Concept analysis: resilience

Psychological Hardiness and Spirituality in Patients with Primary Brain Tumors: A Comparative Study

The purpose of this research was to compare healthy individuals with patients having primary brain tumors (PBTs) with respect to their psychological hardiness and spirituality. In this study, a comparative and descriptive research design was employed. The research sample included 122 individuals: 61 patients with PBTs and 61 healthy individuals. When healthy individuals were compared with patients with PBTs, it was found that the patients with PBTs had significantly lower mean scores for spirituality and psychological hardiness. The study revealed that spirituality (β = .661) and age (β = - .270) were statistically significant predictors of psychological hardiness (p < .001). These variables explained 53% of the total variance. To decrease the negative effects of PBTs on psychological hardiness, nurses and other health staffs should focus on strategies that strengthen patients' spirituality.

Resilience and associated psychological, social/cultural, behavioural, and biological factors in patients with cardiovascular disease: a systematic review

AIMS

The aim of this systematic review of the literature is to synthesize the evidence regarding the associations between individual-level psychological, social/cultural, behavioral, and biological variables with resilience in patients with CVD.

METHODS AND RESULTS

A systematic search of PubMed, PsycINFO and CINAHL was conducted from database inception through March 2020. Studies with a quantitative research design were eligible for inclusion if published in English and focused on resilience among adults with CVD. Of the 788 articles retrieved, 34 studies (35 articles) were included in the review. Twenty-three studies focused on psychological factors, with findings of inverse relationships between resilience and depression, anxiety, and stress. Evidence regarding associations between resilience and social/cultural or behavioral variables was scarce. Four of the 6 studies regarding biological factors found low stress resilience in young adulthood was associated with early diagnoses of stroke, heart failure, and coronary heart disease.

CONCLUSION

Enhancing resilience may improve quality of life for CVD patients, but research is needed to further explore the complex relationships between resilience and associated variables. This research should prioritize under-represented groups (i.e. women and minority racial/ethnic groups), with the eventual goal of developing interventions to support resilience in CVD patients.

Predictive Validity of Resilience in the Treatment of Individuals With Anxiety and Depressive Disorders

The current study sought to evaluate the predictive validity of resilience among individuals with anxiety and/or depressive disorders. Receiver operating characteristics were calculated for each of the 25-item and 10-item versions of the Connor-Davidson Resilience Scale, evaluated against psychological distress and treatment response, at screening and post-treatment. New referrals to an anxiety and related disorders clinic were recruited for this purpose (N = 672 at screening, N = 349 post-treatment). Robust cross-sectional associations between resilience and psychological distress and treatment response were noted and were strongest at post-treatment. However, the related sensitivity (63% to 66% at screening, 69% to 76% post-treatment), specificity (78% to 83% at screening, approximately 73% post-treatment), and areas under the curve (AUC; approximately 73% at screening, 78% to 82% post-treatment) were modest. Furthermore, there was minimal support for resilience as a predictor of recovery using the longitudinal data (sensitivity and specificity could not be determined, with AUC of approximately 68% for psychological distress and 56% for treatment response). Although a relatively large homogeneous sample was available for this study, analyses of specific diagnostic subgroups may offer valuable further insight. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 35-41.].

Factors related to changes in resilience and distress in women with endometrial cancer

The purpose of the study is to explore changes in resilience and physical and psychological distress and their related factors over time in women with endometrial cancer. This study adopted a repeated measures design using purposive sampling and was conducted in a hospital in Taiwan. Data were collected before surgery, 2 weeks after surgery, and 3 months after surgery. The measured variables consisted of demographic and disease characteristics, social support, resilience, and physical and psychological distress. A total of 48 women participated in the study, of whom 42 (mean age = 54.2 years old) completed all of the questionnaires. The results showed that resilience and physical distress in women with endometrial cancer was not statistically significantly changed over time. Rather, their psychological distress was significantly alleviated 2 weeks and 3 months after surgery as compared to before surgery. Women with less social support showed a lower level of resilience. In addition, those with a lower level of resilience experienced greater psychological distress. Compared with those who received only surgical treatment, women who had undergone surgery combined with chemotherapy and radiotherapy had more physical distress. Clinical medical staff should conduct continuing assessments of the resilience, physical distress, and psychological distress of women with endometrial cancer. Interventions related to resilience-enhancing and self-care should be implemented to avoid worsening or to improve women's resilience and distress.

How Emergency Nurses Develop Resilience in the Context of Workplace Violence: A Grounded Theory Study

Purpose

To understand how emergency nurses develop resilience in the context of workplace violence.

Design

This study employed grounded theory methodology. Thirty nurses from three hospital emergency departments in Taiwan were interviewed between August and December 2018.

Methods

Semistructured interviews were used to collect data. Interviews were audio‐recorded and transcribed verbatim.

Findings

The process through which emergency nurses who had experienced workplace violence developed resilience took place in three stages: the release of emotions after the assault; the interpretation of conflicting thoughts and actions; and the establishment of strategies to cope with workplace violence in the future. The core theme was the motivating role of professional commitment to emergency patient care.

Conclusions

The results of this study can inform the development of support systems to enhance the resilience of nurses experiencing workplace violence by alerting healthcare administrators and governing institutions to their needs.

Clinical Relevance

Emergency nurses viewed professional growth and professional commitment as an invisible motivator in the development of resilience following an encounter with workplace violence.

Positive parenting and its mediating role in the relationship between parental resilience and quality of life in children with developmental disabilities in Java Island, Indonesia

BACKGROUNDS

Developmental disabilities exert severe physical, cognitive and social-emotional consequences, such as low quality of life, not only on children but also on their families. However, the extent of the effect of such consequences on quality of life is partially dependent on how parents address the situation.

AIMS

The study aimed to examine whether positive parenting mediates the link between parental resilience and quality of life of children with a developmental disability in Indonesia.

METHODS AND PROCEDURES

Data were derived from a three-wave longitudinal study on 497, 224 and 209 families in waves one, two and three, respectively. The study determined parental resilience by assessing the knowledge of parents about the characteristics of their child, perceived social support and positive perception of parenting. Quality of life consisted of five aspects: material well-being, communication and influence, socio-emotional well-being, development and activity. Positive parenting was assessed through observed levels of support, encouragement and praise.

