Developing the Resilience Framework for Nursing and Healthcare

Predictors of Resilience in Prelicensure Nursing Faculty

BACKGROUND

Nursing faculty vacancies reduce the numbers of students entering the nursing profession, exacerbating the health care workforce crisis. Resilience, known to mitigate occupational burnout, may play a role in retaining existing prelicensure nursing faculty (PNF), a population that has not been extensively studied.

PURPOSE

We examined compassion satisfaction (CS), perceived support (PS), and associated demographic factors of resilience among PNF.

METHODS

This cross-sectional study used a secondary data analysis of survey responses from 499 PNF. Multiple linear regression analyses were conducted to identify significant predictors of resilience.

RESULTS

Multivariate analysis revealed CS and PS were significant predictors of resilience when controlling for age, with CS being the strongest predictor in the regression model.

CONCLUSIONS

This study highlights the importance of CS and PS in fostering resilience among PNF. Understanding these factors can guide academic institutions in developing interventions to retain nursing faculty, thereby addressing the broader nursing shortage.

Resilience in Newly Hired Nursing Faculty: Practical Evidence of a Complex Construct

BACKGROUND

Resilience plays a role in workforce retention and has been linked to job satisfaction, quality of life, and organizational commitment in nursing faculty. Research on the nature of faculty resilience, however, remains sparse.

PURPOSE

The purpose of this study was to contribute to the understanding of nurse faculty resilience by describing examples of specific ways that a group of newly hired nursing faculty enacted resilience during their first few years on the job.

METHODS

Transcripts from one-on-one interviews with 23 faculty in 7 U.S. states were analyzed in a secondary analysis, which generated exemplars of resilience in practice.

RESULTS

Faculty expressed resilience through specific measures that included positive self-talk, reframing of adverse events, drawing analogies to familiar experience, asserting self-worth by helping others, and extensive social networking.

CONCLUSION

These actions enabled faculty to find meaning and support in difficult circumstances.

Resilience, compassion fatigue, moral distress and moral injury of nurses

Background: Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. Aim: To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. Design: The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines for this study. Methods: The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. Ethical considerations: This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey's description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results: Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Conclusion: Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Implications for the profession and/or patient care: Nurse leaders should develop programmes and initiate efforts to improve nurses' resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. Patient or Public Contribution: There was no public or patient participation in this study.

Garcia Adaptive Equilibrium Theory (GAET): A New Nursing Theory for Mental Health Nursing

Mental health nursing demands a dynamic, patient-centered approach that goes beyond crisis intervention and symptom management. Traditional models like the Roy Adaptation Model and Tidal Model emphasize adaptation and recovery but fall short in capturing the fluid, nonlinear nature of mental health. The Garcia Adaptive Equilibrium Theory (GAET) introduces a new framework viewing mental health as a continuous balancing process. In this model, nurses serve as Equilibrium Facilitators, identifying points of instability and intervening early to prevent crises.Central to GAET is the Equilibrium Spectrum, which conceptualizes mental health as a fluctuating continuum-from stability to severe distress. Unlike traditional psychiatric approaches focused on reactive treatment, GAET incorporates Equilibrium Forecasting, a proactive assessment strategy that integrates subjective tools (scales, narratives) and objective data (biomarkers, physiologic signs) to anticipate deterioration.By reframing mental health care around real-time stabilization, GAET promotes early intervention, sustained well-being, and a shift toward preventive, holistic care. This theory redefines psychiatric nursing as an active, interdisciplinary practice focused on maintaining equilibrium rather than responding to disruption-empowering nurses to lead in mental health stabilization and prevention.

Exploring resilience in critical care nursing: a qualitative inquiry into continuous adaptation, collaborative unity, and emotional balance

BACKGROUND

Resilience is essential for nurses in critical care, where they face high-stakes situations requiring continuous adaptation, collaborative unity, and emotional balance. This study aimed to investigate resilience in critical care nursing, focusing on how nurses adapt to challenges, the role of teamwork in fostering resilience, and strategies for maintaining emotional balance.

OBJECTIVE

The objective of this study was to explore resilience among critical care nurses, emphasizing their adaptation to challenges, the influence of collaborative practices, and methods for sustaining emotional well-being in intensive care units.

METHODS

A qualitative study with a thematic analysis approach was used in this study. The study was conducted in five intensive care units across two hospitals in Egypt. The purposeful sampling approach includes 17 critical care nurses with diverse experiences. Data was collected through in-depth semi-structured interviews using an interview guide focusing on challenges, adaptation strategies, collaborative practices, and coping mechanisms.

