A Concept Analysis of Resilience Integrating Genetics

Resilience of individuals with chronic illness who reside in low resource communities: a concept analysis

Background

Chronic illness diagnosis while living in low resourced communities creates ongoing adversity in the process of adaptation. Resilience is an important phenomenon of study to improve health outcomes. The subject in this particular population has been poorly studied.

Objective

To conceptualize resilience of individuals with chronic illness who reside in low resource communities.

Design

Concept analysis.

Data sources

Seminal works and current studies were searched in PubMed (including Medline), Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Google Scholar, OVID, Ebsco, and the Cochrane Database. Qualitative and quantitative studies that investigated individual resilience of adults in the setting of chronic illness who reside in low resource communities were included. Exclusions included children with chronic illness and resilience of communities and populations.

Methods

Walker and Avant's method of concept analysis was utilized. The key elements for conceptualizing resilience in the setting of chronic illness who reside in low resource communities included defining attributes, antecedents and consequences of resilience identified from the literature search.

Results

Analysis revealed three defining attributes: (1) reflection, contemplation, and the will to live despite adversity through hope; (2) personal transcendence through action; and (3) continuous personal transcendence and maintenance. Antecedents and consequences of resilience in the setting of chronic illness who reside in low resource communities were described and outlined.

Conclusions

The conceptualization of resilience in the setting of chronic illness who reside in low resource communities is based on the defining attributes, antecedents, and consequences that resulted in a preliminary conceptual model. The model can be further tested in diverse populations to add to the existing knowledge on the subject, and develop interventions to foster resilience aimed to improve health outcomes and quality of life.

Identification of Relationships Among Resilience Factors Using Network Analysis: A Pilot Study

BACKGROUND

Although college life can be fulfilling, it can be stressful, particularly for health professional students. In addition, they may have had Adverse Childhood Experience (ACE) that increases their sensitivity to academic stress. Yet, students need to overcome challenges to become successful professionals. The literature suggests the following factors may be associated with resilience: ACE and academic stress as the antecedents; ego-resilience, emotion regulation, resources, social support, inflammatory markers, and genes as the defining attributes; and mental health and sense of coherence (SOC) as the consequences.

AIMS

The purpose is to identify the relationships among factors associated with resilience using network analysis.

METHODS

A total of 70 college students participated in this cross-sectional pilot study. They completed measures of psychosocial variables and provided saliva samples, which were analyzed for Serotonin Transporter-Linked Promoter Region (5-HTTLPR)/rs25531 and inflammatory markers. Mixed graphical models including all variables were estimated using the R-package mgm.

RESULTS

Network analysis revealed positive associations between (1) mental health and SOC; (2) mental health and resources; (3) mental health and social support; (4) SOC and reappraisal of emotion regulation; (5) resources and reappraisal of emotion regulation; and (6) resources and social support. In addition, SOC and academic stress were negatively associated. Furthermore, the short variant of 5-HTTLPR/rs25531 was associated with stronger suppression of emotion regulation and fewer resources compared with the long variant.

CONCLUSION

Resilience may be influenced by biopsychosocial factors, notably SOC and 5-HTTLPR/rs25531. However, longitudinal research is needed with a larger sample size to better understand how these and other factors may affect resilience.

The Lived Experiences of Students With Food Allergies During a Usual Weekday

BACKGROUND

Extant literature indicates students living with food allergies (FA) experience biopsychosocial challenges (eg, social isolation, anxiety). The purpose of this study was to explore the experiences of students living with FA during a usual weekday in a school setting.

METHODS

Phenomenological study with purposive convenience sample from the US states of Florida and Colorado. Students aged 10-14 years who have been managing an IgE-mediated FA for more than 1 year within a school setting. Data collection was guided by a story path process with semi-structured interview, with Interpretive Phenomenological Analysis used to ascribe meaning to their experiences.

RESULTS

Four themes: (1) Living with Restraints: A Way of Life, (2) Managing Exposure, (3) Experiencing Stigma, and (4) Experiencing Lack of Knowledge.

CONCLUSION

Findings underscore unique biopsychosocial challenges faced by students living with FA, highlighting the need for comprehensive approaches beyond traditional biological management in developing strategies, policies, future research, and recommendations in school settings.