CONCLUSIONS AND IMPLICATIONS

The results demonstrated that positive parenting mediated the impact of positive perception of parenting on quality of life. This finding implies that positive perception and positive parenting should be encouraged when families with children with developmental disabilities receive care or support.

Factors Affecting Resilience of Nursing, Optometry, Radiography and Medical Laboratory Science Students

Background: The concern over the high level of stress experienced by students of the caring professions has led to increased attention being paid to the promotion of their resilience. Most earlier studies have focused on the resilience of medical and nursing students. There has been little exploration of the resilience and associated factors of students of other health-care disciplines. The aim of this study was to gather data from students of pre-registration health-care disciplines to identify the factors that influence their resilience. Method: Valid questionnaires were used to assess respondents’ resilience, self-efficacy, mindfulness, coping and trait positive and negative affect. The data were analyzed using descriptive statistics and univariate and general linear regression. Results: A total of 1320 university students from nursing, medical laboratory science, radiography and optometry were recruited. The results showed that the subjects’ resilience scores were lower than those of students in Western countries. We found self-efficacy and denial to be the common predictors for students of all disciplines. Conclusion: The resilience of students in the four disciplines was predicted by a combination of predictors. Faculties of universities and clinical mentors should collaborate in building resilience in their health-care students and support them to grow both personally and professionally during their careers.

"Eternally restarting" or "a branch line of continuity"? Exploring consequences of external shocks on community health systems in Haiti

Background

Community health systems (CHS) are integral in promoting well-being in humanitarian settings, like Haiti, a country plagued by disruptive socio-political and environmental shocks over the past two decades. Haiti’s community health workers (CHWs) as critical intermediaries have persisted throughout these contextual shocks. This study explores how shocks influence CHS functionality and resilience in Haiti.

Methods

We applied an inductive and deductive qualitative approach to understand the lived experience of CHS actors. A desk review of peer-review and grey literature searched 393 and identified 25 relevant documents on community health policies, guidelines, and strategies implemented over the last fifteen years in Haiti. In-depth interviews with policy and program stakeholders (n = 12), CHWs (n = 24), and CHW supervisors and community health auxiliary nurses (n = 15) were conducted.

Results

Various shocks – political transitions, natural disasters, and disease outbreaks – describe Haiti’s protracted complex humanitarian setting and reveal distinct influences on CHS functionality (challenges and enablers), resilience, and mediating factors (eg, policy, financing, governance, parallel systems). Consequences of civil unrest and lockdowns (political transitions), internal displacement and infrastructural damage (natural disasters), and livelihood depletion and food insecurity (natural disasters and disease outbreaks) affect CHS functioning. CHW resilience is rooted in their generalized scope of work, intrinsic motivation, history in the community, trusting relationships, self-regulatory capacity, and adaptability. Mental health and safety among CHS actors and communities they serve pose challenges to CHS functionality and resilience, while reinforcing collaborations that promote CHW coverage and support and sustain CHS. Participants recommended government support for CHWs, collaborations stewarded by the government and complemented by partners, sub-national autonomy, and integration of disaster preparedness for all CHWs.

Conclusions

Political transitions, natural disasters, and disease outbreaks in Haiti continue to profoundly influence CHS functioning, despite mitigating policy and programming efforts. This study documents the relevance of CHS in maintaining primary health care for a country in protracted crises and suggests that propositions of CHW resilience can be explored in complex humanitarian settings globally.

Components and Related Factors of Nursing Interventions for Improving Resilience in Cancer Patients Undergoing Chemotherapy

Resilience is considered an effective concept for cancer patients, but nursing interventions for improving resilience have not been studied adequately yet. We aimed to explore the components and related factors of nursing interventions for promoting resilience among cancer patients receiving chemotherapy (NIPRPC). This cross-sectional study included 68 facilities from 396 cancer hospitals in Japan. Participants were 377 nurses who worked at the outpatient chemotherapy center or cancer ward. They completed self-administered questionnaires including the NIPRPC items and Resilience Scale for Nurses, etc. We conducted factor, correlational, and regression analysis. Based on the exploratory factor analysis, six-dimensional factor components: “Support for patients during the present situation and increasing their self-affirmation”, “Support for self-help”, “Support for utilizing the cancer medical team”, “Support for obtaining family cooperation”, “Support for maintaining regular lifestyle during chemotherapy”, and “Support for interacting with cancer patients and utilizing necessary information”. The strong related factors for all six factors were the resilience of the nurses and the number of collaborations with multiple occupations. Our findings will help nurses improve the psychosocial quality of life of cancer patients and address their needs related to cancer chemotherapy treatment.

Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations

BACKGROUND

Stressful environments can have significant effects on an individual and lead to burnout. Psychological consequences of burnout include trauma reactions, depression, anxiety and substance use disorders. Resilience, a protective mechanism can mitigate the negative impact of burnout.

METHOD

This study utilizes an exploratory correlational design to determine whether or not there is 1) a similar correlation between resilience and burnout between psychiatric nurses working in a high stress environment and students who are naive to the high stress academic environment and 2) a higher level of resilience in the psychiatric nurses compared to the healthcare students.

RESULTS

A significant inverse relationship was observed with respect to resilience and burnout in both the professional nurse and student groups. However, the inpatient psychiatric nurse group was not found to have a higher level of resilience than the student group, when controlling for age.

CONCLUSION

This suggests that resilience to burnout is not related to the work environment but life experience (age) was found to be a factor related resilience in this sample.

Challenges to the conceptualization and measurement of resilience in HIV research

The purpose of this study was to evaluate the conceptualization and measurement of resilience in HIV research. Terms related to resilience and HIV were searched in three databases to identify peer-reviewed research articles. Of the 156 articles identified, 49 were included in the analyses. Applied thematic analysis was used to analyze the definitions and measurement of resilience. Articles were reviewed independently by two raters to establish inter-rater reliability. Six recurring themes were identified in the definitions of resilience: adaptation, positive mental health symptoms, the absence of negative mental health symptoms, hardiness, coping, and the ability to "bounce back". Among the articles examined, 14 measures were used to assess resilience, half of which were indirect. These findings help make sense of the available literature on resilience and highlight the importance of clearly operationalizing resilience and measuring it in a way that is congruent with its definition in future HIV research studies.