RESULTS

Themes emerge, depicting resilience as a dynamic process encompassing continuous adaptation, learning, collaborative unity, emotional balance, self-care, and reflection on experiences. Nurses emphasize the importance of teamwork, interprofessional collaboration, and managing emotional complexities. Resilience is portrayed as a collective force within the critical care team, balancing compassion and clinical precision.

CONCLUSION

Critical care nurses demonstrate resilience as a multifaceted and dynamic process. The study provides insights into the collaborative strategies employed and the emotional aspects of resilience. Acknowledging vulnerabilities and prioritizing self-care are integral to sustaining resilience.

Conceptualisation and Measurement of Resilience of Adults With Cancer: An Umbrella Review

AIMS

To (1) clarify the key components of resilience of adults with cancer; (2) summarise and analyse the resilience measures used in this population; and (3) discuss future evaluation directions.

DESIGN

An umbrella review.

DATA SOURCES

MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Cochrane library and Epistemonikos were searched in December 2023.

METHODS

The Joanna Briggs Institute (JBI) guidelines were followed for undertaking this umbrella review. Systematic and narrative reviews that defined resilience of adults with cancer and reported resilience measures, published in English, were included. The methodological quality was assessed using the JBI appraisal tool.

RESULTS

Fourteen eligible reviews were included. Four key resilience components from various resilience conceptualisations were identified. Twenty resilience measures were used among cancer patients, with the 25-item Connor-Davidson Resilience Scale providing a relatively comprehensive assessment of individual resilience. Recommended future research with cancer patients includes assessing these resilience components: (1) available individual resources-key psychological factors that enhance individual resilience; (2) access to social resources-close interpersonal relationships, family cohesion and social support; (3) adaptive coping ability-problem-solving skills, emotional management strategies and experiences in managing adversity; (4) ability to regain mental health and well-being-the capacity to recover a relatively stable psychological state and promote positive psychological functioning.

CONCLUSION

The findings provide evidence for refining future resilience measurement in the adult cancer population. Examining the four key components of resilience with this population across cultures is warranted.

IMPACT

Understanding the key components of resilience of cancer patients can help healthcare professionals identify individuals who may need further support and facilitate early intervention or referral to psychosocial support services. The 25-item Connor-Davidson Resilience Scale is recommended over other tools for use in the cancer population.

PATIENT OR PUBLIC CONTRIBUTION

Patient or public involvement is not applicable in this study.

Perceptions of Resilience Among Nurses: A Qualitative Study Based on the Society-To-Cells Framework

AIM(S)

To explore the perceptions of resilience among nurses using the Society-to-Cells Resilience Theory and examine how multilevel factors influence their ability to maintain resilience in high-stress environments.

DESIGN

A qualitative study using semi-structured interviews.

METHODS

Sixteen registered nurses from various healthcare settings in the Asir region, Saudi Arabia, participated in face-to-face interviews conducted from February to April 2024. The interviews were analysed thematically to identify key factors affecting resilience at individual, familial, institutional and societal levels.

RESULTS

Four key themes emerged: individual coping strategies, family and social support, institutional support mechanisms and societal recognition. Nurses identified personal coping methods, such as mindfulness and exercise, as essential for maintaining resilience. Family and social networks played a crucial role in emotional support. Institutional factors, such as adequate staffing and leadership support, were vital to resilience, while a lack of societal recognition negatively impacted nurses' well-being.

CONCLUSION

Resilience in nursing is a multifaceted process influenced by individual, institutional and societal factors. Supportive work environments, adequate resources and recognition of nurses' contributions are critical in fostering resilience.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The findings emphasise the need for healthcare institutions to implement policies and support mechanisms that address both the personal and professional challenges nurses face. Promoting resilience can improve nurse retention, job satisfaction and patient care outcomes.

REPORTING METHOD

This study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Relationship between transition shock, resilience, career calling, and retention intention among new nurses: a moderated mediation model

BACKGROUND

Nurse shortage has become an ongoing and urgent problem worldwide. The high turnover rate of new nurses, who are the primary backup personnel for the nursing force, exacerbates the possibility of this situation. Transition shock has been demonstrated to be critical in influencing new nurses' retention intention. However, the mechanisms underlying this impact remain unclear.

OBJECTIVES

This study aims to explore transition shock's effect mechanism on retention intention among new nurses, and to clarify the career calling's mediating role and the resilience's moderating role in this relationship.

