Introduction definitions of resilience have been similar

       Introduction            The purpose of this concept analysisis to study the term resilience.

  Thedefinitions of resilience have been similar throughout the years.  These definitions have all included aspectsof positive adaptation, rebounding, or coping in the face of severestress.  Research on resilience hasincreased dramatically over the last two decades and is beginning to show therelationship on the impact on health and quality of life (Windle 2010).  Through the years, scientists, psychologists,and health care professionals have used the term resilience. In regards tonursing, the term resilience can be used when caring or people who are facingphysical and psychosocial adversities. The following analysis will discover the meaning of resilience withinthe nursing profession.  This conceptanalysis will also include defining attributes, case scenarios, and a review ofthe antecedent and consequences of the concept.

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 The concept will be defined using dictionaries and literature both foundwithin and outside of the nursing field.   Definition           The term resilience originates fromthe mid 17th century.  The Latinorigin ‘resilire’, which was later seen as ‘resilient’ means to leap back.  The noun, ‘resilience’, is derived from theadjective ‘resilient’, which has two definitions: (1) (of substance or object)able to recoil or spring back into shape after bending, stretching, or beingcompressed, (2) (of a  person) able towithstand or recover quickly from difficult conditions (Etymology dictionaryonline, 2001).

Reviewof Literature In Nursing and Other Disciplines            One of the definitions that is mostcommonly associated with resilience is the ability to bend but not break,bounce back, and possibly even grow in the face of adverse lifeexperiences.  The American PsychologicalAssociation (2014) defines resilience as “the process of adapting well in theface of adversity, trauma, tragedy, threats or even significant sources ofstress”.  Many studies have shown thepsychological relationship of positive emotions and psychologicalresilience.  Resilient people arecharacterized by positive emotionality, having zestful and energetic approachesto life, and being able to use positive emotions to achieve effective copingoutcomes (Tugade, Fredrickson, & Barrett, 2004).              This paper has discussed what makesa person resilient, but what could make a whole culture resilient?  Dr. Panter-Brick defines resilience in aculture as “a process to harness resources to sustain well-being” (Panter-Brick& Leckman, 2013).

  To define thisconcept, she conducted face-to-face interviews with over a thousand families inAfghanistan.  In the Afghan context, theword resilience primarily meant, “hope” (Southwick, Bonanno, Masten,Panter-Brick, & Yehuda, 2014).  Shefound that the Afghan families became resilient because of their ability tohang on to the sense of hope.  This hopeor “meaning-making” is the essence of a cultural perspective on resilience(Panter-Brick & Eggerman, 2012).

  Dr.Panter-Brick concluded that “What matters to individuals facing adversity is asense of ‘meaning-making’ – and what matters to resilience is a sense of hopethat does indeed make sense, despite chaos, brutality, stress, worry, ordespair (Southwick, et al.).  In orderfor a society to become resilient, we need to provide people with the resourcesthat facilitate their ability to create a better future.  Within the healthcare and nursingsetting, the term resilience can be used to describe many of the healthcareworkers.  Health care professionals havehigh stress jobs that can lead to emotional and physical fatigue.  A study was conducted in 2014 to examine theeffects of interpersonal conflict and workload on job outcomes and examine ifresilience moderates the indirect effects of conflict and workload on joboutcomes.  The reason for this study wasto understand how resilience betters the negative effects of workplacestressors.

A multimodal resilience-training programwas designed and implemented for a group of intensive care unit (ICU) nurses toprove that resilience in nursing can be learned.  Highly resilient ICU nurses used positivecoping skills to address workplace stress and are able to continue working inthe ICU environment (Mealer et al. 2017). The objective of the study was togain data on mindfulness-based cognitive theapy resilience intervention for ICUnurses to see if an intervention program is feasible (Mealer et al. 2017).  In order to prove this, focus groups wereheld and interview questions assessed of mindfulness-based cognitive therapy toreduce burnout syndrome in ICU nurses. The results of this study showed that there were limitations in findinga resiliency program, however, if an institution can plan carefully, and the nursesadhere to the program, then resilience can be learned and burnout symptoms willdecrease (Mealer et.