Factors associated with resilience in spousal caregivers of patients with cancer: An integrative review

Aim

To explore resilience and associated factors in spousal caregivers of patients with cancer.

Design

An integrative review.

Methods

This review used the standardized critical appraisal instruments developed by the Joanna Briggs Institute and was conducted by researching the electronic databases of Cochrane, CINAHL, ProQuest, Science Direct, PubMed, Scopus, EBSCO and Google Scholar. The articles were published in English with full text from January 2010 to January 2020.

Results

According to data retrieval, 26 articles were finally selected. From this review, resilience was typically measured by using exact resilience scales (i.e. Connor‐Davidson or Wagnild Resilience Scales) or using other variables to indicate either more positive psychological outcomes or less negative psychological outcomes. For factors associated with resilience, these were classified as individual internal and external factors. Internal factors included caregiver burden, psychological distress, coping strategies and other factors, whereas social support, couple interaction, patient health status and other parameters were considered external factors.

Conclusions

Resilience plays an important role in promoting positive adaptation in spite of adversity among the spousal caregivers of patients with cancer. Due to the uniqueness of resilience among spousal caregivers, ways to assess resilience and identify its associated factors deserve more attention and careful consideration.

Concept analysis: Resilience in young women with chronic pain

The aim of this article is to define the concept of resilience in the context of chronic pain, while presenting a historical background of resilience. Resilience in young women with chronic pain is discussed where findings exist. Chronic pain places a considerable burden on individual and societal health; resilience is critical to chronic pain management. Enhancing understanding of the concept of resilience can promote resilience and aid in early recognition of impaired coping. Rodgers's evolutionary method of concept analysis was used. Using CINAHL, PubMed, and Google Scholar databases, articles published from 1979 to 2020 were analyzed to identify conceptual components of resilience. We reviewed included articles to determine surrogate terms, relevant uses of the concept, attributes, references of the concept, antecedents, consequences, and related concepts. Resilience in the context of chronic pain is a lifelong process of positive adaption and thriving despite adversity. Components of Rodgers's evolutionary method are identified for the concept. Further research on resilience in young women with chronic pain is needed, given the current lack of literature. Developing nursing interventions to foster resilience is important to promote long-term, effective self-management of individuals living with chronic pain.

Epidemic Rumination and Resilience on College Students' Depressive Symptoms During the COVID-19 Pandemic: The Mediating Role of Fatigue

The restriction of numerous sectors of society and the uncertainty surrounding the development of the COVID-19 pandemic have resulted in adverse psychological states to college students isolated at home. In this study, we explored the mediating role of fatigue in the effects of epidemic rumination and resilience on depressive symptoms as well as how epidemic rumination and resilience may interact with one another. A large sample of Chinese college students (N = 1,293) completed measures on epidemic rumination, resilience, fatigue, and depressive symptoms. Results indicated depressive symptomology was positively predicted by epidemic rumination while negatively predicted by resilience. In both cases, fatigue partially mediated these effects and positively predicted depressive symptoms. Unexpectedly, epidemic rumination and resilience interacted in a manner where the effect of rumination on fatigue became stronger as resiliency increased. Theoretical and practical implications are provided to further interpret the results.

Perinatal Resilience for the First 1,000 Days of Life. Concept Analysis and Delphi Survey

Background

The ability to cope with challenges and stress in life is generally understood as resilience. Pregnancy and parenthood are challenging times. The concept of resilience is receiving increasing interest from researchers, clinicians, and policy staff because of its potential impact on health, well-being, and quality of life. Nevertheless, the concept is less studied during the perinatal period.

Objectives

The aim of this study is to understand the concept of perinatal resilience, including the underlying processes and more specifically for the first 1,000 days of life.

Methods

A concept analysis according to the Walker and Avant (2011) framework was used, to investigate the basic elements of the concept. Concurrently, a two-round Delphi survey involving researchers, clinicians, epidemiologists, mothers, and fathers (N = 21), was conducted to prioritize the terms associated with perinatal resilience. Data collection took place between January and April 2019.

Results

Through concept analysis and Delphi survey, five defining attributes for perinatal resilience were identified: social support, self-efficacy, self-esteem, sense of mastery and personality. The additional terms, rated important by the Delphi survey, were linked to the consequences of being resilient during the perinatal period for the individual and his/her family. Specifically, highlighted were the experiences of families in personal growth and achieving family balance, adaptation, or acceptance.

Conclusion

Based on the results of the concept analysis and Delphi survey, we describe perinatal resilience for the first 1,000 days as a circular process towards a greater well-being in the form of personal growth, family balance, adaptation or acceptance, when faced with stressors, challenges or adversity during the perinatal period. The presence of resiliency attributes such as social support, sense of mastery, self-efficacy, and self-esteem enhance the capacity to be resilient and probably prevent mental health problems.

Resilience Among Professional Health Workers in Emergency Services

INTRODUCTION

Although it seems logical to assume that working in an emergency service implies having a great capacity to face extreme situations, resilience in health care workers has been shown to be related not only to individual personality characteristics but also with external factors. The objective of this study was to determine the resilience of professional health workers in emergency services and its relationships with sociodemographic and working conditions.

METHODS

This cross-sectional study included emergency physicians, nurses, and nursing assistants. Sociodemographic variables and the Resilience Scale-25 were analyzed.

RESULTS

A total of 320 professionals participated. Their mean age was 43.5 years (SD 8.9), and 81.87% were women. The mean resilience score was 133.52 (SD 7.22), which corresponds to moderately low to moderate levels. An association was found between the highest resilience scores and being a physician (χ² 8.84; P = 0.01) and a higher capacity if working in emergency mobile units (χ² 6.29; P = 0.04). Working the day shift and being a nurse (beta = -5.71; P = 0.02) were associated with lower resilience scores. Age (odds ratio 1.095; P = 0.02; 95% confidence interval 1.015, 1.184), and not having a partner decreased resilience (being divorced odds ratio 5.17; P = 0.01; 95% confidence interval 1.503, 18.235 and being single odds ratio 3.371; P = 0.01; 95% confidence interval 1.259, 9.257). However, more work experience increased the resilience levels (odds ratio 0.906; P = 0.02; 95% confidence interval 0.833, 0.983).