METHODS

This is a multicenter cross-sectional study. From January 28 to February 20, 2024, an online questionnaire survey was administered among 739 new nurses from 11 hospitals in Shanxi Province, China, using convenience sampling. The survey included a demographic information questionnaire, the Transition Shock of Newly Graduated Nurses Scale, the Medical Staff Resilience Scale, the Career Calling Scale, and the Nurses' Intention to Stay Scale. The data were analyzed using descriptive analysis, Pearson correlation analysis, and the PROCESS Macro Model 4 and 7 for the regression.

RESULTS

Transition shock was significantly negatively correlated with retention intention (p < 0.001). Career calling played a partial mediating role between transition shock and retention intention, accounting for 63.53% of the total effect. Further, resilience moderated transition shock's effect on career calling; thereby, a moderated mediation model was developed.

CONCLUSIONS

Transition shock reduces retention intention by decreasing new nurses' levels of career calling, while resilience moderates this mechanism. Nursing managers can adopt measures to increase retention intention among new nurses by reducing their transition shock and enhancing their career calling education and resilience training.

TRIAL AND PROTOCOL REGISTRATION

This study was registered with the Chinese Clinical Trial Registry ( http://www.chictr.org/cn/ ) under the following ID: ChiCTR2400080373.

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.

Building resilience in nursing through strategic policy interventions

In the context of a global nursing shortage, this paper explores the concept of resilience within the nursing profession, highlighting its implications for practice and policy on an international level. Although resilience is a vital concept for coping with stressors, we argue that placing the burden of resilience on individual nurses may obscure systemic issues that contribute to burnout and attrition. Resilience in nursing is a multifaceted concept that should be examined critically. Relying heavily on individual resilience may inadvertently perpetuate systemic issues and risk internalization of blame by nurses. Upon critical analysis of recent global statistics, this paper advocates for a shift toward collective resilience strategies, specifically, nurse participation in policy-making. This approach not only addresses immediate workforce challenges but also reinforces the essential role of the nursing profession in shaping health and social policies, ensuring sustainable healthcare systems worldwide.

Understanding the importance of therapeutic alliance during physiotherapy treatment for musculoskeletal pain in children: a scoping review

Introduction

Musculoskeletal pain affecting children is common. Rehabilitation and treatment effectiveness can be influenced by multiple individual and contextual factors. The need for more rigorous evaluation of physiotherapy treatment for children's pain, identification of the role of specific techniques, and exploration of the influence of the therapeutic alliance is needed. This scoping review of research aimed to examine: (1) What are the perceptions of children, parents, and physiotherapists about the importance of therapeutic alliance during musculoskeletal pain treatment? (2) What are the key characteristics of therapeutic alliance during a child's musculoskeletal pain treatment from the perspectives of children, parents, and physiotherapists? and (3) What are the perceived impacts of therapeutic alliance (positive and negative) during a child's physiotherapy treatment for musculoskeletal pain?

Methods

The scoping review, based on Arksey and O'Malley's framework and reporting was guided by PRISMA-ScR. The search strategy was based on three concept blocks: (1) Study population: Children (<18 years); (2) Medical condition: Any musculoskeletal pain (acute, chronic primary, chronic secondary); (3) Intervention: Qualitative exploration of experience of physiotherapy treatment delivered by a physiotherapist from the perspective of a child, parent, or physiotherapist. The search (no date limit) was conducted in February 2024 across Medline, AMED and CINAHL.

Results

Following duplicate removal and assessment of eligibility of the initial 236 articles, nine articles were included; of these, only one specifically aimed to explore therapeutic alliance and it was the only paper to directly mention therapeutic alliance. All nine articles presented the child's experience. One overarching theme "Finding resilience within me through therapeutic alliance" and three main themes: "A trusted guide through the ups and the downs of rehabilitation"; "Having a route map"; and "Take me seriously but make it fun" were identified.

Discussion

Therapeutic alliance was considered important by children, parents and physiotherapist and it influenced child and parent perceptions of physiotherapy and overall treatment outcomes. Physiotherapists can foster the children's resilience when experiencing musculoskeletal pain by providing disciplinary expertise, connecting and collaborating with the child by becoming their trusted guide, and co-creating a route map for rehabilitation by helping them to learn about their body, pain and recovery timeline.

Resilience in Nursing Faculty: An Integrative Review

The current documented nursing faculty shortage is an important factor affecting our ability to address the nationwide nursing shortage. Occupational burnout is a common phenomenon among nurses that may negatively impact retention of nursing faculty. While research suggests that promoting resilience moderates occupational burnout and relates to occupational satisfaction in practicing nurses, very few investigations have examined resilience among nursing faculty. The purpose of this integrative review is to describe the current state of the science on resilience in nursing faculty and includes an analysis of 14 studies. Three major foci were identified in the literature: 1) descriptions of resilience levels in nursing faculty, 2) examinations of resilience based upon demographic factors, and 3) resilience and related concepts. Existing research indicates there may be demographic differences in resilience levels of nursing faculty, but additional investigation is necessary to confirm these relationships. There is evidence that quality of life (QOL), components of QOL, and support are correlated with resilience in nursing faculty but more rigorous research on these relationships is needed. Understanding more about the relationship between resilience, demographics, and associated factors will guide future development and choice of interventions tailored to promote resilience among nursing faculty.

