A cross-cultural comparison of resilience in adolescents

Depression, Anxiety, and Psychological Resilience in Healthcare Workers during the Pandemic (COVID-19)

BACKGROUND/OBJECTIVES

The aim of this study is to examine the relationship between depression, anxiety, and psychological resilience variables with working conditions and various demographic variables in healthcare professionals who are actively involved in the pandemic process.

METHODS

This study included 1440 healthcare workers in different professions in two state hospitals accepted as pandemic hospitals. The research data were collected with the Sociodemographic Data Form, Hospital Anxiety and Depression Scale (HAD), and Psychological Resilience Scale (PRS). Independent samples t-test, one-way analysis of variance (ANOVA), and descriptive analyses were used to analyze the data.

RESULTS

As a result of the analyses, female participants had higher anxiety scores than male participants; healthcare professionals working as nurses, midwives, and health officers had higher anxiety scores than other healthcare professionals; those with less professional experience had higher anxiety scores than those with more professional experience; and those who had long hours of contact with COVID-19-positive patients (8 h or more per day) had higher anxiety scores than those with less contact. Single female healthcare workers reported higher depression symptoms than married female healthcare workers, those with children reported higher depression symptoms than those without children, and those with average professional experience (6-10 years) reported higher depression symptoms than those with more experience. Being single, having children, and having an average number of shifts (working at night) caused an increase in psychological resilience.

CONCLUSIONS

The results of the study may contribute to the structuring of health policies to protect and support the mental health of healthcare workers in ongoing and future pandemic processes.

A Concept Analysis of Maternal Resilience against Pregnancy-Related Mental Health Challenges in Low- and Middle-Income Countries

Suicide accounts for 33% of deaths of women during the postnatal period in many low- and middle-income countries (LMICs). Resilience refers to an ability to adapt and recover from adversity or misfortune. Resilience building against mental health challenges during pregnancy and the postnatal period is critical for women to raise their child efficiently and maintain a healthy life. The exploration of maternal resilience against mental health challenges including its developmental processes and the determinants of its successful or unsuccessful cultivation among mothers during pregnancy and childbirth is of paramount importance. Understanding why a subset of mothers effectively develops resilience while others significantly struggle is critical for devising targeted interventions and support mechanisms aimed at improving maternal well-being. This inquiry not only seeks to delineate the factors that contribute to or hinder the development of resilience but also aims to inform the creation of comprehensive support systems that can bolster maternal health outcomes. This paper endeavors to present a comprehensive analysis of maternal resilience, aiming to cultivate a nuanced and profound understanding of the concept within the framework of previous traumatic events and adverse pregnancy outcomes in LMICs. The eight-step method approach proposed by Walker and Avant was utilized for this concept analysis. Several defining attributes were identified in the analysis including social adaptation, support system, optimistic approach, and mindfulness. This analysis contributes to knowledge advancement regarding maternal resilience and provides nurses and other healthcare professionals with a clear understanding of the concept of maternal resilience to help promote resilience among mothers.

How to build resiliency in autistic individuals: an implication to advance mental health

INTRODUCTION

Individuals on the autism spectrum (ASD) often experience poor mental health and coping strategies compared to their peers due to social exclusion and co-occurring conditions. Resiliency has been identified as a key factor in preventing adverse outcomes and promoting mental health. Therefore, it is important to determine what strategies can be used to build resiliency among autistic individuals. The current paper is one of the first studies that aims to collect information from autistic individuals and their caregivers on potential strategies to enhance resiliency.

METHODS

We interviewed 18 participants from various provinces in Canada, comprising of 13 autistic individuals and 5 parents. We used thematic analysis to identify patterns in the data.

RESULTS

Thematic analysis revealed three themes to indicate strategies that could be used to enhance resiliency, including: (a) self-reliant strategies, (b) using community-based facilities, and (c) contextual and individual characteristics.

CONCLUSION

Although the body of literature on resiliency is evolving, this paper provides a unique perspective as it is one of the few studies that considers the experiences of individuals on the spectrum. In addition, this study focuses on identifying and describing specific strategies that can be used to enhance resiliency and mental health, which consequently can help address the existing gaps in knowledge and practice.

