Systematic Review for Bedside Nursing Coping Skills Study

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Exploring nurse perceptions and experiences of resilience: a meta-synthesis written report

BMC Nursing volume 21, Article number:26 (2022) Cite this article

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A Correction to this article was published on 15 February 2022

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Abstract

Aim

To understand nurse resilience past integrating the qualitative inquiry results on nurses' resilience-related experiences.

Methods

We applied the seven steps of the meta-ethnographic procedure by Noblit and Hare (1988). 5 databases (PubMed, EMBASE, Web of Science, CINAHL and PsycINFO) were used to search for relevant studies published from Jan 2011 to September 2021.

Results

Sixteen qualitative studies were included. The 4 themes of "self-evolution based on one's inner cocky", "fostering a positive attitude towards life", "developing personal strategies for overcoming arduousness" and "building professionalism to go a better nurse" illustrate that they want to improve their inner strength and develop themselves through self-test.

Conclusion

In this report, we examined nurse resilience, and the results can provide primal conclusions useful for the evolution of an intervention report to amend nurse resilience.

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Introduction

Nurses are the largest occupational group in the medical health field. They business relationship for approximately 59% of the total global medical health workforce [i], and play a very important role in patient care. Globally, in recent years the nursing profession has been a rapidly growing sector of the workforce [ii]. Nonetheless, nurses suffer stress and burnout related to their chore, and this has a very negative outcome on their mental health [3]. Problems that negatively affect the mental health of nurses can accept serious consequences, such as decreased nursing professionalism, poor quality of care, increased social and financial losses, and increased turnover and resignation [4, v].

Nurse job satisfaction has been in pass up over recent years, and nurses have been establish to develop negative perceptions near their job [two]. Nurse job satisfaction is related to the turnover rate, which affects the quality of patient nursing care. As concern over nurse task satisfaction and burnout is increasing worldwide [6], timely studies of concepts that tin ameliorate the negative job perceptions of nurses acquired by their negative experiences are required.

Resilience is a positive concept that allows nurses to overcome stressful situations [vii] and to adapt positively, resulting in the maintenance of their psychological well-existence and mental health [8, nine]. In a recent report, nurse resilience was constitute to significantly reduced nurse exhaustion [10, xi]. Resilience is emerging as an important concept for reducing the psychological brunt of nurses and increasing their concrete and mental health, since resilience has been shown to accept a mediating issue on the relationship between burn out and physical/mental health [12]. Recently an understanding of an individual's civilisation is considered very important for understanding resilience [13], so when exploring resilience in nurses, a key occupational group in social club, nosotros demand to pay attention to their culture.

Background

Nigh people accept life-threatening experiences or are exposed to 1 or more stressors in their lifetime [xiv]. Therefore, it is very of import to amend and adapt mental wellness to aid recovery from the challenges and adversities one faces and to arrange positively. Since nurses in particular are exposed to wide-ranging stresses, the ability to overcome such adversity is particularly important for them. The concept of resilience originated in psychology [15, sixteen] and tin be described as an individual's characteristics, processes, and outcomes [xv].

According to Ungar [17], studying resilience requires a contextualized approach because the dynamic partnerships between individuals and social ecosystems tin can lead to positive adaptation when individuals face difficulties. Given this perspective, the effect of civilization is very important, and exploring resilience in the context of the culture to which nurses belong can aid to properly identify the dynamic property of resilience nurses. An understanding of resilience can be effectively applied to improving the mental well-beingness of nurses.

Research into nursing resilience has been steadily improving, and over the concluding 10 years the importance of the concept of resilience has go emphasized as related inquiry has rapidly increased. In particular, resilience has been proposed as a solution to burn out [x, 11, 18] and mental health issues [19, xx], which nurses frequently suffer from, and related research has been actively conducted.

Nurse resilience contains a complex and dynamic process that changes over time and co-ordinate to the situation, embodying non just personal attributes only also external resources, and describes a nurse's ability to adapt positively to stress and adversity [21].

Academic interest in nurse resilience has been increasing recently, and many qualitative studies are beingness conducted to explore the essence of nurse resilience. However, the diversity of these qualitative studies and the differences in their findings has hindered understanding of the core concepts of nurse resilience.