Resilience in adolescents with type 1 diabetes: An integrative review

PROBLEM

Despite advances in diabetes technology, many adolescents with type 1 diabetes (T1D) cannot achieve target metabolic control. Resilience is associated with better outcomes in diabetes care. The aim of this review is to synthesize studies on resilience in adolescents with T1D, particularly how the concept of resilience has been explored.

METHODS

This integrative review was carried out according to Whittemore and Knafl's framework. A systematic search was conducted in the CINAHL, PubMed/Medline and PsycInfo databases. Eligibility criteria included studies on resilience in adolescents with T1D, aged 13 to 18 years, that were published in English in peer-reviewed scientific journals. The Mixed Methods Appraisal Tool was used to assess study quality.

RESULTS

The review included twenty-four studies. Resilience was defined as the ability or capacity, or the process, to maintain physical and psychological well-being despite exposure to significant stressors or distress events. Diabetes resilience was defined as achieving positive psychosocial and health outcomes despite the challenges of living with T1D. Studies were quantitative (n = 21), qualitative (n = 1) and mixed methods (n = 2). Six resilience instruments were found. The DSTAR-Teen was the most used and the only instrument for adolescents with T1D.

CONCLUSIONS

This review highlighted the need for an explicit definition of the concept of resilience because previous studies used different definitions or lacked a definition. In the future, a more precise concept analysis of resilience in adolescents with T1D is warranted.

IMPLICATIONS

The DSTAR-Teen is a promising resilience measure with good psychometric properties for further studies in adolescents with T1D.

Exploring society-to-cells resilience among community members: A multidisciplinary study in outpatient clinics with diverse participant demographics

AIM

This study explores and understands community members' resilience in outpatient clinics, considering various dimensions and types of resilience.

DESIGN

A cross-sectional study.

METHODS

This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index.

RESULTS

Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains.

CONCLUSION

This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience.

IMPACT

This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work.

PATIENT OR PUBLIC CONTRIBUTION

Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.

Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Background

The COVID-19 pandemic significantly impacted people's mental health significantly. Frontline healthcare workers (HCWs) were arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is important to inform interventions for social and psychological support for future pandemics.

Aim

This study explored the experiences of frontline HCWs in South Africa during the COVID-19 pandemic.

Setting

The sample included HCWs from various professions and health sectors who worked with COVID-19 patients across South Africa.

Methods

An exploratory descriptive qualitative design was used. Semi-structured interviews were conducted with 11 frontline HCWs recruited via purposive sampling. Data were analysed using principles of inductive thematic analysis.

Results

Four major themes were identified in the data: (1) Working during COVID-19 was an emotional rollercoaster; (2) Working during COVID-19 was physically and mentally exhausting; (3) Participants held negative attitudes towards the Department of Health; and (4) COVID-19 had a transformative impact on the daily life of HCWs.

Conclusion

HCWs' experiences were diverse and marked by contradictions. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants. Qualitative methodologies provided depth and insights into the diverse realities of frontline HCWs.

Contribution

This study provides significant insights into the experiences of a diverse group of frontline South African HCWs during COVID-19. It demonstrates a shift in the definition of a 'frontline' HCW and highlights the need for greater psychological support and individualised public health interventions during future pandemics.

The mediating effect of resilience and COVID-19 anxiety on the relationship between social support and insomnia among healthcare workers: a cross-sectional study

Background

Insomnia in healthcare workers has become a topic of concern in the health system. The high infectivity and longevity of the COVID-19 pandemic have resulted in great pressure and a high incidence of insomnia among healthcare workers. Insomnia among healthcare workers has a negative impact on high-quality healthcare services in addition to their health. Thus, it's necessary to explore insomnia's underlying mechanisms.

Object

The present research's aims were threefold: explored the association between social support, resilience, COVID-19 anxiety, and insomnia among healthcare workers during the pandemic, elucidated the underlying mechanism of insomnia, and offered recommendations for improving the health of these workers.

