Objective To analyze the effect of nursing intervention based on the PERMA model on trauma stress disorder and psychosocial adaptation in patients undergoing scar plastic surgery. Methods A total of 80 patients who underwent scar plastic surgery and were admitted to Houjie Hospital of Dongguan from January to October 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 40 patients in each group. The control group received conventional nursing, and the observation group received nursing intervention based on the PERMA model. The negative emotions, coping styles, trauma stress disorder and psychosocial adaptation, nursing satisfaction and adverse reactions were compared between the two groups. Results After 7 days of nursing, the scores of the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) in the observation group were lower than those in the control group (P <0.05). After 7 days of nursing, the negative coping score of the Simple Coping Style Questionnaire (SCSQ) in the observation group was lower than that in the control group, and the positive coping score was higher than that in the control group (P<0.05). After 7 days of nursing, the scores of the PTSD Checklist-Civilian Version (PCL-C) and the Psychosocial Adjustment to Illness Scale- Self-Report (PAIS-SR) in the observation group were lower than those in the control group (P <0.05). After 7 days of nursing, the score of the Newcastle Satisfaction with Nursing Service (NSNS) in the observation group was higher than that in the control group (P <0.05). The incidence of adverse reactions in the observation group (2.50%) was lower than that in the control group (20.00%) (P <0.05). Conclusion The nursing intervention based on the PERMA model for patients undergoing scar plastic surgery has a definite effect, which can improve the negative emotions of patients, enhance their psychosocial adaptation ability and coping ability, relieve the degree of their stress disorder, improve the clinical nursing satisfaction, and reduce the incidence of adverse reactions.