Resilience in Older People: A Concept Analysis

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Perceived organisational support and work engagement among health sector workers during the COVID-19 pandemic: a multicentre, time-lagged, cross-sectional study among clinical hospital staff in Pakistan

OBJECTIVE

Workplace engagement is associated with several significant positive organisational outcomes. The COVID-19 pandemic has emphasised the importance of workplace engagement, particularly for front-line healthcare workers. Drawing on the conservation of resources theory, this study examines the impact of personal and job resources in a workplace that help in resource conservation for work engagement. In view of the high burnout rates reported among health professionals during the COVID-19 pandemic, this study aims to investigate the impact of perceived organisational support (POS) on work engagement through the mediating effect of well-being and the moderating role of employees' resilience.

DESIGN

Time-lagged, cross-sectional, split questionnaire-based survey study.

SETTING

Data were gathered from 68 hospitals in Pakistan, of which 45 were public and 23 were private hospitals.

PARTICIPANTS AND ANALYSIS

Simple random sampling techniques were used and data were collected from 345 healthcare professionals (ie, doctors, nurses and allied health professionals) using split questionnaires, in two waves with a 3-week interval, with a response rate of 80%. For analysis of data, the study used the PROCESS macro by Hayes.

RESULTS

Engagement at work was positively correlated with POS, well-being and resilience. POS significantly predicted work engagement through well-being (β=0.06, SE=0.02, 95% bias-corrected CI 0.021, 0.10). Further analysis of the strong effect of resilience on subjective well-being shows the significant value of the mediated moderation index (β=0.06, SE=0.02, 95% bias-corrected CI 0.03, 0.11).

CONCLUSION

The findings suggest that well-being may be an important pathway through which healthcare workers' POS may influence work engagement, particularly when their resilience capability is high. To maintain engagement at the workplace, hospital administrators should consider strengthening organisational and individual resources that build a supportive environment to meet the demands of challenging times.

Interindividual Variability in Mental Fatigue-Related Impairments in Endurance Performance: A Systematic Review and Multiple Meta-regression

BACKGROUND

The negative effect of mental fatigue (MF) on physical performance has recently been questioned. One reason behind this could lie in the interindividual differences in MF-susceptibility and the individual features influencing them. However, the range of individual differences in mental fatigue-susceptibility is not known, and there is no clear consensus on which individual features could be responsible for these differences.

OBJECTIVE

To give an overview of interindividual differences in the effects of MF on whole-body endurance performance, and individual features influencing this effect.

METHODS

The review was registered on the PROSPERO database (CRD42022293242). PubMed, Web of Science, SPORTDiscus and PsycINFO were searched until the 16th of June 2022 for studies detailing the effect of MF on dynamic maximal whole-body endurance performance. Studies needed to include healthy participants, describe at least one individual feature in participant characteristics, and apply at least one manipulation check. The Cochrane crossover risk of bias tool was used to assess risk of bias. The meta-analysis and regression were conducted in R.

RESULTS

Twenty-eight studies were included, with 23 added to the meta-analysis. Overall risk of bias of the included studies was high, with only three presenting an unclear or low rating. The meta-analysis shows the effect of MF on endurance performance was on average slightly negative (g = - 0.32, [95% CI - 0.46; - 0.18], p < 0.001). The multiple meta-regression showed no significant influences of the included features (i.e. age, sex, body mass index and physical fitness level) on MF-susceptibility.

CONCLUSIONS

The present review confirmed the negative impact of MF on endurance performance. However, no individual features influencing MF-susceptibility were identified. This can partially be explained by the multiple methodological limitations such as underreporting of participant characteristics, lack of standardization across studies, and the restricted inclusion of potentially relevant variables. Future research should include a rigorous description of multiple different individual features (e.g., performance level, diet, etc.) to further elucidate MF mechanisms.

The Lived Experience of Resilience in the Setting of Chronic Illness and Low-Resource Communities of African Americans That Reside in Tallahatchie County, Mississippi

Introduction

Strong links can be made between chronic illness, low-resource communities, and poor health outcomes. One such area is the Mississippi Delta within the United States that has identified its residents rank the lowest in overall health indicators with high rates of chronic illness.

Objective

This study aimed to explore the phenomenon of resilience in the setting of chronic illness and low resourced communities to gain baseline knowledge of the topic to improve protective resilience within the community.

Methods

The descriptive phenomenological psychological reduction method outlined by Giorgi et al. was used based on semistructured and in-depth interviews with eight individuals (ages 33-64) who were recruited by purposive sampling through a humanitarian organization.