Resilience of sub-Saharan children and adolescents: A scoping review

The population of sub-Saharan children and adolescents is substantial and growing. Even though most of this population is vulnerable, there is no comprehensive understanding of the social-ecological factors that could be leveraged by mental health practitioners to support their resilience. The present study undertakes a narrative scoping review of empirical research (quantitative, qualitative, and mixed) on the resilience of children and adolescents living in sub-Saharan Africa to determine what enables their resilience and what may be distinctive about African pathways of child and adolescent resilience. Online databases were used to identify full-text, peer-reviewed papers published 2000-2018, from which we selected 59 publications detailing the resilience of children and/or adolescents living in 18 sub-Saharan countries. Studies show that the resilience of sub-Saharan children and adolescents is a complex, social-ecological process supported by relational, personal, structural, cultural, and/or spiritual resilience-enablers, as well as disregard for values or practices that could constrain resilience. The results support two insights that have implications for how mental health practitioners facilitate the resilience of sub-Saharan children and adolescents: (i) relational and personal supports matter more-or-less equally; and (ii) the capacity for positive adjustment is complexly interwoven with African ways-of-being and -doing.

Compassion fatigue and psychological resilience levels of nursing final students: A descriptive, cross-sectional, and relational study

OBJECTIVES

Nursing students often encounter real-life trauma situations during their clinical experience and similar workplace environment and climate as professional nurses. This research was carried out to determine the reflections of the compassion fatigue levels of nursing final year students on their psychological resilience levels.

METHODS

This research was conducted as descriptive and cross-sectional. The sample of the study consists of 250 final year nursing students. Data were collected using Personal Information Form, Compassion Fatigue Scale, and Resilience Scale. It was determined that the compassion fatigue and psychological resilience levels of nursing final year students were moderate.

RESULTS

It was determined that as the levels of compassion fatigue increased, psychological resilience decreased. A highly negative and significant correlation was found between the total and sub-dimension mean scores of compassion fatigue and psychological resilience (p = 0.001).

SIGNIFICANCE OF RESULTS

It was found that there was a negative and high level relationship between nursing students' compassion fatigue levels and all its sub-dimensions and psychological resilience. Resilience can improve psychosocial functioning and professional performance, including for nursing students facing stressful clinical experiences. It is important to determine the compassion fatigue and psychological resilience levels of nursing students, to determine the existing problems, and to take initiatives for this.

The Effects of Resilience-Focused Psychoeducation in Patients Diagnosed with Depression

This study was conducted to determine the effects of resilience-focused psychoeducation on the level of depression, hopelessness, coping with stress, and psychological resilience in patients diagnosed with depression. This experimental study was conducted using pre and post-tests, with control groups. The sample of the research has been consisted of 60 patients (30 patients in experimental group and 30 patients in control group). Data has been collected by using Beck Depresssion Scale (BDI), Beck Hopelessness Scale (BHS), Ways of Coping Scale (WCS) and Resilience Scale for Adults (RSA). BDI and BHS posttest score of experimental group was found to be decreased to be significantly according to pre-test score (p < 0.05), at the control group was not found to be significantly decreased (p > 0.05). The increases in the score of WCS sub-dimension Self-confident, Optimistic approaches and Seeking of social support coping styles and the decrease of score of Helpless approach of patients in experimental group in posttest compared with pre-test are significant (p < 0.05). Psychoeducation has been effective on decreasing depression and hopelessness levels, and increasing effectively-active coping and decreasing-passive coping strategies of patients. It has been partially effective on level of resilience.

Predictive effect of resilience on self-efficacy during the COVID-19 pandemic: The moderating role of creativity

INTRODUCTION

To appraise the relationship and mechanism between resilience and self-efficacy in the context of the COVID-19 pandemic, we proposed a model to investigate the effect of resilience on self-efficacy and the moderating effect of creativity in this regard.

METHODS

Scales that measured resilience, creative behavior, and self-efficacy were rated by 881 college students in China to establish the moderating model.

RESULTS

The results showed that resilience and self-efficacy of participating college students were positively correlated, which meant that high resilience could predict a high level of self-efficacy. Moderating analysis using the SPSS PROCESS plug-in showed that creativity was an important element of resilience that positively affected self-efficacy and that this moderating effect was more significant in participants with a high degree of creativity.

DISCUSSION

These findings can provide a better understanding of the relationship between resilience and self-efficacy in demonstrating the traumatic impact of the COVID-19 pandemic on adolescent mental health and academic performance.

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 and its Predictors among the Parents of Children with Cancer: A Descriptive-Correlational Study

Context:

As a common debilitating illness, cancer is among the leading causes of child mortality in developed and developing countries. Cancer diagnosis for children is considerably stressful for their parents. Resilience is a key factor behind effective coping with cancer-related problems. This study evaluated resilience and its predictors among the parents of children with cancer.

Aim:

This study evaluated resilience and its predictors among the parents of children with cancer.

Settings and Design:

This cross-sectional descriptive-analytical study was conducted in 2017 on 400 parents of children with cancer in Tabriz Children's Hospital, Iran.

