Validation of the Connor-Davidson Resilience Scale-10 in South Africa: Item Response Theory and Classical Test Theory

Sociodemographic and work-related factors associated with psychological resilience in South African healthcare workers: a cross-sectional study

BACKGROUND

Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers.

OBJECTIVES

To determine the prevalence and factors associated with psychological resilience in a group of South African medical doctors and ambulance personnel.

MATERIALS AND METHODS

This analytical cross-sectional study used secondary data obtained from two studies conducted among healthcare workers in 2019 and 2022. Self-reported factors associated with resilience, as measured by the Connor-Davidson Resilience Scale-10 (CD-RISC-10), were evaluated. R statistical software was used for analysing the data and performing statistical tests.

RESULTS

A total of 647 healthcare workers were included in the study, of which 259 were doctors and 388 were ambulance personnel. Resilience scores were low overall (27.6 ± 6.6) but higher for ambulance personnel (28.0 ± 6.9) than for doctors (27.1 ± 6.0) (p = 0.006). Female gender (OR 1.94, 95%CI 1.03-3.72, p = 0.043), job category (OR 6.94 95%CI 1.22-60.50, p = 0.044) and overtime work (OR 13.88, 95%CI 1.61-368.00, p = 0.044) significantly increased the odds of low resilience for doctors. Conversely, salary (OR 0.13, 95%CI 0.02-0.64, p = 0.024) and current smoking status (OR 0.16, 95%CI 0.02-0.66, p = 0.027) significantly reduced the odds of low resilience amongst doctors. In addition, only previous alcohol use significantly reduced the odds of low resilience for ambulance personnel (OR 0.44, 95%CI 0.20-0.94, p = 0.038) and overall sample (OR 0.52, 95%CI 0.29-0.91, p = 0.024).

CONCLUSIONS

Resilience was relatively low in this group of South African healthcare workers. The strong association between low resilience and individual and workplace factors provides avenues for early intervention and building resilience among healthcare workers.

Evaluation of the Friendship Bench' Circle Kubatana Tose (CKT): an add-on support group intervention - a mixed-methods pilot interventional cohort study protocol

INTRODUCTION

Mental disorders are endemic. However, the mental health treatment gap remains high, especially in low-resource settings. Task-shifting is a universally recommended strategy to mitigate the care gap. The Friendship Bench (FB), a task-shifting, low-intensity psychotherapy programme founded in Zimbabwe, is effective in managing anxiety and depression. The FB programme offers clients the choice of joining add-on mental health support groups known as Circle Kubatana Tose (CKT). These groups offer an opportunity for continued psychoeducation, social support and economic strengthening. However, the evidence base for the effectiveness of add-on support groups is sparse. We hypothesise that participation in CKT is associated with increased adherence to treatment regimens, social support and well-being. This mixed-methods prospective cohort study seeks to evaluate the intermediate effects (6-month follow-up) of CKT groups, including process outcome evaluation.

METHODS AND ANALYSIS

We will recruit participants (N=178) receiving mental healthcare from the FB in Harare primary care clinics. Follow-up assessments will occur at enrolment, 6 weeks, 3 months and 6 months, assessing changes in common mental disorders (depression and anxiety), social support, positive psychological indices (hope and resilience), health-related quality of life, working alliance, economic outcomes (net income) and implementation outcome (feasibility, acceptability/satisfaction and uptake of services). Quantitative data will be analysed using descriptive analysis, bivariate statistics, Cox proportional hazard models and generalised mixed models (maximum likelihood estimation). Qualitative data will be analysed using thematic analysis.

DISSEMINATION AND ETHICS

Ethical approval was granted by the Medical Research Council of Zimbabwe (MRCZ/A/2427). The findings will inform the potential utility of add-on support groups in the management of anxiety and depression using task-shifting. Dissemination study outcomes will be disseminated in academic journals, social media, conferences and policy briefs.

Analysis on effect of psychological nursing combined with extended care for improving negative emotions and self-care ability in patients with colorectal cancer and enterostomy: A retrospective study

This study investigates the effectiveness of combining psychological nursing with extended nursing in patients with colorectal cancer who have undergone enterostomy. Conducted from January 2021 to January 2022, this retrospective study involved 78 patients split into 2 groups of 39 each. The control group received standard nursing care, while the observation group benefitted from both psychological and extended nursing. The evaluation focused on anxiety, depression, sleep quality, mental resilience, and self-care abilities. Results, 3 months postdischarge, indicated that the observation group had significantly lower scores in the Hamilton Depression Rating Scale and the Pittsburgh Sleep Quality Index, and higher scores in the Connor-Davidson Resilience Scale and the Enterostomal Self-Care Ability Scale, compared to the control group (P < .05). The findings suggest that integrating psychological nursing with extended care significantly improves mood, sleep quality, psychological resilience, and self-care capabilities in these patients.

Connor-Davidson Resilience Scale: a systematic review psychometrics properties using the COSMIN

Background

Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical.

Objective

This review study aimed to evaluate the psychometrics quality of resilience scales.

