Nivel de resiliencia y síntomas depresivos en el internado médico en el Perú / Level of resilience and depressive symptoms in medical interns in Peru

INTRODUCCIÓN: El interno de Medicina se encuentra sometido a múltiples factores que pueden llegar a generarle síntomas depresivos. La resiliencia es un mecanismo que permite sobrellevar y contrarrestar esta circunstancia. Existe escasa información sobre la dimensión y la relación entre estos 2 aspectos en la población descrita. OBJETIVO: Determinar la relación entre el nivel de resiliencia y la presencia de síntomas depresivos durante el internado médico en Lima, Perú. MATERIALES Y MÉTODOS: Se realizó un estudio transversal en una muestra representativa de internos de Medicina Humana de 4 hospitales de Lima, Perú. El nivel de resiliencia se midió con la Escala de Resiliencia de Wagnild y Young abreviada y la presencia de síntomas depresivos con la Escala de Autoevaluación para la Depresión de Zung abreviada. Se utilizó el modelo de regresión logística para determinar la asociación estadística. RESULTADOS: Se encuestó a 202 internos (83,5% del total de internos). El nivel de resiliencia presentó una media de 78,01±11,59, con una prevalencia de resiliencia alta del 87,1% (n=176), y la prevalencia de síntomas depresivos fue del 42,6% (n=86). Se encontró una relación inversa entre el nivel alto de resiliencia y la ausencia de síntomas depresivos (OR 13,75; IC 95% 3,9-47,6; p < 0,05). CONCLUSIÓN: Aquellos internos con un mayor nivel de resiliencia presentaron menos síntomas depresivos. El contacto con amigos y la conformidad con la sede y con el personal de trabajo se asociaron con un nivel alto de resiliencia

INTRODUCTION: The medical intern is susceptible to multiple factors that can lead to depressive symptoms. Resilience is a mechanism that allows them to overcome and counteract this problem. There is limited information about the scope and relationship between these 2 aspects in the population described. OBJECTIVE: To determine the relationship between the level of resilience and the presence of depressive symptoms during the medical internship in Lima, Peru. MATERIALS AND METHODS: A cross-sectional study was carried out on a representative sample of interns from four hospitals in Lima, Peru. The level of resilience was measured with the Wagnild and Young Abbreviated Resilience Questionnaire, and the presence of depressive symptoms with the abbreviated Zung Self-Rating Depression Scale. A logistic regression model was used to determine statistical relationship. RESULTS: A total of 202 interns were surveyed (83.5% of the total number of interns). The mean level of resilience was 78.01±11.59, with a high resilience prevalence of 87.1% (n=176), with the mean prevalence of depressive symptoms being 42.6% (n=86). An inverse relationship was found between a high level of resilience and the absence of depressive symptoms (OR 13.75; 95% CI 3.9-47.6; P<.05). CONCLUSION: Those with a higher level of resilience had fewer depressive symptoms. Contact with friends, and conformity with the hospital and with staff were associated with a high level of resilience

Medición de la voluntad de vivir en adultos mayores: adaptación transcultural, validez y confiabilidad de la Will-to-Live Scale / Measurement of the will to live in older adults: Transcultural adaptation, validity and reliability of the Will-to-Live Scale

OBJETIVO: La Will-to-Live Scale (WTLS) es utilizada para medir la voluntad de vivir en adultos mayores; sin embargo, no existe una versión en español. El objetivo del estudio fue traducir la WTLS al español, evaluar su estructura interna, su confiabilidad y los correlatos entre la WTLS y la satisfacción con la vida, la resiliencia y la depresión en adultos mayores peruanos. MÉTODO: Los participantes fueron 235 adultos mayores peruanos (M=72,69, DE=6,68) evaluados entre marzo y mayo de 2019, seleccionados a través de un muestreo no probabilístico. Se administró la WTLS, la Satisfaction with Life Scale (SWLS), la Brief Resilient Coping Scale (BRCS) y el Patient Health Questionnarie-2 (PHQ-2). El análisis de datos incluyó confiabilidad por consistencia interna y modelos de ecuaciones estructurales, específicamente el análisis factorial confirmatorio (AFC), para probar la solución unidimensional de la WTLS y la validez convergente de la WTLS a nivel latente, al especificar un modelo de cuatro factores (voluntad de vivir, satisfacción con la vida, resiliencia y depresión). RESULTADOS: El coeficiente alfa de Cronbach y el índice de confiabilidad compuesto obtienen valores de 0,93 y 0,94, respectivamente. La estructura unidimensional de la WTLS se ajustó a los datos (χ2(5)=10,067, p = 0,073, CFI=0,999, RMSEA=0,066, SRMR=0,014) y mostró asociaciones positivas con la SWLS (ρ=0,82) y la BRCS (ρ=0,86), así como negativa con el PHQ-2 (ρ=−0,66). CONCLUSIÓN: La WTLS en español presenta evidencias de validez y confiabilidad para medir la voluntad de vivir en adultos mayores peruanos