Results

Six themes of the lived experience of the participants revealed the eidetic structure and essence of the experience. The results of the study provided important implications related to the meaning of chronic illness to the individual, poor resilient risk factors, antecedents to resilience, and areas to focus on for resilience promotion.

Conclusion

A lifeworld perspective of the individual can help nurses develop a greater understanding in formulating interventions for resilience promotion.

Genetic associations with resilience to potentially traumatic events and vantage sensitivity to social support

INTRODUCTION

Stress responses and mental health outcomes greatly vary when individuals are exposed to potentially traumatic events (PTEs). The Differential Susceptibility Model (DSM) (Pluess, 2015) suggests individual differences in stress responses are influenced by gene-environment interactions, with genes conferring reactivity. While individuals can be resilient (or vulnerable) to PTEs, they can also have vantage sensitivity (or resistance) to social support. This study examined whether selected genotypes moderated the effect of PTEs and social support on mental health.

METHODS

This cross-sectional candidate gene study included 450 college students (M age = 20.4, 79.3 % women) who provided buccal cells for genotyping and completed measures of psychosocial variables. DNA was genotyped for 12 genetic variants.

RESULTS

Hierarchical regression revealed that the Mental Health Inventory (MHI) was associated with the Trauma History Questionnaire (THQ), rs1800795 in IL-6, and THQ × rs1800795 [R² = 0.10, F(3, 418) = 15.68, p < .01]. The MHI was associated with the Social Support Survey (SSS), rs4680 in COMT, and SSS × rs4680 [R² = 0.24, F(3, 429) = 44.19, p < .01]. Only THQ and SSS survived multiple testing corrections.

DISCUSSION

Findings partially support the DSM that the G/G genotype of rs1800795 in IL-6 is associated with resilience to PTEs, and the Met/Met genotype of rs4680 in COMT is associated with vantage sensitivity to social support. Limitations include cross-sectional design, limited PTE measurement, small convenience sample, and noncorrection for multiple significance test. Clinicians need to view resilience holistically and understand resilience is associated with psychosocial and genetic factors.

Internationally educated nurses and resilience: A systematic literature review

Aim

To synthesize knowledge extracted from the literature about protecting factors and challenges to resilience, among migrant nurses, and specifically how knowledge synthesized through the process of the literature review is relevant to nursing and health policy.

Background

How nurses, in general, face challenges is well documented and is often linked to the concept of resilience; however, there seems to be a lack of systematic knowledge synthesis focusing on the resilience of internationally educated nurses following migration.

Method

The review was guided by the PRISMA guidelines, and a systematic search of peer‐reviewed qualitative and mixed‐method articles reporting empirical research was performed in the MEDLINE, CINAHL, PsycINFO and Academic Search Ultimate databases. Methodological rigour was assessed by the Joanna Briggs’ checklist, and a structured theme‐based ecological framework, inspired by Ungar's model of resilience, was chosen.

Results

Following critical appraisal, 37 studies were included that identified both challenges and individual, contextual and structural protective factors in host countries and are linked to resilience.

Discussion

Resilience of internationally educated nurses depends on a combination of individual and contextual protective factors, with the major emphasis being placed on individual protective factors. It is crucial to consider resilience in ensuring that internationally educated nurses’ experience is appreciated, as this is necessary if nurses are to deliver the best possible health service while integrating into their host country.

Implication for nursing and health policy

Authorities, managers in clinical practice and education, trade unions and nurses in general should be aware of the coping strategies, the strengths and supportive factors that can promote resilience and be aware of the challenges that undermine resilience and negatively impact internationally educated nurses’ practice and social interactions.

Unveiling the Effects of Stressors on Task Performance: The Role of Thriving at Work and Resilience

This study unveils the effects of stressors on employees' task performance through the mediating role of thriving at work (TAW) and a moderating role of resilience (RES) grounding on conservation of resources (COR) theory. The analysis of collected data from 331 supervisor-employee dyads in the hospitality sector of China explicates that the role conflict (RC) and perceived workload have a negative influence on TAW, and thriving has a positive relationship with task performance. The results corroborate the mediating role of TAW between RC, perceived workload, and task performance. Furthermore, the RES suppressed the negative relationship between RC, perceived workload, and TAW. Moreover, our study underscores the theoretical and practical contributions regarding the negative influence of stressors on TAW by exhibiting the importance of the COR mechanism for employees' behavioral outcomes.