Qualitative meta-synthesis is a methodology for synthesizing and analyzing private qualitative research [22]. This methodology is recognized equally a useful tool for analyzing the meaning, experience, and perspectives that participants' express [22]. Information technology can help accumulate knowledge and derive expanded knowledge and new interpretations from the the areas of enquiry and phenomena suggested by the results of existing studies [23]. The methodology as well enables more specific suggestions for future studies [22].

Noblit and Hare adult one of meta-synthesis method, meta-ethnography in 1988 [24]. This method has the potential to lower study duplication, create new research questions, and promote higher-level analyses [25].

In this study, the results of qualitative studies on nurse resilience are integrated, a new interpretations are attempted. This report will help provide key information for the enquiry and development of interventions to meliorate nurse resilience. The purpose of this study was to systematically review and synthesize the qualitative evidence on the nurse resilience feel.

Aim

The aim of this study is to understand nurse resilience and to suggest directions for future inquiry through the process of synthesizing and integrating qualitative research results on nurse resilience-related experiences.

Methods

Blueprint

Nosotros used a meta-synthesis methodology, which provides broad understandings of social phenomena, to integrate the findings of qualitative studies [26]. Since meta-ethnography is an interpretive approach suitable for higher-level analyses and the formation of new interpretations beyond the discoveries of individual qualitative research [24], it is suitable for the purpose of this study, which is to synthesize and newly interpret research on nurse resilience feel. We followed the meta-ethnography method, which is suitable for both preserving the interpretations of the chief data and forming new interpretations, theories and models [27]. We practical the seven steps of the meta-ethnographic process by Noblit and Hare [24]: (a) getting started, (b) deciding what is relevant to the initial interest, (c) reading the studies, (d) determining how the studies are related, (e) translating the studies into one some other, (f) synthesizing those translations, and (g) expressing the synthesis.

The research questions were:

1. ane.

   "How practise nurses overcome arduousness?"

2. 2.

   "What are the characteristics of nurses resilience experiences?"

This review was prepared in accordance with ENTREQ (Enhancing transparency in reporting the synthesis of qualitative research Statement) guidelines [28]. This meta-synthesis study was registered (CRD42021275787) with PROSPERO, which is the International Annals of Systematic Reviews.

Phase 1. Getting started & Phase two. Deciding what is relevant to the initial interest.

Search methods

We used the narrative literature review method. Every bit this method is mainly used for searching literature representing the entirety of the phenomenon of interest, it is suitable for meta-synthesis studies [25].

Earlier the literature search, the two authors discussed the search strategy and databases to exist used to search for appropriate articles that meet the purpose and inclusion criteria of this study. The authors selected PubMed and EMBASE, which are considered the most of import databases for literature searches in the medical field [29], and included Spider web of Scientific discipline to broaden the search to the field of social scientific discipline. In add-on, CINHAL, a nursing database, and PsycINFO were of import to include due to the psychological nature of the concept of resilience. Thus, literature searches were carried out beyond 5 databases overall (PubMed, CINAHL, EMBASE, Web of Science and PsycINFO). The representative search terms used in the search were "Nurses", "Resilience, Psychological", "Qualitative Research", and "Hermeneutics" from the list of Medical Discipline Headings (Mesh terms). The search terms were adapted according to the index terms of each database. The search terms were used with the Boolean operators "AND" and "OR" in different combinations. The search strategy of this written report is presented in supplementary fabric Table S1. A flow chart of the systematic review of literature pick process of the present research is presented in Fig. 1. A review report on a similar subject was conducted in 2012 [30]. In our search process we plant that relevant studies had increased rapidly since 2011. Therefore, we express the search results to the last 10 years to achieve a synthesis focusing on the latest enquiry results.

Fig. i

Flowchart of systematic review for literature option

Total size paradigm

The inclusion criteria required qualitative studies that were: (a) aimed at exploring the resilience of nurses, (b) published from January 2011 to September 2021 (c) peer-reviewed journals (d) published in English, and (e) full-text searchable. The exclusion criteria were (one) nurse experiences were not reported separately, (2) mixed methods were used but qualitative information could not exist extracted or (3) necessary qualitative depth was lacking in the data analysis.

Through the search procedure, 1020 studies were identified. 528 studies were excluded as duplicates in Endnote, and the two authors independently reviewed each title and abstract, thereby excluding 394 studies. When the two authors independently reviewed the total-texts and discussed any disagreements, 82 studies were excluded because of a lack of focus on nurse perspectives, an inappropriate topic, bereft qualitative criteria, or because the full text could not be found. After this procedure, 16 studies remained for inclusion (Fig. 1).