OBJECTIVE: The Will-to-Live Scale (WTLS) is used to measure the will to live in older adults; however, there is no Spanish version. The objective of the study was to translate the WTLS into Spanish, assess its internal structure, reliability, and the correlates between WTLS and life satisfaction, resilience, and depression in older Peruvian adults. METHOD: The participants were 235 Peruvian older adults (M=72.69, SD=6.68), evaluated between March to May 2019, selected through non-probability sampling. The WTLS, the Satisfaction with Life Scale (SWLS), the Brief Resilient Coping Scale (BRCS) and the Patient Health Questionnaire-2 (PHQ-2) were administered. Data analysis included reliability by internal consistency and structural equation models, specifically confirmatory factor analysis (AFC), to test the one-dimensional solution of the WTLS and the convergent validity of the WTLS at the latent level, by specifying a four-factor model (will to live, life satisfaction, resilience and depression). RESULTS: Cronbach's alpha coefficient and the composite reliability index obtain values of .93 and .94, respectively. The one-dimensional structure of the WTLS was fitted to the data (χ2(5)=10,067, P=.073, CFI=.999, RMSEA=.066, SRMR=.014) and showed positive associations with the SWLS (ρ=.82), and BRCS (ρ=.86), as well as negative associations with the PHQ-2 (ρ=−.66). CONCLUSION: The WTLS in Spanish presents evidence of validity and reliability to measure the will to live in Peruvian older adults

Retrospective development of a novel resilience indicator using existing cohort data: The adolescent to adult health resilience instrument.

BACKGROUND: Cohort studies represent rich sources of data that can be used to link components of resilience to a variety of health-related outcomes. The Adolescent to Adult Health (Add Health) cohort study represents one of the largest data sets of the health and social context of adolescents transitioning into adulthood. It did not however use validated resilience scales in its data collection process. This study aimed to retrospectively create and validate a resilience indicator using existing data from the cohort to better understand the resilience of its participants. METHODS: Questions asked of participants during one Add Health data collection time period (N = 15,701) were matched to items on a well-known and widely validated resilience scale called the Connor Davidson Resilience Scale. Factor analysis and psychometric analyses were used to refine and validate this novel Adolescent to Adult Health Resilience Instrument. Construct validity utilized participants' answers to the 10 item Center for Epidemiologic Studies Depression Scale, which has been used to validate other resilience scales. RESULTS: Factor analysis yielded an instrument with 13 items that showed appropriate internal consistency statistics. Resilience scores in our study were normally distributed with no ceiling or floor effects. Our instrument had appropriate construct validity, negatively correlating to answers on the depression scale (r = -0.64, p<0.001). We also found demographic differences in mean resilience scores: lower resilience scores were seen among women and those who reported lower levels of education and household income. CONCLUSIONS: It is possible to retrospectively construct a resilience indicator from existing cohort data and achieve good psychometric properties. The Adolescent to Adult Health Resilience Instrument can be used to better understand the relationship between resilience, social determinants of health and health outcomes among young adults using existing data, much of which is publicly available.

Experiencias y necesidades de los hermanos de niños en situación paliativa: estudio cualitativo desde la perspectiva de los profesionales / Experiences and needs of siblings of children in a palliative situation: a qualitative study from the perspective of professionals

INTRODUCCIÓN: Los cuidados paliativos pediátricos consisten en los cuidados activos e integrales que se realizan al cuerpo, mente y espíritu del niño y su familia, desde que es diagnosticado de una enfermedad amenazante para la vida. Las investigaciones se centran sobre los efectos que esto causa en los padres y los niños, sin centrarse en las repercusiones que esto tiene en los hermanos. OBJETIVO: Conocer y analizar las experiencias y necesidades de los hermanos de niños en situación paliativa desde la perspectiva de los profesionales más cercanos a ellos. MATERIALES Y MÉTODO: Estudio cualitativo exploratorio, que se centró en la provincia de Valencia. Participaron cinco profesionales que trabajan en la Asociación de Padres de Niños con Cáncer de la Comunidad Valenciana (ASPANION), y la obtención de datos se realizó mediante entrevistas individuales semiestructuradas. RESULTADOS: Aspectos referidos a la adaptación de la familia, los cambios de comportamiento de los hermanos durante el proceso, la comunicación entre ambos, la importancia de la información y la participación del hermano durante la enfermedad, así como las dificultades que encuentran los profesionales para tratar con estos hermanos, son algunos de los resultados obtenidos. CONCLUSIONES: Los hermanos viven los procesos paliativos con gran capacidad de adaptación, aunque, en momentos de estrés o cuando aparecen sentimientos de abandono o culpa, los hermanos lo expresan a través de cambios en el comportamiento. Es importante que los padres expresen sus miedos y mantengan el vínculo con el hermano, haciéndoles partícipes de la situación e informándoles de todo, teniendo muy en cuenta el factor de la edad. La gran demanda de los profesionales es la de poder trabajar con los hermanos directamente, de manera que puedan tener una atención más cercana

