Archives of Psychiatric Nursing 28 (2014) 206211

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Archives of Psychiatric Nursing

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Work Satisfaction and Posttraumatic Growth 1 Year After the 2008

Wenchuan Earthquake: The Perceived Stress as a Moderating Factor
Jiuping Xu , Wei Wu 1
Uncertainty Decision-Making Laboratory, Sichuan University, Chengdu 610064, PR China

a b s t r a c t
This study investigated the role of perceived stress as a possible moderating factor between posttraumatic
growth (PTG) and work satisfaction. A stratied random sampling strategy was used to survey 2080 adult
survivors of the 2008 Sichuan earthquake. The Posttraumatic Growth Inventory, the Job Satisfaction Index
Scale and the Perceived Stress Scale were used in the assessment of the posttraumatic growth, work
satisfaction and perceived stress respectively, and hierarchical multiple regression analyses were used for the
analysis. The ndings highlight work satisfaction as an important factor in both the prediction of
posttraumatic growth and for its moderating effect on perceived stress. Some demographic characteristics,
such as gender, education level, and housing condition were found to also affect the survivors' posttraumatic
growth. This conclusion indicates that managers should pay closer attention to their employees' psychological
state after a disaster and medical practitioners should consider survivors' work status and perceived stress
when dispensing mental health care.
2014 Elsevier Inc. All rights reserved.

Natural disasters such as oods, hurricanes, and earthquakes occur

frequently in the world. Although a surprisingly large percentage of
individuals are relatively unaffected by traumatic events (Bonnano,
2004, 2005), some individuals experience signicant negative or
positive trauma consequences. Traumatic events can negatively affect
survivors and cause psychological problems such as posttraumatic
stress disorder (PTSD), but positive changes have also been reported
as a consequence of trauma (Frazier, Conlon, & Glaser, 2001; Frazier,
Tashiro, Berman, et al., 2004; Tedeschi & Calhoun, 2004), which has
been formally recognized as posttraumatic growth (PTG).
A growing body of research has indicated that there can be
personal growth after life-threatening events. Generally speaking,
posttraumatic growth (PTG) refers to the development of a positive
outlook towards change following a trauma, and focuses on ve major
aspects: an improved relationship with others, an increased personal
strength, the identication of new possibilities, positive spiritual
changes, and an increased appreciation of life (Tedeschi & Calhoun,
1996; Tedeschi & Calhoun, 2004). Some of the best predictors for
posttraumatic growth have been recognized as being female, being of
a younger age, having a higher level of education, having a higher
degree of earthquake-related exposure, and showing PTSD symptoms
such as intrusion and hyper arousal (Xu & Liao, 2011). Strong positive

Corresponding Author: Jiuping Xu, PhD, Uncertainty Decision-making Laboratory, Sichuan University, No. 24, South Section 1, Yihuan Road, Chengdu, Sichuan,
610064 P. R. China.
E-mail address: xujiuping@scu.edu.cn (J. Xu).
1
Uncertainty Decision-Making Laboratory, Sichuan University, No. 24, South Section
1, Yihuan Road, Chengdu, Sichuan, 610064 P. R. China.
http://dx.doi.org/10.1016/j.apnu.2013.12.006
0883-9417/ 2014 Elsevier Inc. All rights reserved.

associations have also been found between PTG and concurrent stress
(Holgersen, Boe, & Holen, 2010), and PTG has been found to be
best predicted by event centrality, problem-focused coping, and a
positive perspective of the event (Schuettler & Boals, 2011). Although
many of these articles have studied PTG and its relationship with
other factors, few papers have examined the effect of working status
on survivors.
After a traumatic event, life really does go on and people continue
to work, but their emotions and feelings can inuence both their lives
and their work. An individual's response to perceived stress is
considered to be inuenced by the personal and environmental
resources available to that person to deal with the stressor
(Dirkzwager, Bramsen, & Ploeg, 2003).When traumatic experiences
signicantly affect a survivors ability to cope, they often label
themselves as being stressed and experiencing negative emotional
and attitudinal responses. A general population survey of New
Yorkers 3 to 6 months after the September 11 attacks found almost
one third of people who experienced this trauma had had their
employment negatively affected in some way, primarily by losing
their job, losing time from work, or experiencing reduced hours or
responsibilities at work (Nandi, Galea, Tracy, et al., 2004). Since the
2008 Wenchuan earthquake, signicant time has been spent
researching PTG and stress, and from the ndings the focus of this
article was determined. In our previous study, signicant correlations
were found between work satisfaction and satisfaction with life,
satisfaction with life and health self-perception, satisfaction with life
and psychological recovery, and psychological pressure and psychosocial recovery (Xu & Wu, 2011). For adults, the status of their work
has been found to play an important role after trauma, and research