DISCUSSION

Resilience in professional health workers was related to personal and working conditions. The scores of emergency staff were low and should be improved with specific strategies.

Community Gardening: Stress, Well-Being, and Resilience Potentials

The financial and health burdens of stress associated with increased urbanization have led to a demand for mental health enhancement strategies. While some extant literature details mental health benefits of community gardening, a coherent narrative on the construct of resilience and its relationship with the mental health benefits of community gardening is lacking. The present study examined the relationship between community gardening and a number of mental health benefits, in the forms of subjective well-being, stress, resilience potentials, and resilience factors (self-esteem, optimism, and openness). A total of 111 residents in Singapore completed a survey. Results from Multivariate Analysis of Covariance (MANCOVA) and Pearson’s correlation analyses show that, after controlling for age and levels of connection to nature, community gardeners reported significantly higher levels of subjective well-being than individual/home gardeners and non-gardeners, indicating that engagement in community gardening may be superior to individual/home gardening or non-gardening outdoor activities. Community gardeners reported higher levels of resilience and optimism than the non-gardening control group. These novel results indicate some potential for mental health benefits in urban environments, specifically in terms of subjective well-being and resilience. These findings have implications for future research in clinical psychology, mental health promotion, and policy.

Advancements to the Multi-System Model of Resilience: updates from empirical evidence

In this paper, we discuss further advancements to the Multi-System Model of Resilience through examining empirical factor structures of the Multi-System Model of Resilience Inventory along with other measures of resilience. Evidence from multiple sampled populations provided support for the three-systems organization of the model and highlight its similarities and differences in relation to other measures of resilience. The MSMR conceptualizes resilience as a capacity that enables functioning across a continuum from vulnerability to resilience, whereby internal and external resources interface with dynamic coping processes in response to varying needs and goals. Meaningful applications of this model and future steps in model and measurement developments are discussed.

Resilience in family caregivers of patients diagnosed with advanced cancer - unravelling the process of bouncing back from difficult experiences, a hermeneutic review

Background

Despite the risk for developing mental disorders, most of advanced cancer patients’ family caregivers undergo a resilient process throughout the caregiving period. Research on resilience in caregivers of advanced cancer patients is scarce and further hindered by the lack of a univocal definition and a theoretical framework.

Objectives

To provide clarity on the concept of resilience by proposing an integrative view that can support health care professionals and researchers in conducting and interpreting research on resilience.

Methods

The review process was inspired by the hermeneutic methodology: a cyclic review process, consisting of repeated searching and analysing until data saturation is reached and focussed on achieving a deeper understanding of ill-defined concepts. The definitions from eighteen reviews on resilience and the theoretical frameworks from eight concept analyses were analysed. The composing elements of resilience were listed and compared.

Results

The American Psychological Association’s definition of resilience and Bonanno’s theoretical framework are suggested to guide further research on resilience. Moreover, four knowledge gaps were uncovered: (1) How do resilience resources interact? (2) What are the key predictors for a resilient trajectory? (3) How do the resilient trajectories evolve across the caregiving period? And (4) how does the patient’s nearing death influence the caregiver’s resilience?

Conclusion

To address flaws in conceptualisation and the resulting gaps in knowledge, we suggest a definition and a theoretical framework that are suited to allow heterogeneity in the field, but enables the development of sound interventions, as well as facilitate the interpretation of intervention effectiveness.

The Effect of Tidal Model-Based Psychiatric Nursing Approach on the Resilience of Women Survivors of Violence

This study examined the effect of a psychiatric nursing approach based on the Tidal Model. The outcome variable was resilience in women survivors of violence. The experimental and descriptive study was conducted with a control group and a pretest post-test procedure. The research was carried out with 13 women in the intervention and 14 women in the control group. Resilience Scale for Adults Turkish Version (RSA) was used. Seven one to one sessions were performed with the intervention group. Inter-group comparison of pre- and post-test variation showed significant variations in favor of the intervention group in perception of the future and RSA scale total scores. Consequently the resilience of the intervention group increased, and they had a more positive, target-focused view of the future.

Predictors of resilience among adolescent disaster survivors: A path analysis

AIMS

To investigate a theoretical model of risk and protective factors to predict resilience among adolescent disaster survivors.

DESIGN

A cross-sectional study.

METHODS

Parent's consent and student's informed consent forms were distributed at seven schools in a postdisaster setting (Yogyakarta, Indonesia) between July-October 2017; those who agreed to participate had to complete the self-reported questionnaires. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined using a path analysis.

RESULTS

Results of the model test analysis indicated that six of the seven the hypothesized paths were supported by data from our samples and demonstrated significance on the path coefficients (p < .01). One path coefficient on the association between posttraumatic stress disorder (PTSD) symptoms and resilience was found to be insignificant (β = -0.002, p > .05). However, overall, our hypothesized model was retained, indicating empirical support and adequate model's fit indices for the theoretical model.

CONCLUSIONS

Overall, the findings demonstrated the predictive roles of risk and protective factors in adolescent disaster survivors' resilience.

IMPACT

Resilience is known to be an important concept in recovering from long-term impacts following a disaster in adolescent populations, but its risk and protective factors have not been adequately explored. We found that PTSD symptoms influenced how adolescent disaster survivors developed defensive coping, social support had an indirect effect on resilience through courageous coping and defensive coping acted as a mediator between PTSD symptoms and courageous coping. These findings can help mental health professionals (i.e., community mental health nurses) promote intervention strategies to enhance resilience through improving coping skills in adolescent populations exposed to a disaster.

Fostering the Resilience of People With Dementia: A Narrative Literature Review

Background: Resilience is a process through which people use resources to adapt to adversity. Interventions aiming to support resilience in people with dementia have been developed. However, the optimal content, structure and impact of these interventions is unclear. This literature review explores the factors through which interventions foster resilience in people with dementia and examines their efficacy.