INTRODUCTION: Research on children in a palliative situation and the effects this exerts on parents is increasingly abundant. Despite this, there is still a gap in understanding the way in which siblings live through the stages of terminal illness and death. OBJECTIVE: To know and analyze the experiences and needs of the siblings of children in a palliative situation from the perspective of the professionals closest to them. MATERIAL AND METHOD: A qualitative exploratory study focused on the province of Valencia. Five professionals working for the Asociación de Padres de Niños con Cáncer de la Comundad Valenciana (ASPANION) participated, and the data collection was carried out using semi-structured individual interviews. RESULTS: Aspects related to family adaptation, behavior changes in siblings during the process, communication between family members, the importance of sibling information and participation during the illness period, and the difficulties professionals find in dealing with siblings are some of the results obtained. CONCLUSIONS: Siblings live palliative processes with great adaptability, although in times of stress, or when feelings of abandonment or guilt appear, they express their discomfort through changes in behavior. It is important that parents express their fears and maintain their bond with siblings, making them participants in the situation and informing them of everything, taking into account the age factor. The great demand by professionals is that they may work with siblings directly, so these may receive closer attention

Ajuste familiar durante la pandemia de la COVID-19: un estudio de díadas / Family adjustment during the COVID-19 pandemic: a dyad study

La pandemia mundial del COVID-19 ha traído una gran cantidad de cambios vitales para la sociedad. Ante esta situación, las familias y sus hijos han tenido que adaptarse a nuevas rutinas y situaciones, lo que puede haber aumentado o agravado el padecimiento de sintomatología emocional. No obstante, la presencia de resiliencia y de estrategias de regulación emocional positivas, puede amortiguar este impacto en las familias con hijos pequeños. El objetivo del presente trabajo es conocer las variables que explicaban los problemas de ajuste emocional familiar ante la pandemia del COVID-19, teniendo en cuenta las díadas de progenitores y sus hijos adolescentes. Participaron 31 díadas de adolescentes entre 11 y 19 años (M =13.90; DT=1.85) y sus cuidadores principales, siendo el 93,50% madres. Tras aceptar participar en el estudio se evaluó la regulación emocional (Cuestionario de Regulación Emocional; ERQ), la resiliencia (Escala de Resiliencia de Connor-Davidson; CD-RISC) y la sintomatología ansiosa, depresiva y el estrés (Escala de Depresión, Ansiedad y Estrés; DASS). Se realizaron modelos de análisis comparativo cualitativo de conjuntos difusos (fsQCA). En la explicación del desajuste emocional de los cuidadores, el clima familiar negativo y las estrategias de regulación emocional deficientes en sus hijos fueron las variables más relevantes. En la explicación del malestar emocional de los adolescentes, lo fueron la baja resiliencia de estos y las estrategias deficientes de regulación emocional de sus padres. Nuestro estudio señala la relevancia de atender a los miembros de las familias en su conjunto ante crisis vitales de este tipo, mediante programas de intervención que mejoren los vínculos familiares y las estrategias de regulación emocional

The global pandemic of COVID-19 has brought a host of vital changes to society. Families and their children have had to adapt to new routines and situations, which may have increased or aggravated the suffering of emotional symptoms. However, the presence of resilience and positive emotional regulation strategies can cushion this impact on families with young children. The aim of the present study is to know the variables that explained the problems of family emotional adjustment to the COVID-19 pandemic, considering the dyads of parents and their adolescent children. Thirty-one dyads of adolescents between 11 and 19 years old (M = 13.90; SD = 1.85) and their main caregivers participated, 93.50% of whom were mothers. After accepting to participate in the study, emotional regulation (Emotional Regulation Questionnaire; ERQ), resilience (Connor-Davidson Resilience Scale; CD-RISC) and anxious, depressive and stress symptoms (Depression, Anxiety and Stress Scale; DASS) were evaluated. Qualitative comparative fuzzy set analysis (fsQCA) models were performed. In the explanation of the emotional maladjustment of the caregivers, the negative family climate and the deficient emotional regulation strategies in their children were the most relevant variables. In the explanation of the emotional discomfort of the adolescents, the low resilience of these and the deficient strategies of emotional regulation of their parents were the most relevant variables. Our study points out the relevance of caring for family members when facing this kind of life crisis, through intervention programs that improve family bonds and emotional regulation strategies

Relación entre el maltrato infantil y la adaptación social en una muestra de jóvenes atendidos en un servicio de intervención precoz en psicosis / Relationship between childhood trauma and social adaptation in a sample of young people attending an early intervention service for psychosis