J. Xu, W. Wu / Archives of Psychiatric Nursing 28 (2014) 206211

has demonstrated that having paid work is signicantly associated

with PTG after a severe trauma (Powell, Gilson, & Collin, 2012). These
studies highlight that work status is signicantly related to PTG, yet
few studies so far have fully examined how work satisfaction
inuences PTG and vice versa.
From an increasing body of research, there is more evidence
that growth and adaptability are related to mental health levels
(Mccausland & Pakenham, 2003). The growth associated with perceived
stress can predict a positive psychological outlook after 6 months (Park
& Fenster, 2004). Hobfoll (Hobfoll, Hall, Nisim, et al., 2007) found that
after witnessing terror or violence, individual posttraumatic growth
levels were related to increased psychological pain. Some research has
suggested that multiple traumatic events may increase the level of
traumatic stress among individuals (Brewin, Andrews, & Valentine,
2000; Resick, Yehuda, Pitman, et al., 1995). Other studies indicate that
stress may be interpreted as a neutral, negative, or positive experience;
however, if the stress becomes excessive, resolution is inevitably needed
because left untreated this stress may cause anxiety (escape) or
depression (withdrawal) (Schafer, 1987; Segerstrom & Miller, 2004).
These concepts are particularly relevant to employees working in
poor working conditions in disaster regions following a traumatic
event who suffer from prolonged stress and who usually do not
have many social resources to combat this stress. Studies on nurses
working in a healthcare telephone-advice service indicated that
the perceived stress from doing shift work was a signicant,
independent predictor of job satisfaction and showed a negative effect
(Farquharson, Allan, Johnston, et al., 2012).This nding is consistent
with the ndings in the pilot test of our investigation after the
Wenchuan earthquake.
Though previous research has separately investigated the relationship between work satisfaction and PTG, the relationship between
stress and work satisfaction, and the inuence stress has on PTG, few
studies have addressed the possibility that perceived stress may be
associated with work satisfaction and PTG. This study has sought to
identify the link between the stressorwork satisfaction, the
moderatorperceived stress, and the outcomePTG. Specically,
this study hypothesized that
H1: Work satisfaction has a positive effect on the PTG among
survivors post-earthquake.
H2: Perceived stress has negative effort on PTG as well as work
satisfaction.
H3: Perceived stress weakens the positive effect of job satisfaction
on the PTG among survivors post-earthquake depending on
severity.
A year after the Wenchuan earthquake, we investigated the
psychological state of 2080 individuals in regions affected by the
disaster. Our project was partly sponsored by the China Association
for Science and Technology, which aims to provide proles of the
current status of workers in local areas, and especially those whose
work is related to science and technology. In this paper we focus on
the factors related to work satisfaction, and examine the moderating
role that perceived stress may have. We further evaluate the effect of
the earthquake and the new working and living conditions 1 year after
the earthquake.
Such research is important for policy makers and society to assist
in understanding the consequences of PTG on an earthquake victims'
job satisfaction, and clear the mechanism of stress between them to
help them develop strategies to aid the disaster survivors.
METHODS
Data Collection
Earthquakes are life threatening, unpredictable and uncontrollable
phenomena which cause widespread devastation and loss of life and

