Nursing home nurses’ experiences of psychological resilience development in dementia care: A qualitative descriptive study

Background Dementia care presents significant psychological challenges for nursing home nurses, yet knowledge about how these nurses develop psychological resilience through their caring experiences remains limited. Understanding the mechanisms of resilience development is crucial for designing effective support interventions and improving the quality of dementia care in institutional settings. Methods A qualitative descriptive study informed by Interpretative Phenomenological Analysis (IPA) principles was conducted. Semi-structured interviews were conducted with 24 nurses from nursing homes in Guangzhou and Jinan, China between January and June 2025. Maximum variation sampling ensured diversity across gender, age, educational background, work experience, and institution type. Data were analysed using IPA combined with the Qualitative Analysis Guide of Leuven (QUAGOL). Transformative Learning Theory (TLT) provided the theoretical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed. Results Nurses’ psychological resilience development followed a transformative learning pathway comprising three interrelated phases. In the first phase, nurses encountered triggering dilemma experiences including professional value concealment, emotional boundary tensions, and therapeutic expectation conflicts. During the second phase of adaptive reconstruction, nurses engaged in professional identity questioning and rebuilding, practical wisdom accumulation, and caring innovation. The third phase of resilience wisdom generation encompassed existential meaning re-examination, reciprocal relationship discovery, and cultural context negotiation. Nurses who actively engaged in critical reflection developed resilience more effectively, while those lacking reflective support experienced more prolonged struggles with adaptation. Conclusions Nursing home nurses develop psychological resilience through transformative learning involving cognitive restructuring, professional identity reconstruction, and meaning-making. Support strategies should target each transformation phase. Chinese cultural context, particularly the interplay between person-centred principles and family-centred traditions, significantly shapes resilience development pathways. Interventions should foster critical reflection, provide mentorship opportunities, and create organizational cultures that value emotional labour in dementia care.