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Resilience in the Healthcare: A Concept Analysis Essay

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Updated: Sep 14th, 2022

Background

Concepts can be defined as the building blocks of a theoretical framework. Walker and Avant (2005) asserted that concept analysis is critical in helping various aspects of a concept to be used in theory and research. This paper provides analyses related to the concept of resilience. This concept has been chosen because it has widely been used in literature. Therefore, there is a need to have a centralized definition that can be accepted by all parties.

The concept of resilience has widely been used due to the numerous tragedies witnessed in the world today. This leads to the need for one definition that is inclusive and acceptable across the board. This paper shall adopt the analysis method adopted by Walker and Avant (2005), in which the concept will be selected, followed by definition of the attributes, antecedents, and consequences, identification of a model case and borderline, related and contrary cases; and lastly, there will be the definition of the empirical referents regarding the concept.

The concept of resilience

Resilience has been incorporated in various disciplines, age groups, and cultural settings. Essentially, resilience is said to have originated from studies centered on children, who have been predisposed to adverse conditions (Werner and Smith, 1982). In addition, this concept owes its definitions from research on human behavior, in which it is defined to be the capacity to overcome suffering and transform the self (Greene, Galambos and lee, 2003).

The definition also emanates from the ability to keep a proficient functioning during a distressful period. Resilience has been described to be the capability to return to the original position despite considerable adversity (Rutter, 1993). Initially, resilience referred to a personality trait, but this has changed, and resilience is now regarded as a dynamic and modifiable process (Luthar, Cicchetti, and Becker, 2000). According to the Merriam-Webster Dictionary of the English Language (2002), resilience is “an ability to recover from or adjust easily to change or misfortune” (p. 596).

In nursing, the level of functioning of patients is related to the definition of resilience. In this respect, Curly (1998) defined resilience as the ability of patients to return to a restorative level of functioning through the use of compensatory and coping mechanisms.

In the definition of the concept of resilience, there is one thing that stands out. In essence, the capability of bouncing back is common in all the definitions. Brand and Jax (2007) defined resilience as the capability of a system to undergo shocking experiences but retain the same previous function. Resilience has also been defined as the capacity of human societies to endure and recover from stressful conditions (Simonsen, 2007).

In archaeology, resilience has been linked to an adaptive cycle of exploitation, conservation, release, and reorganization. In this respect, change is considered as something that happens in episodes and is characterized by stabilizing and destabilizing forces (Redman, 2005). A common aspect among the definition of resilience in various disciplines is the ability to recover from stress to establish an organized and formed entity.

Resilience has also been used to describe populations at the time of hardship. There is no doubt that studies on resilience have been carried out in many societies across the world. In a study on Nigerian natives, the aim was to describe resilience among the young individuals when they were exposed to the ‘American’ way of doing things.

The young natives were noted to stick to their cultural values. The study revealed that the young people had a set of factors that were instilled in them from the onset, which aided them in their resilience against the ‘American’ influence (Ugochukwu, 2008).

O’Rouke (2004) carried out a study to establish resilience among widows. It was discovered that resilience, and the capability to recover after spousal loss was enhanced among individuals who had a commitment and satisfaction to life. The individuals who showed a lot of psychiatric distress did not have elaborate resilience and capacity to continue with life after the demise of their spouses. It can be noted that, in the various use of resilience, key identifiers are present in all definitions. These identifiers are known as defining attributes.

Defining attributes

Walker and Avant (2005) referred to the defining attributes as characteristics of a concept that are consistent and repeated every time the concept occurs. In respect to resilience, the defining attributes are associated with ‘protective factors’ and the similarities among the various situations in which the concept of resilience is involved.

Positive relations with others

A positive relationship among individuals fosters the concept of resilience (Ugochukwu, 2008; Anthony, 2008). This relationship can incorporate members of the family or community.

Self-efficacy

This refers to the aspect of believing that one can manage a situation to overcome difficulties. This is a protective factor relate to the sense of self and belief that an individual can achieve whatever he or she wants in life (Anthony, 2008).

Reintegration

This refers to the ability of an individual to bounce back after a difficulty period in life. This aspect enables one to move on and reintegrate in the society in an effective manner. One should be flexible to achieve reintegration (Anthony, 2008; Ahern, 2006).

Positive perspective on life

A positive perception of life has a significant impact on the resilience of an individual. Individuals with faith and belief in situations have positive outcomes. Research indicates that resilient children effectively minimise the negative impacts in their lives (Ahern, 2006).