207

livelihood. On May 12, 2008, an earthquake measuring 8.0 on the

Richter scale struck Wenchuan in Sichuan Province, China.
According to the Ministry of Civil Affairs, more than 70,000 were
conrmed dead and more than 400,000 were injured, with 18,467
listed as missing and 6.5 million people made homeless. Earthquakes can affect many people and cause great destruction;
however, the experience of this trauma at an individual level is a
struggle which can result in a positive experience, and produce a
positive change.
We conducted a large-scale survey (N = 2080) in severely affected
counties in Sichuan and Shanxi 1 year after the Wenchuan earthquake.
A total of 2300 individuals were involved in this survey with 2080
completing the questionnaire in May and June 2009, a response rate of
90.4%. All participants were randomly selected from the worst-hit
areas in two provinces: Sichuan and Shanxi. In Sichuan Province,
eighteen worst-hit counties were chosen: Dujiangyan, Pengzhou,
Chongzhou, Shifang, Mianzhu, Jiangyou, Anxian, Pingwu, Beichuan,
Jiange, Qingchuan, Hanyuan, Wenchuan, Lixian, Maoxian, Songpan,
Heishui, and Xiaojin. For Shanxi province, Lueyang was selected.
Our survey teams were temporarily established and divided into 19
small groups, with each team, including two graduate students from
Sichuan University and one staff from the local government, presiding
over one county. It was guaranteed that the subjects' information
would remain condential. Before conducting the formal investigation, a pilot test was carried out in May and June 2009 with a group of
randomly selected survivors participating, the feedback from which
led to some minor modications and adjustments to the nal version.
All assessment forms were translated from English to Chinese and
back-translated by a bilingual team of professionals. From July to
September 2009, the trained groups were assigned to the counties
based on a previously arranged schedule. They visited households who
lived in both their original houses and in temporary shelter. Houses
and temporary accommodations were randomly selected on the basis
of the total number, and one respondent within each selected house or
temporary shelter was randomly selected. Group members explained
the goals of the study to the inhabitants and made clear that anonymity
would be ensured. Some of the inhabitants declined to be interviewed
because they were wary of such earthquake surveys and wished to
avoid talking about the event. If this was the case, the next closest
family member was invited. Very few respondents had a low education
level or had literacy problems. The group members helped those who
had problems to note down answers and assisted them in completing

Table 1
Demographic Characteristics.

Age
1830
3140
4150
51
Gender
Male
Female
Income (unit: yuan)
b1000
10002000
20003000
3000+
Education level
High school or below
University or college
Above university
Housing status
Original house
Temporary settlement
Rented house
Public dormitory

441
849
609
181

21.20
40.80
29.30
8.70

1227
853

59.00
41.00

484
1352
214
29

23.30
65.00
10.30
1.40

325
1708
47

15.63
82.12
2.25

1057
328
199
388

53.6
16.6
10.1
19.7

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J. Xu, W. Wu / Archives of Psychiatric Nursing 28 (2014) 206211

the survey. To ensure privacy, interviewers and participants were

encouraged to complete the questionnaire in private. There was daily
supervision throughout the survey.
The study and procedures described were approved by the ethics
committee of Sichuan University, and written informed consent was
obtained from each subject after a full explanation of the study
procedures. The investigation was conducted in accordance with the
latest version of the Declaration of Helsinki.
Measures
The Job Satisfaction Index Scale (JSS) developed by Brayeld and
Rothe measures workers' general work satisfaction, i.e. their comprehensive satisfaction. This scale quotes Hackman and Lawler (1971) for
a denition for job satisfaction from a discrepancy point of view to
assess the sum of the gap between the employee's view of the whole
work environment for "expected satisfaction" and "practical satisfaction". Factors related to work were assessed on 6 items over three
dimensions: inner job satisfaction (wages and benets, promotional
prospects), external satisfaction (work environment, management
and colleagues interpersonal relationships) and job and overall
satisfaction (personal expertise and interest in job, learning opportunities and job security). Participants were questioned about their
opinions and personal experiences on job specication satisfaction,
management relationship satisfaction, colleague interpersonal relationships satisfaction, income satisfaction, promotional prospects
satisfaction and overall work situation satisfaction. A ve-point Likert
scale was used to quantify each of these options. For instance, the
intensity scale for promotion prospects was scaled as follows: 1 =
very satised, 2 = relatively satised, 3 = fair, 4 = relatively dissatised and 5 = very dissatised.
The assessment of positive post-disaster outcomes was evaluated
using the Posttraumatic Growth Inventory (PTGI, Tedeschi & Calhoun,
1996). This inventory has 21 items across ve major domains: relating
to others (7 items), new possibilities (5 items), personal strength
(4 items), spiritual changes (2 items), and appreciation of life
(3 items). Before the investigation a pilot test was carried out with
a pool of 118 workers and some minor modications and adjustments
made according to the feedback to form the nal version of the
questionnaire. Two items were excluded (A better understanding of
spiritual matters and I have a stronger religious faith), as no
participant were found to have any religious beliefs in the pilot test.
Participants responded on a 6-point scale (0 as no change and 5 as
complete change), with higher scores representing higher levels of
posttraumatic growth. The total PTGI score was the sum of the
remaining 19 items, with a total possible score of 95. In Tang's (2006)
study, average mean scores above 3 for the PTGI were indicative of
moderate levels of PTG, and according to Yu, Lau, Zhang, Mak, et al.
(2010), total scores above the 75th percentile were considered to
have probable PTG. In the present study, scores above 57 (including
57) were considered to indicate a moderate level of posttraumatic
growth 1 year following the Wenchuan earthquake. In other words, 57
was the cutoff point for the assessment of posttraumatic growth. This
inventory has previously demonstrated good internal and testretest
reliability for western (Tedeschi & Calhoun, 1996) and Asian samples
(Ho, Chan, & Ho, 2004). The total PTGI internal consistency was 0.90
(Tedeschi & Calhoun, 1996). In the present study, the Cronbach's alphas
coefcient for this instrument was 0.88, and the internal reliabilities of
the four subscales were 83, 79, 81, and 80, respectively.
Perceived stress was measured using the fourteen-item perceived
stress scale, PSS (Cohen, Kamarck, & Mermelstein, 1983). This scale
assesses the degree to which situations in an individual's life are
regarded as stressful. The study used a ve-point Likert scale with
responses ranging from 0 = never, 1 = occasionally, 2 = frequently,
3 = very often, 4 = invariably. A sample item is Have you been
upset because of something that happened unexpectedly? Reliability