INTRODUCCIÓN: El maltrato infantil se ha asociado a un mayor riesgo de psicosis, a una mayor severidad en síntomas psicopatológicos y a un peor pronóstico funcional en pacientes con un trastorno psicótico. El presente estudio pretende evaluar la relación entre el maltrato infantil, psicopatología y la adaptación social en una muestra de primeros episodios psicóticos (PEP) y de estados mentales de alto riesgo (EMAR). MATERIAL Y MÉTODOS: La muestra incluyó 114 jóvenes (18-35 años, 81 PEP y 33 EMAR) atendidos en un Servicio de Intervención Precoz en Psicosis. Se evaluaron síntomas positivos, negativos y depresivos con las escalas PANSS y Calgary de Depresión; los antecedentes de maltrato infantil con el Childhood Trauma Questionnaire; la adaptación social con la Escala Autoaplicada de Adaptación Social (SASS). Se utilizó el modelo de ecuaciones estructurales (SEM) para explorar relaciones entre psicopatología, maltrato infantil y dimensiones de la SASS en toda la muestra (incluyendo PEP y EMAR). Se repitió un análisis SEM exploratorio en la submuestra de PEP. RESULTADOS: Los EMAR presentaron más negligencia emocional y peor adaptación social, comparados con los PEP. El SEM muestra que el maltrato se asocia con una peor adaptación social en todos los dominios, de forma directa en dominios que implican relaciones interpersonales, y por una vía mediada por síntomas depresivos en los dominios que implican ocio y trabajo e intereses socioculturales. CONCLUSIONES: El maltrato infantil tiene un efecto negativo sobre la adaptación social en jóvenes en fases tempranas de las psicosis. Los síntomas depresivos son mediadores de una peor adaptación en aspectos funcionales relacionados con el ocio y el trabajo

INTRODUCTION: Childhood trauma has been associated with an increased risk of psychosis, a greater severity of psychopathological symptoms, and a worse functional prognosis in patients with psychotic disorders. The current study aims to explore the relationship between childhood trauma, psychopathology and social adaptation in a sample of young people with first episode psychosis (FEP) or at-risk mental states (ARMS). MATERIAL AND METHODS: The sample included 114 young people (18-35 years old, 81 FEP and 33 ARMS) who were attending an Early Intervention Service for Psychosis. Positive, negative and depressive symptoms were assessed with the PANSS and the Calgary Depression Scale; history of childhood trauma was assessed with the Childhood Trauma Questionnaire; social adaptation was assessed with the Social Adaptation Self-evaluation Scale (SASS). Structural equation modeling (SEM) was used to explore the relationship between childhood trauma, psychopathology and SASS dimensions in the global sample (including FEP and ARMS). An exploratory SEM analysis was repeated in the subsample of FEP patients. RESULTS: ARMS individuals reported more emotional neglect and worse social adaptation compared to FEP. SEM analysis showed that childhood trauma is associated with a worse social adaptation, in a direct way with domains involving interpersonal relationships, and mediated by depressive symptoms with those domains involving leisure, work and socio-cultural interests. CONCLUSIONS: Childhood trauma has a negative effect on social adaptation in young people with early psychosis. Depressive symptoms play a mediation role in this association, especially in domains of leisure and work

The symbiotic relationship of vulnerability and resilience in nursing.

Background: Whilst the terms vulnerability and resilience are commonly used within professional nursing discourses, they are often poorly understood. Vulnerability is often framed negatively and linked to being at risk of harm, whilst resilience is often perceived as the ability to withstand challenges. Aim: The aim of this paper is to explore resilience and vulnerability; re-positioning them within the context of contemporary professional nursing practice. Design: Discussion paper. Method: Drawing upon historical and contemporary international literature, both concepts are de-constructed and then re-constructed, examining them from the position of patient care as well as from the perspective of nurses and the nursing profession. Conclusion: Resilience and vulnerability have an interdependent relationship as resilience comes into play in situations of vulnerability. Yet, contrary to the popular discourse they are multi-faceted, complex phenomena based on factors such as individual circumstances, supports, and resources.

Factores relacionados con la resiliencia de adolescentes en contextos de vulnerabilidad social: revisión integradora / Factors related to the resilience of adolescents in contexts of social vulnerability: integrative review / Fatores relacionados à resiliência de adolescentes em contextos de vulnerabilidade social: revisão integrativa

INTRODUCCIÓN: La resiliencia puede entenderse como un proceso de superación y persistencia contra las fragilidades experimentadas. Los adolescentes en contextos de vulnerabilidad social encuentran obstáculos en el desarrollo de su resiliencia, dificultando la visibilidad de las estrategias de afrontamiento/respuestas a las adversidades de la vida cotidiana. OBJETIVO: Analizar la evidencia científica disponible en la literatura sobre los factores relacionados con la resiliencia de adolescentes en contextos de vulnerabilidad social. MÉTODO: Revisión integradora de los artículos publicados en portugués, inglés o español, desde 2014 a 2018, en bibliotecas/bases Medline/Pubmed, Scopus, Web of Science, LILACS, Cochrane, BDENF IBECS, CINAHL y PsycINFO. Se utilizaron los siguientes descriptores "Psychological Resilience", "Social Vulnerability", "Adolescent" y "Adolescent Health", resultando en 17 artículos. La pregunta guía fue: ¿Cuáles son los factores relacionados con la resiliencia de adolescentes en contextos de vulnerabilidad social?. RESULTADOS: Se han formado cinco clases que representan los factores que contribuyen a la resiliencia en adolescentes en situación de vulnerabilidad social, nombradas como: aspiraciones para el futuro, factores de riesgo, barreras institucionales, exposición y apoyo social. CONCLUSIÓN: Los factores que fortalecen la resiliencia social son el apoyo prestado por familiares, amigos, profesores, aspectos culturales y religiosos y los factores de riesgo son la violencia, la drogadicción, la falta de seguridad y apoyo institucional precario. El entendimiento de la resiliencia y especificidades que describen las condiciones de salud de los adolescentes en situación de vulnerabilidad social deben ser considerados para reorientar actividades interdisciplinarias e intersectoriales para la promoción de la salud de este grupo poblacional