Quality appraisal

The Critical Appraisal Skills Programme (CASP) checklist, which contains 10 questions for assessing the reliability and rigor of individual studies, was used to appraise the sixteen studies [31]. Two authors independently evaluated the xvi included studies using the CASP checklist. After the appraisement, the two authors compared the CASP results, and whatever disagreements were resolved through discussion. The degree to which the studies met CASP was evaluated to exist 70% for four studies, 80% for nine studies, and 90% for 3 studies. Since all the studies were evaluated as being 70% or college, none were excluded from the evaluation process (Table 1).

Table 1 Summary of the included studies

Full size table

Phase 3. Reading the studies & Phase iv. Determining how the studies are put together.

Information extraction

Two authors independently reviewed the studies in detail. Each author read the studies line past line and tried to derive meaningful concepts by extracting codes. Data extraction for the study was performed using a custom course in Microsoft Excel, including author details, participant characteristics, methods, and original citations [27]. Disagreements between the authors were solved through give-and-take.

Phase 5. Translating the studies into i another, Stage six. Synthesizing the translations & Phase 7. Expressing the synthesis.

Data synthesis

Based on the meta-ethnography process [24], the 16 studies were independently read repeatedly by the two authors, data analysis was performed, and then the extracted data were summarized every bit concepts. In more than detail, later organizing the papers in chronological society, the ii authors independently read the 16 studies, repeatedly. They then summarized and extracted meaningful concepts and themes. The 2 authors compared the themes and concepts of the first paper with those of the second newspaper, and so compared the common themes of those ii papers with the third paper to derive concepts and themes. To synthesize the fundamental concepts and broader themes, this process was repeated until the final study. To excerpt the key concepts, the studies were read several times, and the key concepts of each study were listed and analyzed for comparing. The central concepts were formed based on the 'first-order construct' of the study. In the meta-ethnography analysis procedure, the data is divided into 'first-guild construct', 'second-lodge construct', and 'third-order construct' [32]. The 'first-social club construct' is the original study participant'due south daily linguistic communication equally expressed in their own language in the original written report, the 'second-social club construct' is the researcher'south interpretation based on the 'start-club construct', and 'third-social club construct' is a new interpretation of '2nd-order construct' [32, 33]. In this study the authors of the current paper extracted the key concepts of the 'first-gild construct', and so compared the similarities and differences to class the 'second-order construct', and finally derived the 'third-gild construct', which represented the main themes of the current study, by abstracting the 'second-guild construct'. During this process of analysis and synthesis, the two authors connected to talk over their differences of opinion based on their respective academic and clinical backgrounds. The final assay step, "expressing the synthesis," was accomplished by collating the discussion results. In guild to confirm the value of the data, the researchers asked one incumbent nurse and ane nursing professor to confirm the ceremoniousness of the expression of the results and the choice of terminology, and after the discussion the results were amended accordingly and finalized. The quotes that all-time expressed each sub-theme were identified and are presented in the results.

Ethical consideration

Every bit this report is a review written report, as a meta-synthesis, human participants were not included. Therefore, an ethical committee review was not required.

Results

Sixteen qualitative studies were included in this review study and the publication years of the included studies were from 2012 to 2021. A total of 241 nurses participated in the included reviewed studies. Their ages varied widely, from those in their 20s to those in their 60s, and they were mostly of female gender. Their working departments were varied, and included the ICU, the geriatric ward, the emergency room, the psychiatric ward, and the general ward. The studies were conducted in Africa, Australia, Canada, Iran, Nihon, Singapore, Taiwan, The states, and U.k.. In other words the studies were conducted in various countries around the world (Table 1). This study yielded iv comprehensive themes of nurse resilience experience. These were 'self-evolution based on i's inner self', 'fostering a positive attitude towards life, 'developing personal strategies for overcoming adversity', 'building professionalism to get a amend nurse'. Table 2 shows the key concepts from the first-order constructs, the second club constructs, and the synthesized themes.

Table two Synthesized themes of nurses' resilience experience

Full size table

Theme I. Self-development based on i's inner self

The sub-themes included in theme 1 were "recognizing and acknowledging signs of adversity" and "striving to develop oneself". The nurses tried to find solutions by focusing on the signals that they had encountered adversity, and making an endeavor to grow through that adversity rather than plummet under it.

