Post-traumatic growth promotes resilience development : A Longitudinal Mediation Model

Background
The frequent occurrence of global disasters poses unprecedented challenges to nursing practice. The frontline nurses in disaster relief are exposed to these events and bear significant levels of stress and psychological distress. Resilience and posttraumatic growth (PTG) are essential protective factors that contribute to sustaining their mental health. The purpose of this study was to determine the directional relationship between resilience and PTG using a cross-lagged design. Furthermore, employing longitudinal mediation to test whether the T1 resilience of frontline nurses would promote the development of T3 resilience through the mediating role of T2 PTG.

Methods
A total of 258 frontline nurses were selected as subjects. They completed self-reported measurements in three periods. The present study was conducted using a cross-lagged panel model and a longitudinal mediation model.

Results
The results of cross-lagged path analysis from T2 to T3 showed that PTG could positively predict the development of resilience (β = 0.235, p < 0.001). Resilience did not positively predict the development of PTG (p > 0.05). The analysis of mediating effect results showed that the development of PTG at T2 mediated the relationship between resilience from T1 to T3.

Limitations
Findings may be limited by self-report, recall bias of resilience before the epidemic and short tracking frequency.

Conclusions
These results can identify individuals with an increased risk of low resilience under disaster and the mediating role of posttraumatic growth in promoting the development of nurses' resilience, which provides a theoretical basis for psychological crisis intervention and the resilience promotion plan for posttraumatic growth under disaster events.

Highlights
• Cross-lagged and longitudinal mediation are used to infer causality.
• The posttraumatic growth of frontline nurses can positively predict their resilience.
• The posttraumatic growth of frontline nurses serves as a mediator in the development of resilience.
• Developing posttraumatic growth in frontline nurses is essential to bolster resilience and prepare for future medical crises.