Methods: Eight databases were searched systematically, for literature published from 2000 to 2019. Following the removal of duplicate articles, the titles and abstracts of 6,749 articles were screened. Articles were selected if they: reported empirical studies in English; focused on resilience; involved people with dementia and psychosocial interventions. The full text of 53 articles were examined and three studies, reported in six papers, were included in the final review. Data were systematically extracted, and two authors critiqued the studies using the Critical Appraisal Skills Programme check lists. The studies were examined to determine how resilience was defined and operationalized and their findings were synthesized using the theoretical resilience framework.

Results: Five interventions aiming to foster resilience were identified: Dementia Advisors; Peer Support Network Services; Visual Arts Enrichment Activities; Memory Makers; and Early-Stage and Beyond Community Activities. All studies defined resilience as a process and most involved people with mild dementia who had family carers. The interventions impacted resilience by reducing the adversity of stigma and social isolation; increasing personal and social resources, providing stigma-free space and reciprocal support. Interventions empowered people with dementia, increasing their self-esteem and self-worth. Resilience can be fostered both during, and after interventions. However, the efficacy of interventions could not be determined because the research designs utilized did not measure efficacy.

Conclusions: Interventions need facilitators to ensure they are strength-based, person-centered and they enable reciprocal social interactions. Future research needs to develop interventions that aim to foster the resilience of people with dementia who lack family carers and/or have more advanced dementia through meaningful activities that are identified by people with dementia as important to their resilience. Robust methodologies, including randomized controlled trials should be used to measure effectiveness and explore the impact of interventions regarding the: interplay between individual and community resources; the importance of reciprocity; and temporal aspects of resilience.

Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review

This integrative review aimed to identify and synthesize evidence on workplace stress and resilience in the Australian nursing workforce. A search of the published literature was conducted using EMBASE, MEDLINE, CINAHL (EBSCO), PsycINFO, Web of Science, and Scopus. The search was limited to papers published in English from January 2008 to December 2018. The review integrated both qualitative and quantitative data into a single synthesis. Of the 41 papers that met the inclusion criteria, 65.85% (27/41) used quantitative data, 29.26% (12/41) used qualitative data, and 4.87% (2/41) used mixed methods. About 48.78% (20/41) of the papers addressed resilience issues, 46.34% (19/41) addressed workplace stress, and 4.87% (2/41) addressed both workplace stress and resilience. The synthesis indicated that nurses experience moderate to high levels of stress. Several individual attributes and organizational resources are employed by nurses to manage workplace adversity. The individual attributes include the use of work-life balance and organizing work as a mindful strategy, as well as self-reliance, passion and interest, positive thinking, and emotional intelligence as self-efficacy mechanisms. The organizational resources used to build resilience are support services (both formal and informal), leadership, and role modelling. The empirical studies on resilience largely address individual attributes and organizational resources used to build resilience, with relatively few studies focusing on workplace interventions. Our review recommends that research attention be devoted to educational interventions to achieve sustainable improvements in the mental health and wellbeing of nurses.

A Systematic Scoping Review of the Resilience Intervention Literature for Indigenous Adolescents in CANZUS Nations

Background: The concept of resilience offers a strengths-based framework for interventions to enhance Indigenous adolescent social and emotional well-being. Resilience interventions in or with schools encompass individual, social, and environmental factors that encourage health-promoting behaviors and assist adolescents in navigating toward resources that can sustain their health and well-being in times of adversity. This scoping review examined the literature on resilience-enhancing interventions for Indigenous adolescent students in Canada, Australia, New Zealand, and the United States (CANZUS nations). Intervention strategies, adherence to theoretical constructs, and outcomes were analyzed. Methods: A systematic search was conducted of intervention studies aimed at improving Indigenous adolescent resilience and published in CANZUS nations between January 1990 and May 2016. Eleven peer-reviewed databases and 11 websites and clearing houses were searched for relevant studies. Following double-blinded screening, a total of 16 intervention papers were included for analysis. Study characteristics were identified and study quality was assessed using appropriate assessment tools. Results: Twelve interventions (75%) were delivered in school settings and four (25%) were community-based, conducted in partnership with schools. Seven publications (44%) reported interventions focused exclusively on fostering individual resilience. Another seven (44%) included components that aimed to build staff, school, and/or community capacity to support adolescent resilience, and two (12.5%) had community/school capacity-building as the primary focus. Culturally based approaches to enhancing resilience were evident in most studies (81%). The publications documented the use of a range of program models, processes, and activities aligned with resilience theory. Positive outcomes were reported for improved individual assets (e.g., strengthened self-esteem and Indigenous identity), environmental resources (e.g., increased peer support and social/community connection), and increased community capacity (e.g., increased youth training and leadership opportunities). On average, study quality was assessed as moderate to high. The strongest evidence of intervention effectiveness was for improvements in mental health symptoms and outcomes. Conclusion: Interventions indicated strong alignment with ecological and culturally based resilience theories and models. While the results of the studies indicate some positive impacts on the resilience of Indigenous adolescents, future evaluations should aim to ensure high study quality and focus on measuring strengths-based resilience outcomes.

Resilience and Beliefs in the Effectiveness of Current Antiretroviral Therapies Among Recently Disengaged Low-Income People of Color Living with HIV

Consistent antiretroviral adherence is key to viral suppression, but many low-income people of color living with HIV are not optimally adherent due to a wide variety of interrelated social and structural factors. Previous studies have found that HIV medication beliefs are an important facet of adherence. In contrast to the AZT era , currently available antiretroviral therapies are significantly safer and more effective, but research suggests that negative beliefs may persist among racial and ethnic minority people. Twenty-seven semi-structured interviews were conducted with low-income Black and Latinx people living with HIV in New York City that were currently, or had been recently, disengaged from outpatient HIV medical care. This research suggests that socially and economically marginalized people living with HIV, many long-term survivors who lived through the AZT era, recognized that current treatments are very effective in making HIV a chronic, manageable illness and a significant improvement compared to the therapies early in the epidemic. Most importantly, the data suggests that people demonstrate great resilience despite their experiences of social and economic exclusion. Both clinical practice and public health interventions can benefit from these findings. HIV care providers should speak with patients about their beliefs related to HIV medication, and public health interventions should specifically address HIV medication-related beliefs in order to enhance adherence. In order to avoid reifying people's marginalization, public health should endeavor to recognize and support people's resilience.