Table 2
Scores of Subgroups in Three Aspects (N = 2080).
Work
satisfaction

Perceived
stress

PTG

Category

SD

SD

SD

All participants
Gender
Male
Female
Education level
Doctor
Master
Bachelor
No degree
Age
1830
3140
4150
5168
Income (yuan)
b1000
10002000
20003000
3000+
Housing status
Original house
Temporary settlement
Rented house
Public dormitory

2.58

0.64

2.77

0.88

55.68

11.50

2.52
2.66

0.65
0.61

2.74
2.80

0.53
0.53

55.82
56.81

10.36
10.26

1.58
2.24
2.61
2.58

0.64
0.52
0.68
0.60

1.70
2.63
2.74
2.80

0.90
0.57
0.57
0.50

50.25
56.65
56.95
55.61

5.53
6.35
9.52
11.06

2.53
2.65
2.53
2.48

0.66
0.65
0.60
0.66

2.76
2.78
2.75
2.71

0.57
0.55
0.49
0.54

56.20
57.14
55.70
53.40

9.95
10.27
10.16
11.02

2.63
2.61
2.45
2.24

0.67
0.64
0.58
0.65

2.79
2.79
2.63
2.58

0.62
0.53
0.49
0.43

55.15
56.05
54.93
54.46

12.04
11.45
10.94
11.47

2.53
2.76
2.64
2.54

0.65
0.61
0.59
0.64

2.70
2.89
2.82
2.76

0.54
0.52
0.47
0.58

56.05
58.10
56.91
57.70

9.18
9.24
9.30
9.04

NOTE. M: mean, SD: standard deviation, PTGI: Posttraumatic Growth Inventory.

has been reported in the range 0.84 to 0.86 (Cohen et al., 1983). The
Cronbach's alpha among the present sample was 0.81.
In this study, we assumed that work satisfaction has a primary
effect on PTG, and the survivor's perceived stress played a moderating
role. With this in mind we developed the following hypotheses:
Data Analysis
In our study, descriptive statistics, variance analysis, and correlation analysis were calculated and presented. Data were expressed as a
frequency for the nominal variables and as a mean standard
deviation (SD) for continuous variables. In multiple linear regression
analysis, demographic characteristics such as gender, age, education
level, income and housing conditions were control variables in the
analysis, and work satisfaction and perceived stress were independent variables, whereas PTG was a dependent variable. For missing
data, list wise deletion was used. SPSS 16.0 for Windows was used for
data analysis and p b 0.05 was considered statistically signicant.
RESULTS
Demographic Characteristics
The rst part shows the basic demography and socioeconomic
status, including age, gender, level of education, monthly income,
ethnicity and housing status, which were considered the control
variables (Table 1). Age was divided into four groups: 18 to 30 (coded
as 1), 31 to 40 (coded as 2), 41 to 50 (coded as 3), older than 51 (coded
as 4). Gender was coded 1 (male) and 2 (female). Level of education
was coded 13 and referred to the different education levels. Income
was divided into four income levels, namely, 1 = less than 1000
Yuan, 2 = from 1000 to 2000 Yuan, 3 = from 2000 to 3000 Yuan,
4 = more than 3000 Yuan. Ethnic groups are also listed, coded 15
referring to the Han, Tibetan, Qiang, Hui and others respectively. In
terms of housing, 1 = original house, 2 = public dormitory, 3 =
rented house, 4 = temporary settlement.