Methods:

A demographic questionnaire and the Connor-Davidson Resilience Scale were used to collect the data. Parents were conveniently recruited from Tabriz Children's Hospital.

Statistical Analysis:

Data were analyzed using the SPSS for Windows program (v. 16) via descriptive and inferential statistical methods.

Results:

The mean score of parents’ resilience was 66.83 ± 14.28. Fathers obtained significantly higher resilience scores than mothers (P < 0.001). The predictors of parents’ resilience were financial status, parents’ gender, fathers’ employment status, and children's gender.

Conclusion:

The parents of cancer-afflicted children, particularly their mothers, have low resilience and therefore may be at risk for different physical and mental health problems. Health-care providers need to identify at-risk parents and provide them with greater psychological and educational support.

Characteristics and components of children's and adolescents' resilience in disasters in Iran: a qualitative study

Children and adolescents are vulnerable in times of disaster and they will suffer more severely if neglected. The concept of resilience differs between cultures, and identifying the components of resilience is essential for decision making and interventions in disasters such as risk management. This study aimed to identify the components of children's resilience in disasters in Iran. This qualitative study took a content-analysis approach. Data were collected through semi-structured interviews with 23 people and three group meetings. Conventional content analysis was used for data analysis. MAXQDA 10 software was used for classification. The resilience components derived from the data were categorized into two main categories, internal and external, and eight subcategories covering psychological, emotional, cognitive, mental, spiritual, physical, social, and behavioral factors. The results also showed that the nature of resilience is both intrinsic and extrinsic. Recognizing the dimensions of children's resilience in disasters can lead to a new perspective for authorities and planners in disaster and emergency situations. The results of this study could be used by planners and policymakers to develop interventions to enhance children's and adolescents' resilience at the time of disasters, which is also underlined and highlighted by international documents.

Championing the resilience of sub-Saharan adolescents: pointers for psychologists

In this article, I argue that an ecological systems approach to resilience – specifically, one that is sensitive to how contextual determinants shape successful adaptation differentially – offers a meaningful way to enable sub-Saharan adolescents to adapt well to the apparently intractable risks to their health and well-being. Accordingly, I draw on studies of child and adolescent resilience from sub-Saharan Africa and the global North to show that the resilience field has largely moved beyond individual-focused theories of resilience that have the (long-term) potential to jeopardize adolescent health and well-being and advance neoliberal agendas. I emphasize that the recent attention to differentially impactful resilience-enablers casts suspicion on incautious application of universally recurring resilience-enablers. Allied to this, I problematize the delay in the identification of resources that impact the resilience of sub-Saharan adolescents differentially. Finally, I distil implications for resilience-directed praxis and research that have the potential to advance the championship of adolescent resilience in sub-Saharan Africa.

A Study of Resilience in Young Ethiopian Famine Survivors

We studied resilience related to childhood experiences of famine in Ethiopia. We sought an understanding of how young Ethiopians survived and coped with the devastating effects of famine. Participant observations and in-depth interviews at an orphanage in Addis Ababa with eight boys and girls (ages 18 to 23), survivors from famine catastrophe in Ethiopia 1984-1985, were conducted. Significant resilience factors identified were faith and hope, having a living relative, and having memories of one's past roots. Exposure to famine and multiple early losses may have long-term effects on an individual's capacity to maintain resilience. We discuss how an understanding of resilience can be applied in different cultural settings. Future research on resilience in Africa is suggested to increase our knowledge base of this concept.

The lived experiences of resilience in Iranian adolescents living in residential care facilities: A hermeneutic phenomenological study

BACKGROUND

Resilience is one of the main factors affecting human health, and perceiving its meaning for high-risk adolescents is of particular importance in initiating preventive measures and providing resilience care.

OBJECTIVES

This qualitative study was conducted to explain the meaning of resilience in the lived experiences of Iranian adolescents living in governmental residential care facilities.

MATERIALS AND METHODS

This study was conducted using the hermeneutic phenomenological method. Semi-structured interviews were conducted with eight adolescents aged 13-17 living in governmental residential care facilities of Tehran province affiliated to the Welfare Organization of Iran who articulated their experiences of resilience. Sampling lasted from May 2014 to July 2015 and continued until new themes were no longer emerging. The researchers analyzed the verbatim transcripts using Van Manen's six-step method of phenomenology.

RESULTS

The themes obtained in this study included "going through life's hardships," "aspiring for achievement," "self-protection," "self-reliance," and "spirituality."