A Middle-Range Theory of Nurses' Psychological Trauma

Vicarious trauma, secondary trauma, and workplace violence are the common forms of psychological trauma associated with nurses. Additional areas of nurses' trauma have not been adequately described, defined, or conceptually organized in the literature. In this article, a new middle-range theory of nurses' psychological trauma is presented with a novel discourse of nurse-specific traumas, theoretical statements, and outcomes of psychological traumas that are unique to nurses and the professional worlds in which they live. A middle-range theory is forwarded so that future scholars may test this theory and derive implications for practice, education, policy, and research.

Resilience of Emerging Adults After Adverse Childhood Experiences: A Qualitative Systematic Review

INTRODUCTION

Even as children experience adversity, they can become resilient adults, in large part due to their social supports as emerging adults.

OBJECTIVE

Authors examine constructs of social support applied to the concept of resilience among emerging adults having experienced adverse childhood experiences (ACE).

METHOD

Authors conducted a meta-ethnography with six databases between January 1998 and October 2019. Inclusion criteria were as follows: (i) original peer-reviewed qualitative or mixed-method studies, (ii) sampling adults aged 18-35 years, (iii) reporting at least one ACE as defined by the World Health Organization, (iv) focused on resilience, and (v) in English. Data were collected from six electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science, and Google Scholar). Studies were appraised using the Critical Appraisal Skills Program Qualitative Checklist. Analysis drew on Bourdieu's constructs of capital following Noblit and Hare's methods.

RESULTS

Thirteen studies of 277 emerging adults, aged 18-35 years old (mean 23 years), from six countries, reported resilience as "self-righting" appraisals. These were interdependent of their social supports and within a culturally determined sense of self-reliance. Self-reliance appeared to be a precursor shaping resilience of emerging adults with ACE. Self-reliance may deter self-compassion and, as a self-righting appraisal/capacity, may inhibit accessing social support.

CONCLUSION

This review emphasizes the life stage of emerging adulthood regarding the development of self-righting appraisal skills, which, when enabled with reliance, others help to transform ACEs and allow resilience to grow.

Assessing Resilience in Older Adulthood: Development and Validation of the Resilience Scale for Older Adults

This study presents on the initial development and validation of the Resilience Scale for Older Adults (RSOA). This new measure is based on a theoretical model of resilience grounded in qualitative research conducted with older adults. The scale consists of four resilience protective factors with 11 underlying facets. The Intrapersonal factor consists of Perseverance and Determination, Self-Efficacy and Independence, Purpose and Meaning, and Positive Perspective. The Interpersonal factor consists of Sense of Community, Family Support, and Friend/Neighbour Support. The Spiritual factor consists of Faith and Prayer, and the Experiential factor consists of Previous Adversity and Proactivity. The findings of three independent studies using older adult samples support the four-factor, 11-facet structure of the RSOA. Results also provide promising initial reliability and validity information, and analysis of gender invariance suggests that the factor structure is comparable across men and women. Implications for the applicability of the RSOA in research and clinical settings are discussed.

Do job insecurity, anxiety and depression caused by the COVID-19 pandemic influence hotel employees' self-rated task performance? The moderating role of employee resilience

The COVID-19 health disaster has had a dramatic impact on the global hospitality industry, affecting millions of people. The aim of this study is to examine the impact of job insecurity on hotel employees' anxiety and depression, and whether these psychological strains could influence employees' self-rated task performance during the COVID-19 pandemic. We also examine the moderating role of hotel employees' resilience in this context. The hypotheses were examined by collecting data from 353 hotel employees currently working in the Canary Islands (Spain). The results highlight the significant effects of job insecurity on employees' anxiety and depression levels. However, hotel employees' task performance was not affected by their job insecurity or by their anxiety and depression. In addition, employees' resilience has a moderating effect as it reduces the negative influence of job insecurity on depression. Finally, the discussion section sets out various theoretical and practical implications of the findings.

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.

Examining the Predictors of Resilience and Work Engagement during the COVID-19 Pandemic

Previous studies have acknowledged the importance of resilience in enabling individuals to cope and bounce back from crises and unexpected situations like the COVID-19 pandemic. Thus, this study advances conservation of resources theory by investigating the job, social, and personal resources underlying employees’ resilience, and the impact of resilience in stimulating job engagement amid the COVID-19 pandemic. The model was tested using data collected from 259 employees in Malaysia. Results of path modeling analysis revealed significant impacts of self-efficacy, facilitating conditions, and family and friends’ support on employees’ resilience. Besides, resilience was significantly associated with job engagement. Our findings suggest that management concerns for employees may not enhance employees’ resilience amid the COVID-19 pandemic. Nevertheless, management could stimulate their employees’ resilience by providing them with the flexibility to spend quality time with their loved ones and adequate support for enabling working conditions.