Materials and methods

A cross-sectional design was adopted. From May 20 to 30, 2022, 1038 healthcare workers were selected to fill out the Oslo 3-item Social Support Scale, the eight-item Athens Insomnia Scale, the Coronavirus Anxiety Scale, and the Brief Resilience Scale. Descriptive statistics and correlations were analyzed by SPSS 25.0. Mediation analysis was conducted by Mplus 8.3 using 5000 bootstrap samples.

Results

Of the participating 1038 healthcare workers, the prevalence of insomnia was 41.62% (432/1038). Significant associations were found involving insomnia, resilience, COVID-19 anxiety, and social support. Insomnia was directly affected by social support. Moreover, three indirect pathways explain how social support affected insomnia: resilience's mediating role, COVID-19 anxiety's mediating role, and the chain-mediation role of resilience and COVID-19 anxiety.

Conclusion

The results validated our hypotheses and supported the opinion of Spielman et al. 's three-factor model of insomnia. Social support of healthcare workers has an indirect impact on insomnia in addition to its direct one via independent and chain-mediation effects of resilience and COVID-19 anxiety.

Resilience in Relation to Adherence to Antiretroviral Therapy in People Living With HIV: A Qualitative Study

Antiretroviral therapy (ART) adherence significantly impacts the survival and quality of life of people living with HIV (PLWH). Despite the challenges faced by PLWH, adherence remains crucial. Thus, cultivating resilience in ART is essential for optimal treatment outcomes. This qualitative study explored the experience of resilience in relation to ART adherence among PLWH. Semi-structured interviews with 10 participants were conducted and inductively analyzed. Participants' resilience in ART adherence was reflected in their achievements related to cultivating the habit of taking medication and in their convictions that the medication was a daily necessity. PLWH developed resilience through strategies encompassing finding purpose through faith and motivation, fostering wellness by obtaining adequate information, enjoying life, managing disease therapy, and adopting a healthy lifestyle, and building connections by finding adequate support and involving in the community. Nurses are crucial in HIV management, fostering resilience for successful ART adherence and ensuring effective treatment outcomes.

Effectiveness of the acceptance and commitment therapy on resilience and quality of life in patients with post-acute COVID-19 syndrome

Post-acute COVID-19 syndrome (PCS) is defined as an ongoing symptomatic illness in patients who have recovered from their initial COVID-19 infection which causes long term respiratory problems, muscle atrophy, etc. So, the current research aimed to examine effectiveness of the acceptance and commitment therapy on resilience and health-related quality of life of PCS patients. The research deployed a quasi-experimental design with pre- and post-tests and 3-month follow-up with wait-list group. Thirty PCS patients from a specialized facility in Iran were recruited using available sampling method and were randomly assigned to either treatment or wait-list groups, each group 15 subjects. The subjects answered to Connor and Davidson's (2003) Resilience Scale (CD-RISC) and the World Health Organization's (1995) Quality of Life Questionnaire (WHOQOL-BREF). The posttest score of resilience in the treatment and wait-list groups were 19.6 and 14.47, respectively, and their follow-up scores were 17.13 and 14.55, respectively. Also, total score of HRQoL in the treatment and wait-list groups in the posttest were 65.07 and 55.73 and in the follow-up were 63.27 and 54.6, respectively. The results showed that there were significant differences in the posttest scores of the dependent variables based on the groups. Also, the MANCOVA showed that the acceptance and commitment therapy was still significantly effective on the dependent variables three months after the last session. The ACT can significantly increase PCS patients' resilience and HRQoL even 3months after the intervention. The implications and limitations of the research are further discussed.

Mediating effect of resilience and fear of COVID-19 on the relationship between social support and post-traumatic stress disorder among campus-quarantined nursing students: a cross-sectional study

BACKGROUND

The emergency of Omicron variants, spreading in China and worldwide, has sparked a new wave of the coronavirus disease 2019 (COVID-19) pandemic. The high infectivity and persistence of the pandemic may trigger some degrees of post-traumatic stress disorder (PTSD) for nursing students experiencing indirect trauma exposure to the epidemic, which hinders the role transition from students to qualified nurses and exacerbates the health workforce shortage. Thus, it's well worth an exploration to understand PTSD and its underlying mechanism. Specifically, PTSD, social support, resilience, and fear of COVID-19 were selected after widely literature review. This study aimed to investigate the relationship between social support and PTSD among nursing students during COVID-19, to address the mediating role of resilience and fear of COVID-19 between social support and PTSD, and to provide practical guidance for nursing students' psychological intervention.

METHODS

From April 26 to April 30, 2022, 966 nursing students from Wannan Medical College were selected by the multistage sampling method to fill the Primary Care PTSD Screen for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Brief Resilience Scale, Fear of COVID-19 Scale, and Oslo 3 Items Social Support Scale. Data were analyzed by descriptive statistics, spearman's correlation analysis, regression analysis, and path analysis.