Sub-theme 1. Recognizing and acknowledging the signs of adversity

The nurses did not deny the signs of adversity, but recognized and acknowledged them. The nurses looked within themselves to find problems and tried to reflect on themselves [A2-A5,A8,A11,A13–14,A16]. They tried to focus on the current situation [A2,A5,A8–9,A11–14] and showed an attitude of credence of the state of affairs they were in rather than one of avoidance [A8–9,A11–14]. They believed in their abilities [A2,A5,A6,A9–10,A12–14], tried to express their feelings honestly [A2,A6,A10,A11,A13], and tried to recognize the alert signs of stress rather than ignore them [A5,A9,A11,A13]. They showed themselves as focusing on the state and demands of their bodies and emotions [A5–6, A8,A10–11,A16].

"It is hard....I feel it is a most difficult thing to reflect on my ain feelings. I can sympathize other people, but I practise not sympathize myself. I call back I have experienced a kind of exhaustion." (A2).

"I thought of means when something happens and then that ane tin become away, sit downwardly and reverberate and then possibly come upwardly with any your own strategies are to come up back stronger. So if the same thing comes at yous again, you lot know where to run, which direction is faster" (A11).

Sub-theme 2. Striving to develop oneself

Rather than despair, the nurses wanted to grow on their own. They tried to maintain their concrete health [A3–4,A11] and recognized a sense of self-efficacy [A5–6,A9,A11,A13–fifteen]. In improver, they idea about and developed various means to take care of themselves [A2-A4,A9,A11–15]. They were confident that they could overcome the adversity [A5–6, A9, A11, A13–xv] and tried to command their emotions [A2,A5–6,A9,A11,A13–15]. Nurses tried not to ignore what others had to say and to acquire from their experiences and expertise [A2–4,A6–7,A9–ten, A16]. They tried new challenges [A2–5,A9,A11,A13] and had varied thoughts to solve issues [A2, A5, A9, A11–14]. The nurses showed patience and a willingness to move forrard [A5,A9,A11,A13–14].

"You know more than or less that you lot have to do it and it is going to be tough going. The task could be from manageable to unmanageable depending on what is happening at the moment. I'chiliad able to cope with stress."(A13).

Theme II. Fostering a positive mental attitude towards life

In theme 2, the sub-themes included "accepting life positively" and "enjoying their ain life". In this theme, the power of nurse positivity is axiomatic. The nurses showed that they were trying to overcome adversity with positivity. A positive view toward life and the desire to alive their own lives gave the nurses forcefulness in their professional lives.

Sub-theme three. Accepting life positively

The nurses maintained a optimistic view toward life when overcoming life adversities [A1,A3–7,A9,A14–15] and maintained a sense of sense of humor at work [A3–4,A6,A11]. They were grateful for life [A3–4,A6–vii,A12] and tried to heal themselves past living a life of helping others [A2–4,A6,A15]. They remembered the good memories they had in the past, and drew positive thoughts from them [A1–two,A5–half dozen,A15]. They found enjoyment and pride in what they did [A1,A5–half-dozen,A11,A15].

"But I endeavour to wait at the positive stuff. .. what we are able to do, what changes we were able to make as a issue of a catastrophe or just a bad outcome. .. merely pull my sleeves up and make it at that place and go it done and when I tin, I do effort to encourage advice and good feelings." (A5).

""I call up every type of nurse has their own blazon of black humour only I realized a lot of it is a coping machinery and a way of protection to get yourself through the day" (A11).

Sub-theme four. Enjoying their ownlife

Nurses tried to overcome the adversities they faced while enjoying life on their own terms [A1–2,A5,A11]. They tried to alive a regular and good for you life, enjoy various leisure activities [A1–2,A5,A11,A13] and enrich their lives happily while creating their ain hobbies [A1–two,A5,A13]. They coped with the situation by developing their ain coping behaviors for managing crisis situations [A1–two,A5,A11,A13].

"You have to relish what you are doing. If you hate your work, it will be a abiding stress. I feel that I don't get stressed near it because I feel that no problem is hard." (A13).

"The joy of working is like a hurdle … like jumping over the hurdle. Each time I jump over a hurdle that I cross, at that place is always some satisfaction in the job." (A13).