INTRODUCTION: Resilience can be understood as a process of persistence and overcoming against experienced weaknesses. Adolescents in contexts of social vulnerability find obstacles in the development of their resilience, which impair the visibility of coping/answer strategies for the adversities of everyday life. OBJECTIVE: To analyze the scientific evidence available in the literature on the factors related to the resilience of adolescents in contexts of social vulnerability. METHOD: Integrative review of articles published in Portuguese, English or Spanish, from 2014 to 2018, in libraries/databases Medline/Pubmed, Scopus, LILACS, Web of Science, IBECS, Cochrane, BDENF, CINAHL and PsycINFO. The following descriptors were used "Psychological Resilience", "Social Vulnerability", "Adolescent" and "Adolescent Health", resulting in 17 articles. The guiding question was: what are the factors related to the resilience of adolescents in contexts of social vulnerability? RESULTS: Five classes emerged, depicting the factors that contribute to resilience in adolescents in situation of social vulnerability, namely: aspirations for the future, risk factors, institutional barriers, exposure and social support. CONCLUSION: The factors that strengthen resilience are the social support provided by family, friends, teachers, cultural and religious aspects, and risk factors are violence, substance abuse, lack of security and precarious institutional support. The understanding of resilience and specificities that outline the health conditions of adolescents in situation of social vulnerability must be considered to reorient interdisciplinary and intersectoral actions to promote the health of this population group

INTRODUÇÃO: A resiliência pode ser compreendida como um processo de persistência e superação contra as fragilidades vivenciadas. Adolescentes inseridos em contextos de vulnerabilidade social encontram obstáculos no desenvolvimento de sua resiliência, o que compromete a visibilidade de estratégias de enfrentamento/resposta as adversidades do cotidiano. OBJETIVO: Analisar as evidências científicas disponíveis na literatura sobre os fatores relacionados à resiliência de adolescentes em contextos de vulnerabilidade social. MÉTODO: Revisão integrativa de artigos publicados em português, inglês ou espanhol, de 2014 a 2018, nas bibliotecas/bases Medline/Pubmed, Scopus, LILACS, Web of Science, IBECS, Cochrane, BDENF, CINAHL e PsycINFO. Foram utilizados os descritores "Psychological Resilience", "Social Vulnerability", "Adolescent" e "Adolescent Health", resultando em 17 artigos. A pergunta norteadora foi: quais os fatores relacionados à resiliência de adolescentes em contextos de vulnerabilidade social?. RESULTADOS: Foram formadas cinco classes que retratam os fatores que concorrem para a resiliência em adolescentes em situação de vulnerabilidade social, nomeadas como: as aspirações para o futuro, fatores de risco, entraves institucionais, exposição e o apoio social. CONCLUSÃO: Os fatores que fortalecem a resiliência são o apoio social provido pela família, amigos, professores, aspectos culturais e religiosos e os fatores de risco são violência, abuso de substâncias, falta de segurança e apoio institucional precário. O entendimento de resiliência e as especificidades que delineiam as condições de saúde de adolescentes em situação de vulnerabilidade social precisam ser consideradas para reorientar ações intersetoriais e interdisciplinares de promoção à saúde deste grupo populacional

Validation and psychometric properties of the Arabic psychological well-being post-traumatic changes questionnaire

Psychological Well-Being Post-Traumatic Changes Questionnaire (PWB-PTCQ) is an instrument for measuring positive changes after trauma that has shown reasonable psychometric properties in its original version in English. The aim of this study was to translate and validate the psychometric properties of an Arabic Psychological Well-Being Post-Traumatic Changes Questionnaire (A-PWB-PTCQ). A descriptive correlational design was used to conduct the study among 357 participants sampled from the Saudi population. Participants reported different traumatic events ranged between 59.5 % for sudden death of close person to 23.3% assault or attempted sexual assault incidents. The A-PWB-PTCQ demonstrated excellent internal consistency at 0.93 and test-retest reliability at 0.92. All inter-item and item-to-total correlations for the PWB-PTCQ scale were above the recommended criteria of 0.30. The A-PWB-PTCQ also showed a significant negative correlation with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) (-0.46, p <.001), and those with clinical levels of PTSD had significantly lower scores on the A-PWB-PTCQ (t= 7.62, p <.001) than individuals with subclinical levels of PTSD. The A-PWB-PTCQ was found to be a valid and reliable instrument for measuring the Psychological Well-Being Post-Traumatic Changes among the Arabic population

No disponible

Factors enhancing resilience among older adults experiencing disaster: A systematic review.