Propiedades psicométricas del Instrumento para evaluar capital psicológico en las Organizaciones Ipsicap-24

La literatura científica ha reportado resultados importantes sobre el papel del capital psicológico como antecedente, consecuente, mediador o moderador de variables del comportamiento organizacional. Partiendo de la necesidad de instrumentos de medida adecuados para cada población, el objetivo de esta investigación es presentar un análisis de las propiedades psicométricas del Ipsicap-24. En el estudio participaron tres muestras de trabajadores colombianos provenientes de organizaciones de varios sectores de la economía y caracterización sociodemográfica variada. Con datos de la primera muestra (N = 1517), dividida aleatoriamente en dos partes, se realizaron Análisis Factorial Exploratorio y Confirmatorio, así el Ipsicap original de 36 ítems dio origen al Ipsicap-24, conformado por cuatro escalas: esperanza (7 ítems), optimismo (7 ítems), resiliencia (6 ítems) y autoeficacia (4 ítems). Para obtener evidencia de validez convergente y divergente del Ipsicap-24, respectivamente, la segunda muestra (N = 428) respondió el Cuestionario Utrecht Work Engagement (UWES); y la tercera muestra (N = 105), el Cuestionario General de Salud (General Health Questionnaire, GHQ-28). Los resultados obtenidos aportan evidencia de consistencia interna y validez de constructo para el Ipsicap-24. Esta nueva herramienta permite la evaluación válida y confiable del capital psicológico en trabajadores colombianos.

Towards a Transversal Definition of Psychological Resilience: A Literature Review

Background and objectives: This paper addresses psychological resilience, a multidisciplinary theoretical construct with important practical implications for health sciences. Although many definitions have been proposed in several contexts, an essential understanding of the concept is still lacking up to now. This negatively affects comparisons among research results and makes objective measurement difficult. The aim of this review is to identify shared elements in defining the construct of resilience across the literature examined in order to move toward a conceptual unification of the term. Materials and methods: A literature review was performed using the electronic databases 'PubMed' and 'PsycINFO'. Scientific studies written in English between 2002 and May 2019 were included according to the following key terms: 'Psychological', 'resilience', and 'definition'. Results: The review identifies five macro-categories that summarize what has been reported in the recent literature concerning the resilience phenomenon. They serve as a preliminary and necessary step toward a conceptual clarification of the construct. Conclusions: We propose a definition of psychological resilience as the ability to maintain the persistence of one's orientation towards existential purposes. It constitutes a transversal attitude that can be understood as the ability to overcome the difficulties experienced in the different areas of one's life with perseverance, as well as good awareness of oneself and one's own internal coherence by activating a personal growth project. The conceptual clarification proposed will contribute to improving the accuracy of research on this topic by suggesting future paths of investigation aimed at deeply exploring the issues surrounding the promotion of resilience resources.

"It's More than Just Needing money": The Value of Supporting Networks of Care

It is well established in research, practice, and policy that unpaid caregivers (family and friends of people with care needs) experience stress in their role. Supports that have been put in place by policy planners and program developers to support caregivers may not be accessed by caregivers at all or may do little to reduce their stress. Accessing personal resources (education, finances), in addition to social resources (individual connections) and societal resources (community supports) are critical in fostering resilience in caregivers (helping them adapt to stress and adversity). Social capital theorists argue that creating connections at various levels can improve access to resources. This research, through qualitative interviews (n = 21), identifies the different levels of resources required to address the needs of caregivers. Our findings indicate that interventions that focus on access to personal-level resources (education, funding) are important, but are on their own insufficient. Of more importance were interventions that work to improve relationships between formal providers and families; access to interdisciplinary teams; cross-sectoral collaborations; and inter-organization relationships, highlighting that a system that works together is likely to improve caregivers' access to resources.

Unified and rapid assessment of climate resilience of urban drainage system by means of resilience profile graphs for synthetic and real (persistent) rains

Urban drainage system (UDS) researchers have applied the concept of resilience for minimizing the magnitude and duration of urban flooding in response to climate change. Currently, the relationship between conventional design and resilience analysis still remains unknown, while persistent rain has not been included in resilience assessment. The present study proposes new metrics by means of resilience profile graph for UDS stressed by synthetic short-duration storms and real persistent rains. The graph unifies the concepts of reliability, robustness, resilience and failure, as well as design standards for sewer surcharging, sewer flooding and property flooding, which are linked into curves to show a complete performance under climate stress scenarios. The obtained results show that resilience profile curves for short-duration storms are well fitted by power functions with coefficient of determination 98.13%-99.9%. Chicago hyetograph was used as critical input hyetograph where the error range was -0.34%-6.83% compared with actual hyetograph. Resilience profile graphs for persistent rains reveal that resilience assessment based on short-duration storms underestimates the effect of persistent rains, and it can be obtained by using segmental and reference reliability metrics to reduce working time from weeks to hours. For the rain of the same intensity, resilience to persistent rain was 18.4-33.1% lower than for single rains. Threat of persistent rain doesn't fall under the rains of high intensity but under large rainfall in total (which exceeds 25% of local annual rainfall), while re-planning water landscape as retarding basin reduces the impact of persistent rains to 5.8-11.8%.

Building the Concept of Nurturing Resilience

THEORETICAL PRINCIPLES

Children and adolescents are faced with ubiquitous daily stressors. When faced with various stressors, they will either recover or stay distressed. For those unable to recover, acute daily stressors have potential to turn chronic with long term negative mental health outcomes. Nurturing resilience is one way to prevent distress from turning to mental health disorders. With the ability of adolescents and children to access nurses with various specialties, it is imperative nurses understand the nuances of resilience and the core elements to nurture resilience in youth.