J. Xu, W. Wu / Archives of Psychiatric Nursing 28 (2014) 206211

209

Table 3
Correlation Coefcients Among the Variables.
1
1
2
3
4
5
6

Work satisfaction-total
Overall satisfactiona
Inner satisfactionb
External satisfactionc
PTG-total
Perceived stress-total

0.015
0.479

0.190

0.846
0.845
0.861
0.324
0.556

0.551
0.634
0.289
0.450

0.570
0.404
0.502

NOTE. PTGI: Posttraumatic Growth Inventory.

p b 0.01 (two-tailed).
a
Personal expertise and interest in job, learning opportunities and job security.
b
Wages and benets, promotional prospects.
c
Work environment, management and colleagues' interpersonal relationships.

Basic Data Analysis

The date was grouped according to the demographic variables and
other control variables to assess the effect of these distinct
characteristics on work satisfaction, perceived stress and PTG, the
scores for which are presented in Table 2. For perceived stress, a lower
mean score indicated a better assessment; for work satisfaction and
PTG, a higher mean score indicated a better performance.
For all participants, the work satisfaction mean of 2.58 was between
relatively satised (2) and fair (3), the total stress mean of 2.77 was
between frequently (2) and very often (3), and the PTG was close to a
moderate level (55.68 (SD 11.50)). In all three areas, men scored
lower than women. When looking at participants with an undergraduate or lower education level, the higher the education level the higher
work satisfaction and PTG were found to be. However, for those
participants with post graduate education, lower performance was
perceived with PhD level participants showing the lowest PTG. Elderly
people reported higher assessments in all three areas. The lower income
group were found to have a higher stress level, and participants living in
their original houses had the lowest perceived stress.
Correlation Analysis
Table 3 shows the extent that work satisfaction, PTG, and
perceived stress relate to each other. Most pairs of the selected ve
variables were signicantly correlated but at different levels. As can be
seen from Table 3, the correlations between inner satisfaction and
PTG, each aspect of satisfaction and perceived stress-total, and the
perceived stress-total and PTG were signicant at 0.01 level.
The bivariate correlation analyses showed that PTG was related to
"overall satisfaction" (r = 0.289) and "inner satisfaction" (r =
0.404), and stress was associated with all three aspects of work
satisfaction (r = 0.450, r = 0.502, r = 0.479). There was a moderate
correlation between PTG and perceived stress (r = 0.190).

explanation (R 2 = 0.011, p b 0.01). In step 4 a new variable

multiplying the dependent variable work satisfaction by the moderator variable perceived stress was created to test if stress was a
moderating variable. The interaction was found to make a signicant
contribution to the explained variance (R 2 = 0.013, p b 0.05). Thus,
hypothesis 1(work satisfaction has a positive effect on the PTG among
survivors post-earthquake) and hypothesis 2 (perceived stress was a
moderator which weakened the effect of work satisfaction on PTG)
were supported by the analysis.
DISCUSSION
The present literature represents the mitigating effort of stress on
the positive relationship between PTG and work satisfaction. It
indicated that work satisfaction was positively related to PTG, while
perceived stress weakened the positive effect of the work satisfaction
on PTG among survivors 1 year after the Wenchuan earthquake.
Our study rst examined the risk factors of survivors' three
aspects: PTG, stress and work satisfaction (Table 2). Our survey
indicated that females had lower work satisfaction and higher
perceived stress consistent with previous ndings that being female
was a predictor of mental issues such as depression, traumatic stress
response and anxiety (Armenian, Morikawa, Melkonian, et al., 2002;
Liu, Xiao, Chen, et al., 2009; Varela, Koustouki, Davos, et al., 2008).
Older people reported better evaluations for work satisfaction and less
for perceived stress. As these subjects were mostly workers from
nationally owned enterprises and departments and were usually in
higher level positions, they may have been more content with
their current lives. In our research, participants with a higher
educational level suffered less psychological stress than those with