CONCLUSION

Our study indicates that the meaning of resilience coexists with self-reliance in adolescents' lived experiences. Adolescents look forward to a better future. They always trust God in the face of difficulties and experience resilience by keeping themselves physically and mentally away from difficulties. Adverse and bitter experiences of the past positively affected their positive view on life and its difficulties and also their resilience. The five themes that emerged from the findings describe the results in detail. The findings of this study enable nurses, health administrators, and healthcare providers working with adolescents to help this vulnerable group cope better with their stressful life conditions and improve their health through increasing their capacity for resilience.

What is resilience? An Integrative Review of the empirical literature

AIM

To use systematic methods to examine how resilience is defined in empirical research.

BACKGROUND

Resilience is a term that is increasingly being used to describe and explain the complexities of individual and group responses to traumatic and challenging situations. It is now frequently mentioned in relation to many areas of nursing practice, including research. Given the increasing use of the term, it is timely to examine how resilience has been defined in empirical research.

DESIGN

An integrative review of the empirical literature (2000-2015).

DATA SOURCES

Three health-related databases were searched: Medline, PsycINFO and the Cumulative Index for Nursing and Allied Health (CINAHL). Reference and citation tracking was performed on all articles included in the review.

REVIEW METHODS

The methods described by Whittemore and Knafl were used to guide this review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. Data were synthesized using the constant comparative method of analysis.

RESULTS

One hundred articles were included in the final data analysis. The most significant finding of the review was that there is no universal definition of resilience. There were, however, some common themes identified: rising above, adaptation and adjustment, dynamic process, 'ordinary magic' and mental illness as a marker of resilience.

CONCLUSION

Despite the increasing use of the term 'resilience', this review has identified that there is no universal definition of resilience adopted in the research literature. Further research is required to explore this construct in the context of nursing.

Factors affecting quality of life in Taiwanese survivors of childhood cancer

AIM

This paper is a report of a pilot study to examine the significance, direction, and magnitude of the relationship of risk factors, protective factors, and resilience to quality of life in survivors of childhood cancer, and to explore what these variables meant to participants in order to better understand the quantitative findings and to assess the validity of the instruments with this population.

BACKGROUND

Cancer survivors contend with physical, psychosocial and emotional consequences of the disease and its treatment. There has been little research in Taiwan assessing these outcomes and, as survivor numbers increase, appropriate interventions need to be implemented. Haase's Adolescent Resilience Model was used as the theoretical framework.

METHODS

A mixed methods design was used to assess the relationship between the variables for survivors of leukaemia and brain cancers. Ninety-eight participants completed quantitative tools and interviews, and the data were collected in 2006.

FINDINGS

Survivors of leukaemia had better quality of life than those with brain tumours. This is attributed to more positive protective factors, fewer illness-related and individual risk factors and more positive resilience scores. Findings were congruent with similar studies from other countries. Qualitatively, participants believed that better quality of life meant less loss of self, a more integrated self, less chronic fear, and an ability to rebound and achieve personal control over one's life.

CONCLUSION

Interventions and assessment of their efficacy are necessary to help survivors capitalize on their strengths, to decrease their individual risks and to promote resilience promote self-control.

The relationship between adolescent renal transplant recipients' perceived adversity, coping, and medical adherence

The aim of the present study was to assess adolescent renal transplant recipients' perceived adversity (PA) for various aspects of living with a transplant, including its association with coping and medication non-adherence, from a theoretical perspective. Thirty-three adolescent renal transplant recipients were interviewed using structured questionnaires and medical record reviews. Health care provider ratings of adversity were also collected. Participants reported moderate levels of PA, with those who received a transplant at an older age reporting more adversity on several domains and girls reporting more adversity for missing school. Ratings of adversity for specific aspects of living with a transplant differed depending on age and medical factors and were related to specific coping strategies and measures of non-adherence. Consistent with the Self-Regulation Model, perceived consequences (represented as PA) appears to be related to coping and illness outcomes. Assessing PA and teaching appropriate coping strategies may yield better medical outcomes among this at-risk population.

Resilience and mental health

The relationship between disease and good health has received relatively little attention in mental health. Resilience can be viewed as a defence mechanism, which enables people to thrive in the face of adversity and improving resilience may be an important target for treatment and prophylaxis. Though resilience is a widely-used concept, studies vary substantially in their definition, and measurement. Above all, there is no common underlying theoretical construct to this very heterogeneous research which makes the evaluation and comparison of findings extremely difficult. Furthermore, the varying multi-disciplinary approaches preclude meta-analysis, so that clarification of research in this area must proceed firstly by conceptual unification. We attempt to collate and classify the available research around a multi-level biopsychosocial model, theoretically and semiotically comparable to that used in describing the complex chain of events related to host resistance in infectious disease. Using this underlying construct we attempt to reorganize current knowledge around a unitary concept in order to clarify and indicate potential intervention points for increasing resilience and positive mental health.

