Long-Term Quality of Life Among Rural Older Adults Injured in the 2008 Wenchuan Earthquake: A Constructivist Grounded Theory Study

Abstract Background Major natural disasters can have enduring consequences for survivors’ physical, psychological, and social well-being. However, little is known about the long-term quality of life of people injured in the 2008 Wenchuan Earthquake, particularly older adults living in rural communities. This study aimed to explore how earthquake-related experiences and subsequent life circumstances have shaped long-term quality of life among rural older survivors. Methods We used a constructivist grounded theory approach and conducted individual semi-structured interviews with 128 older adults who had sustained injuries in the 2008 Wenchuan Earthquake. Participants, with a mean age of 63.7 years, were recruited from rural earthquake-affected communities in Sichuan Province, China. Interviews were conducted between November 2024 and January 2025 and explored participants’ long-term physical and psychological health, healthcare experiences, social support, and adaptation following the earthquake. Results Participants described persistent physical disability, chronic illness, psychological distress, and difficulties accessing sustained mental health support. The analysis generated a theoretical framework illustrating how enduring health consequences, healthcare experiences, social support networks, and processes of meaning-making interacted to shape long-term quality of life. Family relationships emerged as the primary source of emotional and practical support. In contrast, formal support from government and community systems, although perceived as important during post-earthquake reconstruction, was considered less responsive to survivors’ long-term psychological and healthcare needs. Participants also described positive changes over time, including reprioritization of family and health, greater gratitude, stronger appreciation of interpersonal relationships, and renewed meaning in life. Conclusions Long-term quality of life among rural older adults injured in the Wenchuan Earthquake reflects an ongoing interaction between persistent health consequences, access to care, social relationships, and adaptive meaning-making. Post-disaster policies should extend beyond short-term reconstruction to address survivors’ evolving needs across the life course. Strengthening mental health literacy, integrating physical and mental healthcare, sustaining community-based support, and reducing digital barriers to healthcare and social assistance may improve long-term well-being among ageing disaster survivors in rural settings.