The importance of developing meaningfulness and manageability for resilience in rural doctors.

INTRODUCTION: Retention of rural doctors is a problem in many countries. A previous study has identified resilience as a factor associated with longer retention. However, this needs a deeper study to understand what local and personal factors are at play. Studies suggest resilience can be developed during training. We propose that a better understanding of factors associated with resilience might assist in training students for rural practice and increase retention. AIM: This study aimed to understand the differences in resilience development between the more and the less resilient rural doctors. A secondary purpose was to identify how to assist this developmental process through health professional education. METHODS: This study employed a mixed-method design and was part of a more extensive study aiming to develop rural doctors' resilience in a low-resource setting. A prior survey assessed rural doctors' resilience levels. This study sampled high-level and low-level resilience participants to be interviewed. A total of 22 rural doctors participated in the individual semi-structured interviews. The interviews were analyzed qualitatively based on Richardson's Resilience Model and the six resilience dimensions looking for factors that explained high or low resilience. RESULTS: Two important themes emerged during the qualitative analysis: 'meaningfulness' and 'manageability.' The different responses of high and low-resilient participants can be explained through cases. CONCLUSIONS: The participants' perceived meaningfulness and manageability of the stressor determine the responses. We suggest that teachers may better construct students' resilience by focussing on assisting them in finding meaning and developing a sense of manageability.

Developing Personal Resilience Questionnaire for rural doctors: an indigenous approach study in Indonesia.

BACKGROUND: Resilience is recognized as a critical component of well-being and is an essential factor in coping with stress. There are issues of using a standardized resilience scale developed for one cultural population to be used in the different cultural populations. This study aimed to create a specific measurement scale for measuring doctors' resilience levels in the rural Indonesian context. METHOD: A total of 527 rural doctors and health professional educators joined this study (37 and 490 participants in the pilot studies and the survey, respectively). An indigenous psychological approach was implemented in linguistic and cultural adaptation and validation of an existing instrument into the local Indonesian rural health context. A combined method of back-translation, committee approach, communication with the original author, and exploratory qualitative study in the local context was conducted. The indigenous psychological approach was implemented in exploring the local context and writing additional local items. RESULT: The final questionnaire consisted of six dimensions and 30 items with good internal consistency (Cronbach's α ranged 0.809-0.960 for each dimension). Ten locally developed items were added to the final questionnaire as a result of the indigenous psychological approach. CONCLUSION: An indigenous psychological approach may enrich the linguistic and cultural adaptation and validation process of an existing scale.