Resilience and nursing care quality in emergency departments: a 2024 study in Kermanshah, Iran hospitals.

BACKGROUND

Emergency department (ED) nurses play a critical role in delivering urgent healthcare services and ensuring patient safety. The quality of nursing care in the ED significantly influences patient outcomes, satisfaction, and the overall performance of the healthcare system. Given the high-stress nature of the ED environment, nurses need to possess resilience—the capacity to adapt and cope effectively with challenging situations. This resilience is crucial for maintaining the well-being and professional satisfaction of ED nurses.

AIM

This study aims to investigate the relationship between nursing care quality and resilience among ED nurses in educational hospitals in Kermanshah city, Iran, during the years 2023–2024

METHODS

This descriptive-analytical cross-sectional study was conducted with the participation of 228 nurses working in the emergency departments of hospitals affiliated with Kermanshah University of Medical Sciences. Data were collected using a demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Quality of Nursing Care (QUALPAC) questionnaire. Statistical analyses were performed using SPSS version 25. The normality of the data distribution was assessed using the Kolmogorov-Smirnov test, which indicated a non-normal distribution of scores. Therefore, non-parametric tests, specifically the Mann-Whitney U and Kruskal-Wallis tests, were used to compare groups. Relationships between variables were examined using Spearman’s rank correlation coefficient. Additionally, stepwise multiple linear regression analysis controlling for confounding variables was conducted to identify predictors of nursing care quality.

RESULTS

Out of 256 invited nurses, 228 completed valid questionnaires (response rate 89%). The mean age of participants was 29.5 ± 5.4 years. The mean nursing care quality score was 96.1 ± 17.0 (moderate level), and the mean resilience score was 66.7 ± 15.1. Nursing care quality scores differed significantly by gender ( = 0.007), age group ( = 0.007), and employment status ( = 0.001) but not by marital status ( = 0.563). Male nurses had higher nursing care quality scores (d = 0.39), while female nurses showed higher resilience ( = 0.001, d = 0.39). Spearman’s correlation showed significant positive associations between resilience and overall nursing care quality ( = 0.275), as well as its psychosocial ( = 0.280) and communication ( = 0.215) dimensions (all  < 0.001). Multiple linear regression controlling for gender, age, and employment status was significant (F = 10.210,  < 0.001), explaining 15.5% of the variance in nursing care quality. Resilience (β = 0.314,  < 0.001) and gender (β = 0.247,  < 0.001) were significant predictors. Age approached significance (β = −0.139,  = 0.051), while employment status was not a significant predictor ( = 0.961).

CONCLUSION

This study demonstrated a significant positive association between resilience and the quality of nursing care among emergency department nurses. Enhancing resilience appears crucial for improving care quality and supporting nurses’ mental health in demanding clinical environments. Therefore, it is recommended to incorporate resilience-building strategies into nursing education and professional development programs. Additionally, organizational interventions aimed at fostering a supportive work environment and managing workload should be prioritized. Assigning more experienced nurses, particularly those over 30 years of age who exhibit higher resilience, to emergency departments may further promote care quality. These measures have the potential to improve both patient outcomes and workforce sustainability in high-pressure healthcare settings.

CLINICAL TRIAL

Not applicable.