Abstract
Background/Objective: Different studies have shown how gratitude increases in times of uncertainty and adversity, such as the COVID-19 pandemic. But most research on gratitude has focused on young people and studies analyzing its predictors are scarce. This study examined the role that sociodemographic variables, COVID-19 characteristics, family functioning, emotional distress (anxiety and depression) and purpose in life had upon gratitude. Method: 361 people aged 60 years and over from different parts of Spain took part in the study. We used hierarchical regression analysis to examine data. Results: The study demonstrated that family functioning, and purpose of life predicted gratitude. These results have implications for the perception of aging, from a traditional negative approach to a strengths-based approach. Conclusion: Strengthening family bonds and increasing meaning in life to promote gratitude in times of crisis interventions is needed.
Introduction
Traditionally, being old has been considered a weakness. Even the World Health Organization recently suggested considering aging as an illness. Chronological age is one of the most repeated variables considered as a risk factor in health-related issues. Most studies are mainly focused on older adults’ negative consequences and risk factors. This approach is based on the dominant paradigm of decline in older people, in which aging has been traditionally associated with physical and psychological illness, functional decline and dependency. The COVID -19 crisis have affected everyone’s lives directly or vicariously. However, the worst consequences of the pandemic, both psychological and physical, were directly associated with aging. Thus, many researchers predicted that older adults would be more affected by the pandemic than other age groups (Li et al., 2020).
But one of the most remarkable aging characteristics is its heterogeneity. Although the probability of experiencing physical and/or mental problems increases as we age, aging can take a lot of pathways. Most older people stay healthy, free of dependence, with high levels of well-being and quality of life. Moreover, some research showed that the prevalence of mental disorders among older people is less frequent than in other age groups (Petrova & Khvostikova, 2021). For example, recent meta-analyses found that older people obtained lower scores in anxious and depressive symptomatology, while young people obtained the highest scores during the COVID-19 pandemic (Dragioti et al., 2022; Santomauro et al., 2021).
There is an alternative perspective based on personal strengths in older adults, a more positive one that stresses the idea that older people can handle very adverse circumstances, including the COVID-19 pandemic, and develop capabilities and resources (Chamorro-Garrido et al., 2021; edited out for blind review). This positive perspective regained attention due to the development of positive psychology. This approach focuses on character strengths which are morally valued elements of personality crucial to understanding psychological well-being. Peterson and Seligman (2004) described a model comprised of 24-character strengths grouped into six virtues: wisdom and knowledge, courage, humanity, justice, temperance and transcendence.
Gratitude is one of the character strengths related to the virtue of transcendence which determines a vital element of human existence (Watkins, 2015). There is a lack of a universal consensus definition of gratitude. It has been considered an attitude, a moral virtue, an emotion (the most indispensable emotion), a habit, a personality trait, and a coping response related to positive outcomes (Emmons, 2004). According to Emmons (2004), gratitude is ‘‘a sense of thankfulness and joy in response to receiving a gift, whether the gift is a tangible benefit from a specific other or a moment of peaceful bliss evoked by natural beauty’’ (p. 554). Generally, it consists of a tendency of being aware of and thankful for the good things that happen. It plays a key role in social, interpersonal, and personal life and considering its implications, it is described as the most beneficial character strength (Park et al., 2004). What is more, Fredrickson (2004) and Peterson and Seligman (2004) found that gratitude was the most effective emotion that increases after significant adversities. Besides, there is also research that shows how people who feel and express gratitude manifest better physical and psychological health (Emmons & McCullough, 2004). For this reason, we based our study on the Peterson and Seligman model that describes character strengths as “positive traits reflected in thoughts, feelings and behaviors” (Park et al., 2004, p.603).
According to these results, scientific attention to gratitude is completely justified. However, most of the research on gratitude has focused on childhood and adolescence and the assessment of how gratitude affects the adaptation to life events in older adulthood has received less attention (Chopik et al., 2019). And the pandemic situation provoked a higher interest to analyse the benefits of gratitude during the pandemic. For example, a recent study found that older people more grateful showed lower levels of emotional distress and higher levels of psychological wellbeing (edited out for blind review). Jiang (2022) also found a positive relationship between gratitude and positive emotions and a negative one between gratitude and COVID-19 subjective stress.
