Article Text

Download PDFPDF
Original research
Post-traumatic growth and influencing factors among frontline nurses fighting against COVID-19
  1. Pan pan Cui1,2,
  2. Pan pan Wang2,
  3. Kun Wang1,
  4. Zhiguang Ping3,
  5. Peng Wang2,
  6. Changying Chen1
  1. 1 The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
  2. 2 School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
  3. 3 College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
  1. Correspondence to Professor Changying Chen, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; changying{at}


Objective To explore the level and influencing factors of frontline nurses’ post-traumatic growth (PTG) during COVID-19 epidemic.

Methods A cross-sectional survey was conducted in February 2020 in three hospitals in China. The Post-traumatic Growth Inventory (PTGI) was used to investigate the PTG of frontline nurses. Data on related factors, including demographic characteristics and subjective variables, were collected. The Event-Related Rumination Inventory was used to assess rumination. Pearson’s or Spearman’s correlation was calculated for bivariate analysis. Independent sample t-tests or one-way analysis of variance and multiple linear regression analysis were used to examine the related factors.

Results A total of 179 frontline nurses were recruited, and 167 were included in the analyses. The mean PTG score was 70.53±17.26. The bivariate analyses showed that deliberate rumination was modestly positively correlated with PTG (r=0.557, p<0.01), while intrusive rumination had a modest negative correlation with PTG (r=−0.413, p<0.01). Multiple linear regression demonstrated that working years, self-confidence in frontline work, awareness of risk, psychological intervention or training during the epidemic and deliberate rumination were the main influencing factors of PTG among frontline nurses and accounted for 42.5% of the variance (F=31.626, p<0.001).

Conclusions The PTG of frontline nurses was at a medium to high level and was influenced by working years, self-confidence in frontline work, awareness of risk, psychological intervention or training and deliberate rumination. It is necessary to strengthen psychological guidance and training for frontline nurses and promote their deliberate rumination on epidemic events to improve their PTG.

  • epidemiology
  • health care workers
  • rehabilitation
  • mental health
  • cross sectional studies

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors PpC: study concept and design, analysis of data and draft the manuscript; CC: study concept and design, revise the manuscript critically for important intellectual content and final approval of the version to be submitted; PpW and KW: acquisition of data and enter in database; ZP and PW: revise the manuscript critically for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the ethics committee of the corresponding institute (approval number: 2020-KY-065).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.