Yu Fiona, Raphael Deborah, Mackay Lisa, Smith Melody, Fernandez Ritin
School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
School of Nursing, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand.
Int J Nurs Stud. 2025 Jun;166:105054. doi: 10.1016/j.ijnurstu.2025.105054. Epub 2025 Mar 18.
Nursing shortages and increased workforce turnover have significantly increased nurses' workloads, thus increasing the risk of burnout and stress, particularly during the COVID-19 pandemic. A systematic review published in 2019 suggested that resilience could act as a buffer to adversity; however, the factors associated with resilience during and after this global pandemic have not been identified.
To identify personal and work-related factors associated with nurse resilience, including the period during and after the COVID-19 pandemic.
Systematic review.
The search was conducted between January and February 2024 in the following databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, using the key terms 'resilience', 'hardiness', 'work', 'employ', 'occupation', 'job', and 'nursing'.
Quantitative studies with English full text, published between 2018 and 2024, were selected if they assessed resilience and its associated factors among nurses providing direct patient care. Two authors independently completed the data selection process. Studies with quality assessment grades of 3 or above were included for final analysis. A meta-analysis was utilised for the mean resilience levels from studies using the same measures of resilience, and a narrative synthesis was performed for the demographic and work-related factors.
Fifty-nine cross-sectional studies with a quality assessment score of 3 or above were included. Forty-seven studies were included in a meta-analysis, which reported an estimated mean resilience level of 20.69 using a random-effects model (95 % CI [18.53, 22.85], z = 18.79, p < 0.0001, I = 95.1 %). Twenty studies with the Connor Davidson Resilience Scale (CD-RISC)-25 and five with the CD-RISC-10 were meta-analysed for the mean resilience levels of 62.85 (95 % CI: [55.60, 70.10], z = 16.97, p < 0.0001, I = 31.70 %) and 26.34 (95 % CI: [20.85, 31.83], p < 0.0001, I = 0 %), respectively. A low mean resilience level was identified. Sixteen demographic factors were identified as associated with resilience. Twenty job demand factors negatively associated with resilience were determined and categorised into exhaustion, psychological factors, and work challenges. Thirty-two job resource factors positively related to resilience were identified and classified into the following categories: psychological factors, leadership, work performance, well-being and quality of life, and social and organisational support.
Understanding the job demand and resource factors can help organisations minimise the risks and develop institutional strategies to protect nurses from the negative impact of COVID-19 or future pandemics on nurses' well-being.
护理人员短缺和劳动力更替率上升显著增加了护士的工作量，从而增加了职业倦怠和压力的风险，尤其是在新冠疫情期间。2019年发表的一项系统评价表明，心理韧性可以作为应对逆境的缓冲；然而，尚未确定在这场全球大流行期间及之后与心理韧性相关的因素。
确定与护士心理韧性相关的个人因素和工作相关因素，包括新冠疫情期间及之后。
系统评价。
于2024年1月至2月在以下数据库进行检索：CINAHL Plus、MEDLINE（Ovid）、PsycINFO、EMBASE和Scopus，使用关键词“心理韧性”“心理承受力”“工作”“雇佣”“职业”“工作”和“护理”。
选取2018年至2024年发表的、具有英文全文的定量研究，这些研究评估了提供直接患者护理的护士的心理韧性及其相关因素。两位作者独立完成数据筛选过程。纳入质量评估等级为3或以上的研究进行最终分析。对使用相同心理韧性测量方法的研究的平均心理韧性水平进行荟萃分析，对人口统计学和工作相关因素进行叙述性综合分析。
纳入了59项质量评估得分3或以上的横断面研究。47项研究纳入荟萃分析，采用随机效应模型报告估计平均心理韧性水平为20.69（95%CI[18.53，22.85]，z = 18.79，p < 0.0001，I = 95.1%）。对20项使用康纳·戴维森心理韧性量表（CD-RISC）-25的研究和5项使用CD-RISC-10的研究进行荟萃分析，平均心理韧性水平分别为62.85（95%CI：[55.60，70.10]，z = 16.97，p < 0.0001，I = 31.70%）和26.34（95%CI：[20.85，31.83]，p < 0.0001，I = 0%）。确定心理韧性平均水平较低。确定了16个人口统计学因素与心理韧性相关。确定了20个与心理韧性呈负相关的工作需求因素，并分为耗竭、心理因素和工作挑战。确定了32个与心理韧性呈正相关的工作资源因素，并分为以下几类：心理因素、领导能力、工作绩效、幸福感和生活质量以及社会和组织支持。
了解工作需求和资源因素有助于组织将风险降至最低，并制定机构战略，以保护护士免受新冠疫情或未来大流行对护士幸福感的负面影响。