Theme III. Developing personal strategies for overcoming adversity

The sub-themes "staying away from stress" and "getting comfort through positive interpersonal relationships" were included in theme 3. Nurses were shown to develop their own strategies when overcoming adversities. They tried to stay away from situations that were stressful to them and formed their own defenses through positive interactions provided by wide-ranging human relationships. These methods of overcoming arduousness were their own individual strategies learned through their own experiences.

Sub-theme five. Staying away from stress

Nurses had to face varied sources of stress, merely tried to avoid them, such as past trying to not create stressful situations or focusing on stress [A1,A9,A10–11]. They tried to maintain a piece of work-life residue so that neither aspect became too big or too pocket-sized, breaking the balance [A5–half-dozen,A8,A10–12]. In addition, by thoroughly separating their piece of work and life, they tried to thoroughly protect their individual life, avoiding the intrusion of work. They tried to respect their own privacy [A5–6,A8,A10–12].

"Sometimes, I tin't control myself. In such situations, I attempt to distance myself from that state of affairs or the immediate environs. In these conditions, I ask my colleagues to proceed care delivery and and so, I go out the situation. I never stay in such a situation because I know that my presence volition aggravate the problem. Thus, I leave that state of affairs and start providing care to another patient."(A10).

"I call back that the only way for me to stay resilient is to keep stepping away from the bedside, because that's where all the stress is for me, it's at the bedside. You lot demand to remove yourself from the state of affairs" "I have to have this proper residue and this niggling routine to maintain a healthy, functional life, and I call back the younger ones know that which is expert." (A11).

Sub-theme 6. Getting condolement through positive interpersonal relationships

In their professional person positions the nurses developed a variety of interpersonal relationships, including relationships with patients, colleagues, and families. Nurses received comfort from their relationships with friends [A1,A3–v,A7,A10–12,A14–16] and condolement and support from their families [A1,A3–five,A7,A11–12,A14–16]. The nurses tried to maintain good relationships with their colleagues and other nurses and every bit colleagues they helped each other in difficult situations [A1–5,A7,A10–xvi]. In improver, they tried to grow ane step at a time by orientating their own future direction through role models and mentors they could imitate [A1–2,A6,A11–12, A15], and they shared their feelings with people they could trust [A1–2, A5–6, A11–16]. They besides received assist from a mental health professionals for stress management [A6,A9,A12].

"It's the people you work with. I take a lot of caring friends. I talk to my husband - he e'er backs me up. I call back that how you deal with it... with another manager's support. Nosotros run into for luncheon sometimes — a laughs the best way — nosotros quite often see the funny side." (A4).

"Talking to colleagues considering they know the scope of your job. They know what is happening in your ward, then they volition be able to understand better.", "I have proficient friends to whom I tin confide my bug. I think information technology'due south important y'all don't bottle up your feelings also much, because you know you can just cocky-destruct if y'all're non able to handle it. They may not be able to solve the problem; a listening ear does help." (A13).

"I'm very fortunate as I have a large network of friends and colleagues that I can safely vent to or talk over things with or bounciness ideas off that aren't my staff. And I found that you actually need that. Information technology is pretty much a lifeline whether you're a front-line manager or if y'all're a director you need to accept that core grouping of people that you tin call and say, 'Am I crazy'" (A11).

Theme 4. Edifice professionalism to become a improve nurse

In theme 4, the sub-themes "planning their life for a ameliorate future" and "building cocky-esteem past thinking about the value of a chore" were included. The nurses planned their future to live a better life than just leaving their lives to arduousness. They felt that they had to develop themselves for a better hereafter, set up for a new life, and adapt to a new state of affairs. They idea they had to rearrange their work by considering their priorities. This process led them to build their professionalism.

Sub-theme 7. Planning their life for a improve futurity

In difficult situations, nurses thought about how to live their future. Even in difficult situations, the addiction of planning for the future and thinking about the future rather than staying in the present and despairing was exhibited by nurses [A2–4,A6–7,A9,A13,A16]. They wanted to develop themselves, to fix for new assignments including hard situations [A2–four,A6–vii, A9,A14,A16], and to adapt well to new situations [A2,A7,A9,A13–14,A16]. They re-prioritized their work and tried to work according to their priorities [A5,A8,A13–16].