RESULTS

15.42% of nursing students had PTSD. There were significant correlations between social support, resilience, fear of COVID-19, and PTSD (r =-0.291 ~ 0.353, P <0.001). Social support had a direct negative effect on PTSD (β =-0.216; 95% confidence interval, CI: -0.309~-0.117), accounting for 72.48% of the total effect. Analysis of mediating effects revealed that social support influenced PTSD through three indirect pathways: the mediated effect of resilience was statistically significant (β =-0.053; 95% CI: -0.077~-0.031), accounting for 17.79% of the total effect; the mediated effect of fear of COVID-19 was statistically significant (β =-0.016; 95% CI: -0.031~-0.003), accounting for 5.37% of the total effect; the chain mediating effect of resilience and fear of COVID-19 was statistically significant (β =-0.013; 95% CI: -0.022~-0.006), accounting for 4.36% of the total effect.

CONCLUSION

The social support of nursing students not only directly affects PTSD, but also indirectly affects PTSD through the separate and chain mediating effect of resilience and fear of COVID-19. The compound strategies targeted at boosting perceived social support, fostering resilience, and controlling fear of COVID-19 are warranted for reducing PTSD.

Factors associated with perceived resilience among unergraduate nursing students: findings of the first cross-sectional study in Palestine

BACKGROUND

Resilience has emerged as a concept that could explain and predict good academic and well-being of students in stressful and traumatic situations. This study was conducted to assess resilience and identify predictors of high or low resilience scores among future nurses in Palestine.

METHODS

This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology statement. Undergraduate nursing students in all academic years were recruited and asked to complete a questionnaire that contained the Trait Resilience Scale and the State-Resilience Scale. Multiple linear regression models were used to identify predictors of higher resilience scores and to control for potentially confounding factors.

RESULTS

In this study, 290 students completed the questionnaire (response rate = 92.4%). The means of trait, state, and combined resilience scores were 71.4 (SD: 7.5), 62.7 (SD: 6.7), and 134.1 (SD: 12.8), respectively. There was a significant moderate positive correlation between state resilience scores and trait resilience scores (r = 0.63, p < 0.001). Having a study routine on daily basis predicted higher trait (β = -0.20, p < 0.001), state (β = -0.12, p = 0.032), and combined (β = -0.18, p = 0.001) resilience scores. Trait and combined resilience scores were predicted by the absence of chronic diseases (β = 0.12, p < 0.05), experiencing addiction issues (β = -0.11, p < 0.05), living in Israeli seized areas (β = 0.16, p < 0.05), and living in a house with enough number of rooms per siblings (β = 0.13, p < 0.05). On the other hand, state and combined resilience scores were predicted by being in the first academic year (β = -0.18, p < 0.01), and state resilience scores were predicted by living in urban areas (β = -0.12, p < 0.05).

CONCLUSIONS

Undergraduate nursing students in Palestine reported relatively high trait and state resilience scores. Higher trait, state, and combined resilience scores were predicted by having a study routine on daily basis. More studies are still needed to investigate the relationship between resilience scores, perceived well-being, willingness to care, and the future success of nursing students in Palestine.

American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide

Rates of nurse mental health and substance use disorders are high. Heightened by the COVID-19 pandemic, nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families. These trends exacerbate the epidemic of suicide in nursing underscored by several professional organization clarion calls to nurses' risk. Principles of health equity and trauma-informed care dictate urgent action. The purpose of this paper is to establish consensus among clinical and policy leaders from Expert Panels of the American Academy of Nursing about actions to address risks to mental health and factors contributing to nurse suicide. Recommendations for mitigating barriers drew from the CDC's 2022 Suicide Prevention Resource for Action strategies to guide the nursing community to inform policy, education, research, and clinical practice with the goals of greater health promotion, risk reduction, and sustainment of nurses' health and well-being are provided.

Ambiguous loss in family caregivers of loved ones with cancer, a synthesis of qualitative studies

PURPOSE

The purpose of this synthesis of qualitative studies is to explore manifestations of ambiguous loss within the lived experiences of family caregivers (FCG) of loved ones with cancer. Grief and loss are familiar companions to the family caregivers of loved ones with cancer. Anticipatory loss, pre-loss grief, complicated grief, and bereavement loss have been studied in this caregiver population. It is unknown if family caregivers also experience ambiguous loss while caring for their loved ones along the uncertain landscape of the cancer illness and survivorship trajectory.