Table 4
Risk Factors and Interaction Effect Analysis for Total PTG Score.
PTG

The Regression Analysis

With work satisfaction as the independent variable and PTG as the
dependent variable, the results for the hierarchical regression
analyses are presented in Table 4. In step 1, when all demographic
variables were considered, the control variables, gender, education
level and housing status were found to be signicant. Generally
speaking, male survivors and those with a better level of housing
showed higher PTG points. However, survivors with a higher
education had a lower PTG. The demographic characteristics showed
a 14.0% change in the PTG points (R 2 = 0.14, p b 0.01). In step 2
demographic variables were controlled, and a higher PTG score was
explained by a higher level of work satisfaction, which accounted for
the 12.2 % change in the R 2 of the model (R 2 = 0.122, p b 0.01). In
step 3 perceived stress was added to test its moderating effect on PTG
and work satisfaction and was found to negatively contribute to the

Variables
Step 1
Gender
Age
Education
Income
Housing
Step 2
WS
Step 3
Perceived stress
Step 4
WS perceived stress

Std. error

Beta

0.747
0.259
0.250
0.377
0.373

0.404
0.242
0.376
0.299
0.159

0.050
0.031
0.019
0.036
0.062

0.115

0.051

0.345

0.072

0.229

0.108

0.005

0.026

0.059

R2

R2

0.14

0.14

0.122

0.262

0.011

0.273

0.013

0.286

NOTE. WS: work satisfaction, B = unstandardized, beta = standardized coefcients

derived from the nal step; R2 = explanation rate, R2 = change in explanation rate
in each step.
p b 0.05.
p b 0.01.

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J. Xu, W. Wu / Archives of Psychiatric Nursing 28 (2014) 206211

a lower educational level, consistent with other research ndings

where lower education was found to be related to higher
psychological problems among earthquake survivors (Kilic &
Ulusoy, 2003; Livanou, Bassoglu, Salcioglu, et al., 2002; Montazeri,
Baradaran, Omidvari, et al., 2005). Survivors who were living in
their original houses suffered the least perceived stress. Studies
have shown that earthquakes may cause stress reactions in
survivors who have had to adapt to new circumstances (Bodvarsdottir
& Elklit, 2004; Karanci & Rustemly, 1995). Wenchuan earthquake
caused damage to many homes leaving many families homeless and in
need of temporary accommodation, so these poor or altered living
conditions added to their stress.
Second, we found that work satisfaction was an important factor in
the prediction of PTG. The results of the bivariate correlation analyses
indicated that there was a positive association between PTG and work
satisfaction in the present study (r = 0.324, p b 0.01). Xu and Wu
(2011) found the earthquake survivors' opinions on work satisfaction
inuenced their views on psychological pressure and psychological
recovery. The earthquake caused signicant changes to many
survivor's work environments and status, such as damage or
destruction of work facilities, lack of funds for rebuilding, a heavier
work load or even job loss. In our small-scale telephone interview, the
employees with a higher work satisfaction were found to have better
interpersonal relationships, more condence in their lives and the
courage to overcome difculties. We also found that the survivors'
perceived stress was associated with their work satisfaction (r =
0.556, p b 0.01). As the earthquake caused work problems,
perceived stress was seen as a consequence of these work troubles
(Farquharson et al., 2012). So those with higher work satisfaction
evaluations had higher performances in the psychological aspects
because of their better work status or working conditions. As a study
of rescue workers after the Oklahoma City bombing reported, PTSD
was found to be associated with reduced job satisfaction (North, Tivis,
McMillen, et al., 2003), with the opinions on work inuencing views
on perceived stress and psychological recovery. Those with a higher
work satisfaction showed higher psychological aspect performances.
Third, the regression analysis demonstrated that stress functioned
as a moderator between PTG and work satisfaction. The results of this
study showed a positive association between work satisfaction and
PTG while perceived stress contributed negatively. In Table 4, the
coefcient of the interaction item WS perceived stress is not zero
( 0.005) and is signicant at 0.01 level, which indicates that
perceived stress has a moderating effect on work satisfaction and
PTG. This WS perceived stress (R 2 = 0.013, p b 0.01), also indicates that the more severity the perceived stress, the weaker the
positive effect of work satisfaction on PTG. These ndings suggest that
perceived stress buffers the PTG-JSS intention linkage: from an
individual's perspective, those having a higher work satisfaction had
a better status and were better able to deal with their stress and
recovery, which buffered the negative effects of stress on PTG. When
an individual had severe stress, it may inuence their mood at work
and possibly conicted with their work status, weakening the positive
effect of work satisfaction on PTG.
Some stresses such as power and water cuts, family troubles, and
daily tries may have existed before but didnt inuence work
satisfaction because most survivors thought they were able to
overcome this slight stress. However, because of the earthquake,
some stresses in daily life would make them feel more pressure. This
earthquake occurred in West China, a region which is underdeveloped and where the local residents are mostly poorly educated,
so the impact of stress on their mental health was high. Prior to the
earthquake, most of these people worked in peace (even though their
jobs may not have been very good), but the occurrence of the
earthquake broke this balance (destroyed their working equipment,
worsened their working environment and even deprived them of
their job.), so the stress resulting from the earthquake became serious,

