Mapping resilience and co-occurring theoretical constructs in nurses: a scoping review.

Abstract

Objective: The aim of this scoping review was to map the concept of resilience, its definition, and measurement along with co-occurring theoretical constructs within nursing research, using the COVID-19 pandemic as a critical date range for the current evidence.

Introduction: The research literature offers a wide range of definitions of resilience, and the concept is frequently examined in conjunction with related theoretical constructs. Nurse resilience is a key element in interventions targeting nurse well-being and has been tied to burnout and mental health. Resilience is influential in workforce stabilization and impactful to nurse retention both within facilities and within the field of nursing. This is significant given the worldwide nursing shortage and the attrition from the field.

Eligibility criteria: This review considered published and unpublished quantitative studies that investigated resilience and co-occurring theoretical constructs in nurses from the onset of the COVID-19 pandemic, January 10, 2020, to the present. Studies published in English or Spanish were eligible, without restriction to setting or geographic location. All instruments that measure resilience were considered and mapped in conjunction with the co-occurring constructs.

Methods: This review was guided by JBI methodology for scoping reviews and published a priori protocol. CINAHL (EBSCOhost), PubMed, Embase (Embase.com), APA PsycINFO (EBSCOhost), Scopus, and LILACS were searched for evidence from January 10, 2020, to May 17, 2024. A search for unpublished studies and gray literature was conducted in ProQuest Dissertation and Theses. Titles and abstracts, followed by full texts, were screened against the inclusion criteria independently by 2 or more reviewers. Data were extracted using a piloted extraction tool, and findings are presented as a narrative summary supported by figures and tables, including a cluster analysis and qualitative coding of co-occurring constructs into theoretical domains.

Results: A total of 337 records met the inclusion criteria. Research on nurse resilience was conducted in 52 countries. Most of the evidence was cross-sectional in design (n = 277), of which 23 were interventional studies. Hospital-based nurses represented 70% of studies (n = 238). COVID-19 was a key element in the research for 65% of studies (n = 220), with only 3% of evidence published during 2020. Resilience was measured by 39 different validated tools, with the Connor-Davidson Resilience Scales accounting for more than half of the studies. There were 193 theoretical constructs studied alongside resilience: burnout (n = 73), stress (n =69), anxiety (n = 48), and depression (n = 44) were the most prevalent. A total of 175 constructs were measured fewer than 10 times, while 118 constructs appeared only once. Exploration of the co-occurring theoretical constructs included a cluster analysis, which identified 5 thematic clusters, and qualitative coding of the theoretical constructs into 13 domains to capture broad thematic categories.

Conclusion: This scoping review maps the quantitative evidence on nurse resilience during and after the COVID-19 pandemic. The literature demonstrates notable methodological gaps and limited attention to organizational factors and culture beyond the level of the individual, highlighting the need for more rigorous, context-sensitive research to inform effective interventions.

Review registration: OSF https://osf.io/n2uge/.

Supplemental digital content: A Spanish-language version of the abstract is available: https://links.lww.com/SRX/A193.