Gratitude and Subjective Well-Being in Older Chinese Adults in Nursing Homes: The Mediating Roles of Self-Efficacy and Social Support.

Because the study was cross-sectional, it cannot show that gratitude causes higher well-being or that improving gratitude would improve well-being. It used convenience sampling from three nursing homes in Guangzhou, so the results may not apply to all older adults in Chinese nursing homes. Residents with dementia, cognitive impairment, hearing impairment, acute or end-stage medical conditions were excluded, so the findings may not apply to those common groups in nursing homes. Key variables were self-reported questionnaires, so associations may be influenced by how residents understood or answered the items. The analysis adjusted only for age and number of chronic diseases; activities of daily living and cognitive function were not included. The study did not test any intervention, so it cannot support the effectiveness of gratitude, self-efficacy, or social support activities.

The authors declared no conflicts of interest. The paper names funding from the National Social Science Foundation of China and The Key Discipline Project (Nursing) of Guangzhou.

Do not read the indirect paths as proof that gratitude causes better well-being. The study was cross-sectional, used convenience sampling, and did not test a gratitude intervention.