PHENOMENA ADDRESSED

The purpose of building the concept of nurturing resilience is to clarify the meaning of this concept in children and adolescents, develop a conceptual definition of nurturing resilience, and provide a conceptual model of nurturing resilience based on the building process. The concept was formulated utilizing Liehr and Smith's practice-based approach to concept building.

RESEARCH LINKAGES

Concept building defines nurturing resilience as developing secure connections with another to support self-acceptance that aids in tempering reactivity when faced with environmental hardships. Resilience is a protective mechanism which keeps youth balanced while promoting positive mental health when faced with adversities by allowing one to bounce back after adversity to an original, fundamental state. Understanding patterns and processes of resilience enables nurses to nurture resilience. Nurturing resilience provides adolescents and children the ability to change in response to difficult circumstances; in turn, mental distress is reduced, and mental health of youth are optimized.

The Process of Developing Resilience in Patients With Burn Injuries

BACKGROUND

Patients with burn injuries resulting in visible disabilities may face negative emotional experiences during rehabilitation. Understanding the development of resilience in these patients may help those who are seeking methods to better adapt to their new situation.

PURPOSE

This study aimed to explore the development of resilience in patients with burns during their convalescence.

METHODS

Ten patients with burn injuries who were convalescing in a general hospital in China were recruited and enrolled as participants. Data were collected using recorded, semistructured in-depth interviews and analyzed following the principles of grounded theory.

RESULTS

The development of resilience in patients with burns included five stages of "black hole," "introspection," "integration," "practice," and "growth." Both internal and external protective factors were identified. The internal protective factors included hope, sincerity, will, belief, and curiosity, and the external protective factor was mutual relationships that reflected the qualities of caring, support, sharing, commitment, and intimacy.

CONCLUSIONS

Resilience was achieved gradually over several progressive steps through the five stages (black hole, introspection, integration, practice, and growth). The results of this research may provide insights and support to patients who seek to improve their adaptation to new situations.

Iranian Hospital Nurses' Lived Experiences of Emotional Intelligence: A Phenomenological Study

Emotional intelligence can help nurses improve their clients' satisfaction and health. The aim of this hermeneutic phenomenological study was to explore Iranian hospital nurses' lived experiences of emotional intelligence. Data collection was done through holding ten in-depth semi-structured interviews with ten hospital nurses. Participants were recruited from hospitals affiliated with Hamedan University of Medical Sciences, Hamedan, Iran. Data analysis was done using Van Manen's ( 1997 ) six-step approach and resulted in the development of the main theme of normative interactive management and the following three subthemes of resorting to spiritualities, self-protection, and intelligent resilience.

Bounce back- bounce forward: Midwifery students experience of resilience

Resilience is considered a vital characteristic and has gained attention in midwifery practice and education. In particular, midwifery students face challenges during their education in both academic and clinical components of the program. There is need for greater understanding and strategies to develop resilience in the midwifery student population. The aim of this study is to gain insight into how midwifery students conceptualise resilience, and explore how education might support the development of resilience. A focus group was conducted as part of a broader study underpinned by a concept analysis methodology to explore the students understanding of resilience. Participants included six third year midwifery students from one university. Thematic analysis was used to analyse the data. Four key themes were identified. Resilience contextualised to midwifery was triggered by exposure to adversity; resilience was identified as the ability to bounce back and move forward, and was seen to be important for midwifery students. The concept of resilience appears to play an important role in student success. Evidence suggests resilience can be developed and education providers have a role to foster student's resilience. Findings offer strategies to strengthen resilient behaviour for the midwifery student population and provide a basis for further research.

Children's description of pain through drawings and dialogs: A concept analysis

AIM

To present a concept analysis of pain in children's drawings and dialogs.

INTRODUCTION

The complexity and subjectivity of the concept of pain in children remain ambiguous. As a result, children are exposed to inappropriate diagnosis and inadequate treatment. Children can describe or draw their painful experiences. Analysing the concept of pain based on children's experiences can help identify, assess and properly manage and treat pain in children.

DESIGN

Concept analysis.

METHODS

Walker and Avant's framework for concept analysis was used in this current study.

RESULTS

Major aspects of pain revealed in this concept analysis are affected by children's different concerns about pain. The description of pain in children with chronic diseases or chronic pain is completely different from that in healthy children. Children perceive pain to be internal, external and emotional. Pain in children is associated with poor psychological and emotional conditions, which add new features and aspects to the concept of pain. Children's descriptions and drawings of pain indicate different concepts of pain in their minds. From the perspective of children, pain has an identity that is formed based on reality.

CONCLUSION

When developing pain evaluation tools, it is necessary to address the characteristics of pain. In the case of chronic pain, emotional effects of pain on children's psyche need extra attention. Child-based pain management guidelines can then be formulated with the results of relevant concept analyses. Pain assessment is a major part of pain management in children. By considering the characteristics of the concept of pain, the efficiency and usefulness of developed tools can be enhanced to create advancement in paediatric pain management.

Evaluation of a stress coping course for psychological resilience among a group of university nursing students

PURPOSE

This study was conducted to evaluate a stress coping course for psychological resilience among a group of university nursing students.

DESIGN AND METHODS

This was a quantitative study that had a pretest/posttest design without a control group. Data were collected from 78 first-year nursing students using a Stress Self-assessment Checklist and the Psychological Resilience Questionnaire (PRQ).

FINDINGS

A significant increase was determined in the subscales of self-perception and social resources of PRQ following the course (P ≤ 0.05).

PRACTICAL IMPLICATIONS

The findings emphasized that more attention should be given to the potential role of psychological resilience in dealing with the inevitable sources of stress in the education of nursing students.

Resilience in inpatient palliative care nursing: a qualitative systematic review

Background

Nurses in inpatient palliative care are frequently exposed to death and dying in addition to common stressors found in other nursing practice. Resilience may mitigate against stress but remains ill-defined and under-researched in the specialist palliative care setting.

Objective

The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses.

Design

A thematic synthesis of qualitative studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

Academic Search Ultimate, Cumulative Index to Nursing and Allied Health Literature, Medline Complete, PsycINFO and Scopus.

Review methods

The review stages were searching for relevant literature, selecting relevant papers, data extraction, critical appraisal and thematic synthesis.

