Publication date: Jul 21, 2026
The COVID-19 pandemic has imposed unprecedented psychological demands on nurses working in care homes, profoundly affecting their well-being. Thus, this cross-sectional study examined the psychological burden among German care home nurses during the fourth COVID-19 wave and the early phase of the fifth wave in Germany, focusing on posttraumatic stress disorder (PTSD) and burnout, and assessed the availability of workplace psychosocial resources. A total of 719 nurses completed an online cross-sectional convenience survey between October 2021 and January 2022. Given the voluntary online recruitment, the findings should be interpreted with caution due to the potential for self-selection bias. PTSD symptoms were assessed using the International Trauma Questionnaire (ITQ), and burnout dimensions were assessed using the Copenhagen Burnout Inventory (CBI). Multiple linear regression analyses were conducted to identify factors associated with PTSD and different dimensions of burnout, including personal burnout, work-related burnout and resident-related burnout. Among nurses, 91. 4% fulfilled PTSD screening criteria and/or exceeded the indicative CBI cut-off for at least one burnout dimension, indicating a high psychological burden within the present study sample. Specifically, 29. 5% met screening criteria for PTSD, 90. 0% exceeded the indicative CBI cut-off for personal burnout, 78. 9% for work-related burnout, and 33. 4% for resident-related burnout. Only 21. 7% reported availability of psychosocial support at work. PTSD was significantly associated with poorer general health, lower job satisfaction, COVID-19-related deaths among residents in care home, dementia-focused care and female gender. Personal burnout was significantly associated with poorer general health, lower job satisfaction, female gender, absence of participatory leadership at care home, younger age, no COVID-19 infection history, and lower posttraumatic growth. Work-related burnout was significantly associated with lower job satisfaction, poorer general health, lower posttraumatic growth, female gender, no COVID-19 infection history, absence of participatory leadership at care home, and full-time employment. Resident-related burnout was significantly associated with lower job satisfaction, poorer general health, lower posttraumatic growth, and no COVID-19 infection history. The high levels of PTSD and burnout found in the present study likely reflect strain placed by the pandemic as well as constant work-related strain on care home nurses. These findings underscore the urgent need for improved psychosocial support and organizational strategies to strengthen mental health in long-term care settings. Not applicable.
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| Concepts | Keywords |
|---|---|
| Copenhagen | COVID-19 |
| Germany | Long-term care |
| Nurses | Nursing homes |
| October | Psychosocial support |
| Ptsd | PTSD |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 pandemic |
| disease | MESH | posttraumatic stress disorder |
| disease | MESH | PTSD |
| disease | MESH | Trauma |
| drug | DRUGBANK | Methionine |
| disease | MESH | dementia |
| disease | MESH | infection |
| disease | MESH | strain |
| pathway | REACTOME | Reproduction |
| disease | MESH | included |
| disease | MESH | Ger |
| drug | DRUGBANK | Etoperidone |
| disease | MESH | Job Demands |
| drug | DRUGBANK | Esomeprazole |
| drug | DRUGBANK | Cysteamine |
| disease | MESH | ICD |
| drug | DRUGBANK | Trestolone |
| disease | MESH | mental illness |
| disease | MESH | burn |
| disease | MESH | IBM |