Al 2017).  DefiningAttributes            Defining attributes are a cluster ofinformation of attributes most frequently associated with the concept (Walker &Avant, 2005).  According to Scoloveno(2016), there are three attributes that distinguish the concept of resiliencefrom other concepts.  These definingattributes are: (1) self-esteem, (2) self-reliance, and (3) socialresponsiveness (Scoloveno, 2016).Definition            Resilience is defined as a “dynamicconcept that describes the ability of individuals, families and groups tosuccessfully function and adapt and cope in spite of psychological,sociological, cultural, and/or physical adversity.

  Resilience, a trait and process, was found inindividuals along the developmental continuum” (Scoloveno, 2016).  CasesModel Case            A model case is defined as ascenario or situation that includes attributes of a concept (Walker &Avant, 2005).  The following case is anexample of a model case for the concept of resilience.              Judy is a 25-year-old female whogrew up in a dysfunctional family environment. She is the primary caregiver for her father, who is widowed, and herbrother who has downs syndrome.  Judy’smother died when she was 15-years-old from Multiple Sclerosis (MS). Judy hadall of these responsibilities before getting married.  Judy had the support of her Aunt Maria, whowould come over to help clean, make dinner, and take her brother or father todoctor’s appointments.

              Judy is typically very social andactive.  She played sports in high schooland college.  Her friends would commenton how Judy social, caring, and positive individual.  One day, Judy woke up and she suddenlynotices her left leg is dragging.  Thiswas alarming because not only is Judy is left-side dominant, but she is alsoworried that it could be MS because of her familial history.  Judy’s husband brings her to the emergencydepartment where she is later diagnosed with a thrombolytic stroke.

              Judy begins experiencing moreleft-sided weakness, but is still able to talk and communicateeffectively.  She is happy because she isstill able to utilize her laughter and humor in such a difficult time, and thisis her primary coping mechanism.  Sheremains very positive with family, friends, doctors, and nurses.

  She is able to overcome her fear of needlesand undergo many tests to determine the cause of the stroke.              During Judy’s recovery process, AuntMaria offered for Judy and her husband to stay with her for a period oftime.  Since Judy is so positive, shereplied, “We won’t have to stay long.  Ifully intend on going to physical therapy and doing what I have to do to getwell.

  I can control my outcome.”  When the nurses asked Judy how she is able toremain so positive Judy replied, “I rely on my support systems.  I have also been through other crises in mylife and have been able to bounce back from them all.  I am very independent and will continue towork through any adversity that comes my way.” Over the next year, Judy worked with the physical therapy staff to makea full recovery from the stroke.  She nowtakes blood thinners to prevent any further strokes, has continued to remainactive and social, and is now a new mother.

             In this case, Judy is able to seepast the current negative situation life has thrown at her.  Judy is a young woman to have a stroke.  A person who is not resilient may changetheir life views and think of this as something negative.  Judy truly encompasses the meaning of”resilience” and is able to “bounce back” and overcome the thrombolytic strokeand she is now flourishing in accomplishments.

 This is a model case of resilience. Borderline Case            A borderline case, as defined byWalker and Avant (2005), is a case that includes some of the definingattributes, but not all of them.  Aborderline case my contain most of the attributes but differ significantly in alength of time, intensity, or occurrence. The following is an example of a borderline case of the concept ofresilience.              Carmen is a 30-year-old Hispanicfemale who has a 5-year-old daughter. Carmen and her daughter were recently rehoused after living in ahomeless shelter for several months.  Carmenis currently eight months pregnant and has another 2-year-old son who liveswith the boy’s parents since she is homeless. This is her second time being homeless in less than a year.

  Both episodes of homelessness occurred afterher friend, who she was financially dependent on, was unable to support herselfand her children anymore.              When Carmen moved to Atlanta, shewas initially highly motivated to find new housing for her family, but did notrealize how much worked needed to be done to find the financial helpneeded.  She relied on other people to giveher this information instead of trying to find it herself.  Carmen eventually achieved her goal offinding housing and was reunited with her 2-year-old son.

  However, she did not have any long-term plansof how she was going to maintain this stable housing, and she is not currentlyseeking employment.  She is currentlyliving day-by-day.              Carmen’s case is a borderline caseof resilience.

  Carmen only was able toovercome her situation when she was faced with the reality of being separatedfrom one child, and the fact that she, and her daughter, were living in ahomeless shelter.  She only acted uponthe steps necessary to get her into the rehousing process.  Once she was able to find a house, she hasnot done any planning for her future to fully remedy the cause of herhomelessness.  Carmen has not overcomethe risk for future episodes of homelessness. Related Case            A related case is a case that isrelated to the concept, but does not contain the defining attributes (Walker& Avant, 2005).