Two theoretical models explain the gratitude role in older adults: the socioemotional selectivity theory (Carstensen, 2006) and the gerontranscendence theory (Tornstam, 2011). On the one hand, the socioemotional selectivity theory points out that older people perceive time as more limited and finite and, therefore, they prioritize and invest in positive and meaningful events and social interactions with close and significant others and endeavor to conserve intimate and healthy relationships (Carstensen, 2006). According to this theory, gratitude would help to develop close and positive relationships with others (Chopik et al., 2019). This theory focuses on gratitude functional aspects because older adults perceive the limited nature of time, and the consequence is the increase of gratitude.
On the other hand, the gerotranscendence theory (Tornstam, 2011) describes aging as a transition process in which people redefine self-identity, time, space, life, relation to others and death from a positive development that transcends their life and face their existential issues. Some older people may perceive they are linked to earlier generations and may have a huge sense of being part of coming generations. And for this reason, they become more selective with their social relationships, avoiding superficial social interactions. Gratitude is one of the characteristics of gerotranscendence that allows them to concentrate on the significant issues upon their losses and overcome the “integrity versus despair” of Erikson’s psychological development stages (Erikson, 1950). This theory is directly related to transcendence, a virtue in the Peterson and Seligman model (2004) in which gratitude is one of its character strengths and consequently, the gerotranscendence theory is focused on the mechanisms underlying gratitude.
What is more, these theories offer older adults′ divergent gratitude interpretations. Whereas the goal of gratitude in the socioemotional selectivity approach is specific and tangible, in the gerotranscendence theory is intangible.
Gratitude in older adults is particularly significant because, on the one hand, it is related to well-adapted aging despite life adversities and strong psychological health (Hörder et al., 2013). On the other hand, older people are in a stage life in which they recognize the limited time they have left to live and focus on their meaning and purpose in life priorities (Chopik et al., 2019).
Gratitude, like other psychological constructs, is a multidimensional phenomenon related to physical, psychological, and social factors. Regarding physical and sociodemographic variables, some studies show differences between men and women related to the expression and experience of gratitude. Generally, these studies found lower levels of gratitude in men, and they indicated that they feel uncomfortable with it because they think it is a risk factor for maintaining their social position and masculinity and that higher levels of gratitude are expected in women (Schwartz & Rubel, 2005). During the pandemic and postpandemic situation the studies carried out revealed that women showed higher gratitude than men Büssing et al., 2021.
The study of whether gratitude is related with physical health benefits is more limited (Wood et al., 2010), although research has shown that gratitude is higher in healthier people (McCullough et al., 2002), with higher health satisfaction (Robustelli & Whisman, 2018) and self-reported physical health (Hill et al., 2013). The relationship between physical health and gratitude is higher in older adults than younger ones (Hill et al., 2013). During the pandemic situation the results have remained in the same direction (Jiang, 2020).
With respect to psychological variables, some research has found a relationship between positive meaning and gratitude (Sacco et al., 2014). Gratitude is strongly directly and indirectly associated with psychological well-being, including life purpose (Chamorro-Garrido et al., 2021; Wood et al., 2010), even in studies carried out in pandemic times (Bernabé-Valero et al., 2021; edited out for blind review). A wide perspective on life is needed to feel grateful (Peterson & Seligman, 2004). Psychological well-being consists of an optimal psychological functioning and achieving one′s full potential. It could also help to cope with adversities and stressful situations in aging. Purpose of life is considered by Ryff (2018) as one of the most crucial aspects of eudaimonic well-being, and the Grateful Aging Program has proved that along with increased longevity, the consideration that natural and irreversible aging changes offer the possibility to grow and fulfil their potential and contribute to their perception of meaning and purpose in life (Schlitz, 2017). Moreover, it facilitates a new perspective with a lot of opportunities and possibilities that contribute to experience gratefulness (Schlitz, 2017).
Regarding emotional distress, while positive emotions influence positively gratitude (Emmons & McCullough, 2004), gratitude led directly to lower levels of depression (Wood et al., 2010). Recent studies have confirmed the significant relationship between gratitude and other psychological variables during the COVID-19, like depression and anxiety related to COVID-19 (edited out for blind review; Iodice et al., 2021). It helps to value positive things. A recent study has confirmed the significant positive impact of gratitude during the COVID-19, finding lower levels of stress and anxiety related to COVID-19 when participants felt more gratitude than usual (Jiang, 2020). Gratitude helps to re-assess life events from a grateful approach. In their study, Unanue et al. (2019) point out that happier people feel more grateful because when the positive affect is present since people could assess things positively and increase their feelings of gratitude.