Methods

International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality.

Results

Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent.

Conclusion

The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

Medical registrars at the University of the Free State: Burnout, resilience and coping strategies

BACKGROUND

 Burnout among doctors has been linked with decreased quality of patient care. The coronavirus disease 2019 (COVID-19) pandemic highlighted the need to protect doctors' mental health and well-being. This study aimed to investigate burnout, resilience and coping strategies among registrars in the MMed programme of the University of the Free State (UFS) in 2020.

METHODS

 In this quantitative, cross-sectional study, a link to an online anonymous self-administered questionnaire with socio-demographic questions, perceived stress, Copenhagen Burnout Inventory (CBI), Connor-Davidson Resilience Scale and Brief Cope was emailed to all 278 registrars.

RESULTS

 Sixty registrars responded (response rate 21.6%). More than half (55.0%) were male and 73.3% were married. There were 28.3% second- and third-year students, respectively. Most (58.3%) had 5-10 years' work experience. The CBI personal scale had the highest median value (58.3; interquartile range [IQR]: 43.3; 70.8) with 70% scoring ≥ 50. The median score for resilience was 78 of 100 (IQR: 69; 84). There were weak negative correlations between resilience and burnout scores (r = -0.31 to r = -0.37). Planning, positive reframing and acceptance were the most frequently used adaptive coping mechanisms; self-distraction was the most frequently used maladaptive coping mechanism. There was no association between gender and burnout and resilience scores.

CONCLUSION

 Registrars were resilient with low levels of patient- and work-related burnout, and higher personal burnout, using mostly positive coping strategies.Contribution: This study gives insight into the well-being of registrars at the UFS during COVID-19. Continuous monitoring and support for this population are essential to foster mental health and well-being.

Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China

It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI  =  0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.

Satisfied with Life? The Protective Function of Life Satisfaction in the Relationship between Perceived Stress and Negative Mental Health Outcomes

Life satisfaction is a key index of well-being, yet few studies have examined its role as a protective factor in the context of the COVID-19 pandemic. The current study expands the research in this area through an examination of the role of life satisfaction in the relationship between perceived stress and negative indices of mental health. Participants were university students (N = 322) who completed the Perceived Stress Scale, the Satisfaction with Life Scale, and short forms of the trait scale of the Spielberger State-Trait Anxiety Inventory, the Center for Epidemiological Depression Scale, and the Beck Hopelessness Scale. The results indicate that life satisfaction had a health-sustaining effect on indices of well-being. It also moderated the relationship between perceived stress, on the one hand, and anxiety and hopelessness, on the other hand. Further, life satisfaction played a partial mediating role in the relationship between perceived stress and indices of mental health. The findings suggest that life satisfaction could be a protective factor in the context of stressful life events. Cultivating life satisfaction through mindfulness training and the enhancement of gratitude could potentially sustain mental health.

The Resilience of South African School Teachers in the Time of COVID-19: Coping with Risk of Infection, Loneliness, and Anxiety

The COVID-19 pandemic precipitated an overall increase in the global prevalence of mental health disorders and psychological distress. However, against this backdrop, there was also evidence of adaptation and coping, which suggested the influence of protective factors. The current study aims to extend previous research on the role of protective factors by investigating the health-sustaining and mediating roles of resilience in the relationship between perceived vulnerability to disease, loneliness, and anxiety. Participants consisted of a convenience sample of schoolteachers (N = 355) who completed the Perceived Vulnerability to Disease Questionnaire, the short form of the Connor-Davidson Resilience Scale, the University of California, Los Angeles Loneliness Scale, and the trait scale of the Spielberger State-Trait Anxiety Scale, through an online link created with Google Forms. The results of path analysis indicated significant negative associations between resilience and both loneliness and anxiety. These results indicate the health-sustaining role of resilience. In addition, resilience mediated the relationships between germ aversion and perceived infectability, on the one hand, and loneliness and anxiety, on the other hand. The findings confirm that resilience can play a substantial role in counteracting the negative impact of the pandemic on mental health.

The role of resilience in the relationship between role stress and psychological well-being during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Stress resistance resources, such as social support and resilience, have been found to be important in promoting psychological well-being during the COVID-19 pandemic. However, most prior research studies have conceptualized stress resistance resource variables as having a mediating or moderating role. Cooper (2018) proposed a model of the relationship between stress and health which posits that coping resources are always present and not only invoked in the face of adversity. Thus, we hypothesize that coping resources are causally antecedent to stressors and influence well-being indirectly via the stressor. We focused specifically on school teachers due to them being at the frontlines of service provision during the pandemic. Teaching was already identified as a highly stressful profession prior to COVID-19 and disease containment measures placed additional strain on teachers who had to adapt to emergency remote teaching.

AIM

The current study tests this hypothesis by examining the indirect effects of resilience on indices of psychological health via role stress.