BACKGROUND: Resilience is important to adapt and deal with difficult situations, particularly in a disaster, yet its related factors among older adults are unknown. This study aimed to synthesize the factors enhancing resilience among older adults experiencing disaster. METHODS: A systematic review was conducted using international databases, i.e., CINAHL, ProQuest, JAMA Network, SCOPUS, Ovid, PubMed, and Google Scholar since 2000. The studies were independently appraised by two authors using a quality appraisal tool and the parallel-results convergent synthesis design was adopted for the synthesis. RESULTS: Five articles related to technological disasters, hurricanes, floods, and typhoons were included for review. Consideration for methodological strengths was limited in some studies. The factors enhancing the resilience of older adults were categorized into (1) demographic, (2) physical, (3) psychological, (4) spiritual, and (5) socio-cultural factors. The studies revealed that previous experience, social support and spirituality were the common factors. CONCLUSION: Five factors related to resilience should be considered by nurses and other health professionals when caring for older adults experiencing disasters. Due to limited robust evidence and the diverse contexts of the selected studies, future research remains important to enhance the older adults' resilience in long term care.

Genetics of resilience: Implications from genome-wide association studies and candidate genes of the stress response system in posttraumatic stress disorder and depression.

Resilience is the ability to cope with critical situations through the use of personal and socially mediated resources. Since a lack of resilience increases the risk of developing stress-related psychiatric disorders such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), a better understanding of the biological background is of great value to provide better prevention and treatment options. Resilience is undeniably influenced by genetic factors, but very little is known about the exact underlying mechanisms. A recently published genome-wide association study (GWAS) on resilience has identified three new susceptibility loci, DCLK2, KLHL36, and SLC15A5. Further interesting results can be found in association analyses of gene variants of the stress response system, which is closely related to resilience, and PTSD and MDD. Several promising genes, such as the COMT (catechol-O-methyltransferase) gene, the serotonin transporter gene (SLC6A4), and neuropeptide Y (NPY) suggest gene × environment interaction between genetic variants, childhood adversity, and the occurrence of PTSD and MDD, indicating an impact of these genes on resilience. GWAS on PTSD and MDD provide another approach to identifying new disease-associated loci and, although the functional significance for disease development for most of these risk genes is still unknown, they are potential candidates due to the overlap of stress-related psychiatric disorders and resilience. In the future, it will be important for genetic studies to focus more on resilience than on pathological phenotypes, to develop reasonable concepts for measuring resilience, and to establish international cooperations to generate sufficiently large samples.

Psychometric properties of the Brief Resilient Coping Scale in a sample of stable severe mental disorder patients

The aim of this study was to analyze the psychometric properties of the Brief Resilient Coping Scale (BRCS). 57 stable severe mental disorder patients (42 men, 73.7%, and 15 women, 26.3%), ranging in age between 23 and 64 years, (M = 46.25; SD = 7.52) answered to the BRCS and the World Health Organization Quality of Life Assessment (WHOQOL-BREF). Descriptive analyses, estimations of internal consistency, and confirmatory factor analysis were conducted, and correlations between the BRCS and the WHOQOL-BREF were calculated. The factorial validity of the scale was tested using confirmatory factor analysis, with a single dimension of resilience. The BRCS showed acceptable internal consistency (alpha of .69). Correlations between the BRCS and WHOQOL-BREF were positive, r(PhH-R) = .42, r(PsH-R) = .40, r(SR-R) = .33, r(E-R) = .35, and significant (p < .01). In conclusion, the Spanish adaptation of the BRCS seems to be a reliable and valid measure of resilience in stable severe mental disorder patients

No disponible

The role of resilience between workplace bullying and health: a mediational analysis / El papel de la resiliencia en la relación entre el acoso psicológico en el trabajo y la salud: un análisis de mediación

Workplace bullying is a serious problem that may arise within any occupation or organisation. Situations of workplace bullying are highly stressful and affect the health of workers who experience them in a negative way. Resilience has beenidentified as an essential capacity to protect people's health. This study focuses on how resilience functions in situations of workplace bullying. By means of questionnaires, information about workplace bullying behaviours, resilience, andpsychological health in a sample of 762 workers was collected. The results show that exposure to bullying behaviours is related to poorer health, and resilience has a mediating role in the relationship between workplace bullying and employees'health. Main findings, limitations, and practical consequences of this study are discussed. The results obtained may serve to assist human resources managers and professionals when they are designing programs aimed at both controlling andpreventing workplace bullying within organisations