Finally, gratitude is related to social factors. As we mentioned before, older people are aware of the limited time they have and, for this reason, they prioritize quality instead of quantity in their social relationships. Research has shown the influence of social relationships on older people′s gratitude and how, in turn, gratitude helps to building meaningful relationships and to maintaining intimate bonds (Fredrickson, 2004). Family is the principal group of social interaction and a provider of essential support. The bond developed in the early stages between individuals, and their family is crucial to develop gratitude (Emmons & McCullough, 2004). Algoe (2012) showed the relationship between gratitude and family support, and they described it as a relevant element for developing and maintaining significant relationships. According to Wood et al. (2010), gratitude reflects the level of satisfaction with different factors like social support or family; the higher the satisfaction with these aspects, the higher the level of gratitude. And the relationship between gratitude and social support has been found again during pandemic and post pandemic situation (Jans-Beken, 2021; Mead et al., 2021).
Gratitude allows people to concentrate on and be thankful for positive aspects of life, even in circumstances of terrible losses and difficulties (Griffin et al., 2016). Although older people must face many personal and interpersonal losses, according to Baltes (1997) and Lachman (2015), aging is the result of a balanced process between losses and optimal functioning.
The model of Lazarus and Folkman (1984) suggests that primary stressors (direct and indirect problems associated with COVID-19 (having symptoms, being hospitalized, a loved one hospitalization or loss or fear of virus) can cause distress (anxiety and depression) in the person. However, the impact of the stressor on the person’s wellbeing depends on appraisal style and the resources they may have to assist in managing stressors (family functioning, purpose in life) they put into practice to cope with it (Lazarus & Folkman, 1984). Given the potential impact that the COVID-19 pandemic may have on older adults’ mental health, it is necessary to identify protective factors of their psychological wellbeing (Siette et al., 2021). Only a few studies have focused on older adults’ personal strengths or wellbeing.
To our knowledge, adverse events like the COVID-19 pandemic can increase older people′s gratitude. However, this has been understudied in older adults and most of the research on gratitude has been centred on young people. There is also limited research on the factors that promote or obstruct the development of gratitude (Peterson & Seligman, 2004). Our study is based on Lazarus and Folkman (1984) stress model and aims to examine the relationship between physical, psychological, and social variables related to gratitude. Although some studies have analyzed the relationship between gratitude and different variables, they do not examine them all together. In addition, the knowledge of gratitude predictive factors, may shed light on the process that promotes positive functioning.
This study examined the role that sociodemographic variables, family functioning, emotional distress (anxiety and depression) and purpose in life had upon gratitude. Based on Lazarus and Folkman′s model (1984), we expected that emotional distress (anxiety and depression), family functioning, life purpose and perceived health may predict older adults′ gratitude. Specifically, we expected on the one hand, lower scores in gratitude in males compared to females. On the other hand, there is a positive relationship between gratitude and family functioning, life purpose and perceived health and a negative one between gratitude and emotional distress.
Methods
Participants
We used snowball sampling to recruit 361 community-dwelling individuals aged 60 years and over from different regions of Spain during the sixth wave of the COVID-19 pandemic (from September to December 2021). The sample size was calculated based on Cochran’s formula. The mean age was 68.44 years old (SD = 5.31). Most participants were women (62.9%), married (58.2%) and reported good (42.4%) or fair (41.8%) perceived health. 39 (10,8%) participants had COVID-19 symptomatology; 6 (1.7%) had been hospitalized, 63 (17.5%) had a close family member or friend who has been hospitalized and 56 (15,5%) reported the loss of a loved one by the virus.
Instruments
We collected information on sociodemographic characteristics: sex, age, perceived health, and COVID-19 variables. We assessed both the direct and indirect effects of COVID-19. For direct affection, we asked if the participants had COVID-19 symptoms (0= no; 1= yes) and if they had been hospitalized (0 = no; 1 = yes). For indirect affection, we asked if they have had a loved person hospitalized (0 = no; 1 = yes). or had lost a relative (0 = no; 1 = yes). And we included some standardized questionnaires:
Gratitude
We used the Spanish version of the Gratitude subscale of the Values in Action Inventory of Strengths-Short Form (Azañedo et al., 2017). This 5-item scale (I am an extremely grateful person; I feel thankful for what I have received in life; When I look at my life, I find many things to be grateful for, I feel a profound sense of appreciation every day and I have been richly blessed in my life) was used to measure gratitude, scored on a 5-point Likert scale with response options ranging from 1 (very different to me) to 5 (very similar to me), showing good reliability in our sample (Cronbach’s α = .88). Items assess the emotional and cognitive components of gratitude.