Results

Eight studies revealed 10 subthemes, 3 descriptive themes and 1 analytical theme: resilience occurs when nurses incorporate stressful aspects of their personal or professional lives into a coherent narrative that enhances their ability to cope with the demands of their role.

Conclusion

Palliative care nursing is more stressful if patients or situations remind nurses of personal experiences. Nurses cope better with adequate support; however, coping does not necessarily imply increased resilience. Resilience occurs when nurses cognitively process their experiences, articulate their thoughts and feelings into a coherent narrative, and construct a sense of meaning or purpose. Future research could explore how nurses understand resilience and how it could be enhanced in the palliative care inpatient setting. With resilience, nurses may remain in the profession longer and improve the quality of care when they do.

Relationship between resilience and stress: Perceived stress, stressful life events, HPA axis response during a stressful task and hair cortisol

BACKGROUND

There is no consensus about how resilience is related to the different types of stress such as daily or chronic stress and psychopathology. The main objective of this study is to evaluate the relationship between resilience and the different measures of stress such as perceived stress, chronic stress, life events, HPA axis response during a stressful task and psychopathology.

MATERIAL AND METHODS

The design was cross-sectional. Resilience, perceived stress, stressful life events, hair cortisol and HPA axis response during Trier Social Stress Test measured by salivary cortisol samples and psychopathological symptoms were assessed in a sample of 80 University students.

RESULTS

Participants with low resilience showed higher scores in perceived stress level (p < .001), the number of current life events (p < .02), the intensity of stressful events (p < .025) as well as Obsession and Compulsion (p = .006), Interpersonal Sensitivity (p = .028), Phobic Anxiety (p = .044) and psychopathological severity (p = .033). Resilience was associated with chronic stress by perceived stress (p < .001), hair cortisol concentration (p = .022), obsessions and compulsions (p = .016), interpersonal sensitivity (p = .022), and depression symptoms (p = .039).

CONCLUSION

Resilience seems to be determinant in perceived stress, the number of current life events, the intensity of stressful events, chronic stress, obsession and compulsions, interpersonal sensitivity, phobic anxiety and depression symptoms, and psychopathological severity index.

Risk and Resilience Among Mothers and Fathers of Primary School Age Children With ASD in Malaysia: A Qualitative Constructive Grounded Theory Approach

Little is known about the coping and resilience experiences of parents of children with autism spectrum disorder (ASD) in the Malaysian cultural context. This study utilized a qualitative methodological approach adopting constructive grounded theory. The study sought to address the lack of research to date exploring the risk and protective experiences that contribute to parental stress and resilience for parents of primary school age children with ASD in the Malaysian setting. Twenty-two parents of children with ASD (13 mothers and 9 fathers) participated in semi-structured interviews. A strength of the study was the inclusion of both mother and father participant perspectives. The interviews lasted 50-80 min (mean: 67.5 min). The 22 parents had a total of 16 children (12 males; 4 females) formally diagnosed with ASD. Child age ranged between 5 and 12 years (mean age: 8.44). Overall, analysis of the 22 interviews revealed four prominent themes - "initial reaction to child's ASD symptoms and diagnosis," "family life affected by a child with ASD," "awareness about ASD in Malaysia," and "coping strategies, wellbeing, and becoming resilient." The first three themes revolved around stress and adversity, and, the adaptability and acceptance of the parents. These processes illustrated the risks experienced by the parents of children with ASD in Malaysia. The last theme especially highlighted the strengths and determination of the parents and illustrated the protective experiences and processes that helped parents to develop and enhance resilience. Overall, the findings revealed that resilience develops synergistically and dynamically from both risk and protective experiences across different levels - individual, family, community, society and government. The findings motivated the development of our theoretical model of resilience that can help health and education professionals tailor assessment and interventions for parents of children with ASD in the Malaysian context. Clinical, policy, and research suggestions were discussed.

A Photovoice study on nurses' perceptions and experience of resiliency

AIM

To explore the meaning of resilience to nurses and their perceived resilience enhancing factors.

BACKGROUND

With challenges faced at work, nurses' professional quality of life is adversely affected with nurses experiencing compassion fatigue, depression, burnout and even signs of post-traumatic stress disorder. Degree of resilience can determine job satisfaction and nursing attrition.

METHODS

The study adopted a descriptive qualitative design using Photovoice. Eight nurses from an academic medical centre in Singapore participated in focus group interviews and data were analysed with inductive content analysis approach.

RESULTS

Four themes were generated: (a) resilience is performing nursing duties despite adversities; (b) resilience is a dynamic process that develops over time; (c) religion and faith help build resilience; and (d) support of others is important in overcoming work-related stress.

CONCLUSIONS

Knowledge on resilience is vital to understand influencing factors of personal resilience and relationship to stress and burnout. Building nurses' resilience is significant to improve and sustain healthy and effective functioning of nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

With sufficient external resources and psychosocial support from hospital administrators, early resilience-based approach may provide the buffer and protective factor in facing workplace stress, to improve overall job satisfaction and improve nurses' retention.

Relational care and co-operative endeavour – Reshaping dementia care through participatory secondary data analysis

Dementia is emerging from the shadows of societal exclusion and stigma. The engagement within society for people who are marginalised is co-constructed through the everyday practices that take place between them and those around them. However, this is inherently political, positioning people as active and activist in the relationship of their lives with their communities. The research aimed to interrogate an existing qualitative dataset in partnership with people living with dementia to inform the development of a way of working with people with dementia that is empowering. In this qualitative secondary data analysis project, we (1) analysed data through two theoretical lenses: Douglas’ cultural theory of risk and Tronto’s Ethic of Care, and (2) co-analysed the data together with people living with dementia during 16 workshops. The design involved cycles of presenting, interpreting, representing and reinterpreting the data and findings between multiple stakeholders. We identified a granular understanding of the way relationships change for people with dementia and how subtle factors and nuanced behaviour contribute to social exclusion, or support social inclusion. The results support relational care through the co-operative endeavour (of co-operative communication, co-operative action and co-operative care) in promoting the inclusion of people living with dementia.