Las situaciones de acoso laboral son altamente estresantes y afectan negativamente a la salud de los trabajadores que las perciben. La resiliencia se ha identificado como una capacidad esencial para la protección de la salud de las personas. Este trabajo se centra en cómo actúa la resiliencia en las situaciones de acoso laboral, mediante el análisis de las relaciones y del papel mediador-moderador de la resiliencia entre el acoso laboral y la salud en una muestra de 762 trabajadores españoles. A través de cuestionarios se recogió información sobre conductas de acoso laboral y se evalúo la resiliencia yla salud psicológica autopercibida. Los resultados obtenidos muestran que la exposición a conductas de acoso se relaciona con peor salud y que la resiliencia tiene un efecto mediador y no moderador entre el acoso laboral y la salud de los trabajadores. Se discuten los principales hallazgos de esta investigación, las limitaciones y sus implicaciones prácticas. Los resultados obtenidos pueden servir de ayuda a los directivos y profesionales de recursos humanos a la hora de diseñarprogramas que vayan dirigidos tanto al control y prevención de la violencia en las organizaciones como a desarrollar la resiliencia en los trabajadores

Towards a Transversal Definition of Psychological Resilience: A Literature Review.

Background and objectives: This paper addresses psychological resilience, a multidisciplinary theoretical construct with important practical implications for health sciences. Although many definitions have been proposed in several contexts, an essential understanding of the concept is still lacking up to now. This negatively affects comparisons among research results and makes objective measurement difficult. The aim of this review is to identify shared elements in defining the construct of resilience across the literature examined in order to move toward a conceptual unification of the term. Materials and methods: A literature review was performed using the electronic databases 'PubMed' and 'PsycINFO'. Scientific studies written in English between 2002 and May 2019 were included according to the following key terms: 'Psychological', 'resilience', and 'definition'. Results: The review identifies five macro-categories that summarize what has been reported in the recent literature concerning the resilience phenomenon. They serve as a preliminary and necessary step toward a conceptual clarification of the construct. Conclusions: We propose a definition of psychological resilience as the ability to maintain the persistence of one's orientation towards existential purposes. It constitutes a transversal attitude that can be understood as the ability to overcome the difficulties experienced in the different areas of one's life with perseverance, as well as good awareness of oneself and one's own internal coherence by activating a personal growth project. The conceptual clarification proposed will contribute to improving the accuracy of research on this topic by suggesting future paths of investigation aimed at deeply exploring the issues surrounding the promotion of resilience resources.

Genomics and psychological resilience: a research agenda.

Although exposure to adversity increases risk for poor mental health outcomes, many people exposed to adversity do not develop such outcomes. Psychological resilience, defined broadly as positive emotional and/or behavioral adaptation to adversity, may be influenced by genetic factors that have remained largely unexplored in the era of large-scale genome-wide studies. In this perspective, we provide an integrative framework for studying human genome-wide variation underlying resilience. We first outline three complementary working definitions of psychological resilience-as a capacity, process, and outcome. For each definition, we review emerging empirical evidence, including findings from positive psychology, to illustrate how a resilience-based framework can guide novel and fruitful directions for the field of psychiatric genomics, distinct from the ongoing study of psychiatric risk and related traits. Finally, we provide practical recommendations for future genomic research on resilience, highlighting a need to augment cross-sectional findings with prospective designs that include detailed measurement of adversities and outcomes. A research framework that explicitly addresses resilience could help us to probe biological mechanisms of stress adaptation, identify individuals who may benefit the most from prevention and early intervention, and ascertain modifiable protective factors that mitigate negative outcomes even for those at high genetic risk.

Does social capital and a healthier lifestyle increase mental health resilience to disability acquisition? Group-based discrete trajectory mixture models of pre-post longitudinal data.

Poor mental health is strongly associated with disability acquisition. Social capital and healthier lifestyles pre-disability onset may help promote mental health resilience (i.e. a state of seemingly being unaffected by the event), or the capacity to 'bounce back', post-acquisition. This paper used a novel methodology (discrete trajectory mixture models) to examine discrete trajectories in mental health before and after disability acquisition in the Household Income Labour Dynamics in Australia (HILDA) survey. Group membership in association with pre-onset social capital and healthy lifestyles were then examined using multinomial logistic regressions. Four discrete trajectory groups were identified in 2904 Australians reporting onset of ongoing disability, with about 28.4% demonstrating mental health resilience. Three other groups were identified, each demonstrating increasingly severe reductions in mental health. No clear 'bounce back' group was observed. Group membership was associated with participants who felt they had 'no-help from others' prior to disability acquisition. Pre-disability acquisition measures of social capital and unhealthy behaviours moderated the association between disability acquisition and mental health trajectories. Social capital was protective only for the respondents who had poorer mental health before disability onset and had less resilience after onset, and long working hours and less resilience were positively associated. Public policies that help to enhance levels of social capital and reduce unhealthy behaviours at a population level may help to promote mental health resilience to adversities such as the acquisition of disability.