Family Functioning
The Family APGAR Scale was used (Smilkstein, 1978). This 5-item scale was used to measure family functioning (adaptability, partnership, growth, affection, and resolve). Items were scored on a 3-point Likert scale ranging from 1 (hardly ever) to 3 (usually). We use the Spanish version (Bellón et al., 1996), and adequate reliability in our sample was found (Cronbach’s α = .80).
Purpose in Life
The Purpose in life subscale in Ryff’s Psychological Well-Being Scale measured by six items, was used. We selected this subscale because it is considered one of the most crucial elements of eudaimonic well-being. It was scored on a seven-point Likert scale ranging from 1 (never) to 7 (always). We use the Spanish version (Díaz, et al., 2006), and adequate reliability was found (Cronbach’s α = .79).
Anxiety and Depression
We used the Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983). This 14-item scale is composed of two different subscales that measure anxiety and depression composed of seven items each, with four response options. They were used to measure emotional distress. We used the Spanish version (Terol-Cantero, 2015), and adequate reliability in our sample was found for anxiety (Cronbach’s α = .82) and depression (Cronbach’s α = .75).
Procedure
The study was approved by the University (CEU University Ethics Commitee) Ethics Committee [Reference 436/20/26]. Informed consent was obtained from all respondents and confidentiality was explicitly guaranteed. They were also informed that the study was anonymous, and they had the right to withdraw from the study at any time. We used an online non-probability snowball sampling procedure to gather information. Participants were recruited through older people’s organizations and through social media (Twitter, WhatsApp, LinkedIn). We designed an assessment protocol using Microsoft forms and a web-based survey was administered during the second wave and following the COVID-19 pandemic in Spain (between August and December 2021). The validity and reliability of internet research for subjective well-being surveys have been demonstrated to be comparable to those of the paper-based versions (Howell et al., 2010). The inclusion criterion was age 60 years and above and the exclusion criterion was having a diagnosis or psychiatric or neurological illness.
All participants had to reply whether they agreed to participate in this research before filling out the survey. Participation was voluntary, and no reward was offered for the collaboration. It took participants approximately 30 min to respond.
Data Analysis
Correlation analyses were first performed among all variables to test the relationship between gratitude and some associated values reported in the literature. After that, to know the contribution of each of the assessed variables to an older adult’s level of gratitude, a three-hierarchical regression analysis was carried out, drawing upon the biopsychosocial model. In the first step, sociodemographic variables and perceived health were included. In the second step, we included psychological variables (family functioning, purpose of life, anxiety, depression). And in the third step, family functioning was included as a social variable. All analyses were conducted using SPSS v.28.
Results
Table 1 shows the descriptive statistics for the assessed variables.
Descriptive Statistics.
Note. N = 361; M = Mean; SD = standard deviation.
Before analyzing which variables predicted gratitude, we examined the relationship between gratitude and the relevant variables. The correlations among variables are shown in Table 1. No significant association was found between gratitude and sex and COVID characteristics. Gratitude was significantly and positively associated with family functioning (APGAR), purpose in life and perceived health. A negative and significant association was found with anxiety and depression (Table 2).
Hierarchical Regression Analysis Examining the Association Between Assessing Variables and Gratitude.
p ≤ .01; *p ≤ .05.
After that, we carried out a regression analysis to know which associated variables predict gratitude. The results of the regression model for explaining the influence of the proposed variables on older adults′ gratitude is shown in Table 3. The inclusion of variables at each step contributed significantly to the explained variance of gratitude. In the first step, when including sociodemographic and physical variables (perceived health), the model explained 12.06% of the variance of gratitude. In the second step, related to psychological variables (purpose in life and emotional distress), the model explained 19.42% of gratitude variance but perceived health and anxiety did not contribute to this. And in the third step, when the social variable of family functioning was included, emotional distress (depression and anxiety) did not predict gratitude. More purpose of life and better family functioning were significantly associated with higher gratitude. The final model explains 29% of the variance (F = 22.27, p ≤ .01).
Hierarchical Regression Analysis Gratitude.
p < .01.