Resilience-building module for undergraduate nursing students: A mixed-methods evaluation

In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.

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.

Developing a model of resilience in older adulthood: a qualitative meta-synthesis

The study of resilience in an older adult population is expanding rapidly. However, most theoretical models of resilience have been developed with children or young to middle-aged adults. The objective of the present study was to review systematically the qualitative literature examining resilience in older adults, and to develop a comprehensive model of resilience in older adulthood. A qualitative meta-synthesis was conducted to review the qualitative literature examining resilience from older adults’ perspectives. An exhaustive search of the literature revealed 1,752 articles. From these articles, 34 studies meeting inclusion criteria were selected for analysis. Across the 34 studies analysed, eight themes were revealed as important for achieving resilience later in life: perseverance and determination, self-efficacy and independence, purpose and meaning, positive perspective, social support, faith and prayer, previous experience and being proactive. These themes can be organised into a four-factor model: (a) Intrapersonal Protective Factors; (b) Interpersonal Protective Factors; (c) Spiritual Protective Factors; and (d) Experiential Protective Factors. This study presents a new model of resilience in older adulthood that is grounded in qualitative literature and is relevant and appropriate for an older adult population. This research may be useful for clinicians, support workers and researchers working with older individuals through improving our understanding of what contributes to resilience later in life.

Genomics and psychological resilience: a research agenda

Although exposure to adversity increases risk for poor mental health outcomes, many people exposed to adversity do not develop such outcomes. Psychological resilience, defined broadly as positive emotional and/or behavioral adaptation to adversity, may be influenced by genetic factors that have remained largely unexplored in the era of large-scale genome-wide studies. In this perspective, we provide an integrative framework for studying human genome-wide variation underlying resilience. We first outline three complementary working definitions of psychological resilience-as a capacity, process, and outcome. For each definition, we review emerging empirical evidence, including findings from positive psychology, to illustrate how a resilience-based framework can guide novel and fruitful directions for the field of psychiatric genomics, distinct from the ongoing study of psychiatric risk and related traits. Finally, we provide practical recommendations for future genomic research on resilience, highlighting a need to augment cross-sectional findings with prospective designs that include detailed measurement of adversities and outcomes. A research framework that explicitly addresses resilience could help us to probe biological mechanisms of stress adaptation, identify individuals who may benefit the most from prevention and early intervention, and ascertain modifiable protective factors that mitigate negative outcomes even for those at high genetic risk.

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.

A Systematic Review of Genetic Influence on Psychological Resilience

When exposed to adversity, some individuals are at an increased risk of posttraumatic stress disorder, experiencing persistent biopsychosocial disturbances, whereas others adapt well, described as resilience. Resilience is a complex biopsychosocial phenomenon conceptualized as adaptation to adversity influenced by an individual’s genetic variants, epistasis, epigenetics, and gene-by-environment interactions. Studies on psychological resilience have focused on behavioral and psychosocial variables with far less examination of the genetic contributions. The purpose of this review is to identify specific genetic variants contributing to the biological capacity for psychological resilience. PubMed and PsycINFO were searched using the following key words: psychological resilience AND genotype(s). Additional articles were identified from the Human Genome Epidemiology Navigator using the term resilience, psychological. Ten studies met the criteria. Six genes were empirically associated with psychological resilience: serotonin-transporter-linked polymorphic region ( 5-HTTLPR), dopamine receptor D4, brain-derived neurotrophic factor ( BDNF), corticotropin-releasing hormone receptor 1, oxytocin receptor and regulator of G-protein signaling 2 . The findings of this systematic review suggest that the L/L or L’/L’ genotype of 5-HTTLPR and rs25531 in children/adolescents and the S/S or S’/S’ genotype in adults are most frequently related to resilience. Additionally, the Val/Val genotype of rs6265 in BDNF in Caucasians was also associated with resilience. There are numerous factors contributing to the complexity of determining the genetic influence on resilience including analysis of rs25531, assumptions of the mode of inheritance, operationalization of resilience, demographic and population characteristics, sample size, and other types of genetic influence including epistasis and epigenetics. While current evidence is supportive, further investigation of the genetic influence on resilience is required.