"I always accept an experience as an opportunity to learn from it. To abound. I mean, no feel is bad. It may be a bad experience just you can learn from it and attempt to motility on and try to make things better" (A13).

Sub-theme viii. Edifice self-esteem by thinking about the value of a task

In difficult situations, nurses tried to proceeds the strength to overcome the crisis by reflecting on themselves existence nurses [A2–4,A6,A9–13,A15–sixteen] and on the value of their job [A2–4,A6,A9,A11–13,A15–16]. They took pride in their job, thought about the significant and value of being a nurse, and tried to overcome crises while gaining satisfaction from the value of their work [A2–4,A6,A9,A11,A13–xvi]. They had a passion for their work [A2–4,A6,A9–sixteen] and wanted to develop their knowledge and skills as nurses and upgrade themselves through individual evolution [A24,A6,A9,A12–xiii,A15].

"We are the courage when patients come up in. The nurse is the protector of the patient." (A14) "The patient survived because the nurse stuck out her hand and stopped the bleeding. I am proud of her." (A11).

Give-and-take

Every bit nurses play a very of import role in the medical field, they are exposed to broad-ranging difficulties because of the high intensity of their work. Research on the resilience of nurses, a positive strength to overcome this, has recently attracted attention in both research and practice. This study synthesized the result of qualitative research on nurse resilience to explore nurse experiences of overcoming arduousness.

Co-ordinate to the result of this written report, when nurses felt that they were going through a hard situation, they tried to recognize and admit that state of affairs by exploring their inner selves. They focused on themselves and tried to find out exactly what their situation and issues were through self-exploration and not evading issues. This can be idea of as a preparation procedure for trouble solving. In the context of the more general resilience attributes found past previous studies, information technology can be noted that the nurse attributes discovered past this written report, such as a belief in cocky-efficacy and a desire to better oneself, are aspects of resilience in general [34]. In addition, the results of this written report can support the results of previous studies that internal protection factors such as self-efficacy, optimism, emotional intelligence and self-management should exist covered in the grooming of resilient nurses [35].

However, nurse resilience included striving for self-evolution while focusing on reality. These results show that nurses in a crisis situation take a strong tendency to rapidly grasp problems, trust themselves and solve problems quickly. Also, the nurses showed that they wanted to solve problems and grow step by step rather than remaining in crisis. The subjects of this study were incumbent nurses in their 20s to 60s, including relatively young subjects, and it likely that the specific nature of the agile and developmental results derived in this written report reflect all of them having the profession of nursing in common.

Nurses tried to overcome arduousness past accepting life positively and enjoying their ain lives. In previous studies, this positivity holding as a component of resilience was found to exist universal across varied subjects, as a part of the concept of general resilience [33, 36] and the resilience of chronic disease patients [37]. In add-on, nurses showed the characteristics of wanting to be challenged in life and relish the life given to them. This can be seen every bit showing an active attitude to life, and, since nurses are more often than not fabricated upwards of good for you immature people, this showed a different aspect of resilience from those shown by patients who are highly dependent on their families and medical staff [37, 38]. A positive and active mental attitude towards life could be an important factor to focus on in the development of future intervention research aiming to improve nurse resilience.

Nurses exhibited the resilience characteristics of avoiding stress and separating their lives from stress when overcoming adversity. They showed that they were trying to overcome arduousness by guaranteeing the quality of their ain lives. This characteristic results from the professional stress of a nurse, reflects the substantial stress they face at work, and is something we should pay attention to. The results of this study can back up the findings of previous studies that nurses recognized work-life separation every bit a very of import cistron when because resilience [39]. Nurses got condolement from broad-ranging human relationships. The human relationships of nurses were characterized past wanting to develop their relationships between colleagues to an intimate level, particularly friendship, and them securing comfort from these relationships with such close colleagues. Considering these characteristics of nurse resilience shows the need when developing future intervention studies to improve nurse resilience to create resilience programs that consider peer relationships.