  The following is anexample of a related case of the concept of resilience.              Ron’s childhood was a littledifferent than most.  Ron grew up in anunstable environment.  His mothersuffered from bipolar disease, but she never took her medications, and she experiencedmore mania than depression.  She wouldfrequently show up to Ron’s functions in wild attire and often have grand,outrageous ideas.  His father was asomewhat functioning alcoholic, non-abusive towards Ron, but drank to escapereality.  Ron’s family’s fanicialstability was a roller coaster.

  Theyexperienced many ups and downs.  Attimes, they were able to live very lavishly when Ron’s father’s business wasflourishing, and other times, they had cars repossessed in their frontyard.              Ron attended a private boardingschool for high school.  Every semester,he never knew if he would be asked to leave the school due to nonpayment oftuition.

  He was social and had manyfriendships but was never really confident in himself.  Ron began drinking at boarding school andcontinued to drink until he finished college. He graduated and wanted to become a lawyer.

  He was able to finish law school in threeyears, despite the drinking and the enormous amounts of financial debt he wasin.              Ron was able to pass the bar on hisfirst try, but was never able to hold a steady job as an attorney.  At the age of 35, Ron’s power wouldfrequently be shut down, he would have cars repossessed, or even get evictedfrom apartments.  Despite these setbacks,Ron was always able to get back on his feet. Ron believed he was a good attorney and had come a long way.  He lived his life the way he wanted to, withno regrets.              Ron’s case is an example of arelated case because Ron was able to accomplish many things in his life.  Despite all the accomplishments, his life wasfilled with constant setbacks, which he was never able to grow and learn fromthese setbacks.

  Ron just drifted throughhis life, with all of his struggles, and never did anything to truly change theroot of the difficulties.  Ron continuedto lose jobs, drink, and not pay bills. If Ron was truly resilient, he would have made the necessary changes tobetter his lifestyle, not continue to glide through life.  This is why Ron’s case is considered relatedto resilience.  Contrary Case            A contrary case is a case that isthe opposite of the concept (Walker & Avant, 2005).  The following case represents a contrary caseof the concept of resilience.              Paula is a 37-year-old female whohas been married since the age of 19.  Herhusband is older, abusive, and dominating.

 Although Paula never wanted this life for herself, she was use to theabuse.  Her mother was very abusivetowards her and her stepfather was an alcoholic.  Paula never went to college because she neverbelieved that she could succeed.  Sheworked as a secretary until she married her husband, and then quit her job totake care of him.  Over the course oftheir marriage, Paula had three children. Paula did not have many friends, spoke very little to her own parents,and never truly bonded with her children. Paula turned out to be just as abusive to her children and her motherwas to her.

              Paula decided she had enough of thislife and took her money and left her husband and children.  She had the belief that she could beginworking as a secretary again, but she always called out sick, was not very goodat her job, and did not like associating with people.  She found herself with little money, in asingle bedroom apartment, and living day-by-day.             Paula met a new man, and they weremarried three months later.  He was notabusive, but did not speak much to Paula. Paula spent the entire marriage feeling isolated and miserable.

  She never did anything to becomeself-sufficient or to improve herself. Her husband died of a heart attack and only left her with themortgage.  She was forced to sell thehouse, to go rent an apartment, and to begin looking for a job again.  Paula attempted to reach out to her children,but none of them would help her.  Acouple of years later, Paula died of lung cancer after smoking for almost 40years.              This final case suggests an absenceof the attributes of overcoming, or resilience. Paula saw that she was in unfortunate situations, but was not able toacknowledge the potential of better circumstances.

    Antecedent            Anantecedent is an event that occurs before the occurrence of the concept (Walker& Avant, 2005).  An antecedent fromthe literature related to resilience is an experience or the risk of hardshipthat may carry a significant threat for the development of something negative(Windle, 2010).  Some examples ofsignificant threats or hardships would be stress, a serious diagnosis, poverty,ill health, and bereavement. Vanderbilt-Adriance & Shaw (2008), caution that not all risks areequivalent in severity; some may be acute, some may be chronic. This makes anyfindings of resilience can only be considered within the context of thespecific hardship (Vanderbilt-Adriance & Shaw, 2008).

  Consequences            Consequences are events or incidentsthat emerge as a result of the occurrences of the concept (Walker & Avant,2005).  


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