and signicantly inuenced their work satisfaction. The fear of the

earthquake amplied the stress, which may not have inuenced their
previous work satisfaction. Thus, the moderating mechanism may
have affected this in some way: that is, the survivors were working
normally until they felt the stress resulting from the earthquake, so
the daily stress was amplied by the earthquake, and when the
pressure reached a certain degree, the people had feelings of
dissatisfaction, which affected their experience of PTG. For adults,
the status of their work has been found to play an important role after
trauma, and research has demonstrated that having paid work is
signicantly associated with PTG after a severe trauma (Powell et al.,
2012). With this in mind, therefore, we feel that this may be the
reason why perceived stress moderates PTG and work satisfaction.
Employers in the disaster-hit areas need to attach importance to
their employees' psychological state and the stress caused by the
trauma. As disasters generally cause a negative inuence on working
conditions in the disaster area, employers need to take action to
recover facilities and restore the environment to maintain work
satisfaction. Special efforts need to be focused on removing elements
at work which may cause employees to recall the stresses and terrors
of the earthquake. For example, employers could engage government
policy and nancial support to assist in reconstruction, while for stress
management, allocating workloads appropriately, assisting in the
resolution of workfamily conicts, conducting stress relieving
activities and providing psychological counseling channels would
assist in alleviating worker stress and elevating worker satisfaction.
For posttraumatic psychological rehabilitation, mental health
service providers need to minimize survivors' victimization experiences, improve their regulatory abilities, and promote alternatives to
negative coping in victims following disasters (Terranova, Boxer, &
Morris, 2009). Mental health recovery intervention like early
identication, ongoing monitoring, sustained psychosocial support
and mental health services are required for high-risk populations. Our
study particularly focused on the survivors as employees, and
emphasizes the importance of work status and stress relief for
posttraumatic patients. Medical workers need to be aware of the
importance of job satisfaction and perceived stress on PTG, and put
more effort into survivors' mental health care, such as improving
psychological debrieng.
The limitations of this study are that no comparisons were made
due to a lack of pre-disaster data, so it is difcult to condently discern
the true extent of the earthquake's effect. Our participants were
mainly workers from different elds. However, a survey of affected
populations in rural and remote areas was unavailable. More
representative samples are needed to examine the generalizability
of these ndings. The current endeavor was limited by its crosssectional design as the survey did not cover the broader areas of the
countryside, and all questionnaires were self-reporting, so there was
no objective measure of availability or quality, and hence it was not
possible to evaluate the accuracy and insightfulness of an individual's
perceptions. In addition, as the interview sample was very large, the
measurements were unable to cover all participants, and were limited
by the objective condition, so a skewing in the ndings is inevitable.
Despite these limitations, the results from the study still initially
support the concept that posttraumatic growth relates to work
satisfaction through perceived stress. In particular, the ndings of the
moderating effects of perceived stress suggest the need to focus future
research and practice on organizational stress management. Future
research must analyze additional possible mediating and moderating
factors on the relationship between PTG, perceived stress, and work
satisfaction, as other factors may also account for these effects.
Acknowledgment
The research is supported by the Major Program of National Social
Science Foundation of China (Grant No. 12 & ZD217), Sichuan Provincial

J. Xu, W. Wu / Archives of Psychiatric Nursing 28 (2014) 206211

Social Science Foundation of China (Grant No. SC13ZD06) and the

research funding of Sichuan University (Grant No. SKG2013001). We
appreciated these supports both in nance and in spirit.
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2014 Elsevier