As the nurses overcame arduousness, they endeavour to adapt themselves by developing themselves and preparing for new situations. They endeavour to organize their lives while arranging work priorities. Nurses tried to overcome adversity by planning for the future and developing i step at a time. In add-on, in the face of arduousness they took pride in being nurses by reflecting on why they chose their profession and reminding themselves of its value. By raising their job satisfaction and passion for their piece of work, their self-esteem was as well raised. They wanted to grow further as nurses by constantly exploring and developing task-related knowledge and skills, and tried to overcome the difficult situations they faced through the process of growth. The aspect of resilience, that contains the meaning of growth, has been revealed in previous studies [40]. However, the resilience of nurses has more specific meanings than the previous concept of resilience in that nurses program for a better future, value the professional meaning of nursing, and want to develop every bit nurses. This characteristics of the resilience of nurses who plan for the future in difficult situations and desire to develop themselves further can suggest a direction for intervention enquiry to heighten nurse resilience.

Due to the COVID-xix pandemic of recent years, many medical staff, including nurses, are struggling in the medical field. Several studies have been published that show that, in some countries, facing this difficult state of affairs has lowered the resilience of nurses [41, 42]. Resilience is the strength to overcome such crisis situations, and the importance of the ability of nurses to overcome these global medical crises is increasingly being emphasized [43]. Many studies have emphasized the demand for intervention research to improve nurse resilience [44]. The results of this study can provide cardinal data on what factors to focus on when developing intervention studies to ameliorate nurse resilience, which has been lowered in the pandemic situation. We need to focus on the inner self and plan interventions that will improve that aspect. Also, interventions that rebuild positive forcefulness and allow nurses to overcome arduousness and grow individually will be very helpful for them to overcome adversity. These varied approaches can exist expected to requite positive force to nurses, peculiarly in the currently challenging medical field.

This study helps the understanding of resilience in nursing, and provides an appropriate lens for a contextualized approach to resilience enquiry. This is very meaningful data from a socio-ecological betoken of view and emphasizes the importance of interactions between individuals and society [17], and is expected to ultimately play a positive role in the development of gild.

This study has two strengths. First, the included studies are from very diverse countries, such every bit the United States, Japan, Commonwealth of australia, South Africa, the United kingdom, Canada, Singapore, Iran, and Taiwan, reflecting studies of various cultures. Therefore, this study can provide universal knowledge that is applicative worldwide. Second, of the literature used in this written report, all 16 manufactures were institute to satisfy the quality evaluation criteria by 70% or more, so the study is based on an assay of relatively high quality documents of well-organized construction.

Despite these strengths, this study has limitations. The nurses included in the literature were from wide-ranging sub-fields, and the specific stress characteristics of the particular departments were non reflected in the upshot. Therefore, in the future, conducting qualitative enquiry on the resilience of nurses across nursing sub-fields is suggested. To resolve this, meta-synthesis studies could exist conducted to elucidate the characteristics of nurses inside more specific fields.

Future research

Resilience enhancement is an approach that maximizes human inner force, and we can suggest an intervention that maximizes inner homo resources by using mobile resources featuring excellent individual accessibility. Mobile health intervention applications accept developed quickly lately and their usefulness is recognized in nursing [45]. Recently, mobile health (mHealth) using smartphones for psychotherapy has been attracting attention as useful for the upcoming post-corona era [46]. Mobile applications can be useful resources for problem solving, and providing real-fourth dimension information and stress reduction strategies for nurses in a diversity of healthcare fields and settings [47]. In addition, since previous studies found smartphone app-based resilience interventions constructive for resilience, emotional regulation, and psychological health promotion, the development of a smartphone app-based nurse resilience enhancement program tin can be expected based on the results of this report [48].

Determination

Emphasizing resilience, a positive forcefulness for overcoming adversity, to nurses tin play a very significant role in improving the quality of nursing care. In this study, nurses showed resilience to grow and develop themselves by focusing on their inner selves and finding ways to solve issues on their own. These tin can be considered equally categories of nurse resilience and provide a framework to guide the development of an intervention programme for improving nurse resilience. Based on the results of this report, to improve the quality of nursing care we should try to develop varied intervention programs that raise nurses' inner strength.

Availability of data and materials

All data generated or analyzed during this study is included in this published commodity.

Change history

• 15 February 2022

  A Correction to this paper has been published: https://doi.org/10.1186/s12912-022-00819-z

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Funding

This report was supported past a National Research Foundation of Korea grant funded by the Korea regime (NRF-2021R1I1A1A01048956).