METHODS

We conducted a four-step qualitative meta-synthesis of primary qualitative literature published in three databases between 2008 and 2021. Fourteen manuscripts were analyzed using a qualitative appraisal tool and interpreted through thematic synthesis and reciprocal translation.

RESULTS

Five themes were derived, revealing FCGs appreciate change in their primary relationship with their loved ones with cancer, uncertainty reconciling losses, an existence that is static in time, living with paradox, and disenfranchised grief. The results of this synthesis of qualitative studies complement the descriptors of ambiguous loss presented in previous research.

CONCLUSIONS

The results of this synthesis of qualitative studies complement the descriptors of ambiguous loss presented in previous theoretical and clinical research. By understanding ambiguous loss as a complex and normal human experience of cancer FCGs, oncology and palliative care healthcare providers can introduce interventions and therapeutics to facilitate caring-healing and resiliency.

IMPLICATIONS FOR CANCER SURVIVORS

Untreated ambiguous loss can result in a decrease in wellbeing, loss of hope, and loss of meaning in life. It is imperative that cancer FCGs experiencing ambiguous loss are recognized and supported so that they may live well in the family disease of cancer.

Resilience in adults with colorectal cancer: Refining a conceptual model using a descriptive qualitative approach

AIMS

To examine and refine a conceptual model of resilience in adult cancer care based on the perspectives and experiences of resilience in adults with colorectal cancer.

DESIGN

A descriptive qualitative study was performed.

METHODS

Twelve participants diagnosed with colorectal cancer that had completed cancer treatment with curative intent were recruited from a tertiary hospital in Australia from July to December 2019. The meaning of individual resilience was explored using in-depth individual interviews. Data were analysed using inductive thematic analysis. Following data analysis, the elements of the conceptual model of resilience were mapped against the themes and subthemes to refine the model.

RESULTS

Five themes were identified as key elements of individual resilience in adults with colorectal cancer: (1) seeking motivations to move forward; (2) striving for normality; (3) adapting and managing self; (4) drawing on external supports; (5) redefining self. A refined conceptual model of individual resilience in adults with colorectal cancer was developed based on the integration of the themes and the elements of the conceptual model of individual resilience.

CONCLUSIONS

Our refined conceptual model of individual resilience in adults with colorectal cancer could facilitate nurses' and other health professionals' understanding of the process of how resilient individuals with colorectal cancer overcome their illness-related adversity. This refined model may be used to further develop and test cancer-specific resilience measures and develop interventions to facilitate resilience in people living with colorectal cancer.

IMPACT

This research identified five features of resilience in adults with colorectal cancer and refined a conceptual model of resilience in adults with colorectal cancer. The findings could help nurses and other health professionals with identifying individuals who are at risk of adaptation difficulties and contribute to an early referral to psychosocial support services.

Stress and Resilience of Nursing Students in Clinical Training During the COVID-19 Pandemic: Palestinian Perspective

Introduction

Stress reduces nursing students' capacity to think critically, impedes decision-making, and eventually lowers academic performance and limits success. The circumstances surrounding the COVID-19 outbreak drove students into new virtual learning settings, adding stress to their academic responsibilities.

Objectives

The purpose of this study was to assess the perceived stress and resilience among nursing students in clinical training during the COVID-19 pandemic.

Method

A cross-sectional study was conducted on 315 students studying nursing. Data collection utilized the Perceived Stress Scale and the Connor-Davidson Resilience Scale.

Results

The analysis revealed that the stress score mean was 75.2 ± 6.6 and the resilience score mean was 26.0 ± 3.4. Also, there was a weak negative association between nursing students' stress and their resilience (p < 0.05). Additionally, the results indicated statistically significant differences between stress and gender, study year level, and age (p < 0.05).

Conclusion

Stress was high and resilience was moderate during the COVID-19 pandemic among nursing students.

"What Is the Matter With Me?" or a "Badge of Honor": Nurses' Constructions of Resilience During Covid-19

It has long been known that nursing work is challenging and has the potential for negative impacts. During the COVID-19 pandemic most nurses' working landscapes altered dramatically and many faced unprecedented challenges. Resilience is a contested term that has been used with increasing prevalence in healthcare with health professionals encouraging a "tool-box" of stress management techniques and resilience-building skills. Drawing on narrative interview data (n = 27) from the Impact of Covid on Nurses (ICON) qualitative study we examine how nurses conceptualized resilience during COVID-19 and the impacts this had on their mental wellbeing. We argue here that it is paramount that nurses are not blamed for experiencing workplace stress when perceived not to be resilient "enough," particularly when expressing what may be deemed to be normal and appropriate reactions given the extreme circumstances and context of the COVID-19 pandemic.