Consumer perception of the use of high-pressure processing and pulsed electric field technologies in food production

The success of new food processing technologies is highly dependent on consumers' acceptance. The purpose of this paper is to study consumers' perceptions of two new processing technologies and food products produced by means of these novel technologies. To accomplish this, a qualitative study on consumer attitudes towards high-pressure processing (HPP) and pulsed electric field (PEF) processing of food was carried out. In all 97 adults between 20 and 71 years of age participated in 12 focus groups conducted in Slovenia, Hungary, Serbia, Slovakia, Norway and Denmark using a common guideline. Participants were introduced to the HPP and PEF technologies and then to the effect of the two new technologies on two specific product categories: juice and baby food. The transcribed data was content analysed and the coded data was transformed into diagrams using UCINET 5 and NETDRAW. The results show that consumers perceived the main advantages of HPP and PEF products to be the products' naturalness, improved taste and their high nutritional value, whereas the main disadvantage was the lack of information about the PEF and HPP products. The results of the participants' evaluation of the PEF and HPP processes showed that environmental friendliness and the more natural products were seen as the main advantages, while they were concerned about body and health, the higher price of the products, the lack of information about the technologies and a general scepticism. The study also shows that North European participants were a bit more sceptical towards PEF and HPP products than the East European participants.

Cognitive vulnerability to depression: exploring risk and resilience

Scientific progress in risk research does not always translate to progress in resilience research. One explanation for the disconnect between risk and resilience research is inadequate theory construction in psychopathology. In this article, the authors argue that improved theory construction can help bridge the gap between risk and resilience. An example from the field of depression is used to illustrate how well constructed theories of risk can be used to develop and test preventions and interventions that bolster resilience. This article concludes with a discussion about the need for cross-cultural research on risk and resilience, which exemplifies a variety of environmental and genetic risk and resilience factors encountered by different populations and cultures.

A review of instruments measuring resilience

The objectives of the study were to evaluate the psychometric properties and appropriateness of instruments for the study of resilience in adolescents. A search was completed using the terms resilience and instruments or scales using the EBSCO database (CINAHL, PreCINAHL, and Academic Search Premier), MEDLINE, PsychINFO and PsychARTICLES, and the Internet. After instruments were identified, a second search was performed for studies reporting the psychometric development of these instruments. Using inclusion and exclusion criteria, six psychometric development of instrument studies were selected for a full review. A data extraction table was used to compare the six instruments. Two of the six instruments (Baruth Protective Factors Inventory [BPFI] and Brief-Resilient Coping Scale) lacked evidence that they were appropriate for administration with the adolescent population due to lack of research applications. Three instruments (Adolescent Resilience Scale [ARS], Connor-Davidson Resilience Scale, and Resilience Scale for Adults) had acceptable credibility but needed further study in adolescents. One instrument (Resilience Scale [RS]) was determined to be the best instrument to study resilience in the adolescent population due to psychometric properties of the instrument and applications in a variety of age groups, including adolescence. Findings of this review indicate that the RS is the most appropriate instrument to study resilience in the adolescent population. While other instruments have potential (e.g., ARS, BPFI) as they were tested in the adolescent and young adult populations, they lack evidence for their use at this time. An evaluation of the review and recommendations are discussed.

Adolescent resilience: an evolutionary concept analysis

Resilience is a concept that has enormous utility in nursing, although there is a need for concept clarity as it relates to adolescence. The purpose of this article is to describe the concept and apply the Evolutionary Model of Concept Analysis to resilience in adolescents. A literature search and an analysis of 22 articles specific to the adolescent population were completed. The literature review revealed adolescent resilience to be a composite of attributes that include the characteristics of the adolescent, sources of social support, and available resources. Implications for nursing and a proposed model of adolescent resilience are presented.

Coping with trauma and hardship among unaccompanied refugee youths from Sudan

The purpose of this study was to explore how unaccompanied refugee youths from Sudan, who grew up amid violence and loss, coped with trauma and hardship in their lives. The author used a case-centered, comparative, narrative approach to analyze the narratives of 14 male unaccompanied refugee youths from Sudan recently resettled in the United States. She analyzed narratives for both content and form and identified four themes that reflect coping strategies used by the participants: (a) collectivity and the communal self, (b) suppression and distraction, (c) making meaning, and (d) emerging from hopelessness to hope. The findings underscore the importance of understanding the cultural variations in responses to trauma and are discussed in relation to the concept of resilience.