Forging, protecting, and repairing community resilience informed by the 2019-2020 Australian bushfires

Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada

BACKGROUND

Resilience, a system's ability to maintain a desired level of performance when circumstances disturb its functioning, is an increasingly important concept in healthcare. However, empirical investigations of resilience in healthcare (RiH) remain uncommon, particularly those that examine how government actions contribute to the capacity for resilient performance in the healthcare setting. We sought to investigate how governmental actions during the coronavirus disease 2019 (COVID-19) pandemic related to the concept of resilience, how these actions contributed to the potential for resilient performance in healthcare, and what opportunities exist for governments to foster resilience within healthcare systems.

METHODS

We conducted case studies of government actions pertaining to the COVID-19 pandemic in New South Wales, Australia and Ontario, Canada. Using media releases issued by each government between December 2019 and August 2020, we performed qualitative content analysis to identify themes relevant to the resilience potentials (anticipate, monitor, respond, learn) and RiH.

RESULTS

Direct references to the term 'resilience' appeared in the media releases of both governments. However, these references focused on the reactive aspects of resilience. While actions that constitute the resilience potentials were evident, the media releases also revealed opportunities to enhance learning (eg, a need to capitalize on opportunities for double-loop learning and identify strategies appropriate for complex systems) and anticipating (eg, incorporating the concept of hedging into frameworks of RiH).

CONCLUSION

Though fostering RiH through government action remains a challenge, this study suggests opportunities to realize this goal. Articulating a proactive vision of resilience and recognizing the complex nature of current systems could enhance governments' ability to coordinate resilient performance in healthcare. Reflection on how anticipation relates to resilience appears necessary at both the practical and conceptual levels to further develop the capacity for RiH.

Psychometric properties of the Korean adaptation of the communities advancing resilience toolkit (CART) assessment survey

AIMS

This study aimed to establish a cross-cultural adaptation of the Communities Advancing Resilience Toolkit (CART) assessment survey for Korean communities (K-CART) and evaluated its psychometric properties of K-CART.

DESIGN

A cross-sectional study design was used.

METHODS

A forward and backward translation of the CART was conducted. The psychometric properties of K-CART were evaluated with test-retest reliability, internal consistency, content validity and construct validity. A field study was conducted involving 315 older adults in Pohang city, South Korea from January to March, 2019. Two versions of K-CART were analysed, based on the four-factor and the expanded five-factor K-CART.

RESULTS

The test-retest reliability and internal consistency were acceptable (intraclass consistency coefficient = .90). The consistency reliability was satisfactory (Cronbach's α = 0.91). The content validity index (CVI) was found to be acceptable; wherein the item-CVI and scale-CVI were both 0.95. Confirmatory factor analysis confirmed that the construct validity of the expanded K-CART with five factors reached a more acceptable model fit (χ² /df = 2.27, CFI = 0.89, TLI = 0.86, RMESA = 0.05).

Positive outcomes associated with the COVID-19 pandemic in Australia

ISSUE ADDRESSED

To investigate whether Australians have experienced any positive effects during the COVID-19 pandemic.

METHODS

National online longitudinal survey. As part of a June 2020 survey, participants (n = 1370) were asked 'In your life, have you experienced any positive effects from the COVID-19 pandemic' (yes/no) and also completed the World Health Organisation-Five well-being index. Differences were explored by demographic variables. Free-text responses were thematically coded.

RESULTS

Nine hundred sixty participants (70%) reported experiencing at least one positive effect during the COVID-19 pandemic. Living with others (P = .045) and employment situation (P < .001) at baseline (April) were associated with experiencing positive effects. Individuals working for pay from home were more likely to experience positive effects compared to those who were not working for pay (aOR = 0.45, 95% CI: 0.32, 0.63, P < .001) or who were working for pay outside the home (aOR = 0.40, 95% CI: 0.28, 0.58, P < .001). 54.2% of participants reported a sufficient level of well-being, 23.2% low well-being and a further 22.6% very low well-being. Of those experiencing positive effects, 945/960 (98%) provided an explanation. The three most common themes were 'Family time' (33%), 'Work flexibility' (29%) and 'Calmer life' (19%).

CONCLUSIONS

A large proportion of participants reported positive effects resulting from changes to daily life due to the COVID-19 pandemic in Australia.

SO WHAT

The needs of people living alone, and of those having to work outside the home or who are unemployed, should be considered by health policymakers and employers in future pandemic preparedness efforts.