Discussion and Implications
Most information regarding older adults′ psychological impact during the COVID-19 pandemic is based on risk factors. Research has documented the negative mental consequences of COVID-19. Although previous studies have been dominated by a psychopathological approach, older adults showed less vulnerability toward mental health problems following COVID-19 outbreak than younger population (Talevi et al., 2020). This study stresses the role played by older adults’ gratitude protective factors in the six wave of COVID-19.
The correlations conducted in our study showed positive significant relationships between gratitude and perceived health, family functioning, and purpose in life. These results are like previous findings reported by literature (e.g., Chamorro-Garrido et al., 2021; Hill et al., 2013). In contrast, we found that emotional distress (i.e., anxiety and depression) associates negatively between gratitude and anxiety and depression. This result aligns with a previous work that points out that emotional distress decreases when gratitude increases (Jiang, 2020).
In contrast, COVID-19 associated variables (COVID-19 symptomatology; having been hospitalized, having had a close family member or friend hospitalized because of COVID-19; having lost a loved one by the virus) did not associate with gratitude. Previous research did not find any effect of COVID-19 on gratitude neither (edited out for blind review). Stressful events and losses impact people very differently. One explanation for our results can be related to the moment of the pandemic in which the sampling was carried out. In our case, data was collected in an advanced period of the pandemic (sixth wave), while other studies have been carried out in its initial phases. Another explanation could be associated with Lazarus and Folkman stress process model. These authors explained that personal and environmental resources are more relevant than the stressor itself because they determine how a person evaluates and manages the stressful situation, and it is this evaluation that influences the intensity and nature of the stress response.
In line with this model, results confirmed the relevant relationship between family functioning, purpose in life and gratitude in older adults, since these two variables were the predictors of gratitude while the other variables did not act as predictors.
Gratitude is associated with purpose in life as in previous studies promoting the feeling that their lives are meaningful and worth it. And this relationship has been found in studies carried out in pandemic times (Bernabé-Valero et al., 2021). Purpose in life helps to attribute meaning to difficult situations like the pandemic, offer the opportunity to develop resources to overcome future challenges, and it is useful to make inter and intrapersonal changes (Bernabé-Valero et al., 2021) After a traumatic experience it is important to include fundamental existential questions and the meaning of life.
COVID-19 could have increased older adults’ flexibility and coping strategies to achieve previously valued goals (Ryff, 2014). Moreover, situations valued as less satisfying before COVID-19 can be perceived now as more satisfying (Kivi et al., 2021). People who show higher levels of life purpose evaluate negative events in a more adaptive and proactive way, perceiving and giving them explanations with meaning linked to their personal values. Likewise, people with higher levels of life purpose have more varied resources to face life’s challenges, buffering the possible negative effect of stressors using strategies that help regulate emotions in a more adaptive manner. In this way, they would be better prepared to respond to emotional demands more effectively.
The Grateful Aging Program shows on the one hand how to be aware of and extract life′s full potential as part of the continuous process of regaining awareness of life (Tornstam, 2011). And, on the other hand, this program suggested that the possibility to grow and fulfil their potential contribution to meaning and purpose in life and to experiencing gratefulness (Schlitz, 2017).
The importance of family functioning and its relationship with gratitude in this study contrasts with the less attention received by scientific research in these variables in older adults despite gratitude promoting the maintenance of significant social relationships (Algoe, 2012). Family functioning has a particularly powerful effect on gratitude (Emmons & McCullough, 2004). By maintaining close intimate bonds people may express more gratitude (Kashdan et al., 2018). And the higher level of satisfaction with family, the higher the level of gratitude (Wood et al., 2010). These results are in the same line as Erikson’s psychological developmental theory (Erikson, 1950). The eighth stage is the stage of “integrity versus despair” in which older adults look back on their life and value them with acceptance or rejection. Integrity consists of developing the ability to accept their life as something that was worthwhile with a feeling of satisfaction, peace, and gratitude for what they have been given and received. They harness life as a gift. Family functioning may be more important in predicting gratitude among older adults because they particularly invest time and effort in close relationships.
One unexpected result was the lack of association between sex and gratitude. We expected lower scores in gratitude in males compared to females as found in previous research (Büssing et al., 2021; El Khourhy-Malhame et al., 2023). This result can be related to the fact that more than 60% of the sample were women and this difference between the number of male and female participants could have affected our results. Another explanation may be related to a shift in male minds in which they don′t consider feeling compassion and empathy as an emotional weakness and can express gratitude without feeling their masculinity and social position could be threatened (Yarnell et al., 2019).