METHODS

Participants (N = 355) were teachers who completed the Connor-Davidson Resilience Scale-10, the Role Stress Scale, the Satisfaction with Life Scale, the State-Trait Anxiety Inventory-Trait Scale, and the Center for Epidemiological Studies Depression Scale. An electronic version of the questionnaires was distributed to teachers via Facebook and to officials from the Department of Education, who assisted with distribution of the electronic link to the survey. Participants were mostly women (76.6%) and mean number of years in the teaching profession was 15.7.

RESULTS

Structural equation modelling results demonstrated significant direct effects of resilience on life satisfaction, anxiety, and depression, which indicates that resilience is beneficial for psychological health even in the absence of stress. Resilience also had a significant indirect effect on indices of psychological well-being via role ambiguity but not role conflict.

CONCLUSION

These findings have theoretical implications for the understanding of the role of resilience in promoting psychological health among educators. Practical implications include an empirical contribution to education policy and information that can inform interventions aimed to promote resilience among educators.

We Are Not Islands: The Role of Social Support in the Relationship between Perceived Stress during the COVID-19 Pandemic and Psychological Distress

COVID-19 containment measures, including social distancing, quarantine, and confinement, significantly impacted social connectedness and contributed to heightened levels of perceived stress. Prior research has established that protective factors can mitigate emotional distress. This study investigated the protective role of social support in the relationship between perceived stress and psychological distress among a sample of university students. Participants (n = 322) completed the Multidimensional Scale of Perceived Social Support, the Perceived Stress Scale, short forms of the Center for Epidemiological Studies Depression Scale, the trait scale of the State-Trait Anxiety Inventory, and the Beck Hopelessness Scale. The results indicated that high levels of perceived stress were associated with high levels of hopelessness, depression, and anxiety. In terms of direct and mediating effects, social support was significant for depression and hopelessness but not for anxiety. Furthermore, the relationship between perceived stress and depression was higher for those with high levels of social support than for those with lower levels of social support. The findings suggest that in addition to enhancing social support resources, interventions must assist students in managing the uncertainty and anxiety associated with the pandemic. Furthermore, students' appraisals of support and the extent to which support is experienced as beneficial must also be examined prior to the implementation of interventions.

The Relationship Between Emotional Intelligence and Expatriate Performance in International Construction Projects

Purpose

In the field of construction, it has been shown that individuals with higher emotional intelligence may perform better on the job. However, it is still a question worth exploring about how emotional intelligence affects expatriate performance in international construction projects. Therefore, this study aimed to verify the relationship between expatriates' emotional intelligence and expatriate performance and explore the mediating role of self-efficacy and psychological resilience.

Methods

A cross-sectional study was conducted in June 2021. A non-probability sampling method was used to obtain data. A total of 315 Chinese construction expatriates in 67 countries and regions around the world were evaluated using four scales: the Wong and Law Emotional Intelligence Scale, the General Self-Efficacy Scale, the Connor-Davidson Resilience scale, and the Kraimer's expatriate's performance scale. The hypothesis model was tested using Partial Least Squares Structural Equation Modeling (PLS-SEM).

Results

The results of the data analysis indicated that self-efficacy (β_{Indirect effect} = 0.175, p<0.05) and psychological resilience (β_{Indirect effect} = 0.112, p<0.05) served as fully mediating variables (β _{Direct effect} = 0.177, p=0.101), suggesting a way to explain how emotional intelligence affect the performance of contractor expatriates. The findings also suggest that self-efficacy and psychological resilience also play continuous and multiple mediating roles (β_{Indirect effect} = 0.143, p<0.05) between emotional intelligence and expatriate performance.

Conclusion

This study attempted to investigate the mechanism of emotional intelligence's influence on expatriate performance from the perspective of individual psychological resources. The results of the study suggest that the emotional intelligence of expatriates may bring about an increase in performance levels by improving self-efficacy and psychological resilience levels. This provides a practical way to improve the performance of expatriates and a new management perspective for human resource management in international construction projects.

Resilience in Teachers: Validation of the Spanish Version of the CD-RISC10© Scale in Early Childhood, Primary and Special Education Teachers

Schools are a fundamental context for processes of promotion and generation of resilience, since they focus not only on aspects of academic development, but also of personal and social development. Resilience in the teacher has a dual function. On the one hand, as resilient professionals, teachers can foster the development of resilience in their students; on the other hand, teaching resilience facilitates their own personal and professional well-being. Despite research highlighting the benefits of resilience in education, there is scarce research focused on assessing resilience in teachers. Thus, the aim of this paper is to analyze the psychometric properties of the Spanish version of Connor and Davidson's 10-item resilience scale (CD-RISC 10©) in a sample of 290 teachers. A confirmatory factorial analysis (CFA) is performed, which shows that the 10 items on the CD-RISC 10© Resilience Scale form a one-dimensional structure, with high reliability, McDonald's Omega coefficient (ω = 0.80) and Cronbach's alpha coefficient (α = 0.87). The results obtained in this work support the use of the scale for the assessment of resilience in teachers of Infant, Primary and Special Education, which is considered very useful, not only to know their degree of resilience, but also to assess the effectiveness of training programs.