Sense of humour

This aspect is closely associated with resilience among individuals. A sense of humour enables an individual to make light any life difficulty, thus enhancing the coping mechanisms (Richardson, 2002).

Antecedents and Consequences

In most instances, the definition of these aspects in concept analysis is overlooked. However, their definition can serve as a significant tool to comprehend the application and social context of the concept. Antecedents refer to the events or incidents that should happen before the concept. On the other hand, consequences refer to the events that follow after a concept has occurred (Walker and Avant, 2005).

Antecedents

Adversity has been identified as the chief antecedent. Adversity is the distinguishing factor between resilience and other social management processes. Adversity also distinguishes resilience from personality traits (Earvolino-Ramirez, 2007).

Consequences

This refers to the outcomes emanating from resilience. In resilience, an individual should adopt effective coping mechanisms to adapt to situations. The level of the consequences may be different; however, the presence of consequences is a critical aspect associated with resilience. When an adversity occurs, effective coping should be in place for a person to manage the diversity. When individuals lack resilience, they are likely to crumble in the face of adversity as they will be unable to cope effectively (Earvolino-Ramirez, 2007).

Model case

Anna Jones was the eldest daughter of the Jones’ family. It was not easy for Jones to grow up in the family. This is because there was physical and sexual abuse that Anna and her siblings were subjected to by their father. It was challenging for Anna, being ridiculed in school and often picked up as being dirty.

However, she managed to go through school and carry on with life. Anna’s life continued to be characterised with abusive relationships, and she thought that she was destined to live in abusive life patterns. She got married to John after she was impregnated. In her relationship with John, Anna was subjected to both physical and emotional abuse (Dyer and McGuinness, 1996).

In one incident, Anna was seriously abused and admitted to the emergency room with injuries. Here, she met a registered nurse, Cindy, who was helpful. Anna told Cindy about her previous and present abusive relationship with the people she called family. The two became strong friends, and Anna was determined to change her fortunes.

Cindy gave her the contacts of a women’s shelter for battered women, which could be helpful in her situation. After leaving the hospital, Anna and her child went to the shelter (Dyer and McGuinness, 1996).

When she reached the shelter, she met another registered nurse, Chris. Chris provided counselling and advisory services to help Anna recover. She was told how women find themselves in abusive relationships, and why they opt to stay. Anna was also taught how to identify and avoid abusive relationships. At the shelter, Anna learnt social skills, job skills, and how to develop a sense of self-identity. After some time, Anna was ready to move out and begin a new life.

Indeed, Anna changed after this experience, and she enrolled in a community college where she graduated and got employment. She also met other men and started dating. She used the skills learned at the shelter in identifying the right people with whom to associate. Eventually, she got herself the right man whom she married and lived with happily (Dyer and McGuinness, 1996).

The case presented by Anna’s story is a model case for resilience. This is because the model has incorporated the defining attributes of the concept. Anna’s life was characterised with difficulties. Nonetheless, she got positive aspects in her life when she met the registered nurses, Cindy and Chris. Through their advice, she was able to change for the better.

Additional cases

Invented case

Maria is the second eldest among the Jones’ daughters. She shared abusive childhood with her siblings, just like Anna. When in school, she turned to drugs and alcohol to escape from the reality at home. She ended up dropping out of school and was lured into prostitution. She was arrested severally on drug related issues and other crimes.

On one occasion, and while in jail, she came across a registered nurse, Vivian, who was ready to help her out. The two became acquainted, and Maria would attend counselling session on a regular basis. She was later released from the prison and wanted to experiment what she had been told by Vivian.

At first, Maria was able to rebound, but she could not give up on drugs. She found herself a decent housing and a boyfriend who accepted her experiences and was ready to help her in the recovery process. Maria found solace in drugs during the difficult moments. When the boyfriend found this, he would take her to a rehab. However, this problem continued for years. Maria never wanted to commit herself to the change process, and that is why she kept relapsing.

This scenario presents a borderline case that is characterised with some of the attributes of concepts. Maria grew up in a harsh environment. She established a bond with the nurse. Nonetheless, Maria lacked the will to change. Instead of positively coping with the situation, she turned to drugs and was not able to rebound fully.