Several limitations should be taken into consideration. Firstly, this is a cross-sectional study, so it is not possible to conclude causal relationships. Conducting longitudinal studies could ensure the stability of these results. Women are overrepresented in this study and a wider range of men sample is needed. Regarding participant recruitment, we conducted an online-based survey, which might have limited the number of older adults who could participate. It is necessary to replicate the results in a more representative sample. However, like other similar studies (Losada-Baltar et al., 2020), our study is based on a convenience and nonprobability sample, which may not be representative of the whole Spanish population of 60 years and older (population census; INE, 2019). Furthermore, the sample consisted of non-institutionalized people and is not representative of older people living in long-term care facilities. However, most Spanish older adults live in the community. Finally, the study does not collect information about participants living arrangements during the pandemic or the interaction with their family and it is another limitation of the research.
Gratitude is considered a very effective character strength to buffer the negative influence of adversities. Most of the studies focus on young people despite gratitude having been related to healthy adaptation in aging (Hörder et al., 2013). Our findings are consistent with previous studies that related older adults′ gratitude to physical, psychological, and social variables.
Our study contributions to the field are the following: First, since there are few studies about gratitude in older adults, the similarity of our results to other studies seems a positive point for giving robustness to the topic studied. Second, most previous studies on gratitude consider it as a predictor factor. In contrast, we have analyzed the predictors of gratitude in older adults. Third, although some studies analyzed the relationship between gratitude and different variables, they do not assess them all together. In addition, the knowledge of gratitude predictive factors (family functioning and purpose in life), might shed some light on the process that promotes positive functioning. Despite the purpose of life seems to decline with age when older adults are compared with other age groups (Ryff, 2018), this study shows the importance of this variable for promoting gratitude. Finally, this study represents an important and innovative step in aligning interventions with the specific needs and particularities of individuals and populations and can contribute to their well-being. According to McAdams and Bauer (2004), gratitude is a relevant strength because it helps to confront stressful experiences and allows the person to successfully adapt to them, and this is related with successful aging. Gratitude could be one of the variables that promote the socio-emotional mechanisms that lead to higher levels of well-being in older adults. Finally, according to Lazarus and Folkman (1984) it is not so much the stressor event itself that is relevant, but rather the person’s evaluation of the event and the resources he or she uses to cope with it. The results also suggest that the spread of the pandemic may not be as important for older adults’ distress than their appraisals and personal resources for managing COVID-related problems.
In line with Wood et al. (2009), gratitude is related to psychological well-being because it is the key stone of positive trait, appreciating the positive in life, having more positive account of their environments, and developing productive coping strategies. Gratitude is related to a life that is meaningful and eudemonic. Therefore, the results also suggest that the nature of the COVID-19 impact (except for the loss of a loved one) may not be as important for the older adults’ well-being as their appraisals and personal resources for managing COVID-related problems.
Conclusion
In different studies during the COVID-19 pandemic and post pandemic, gratitude has been a crucial element to protect the older adults′ wellbeing. However, the predictors of gratitude in older adults are understudied. This study aimed to analyze if sociodemographic variables, COVID-19 characteristics, family functioning, emotional distress (anxiety and depression) and purpose in life predicted Spanish older adults′ gratitude in the sixth wave of the COVID-19 pandemic. Within these variables, only life purpose and family functioning predicted gratitude. These results, in line with Lazarus and Folkman (1984), stress the importance of older adults′ strengths (life purpose and family functioning) while facing adversity.
There are some interventions focused on helping older people feel and express gratitude (Ramirez et al., 2014; Schlitz, 2017). Based on our results, it would be interesting to promote interventions in family functioning and purpose in life to, in turn, increase gratitude in older adults. However, a significant amount of research still remains to be done considering the cross-sectional nature of our study and the geographical factors.
Footnotes
Acknowledgements
The authors thank all the participants in the study.
Ethical Considerations
The study was approved by the University CEU San Pablo Ethics Committee (reference 436/20/26).
Author Contributions
“Conceptualization, GPR and JL.; methodology, GPR, JL; formal analysis, GPR, JL, and CN; investigation, GPR, JL, CN, AS, BB and ES; writing—original draft preparation, GPR, JL; writing—review and editing, GPR, JL, CN, AS, BB and ES”.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Universidad San Pablo-CEU, CEU Universities (CEU-Santander, grant number [MCOV20V3]) and by Ministry of Science and Innovation (PID2021-127986OB-I00).
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