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Affiliations

1. Higher of Nursing, Korea University, Seoul, Republic of korea

   Eun Immature KIM

2. College of Nursing, and BK21 Four R&E Center for Learning Health Systems, Korea University, Seoul, South korea

   Sung Ok CHANG

Contributions

Conceived and designed the written report: EYK, SOC. Performed the data collection: EYK, SOC. Analyzed the data: EYK, SOC. Contributed materials: EYK, SOC. Wrote the first draft of the manuscript: EYK. Prepared figures and tables: EYK. Agree with manuscript results and conclusion: EYK, SOC. All the authors read and canonical the final manuscript.

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Correspondence to Sung Ok CHANG.

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The original online version of this commodity was revised: Table 1 has been updated.

Supplementary Data

Appendix i

Appendix 1

List of Synthesized Studies

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A2. Shimoinaba Thou, O'Connor G, Lee Due south, Kissane D. Nurses' resilience and nurturance of the self. Int J Palliat Nurs. 2015;21(x):504–ten. https://doi.org/10.12968/ijpn.2015.21.10.504

A3. Cope VC, Jones B, Hendricks J. Residential aged care nurses: portraits of resilience. Contemp Nurse. 2016;52(6):736–52. https://doi.org/10.1080/10376178.2016.1246950

A4. Cope 5, Jones B, Hendricks J. Why nurses chose to remain in the workforce: Portraits of resilience. Collegian. 2016;23(1): 87–95. https://doi.org/10.1016/j.colegn.2014.12.001

A5. Tubbert SJ. Resiliency in emergency nurses. J Emerg Nurs. 2016;42(1):47–52. https://doi.org/10.1016/j.jen.2015.05.016

A6. Benade P, du Plessis E, Koen MP. Exploring resilience in nurses caring for older persons. Health SA. 2017;22:138–49. https://doi.org/10.1016/j.hsag.2017.01.003

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A8. Prosser SJ, Metzger M, Gulbransen K. Don't just survive, thrive: understanding how acute psychiatric nurses develop resilience. Arch Psychiatr Nurs. 2017;31(2):171–6. https://doi.org/ten.1016/j.apnu.2016.09.010

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A10. Imani B, Kermanshahi SMK, Vanaki Z, Lili AK. Hospital nurses' lived experiences of intelligent resilience: A phenomenological study. J Clin Nurs. 2018;27(9–x), 2031–40. https://doi.org/10.1111/jocn.14310

A11. Jackson J, Vandall-Walker V, Vanderspank-Wright B, Wishart P, Moore SL. Burnout and resilience in disquisitional care nurses: A grounded theory of Managing Exposure. Intensive Crit Intendance Nurs. 2018;48:28–35. https://doi.org/ten.1016/j.iccn.2018.07.002

A12. Ramalisa RJ, du Plessis E, Koen MP. Increasing coping and strengthening resilience in nurses providing mental health care: Empirical qualitative research. Health SA. 2018;23:1094. https://doi.org/10.4102/hsag.v23i0.1094

A13. Ang SY, Uthaman T, Ayre TC, Lim SH, Lopez V. Differing pathways to resiliency: A grounded theory report of enactment of resilience among acute care nurses. Nurs Wellness Sci. 2019;21:132–viii. https://doi.org/x.1111/nhs.12573

A14. Ang SY, Uthaman T, Ayre TC, Lim SH, Lopez Five. A Photovoice study on nurses' perceptions and experience of resiliency. J Nurs Manag. 2019;27(2):414–22. https://doi.org/10.1111/jonm.12702

A15. Lin C-C, Liang H-F, Han C-Y, Chen 50-C, Hsieh C-L. Professional resilience among nurses working in an overcrowded emergency department in Taiwan. Int Emerg Nurs. 2019;42: 44–50. https://doi.org/x.1016/j.ienj.2018.05.005

A16. Udod S, Care WD, Graham JM, Henriquez Due north, Ahmad Northward. From coping to building nurse manager resilience in rural workplaces in western Canada. J Nurs Manag. 2021;Online ahead of print. https://doi.org/x.1111/jonm.13350

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KIM, E.Y., CHANG, South.O. Exploring nurse perceptions and experiences of resilience: a meta-synthesis study. BMC Nurs 21, 26 (2022). https://doi.org/ten.1186/s12912-021-00803-z

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• Received: 23 September 2021

• Accepted: 29 December 2021

• Published: 19 January 2022

• DOI : https://doi.org/10.1186/s12912-021-00803-z

Keywords

• Resilience
• Nurses
• Perception
• Experiences
• Qualitative review

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