Developing Mid-Range Theories for the Maturation of Nursing Care in Colombia

Nursing theory has evolved since the 1960s, from conceptual models to concept analysis to mid-range theories. Mid-range theories are developed primarily for qualitative research, to target patient problems, to respond to patient needs, to identify interventions and the changing patterns of patient care. These mid-range theories cluster in various patterns to provide valid, coherent, and significant interventions. Examples of programs that have dramatically impacted our understanding of nursing and patient care are presented. Thus, by developing and implementing the findings of mid-range theories, nursing care matures, and the standards advance.

Resilience, Coping Strategies and Posttraumatic Growth in the Workplace Following COVID-19: A Narrative Review on the Positive Aspects of Trauma

The COVID-19 pandemic represents a traumatic event that has profoundly changed working conditions with detrimental consequences for workers' health, in particular for the healthcare population directly involved in addressing the emergency. Nevertheless, previous research has demonstrated that traumatic experiences can also lead to positive reactions, stimulating resilience and feelings of growth. The aim of this narrative review is to investigate the positive aspects associated with the COVID-19 pandemic and the possible health prevention and promotion strategies by analyzing the available scientific evidence. In particular, we focus on the constructs of resilience, coping strategies and posttraumatic growth (PTG). A literature search was performed on the PubMed, EMBASE, Scopus, Web of Science, Google Scholar and Psycinfo databases. Forty-six articles were included in the literature synthesis. Psychological resilience is a fundamental variable for reducing and preventing the negative psychological effects of the pandemic and is associated with lower levels of depression, anxiety and burnout. At the individual and organizational level, resilience plays a crucial role in enhancing wellbeing in healthcare and non-healthcare workers. Connected to resilience, adaptive coping strategies are essential for managing the emergency and work-related stress. Several positive factors influencing resilience have been highlighted in the development of PTG. At the same time, high levels of resilience and positive coping strategies can enhance personal growth. Considering the possible long-term coexistence and consequences of COVID-19, organizational interventions should aim to improve workers' adaptive coping skills, resilience and PTG in order to promote wellbeing.

Exploring experiences of COVID-19-positive individuals from social media posts

Aims

This study aimed to explore the experience of individuals who claimed to be COVID‐19 positive via their Twitter feeds.

Background

Public social media data are valuable to understanding people's experiences of public health phenomena. To improve care to those with COVID‐19, this study explored themes from Twitter feeds, generated by individuals who self‐identified as COVID‐19 positive.

Design

This study utilized a descriptive design for text analysis for social media data.

Methods

This study analysed social media text retrieved by tweets of individuals in the United States who self‐reported being COVID‐19 positive and posted on Twitter in English between April 2, 2020, and April 24, 2020. In extracting embedded topics from tweets, we applied topic modelling approach based on latent Dirichlet allocation and visualized the results via LDAvis, a related web‐based interactive visualization tool.

Results

Three themes were mined from 721 eligible tweets: (i) recognizing the seriousness of the condition in COVID‐19 pandemic; (ii) having symptoms of being COVID‐19 positive; and (iii) sharing the journey of being COVID‐19 positive.

Conclusion

Leveraging the knowledge and context of study themes, we present experiences that may better reflect patient needs while experiencing COVID‐19. The findings offer more descriptive support for public health nursing and other translational public health efforts during a global pandemic.

What is already known about this topic?

Social media data can be used to predict potential outbreak areas, which has been beneficial to informing decision makers.

Public opinions about the pandemic can be extracted from social media data, which helps understand patients and the public's experiences and potential needs.

In the early stage of the novel COVID‐19 pandemic in the United States, little was known about the experiences and needs of those with COVID‐19.

What this paper adds?

Individuals who claimed to be COVID‐19 positive used the social media platform (e.g., Twitter) as a broader communication strategy to their social networks during the social distancing phase at the early stage of the COVID‐19 pandemic.

Key messages delivered through the social media included warning their family, friends and network take the pandemic seriously, expressing their symptom profiles related to COVID‐19 and sharing their journey of being a COVID‐19 patient.

Although latent Dirichlet allocation may be underutilized in nursing research, valuable information regarding mental health issues can be discovered and amplified from the social media data using this methodology.

The implications of this paper:

Substantial evidence encourages the public health community to engage in more detailed mental health screening of patients with COVID‐19.

By leveraging the knowledge and context of the social media threads (e.g., patient perspective), there is ample opportunity for more focal and descriptive public health interventions to mitigate the stress and uncertainty of a pandemic.