Contrary case

Diane is a woman who is in an abusive marriage. Though this marriage is hard, she is somehow adapted to it, given that she was raised in an abusive family. She did not attend college for lack of self-believe. She quit her secretarial job to take care of the children and her husband. Diane lived an isolated life, and she did not have close friends. She became abusive towards the children. After 18 years in marriage, Diane finally opted getting out of marriage out to begin a new life.

She wanted to get back to her secretarial job, but she could not succeed. She met another man, Joe, whom she married after three months of dating. Joe was not talkative, and Diane felt isolated and miserable in her new marriage. Diane never engaged in anything to become self-sufficient. Also, she had a poor relationship with her children. After some time, Joe died, and Diane was only left with a car and a mortgage. This spelt doom to her as she sold the house, and did odd jobs to earn some income. Her kids were not willing to help, and she eventually succumbed to lung cancer due to heavy smoking (Earvolino-Ramirez, 2007).

Related case

John was raised in unstable family. His mother was a victim of a bipolar disease, who never took her medicine. John’s mother often showed up frantically wherever the son was wearing wild clothing. The dad had resorted to heavy drinking due to the wife’s situation. Financially, John’s family kept oscillating. John was enrolled in a private school though he was not sure if he could finish her education due to fee requirements.

He formed social bonds with other classmates with ease, but was not sure if he ever fitted in their company. John resorted to alcohol while at the boarding school and all the way to college. He went on to join a law school and managed to graduate after three years despite his drinking. He landed a job as an attorney. However, he struggled to maintain this job. John endured numerous challenges and believed that he was the best attorney. He made social friends and managed to live his life as he pleased (Earvolino-Ramirez, 2007).

Empirical referents

The Resilience Scale for Adults (RSA) was used in this analysis. This tool refers to a 37 item questionnaire that comprises various protective factors. The results indicate whether a person exhibits any of the attributes listed. The Connor-Davidson resilience Scale (CD-RISC) is also a tool used to measure resilience. This tool has excellent psychometric properties to measure resilience. Lastly, there is the Resilience Scale that comprises of twenty-five questions that look at various aspects. This tool is said to be significantly consistent and valid in testing resilience (Ahern, Kiehl, Sole and Byers, 2006).

References

Ahern, N.R. (2006). Adolescent resilience: An evolutionary concept analysis. Journal of Pediatric Nursing, 21(3), 175-185.

Ahern, N., Kiehl, E., Sole, M. and Byers, J. (2006). A review of instruments measuring resilience. Issues in Comprehensive Pediatric Nursing, 29(2), 103-125.

Anthony, E. K. (2008). Cluster profiles of youth living in urban poverty: Factors effecting risk and resilience. Social Work Research, 32(1), 6-17.

Brand, F. S. and Jax, K. (2007). Focusing the meaning(s) of resilience: resilience as a descriptive concept and a boundary object. Ecology and Society, 12(1), 23.

Curly, M.A.Q. (1998). Patient-nurse synergy: Optimizing patient outcomes. American Journal of Critical Care, 7(1), 64-72.

Dyer, J. and McGuinness, T. (1996). Resilience: Analysis of the concept. Archives of Psychiatric Nursing, 10(5), 276-282.

Earvolino-Ramirez, M. (2007). Resilience: A Concept Analysis. Nursing Forum, 42(2), 73-82.

Luthar, S., Cicchetti, D. and Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71, 543–562.

Merriam-Webster Dictionary of the English Language. (4th ed.). (2002). Boston: Houghton Mifflin.

O’Rouke, N. (2004). Psychological Resilience and the Well-Being of Widowed Women. Ageing International, 29(3), 267-280.

Redman, C. (2005). Resilience theory in archaeology. American Anthropologist, 107(1), 70-77.

Richardson, G. E. (2002). The metatheory of resilience and resiliency. Journal of Clinical Psychology, 58, 307–321.

Rutter, M. (1993). Resilience: some conceptual considerations. Journal of Adolescent Health, 14, 598–611.

Simonsen, S. H. (2007). Resilience dictionary. Web.

Ugochukwu, C. (2008). Cultural resistance and resilience amid imported TV programming in Nigeria. Africa Today, 55(1), 34-58.

Walker, L.O. and Avant, K.C. (2005). Strategies for theory construction in nursing. Upper Saddle River, NJ: Pearson Prentice Hall.

Werner, E. E. and Smith, R. S. (1982). Vulnerable but invincible. New York: McGraw-Hill.

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