangements, presence of a close confidante, social support, time since SCAD, number of SCADs, and cardiac rehabilitation (CR) attendance. Variables retained in the multivariable model were younger age, mid-level education, high social support, being nondepressed, longer time since SCAD, greater number of SCADs, and CR attendance. Conclusion: This is the first study to demonstrate that, despite the associated stresses and challenges, there is a great potential for positive growth after SCAD. These findings have implications for the development and targeting of interventions to support post-SCAD recovery.