Apoyo social y resiliencia: factores protectores en cuidadores principales de pacientes en hemodiálisis / Social support and resilience: protective factors in primary caregivers of patients on hemodialysis

Introducción: Garantizar el cuidado del paciente en hemodiálisis se reconoce como una actividad compleja, exigente y estresante a la cual se expone de manera reiterada el cuidador. El apoyo social y la resiliencia constituyen factores protectores que permiten amortiguar el impacto del estrés en la salud mental de los cuidadores. Objetivo: Analizar el apoyo social y la resiliencia como factores protectores en los cuidadores de pacientes en hemodiálisis. Material y Método: Estudio mixto secuencial con alcance descriptivo. La selección muestral se realizó de forma intencional-no probabilística para una muestra de 67 cuidadores de pacientes en hemodiálisis asistentes al Servicio de tratamiento sustitutivo durante el 2018. Se emplearon como instrumentos un Cuestionario de variables sociodemográficas, el Cuestionario de apoyo social funcional Duke-UNK-11 y la Escala reducida de Resiliencia Connor-Davidson. Se desarrollaron entrevistas grupales para la recogida de información cualitativa. Resultados: La percepción de apoyo social así como las dimensiones de apoyo afectivo y confidencial se expresan en niveles medios y bajos, distinguiéndose la familia como la principal red de apoyo para los cuidadores. La resiliencia alcanza niveles medio y alto siendo el optimismo, el sentido del humor y el establecimiento de relaciones sociales los principales mecanismos resilientes para enfrentar la actividad de cuidado. Conclusiones: El apoyo social y la resiliencia se comportan como factores protectores en los cuidadores estudiados. Se constituyen como los principales recursos psicológicos amortiguadores del estrés que ofrecen una perspectiva diferente y enriquecedora para enfrentar situaciones adversas de manera efectiva en los cuidadores

Introduction: Ensuring the care in hemodialysis patient is a complex, demanding and stressful activity to which the caregiver is repeatedly exposed. Social support and resilience are protective factors that allow to mitigate the impact of stress on the caregiver's mental health. Objective: Analyze social support and resilience as protective factors in caregivers of patients on hemodialysis. Material and Method: A sequential mixed model design with descriptive scope. A non-probability sampling was made for a sample of 67 caregivers of hemodialysis patients attending the Substitute Treatment Service during 2018. A questionnaire of sociodemographic variables, the Duke-UNK-11 Functional Social Support Questionnaire and the Connor-Davidson Reduced Resilience Scale were used as instruments. Group interviews were developed for the collection of qualitative information. Result: The perceptions of social support as well as the dimensions of affective and confidential support are expressed in medium and low levels, distinguishing the family as the main support network for caregivers. Resilience reaches medium and high levels, with optimism, a sense of humor and the establishment of social relationships as the main resilient mechanisms to approach the care activity. Conclusions: Social support and resilience operate as protective factors in the caregivers studied. Both are considered as the main psychological resources to mitigate stress. Also they offer a different and enriching perspective to face adverse situations effectively in caregivers

Perfiles de personalidad y resiliencia en dolor crónico: utilidad del CDRISC-10 para discriminar los tipos resiliente y vulnerable / Profiles of personality and resilience in chronic pain: utility of the CDRISC-10 to discriminate between resilient and vulnerable types

Introducción: Uno de los aspectos psicológicos asociados a la vivencia del dolor crónico han sido los perfiles de personalidad y, relacionado con ellos, la resiliencia. En el dolor crónico la resiliencia se refiere tanto a la capacidad de volver atrás tras el daño inicial como también a la de continuar con su funcionamiento habitual pese a la repetición de los problemas. En este campo, sin embargo, no hay referencias sobre si la resiliencia se relaciona con los perfiles de personalidad. En trabajos previos se ha abordado la cuestión de los perfiles de personalidad relacionados con el dolor crónico. El objetivo de este trabajo es replicar los perfiles encontrados previamente, determinar la capacidad diferencial de la resiliencia sobre dichos perfiles de personalidad evaluados a través del Modelo de los Big Five (FFM) y describir su relación con la adaptación a la enfermedad en enfermos con dolor crónico. Material y método: Sobre una muestra de 494 pacientes con diagnóstico de dolor crónico que asisten por primera vez a la Unidad Multidisciplinar para el Tratamiento del Dolor del Consorcio Hospital General Universitario de Valencia, se evalúan las dimensiones de personalidad (NEO-FFI), resiliencia (CDRISC-10), afrontamiento (CAD-R) y calidad de vida (SF-36). Resultados: Mediante análisis clúster se obtienen dos tipos de perfiles de personalidad: resilientes y sobrecontrolados o vulnerables. Posteriormente, mediante una curva ROC se ha determinado el punto de corte ≥ 25 de la medida de la resiliencia que permite separar óptimamente al grupo resiliente del vulnerable, observándose claras las diferencias en afrontamiento y calidad de vida a favor del grupo resiliente. Conclusión: A partir del punto de corte ≥ 25 del cuestionario CDRISC-10, se pueden diferenciar el uso de estrategias de afrontamiento y la repercusión en la calidad de vida del perfil de personalidad del grupo resiliente frente al vulnerable, lo cual supone un claro ahorro de tiempo y de sobrecarga de evaluación del paciente

Introduction: One of the psychological aspects associated with the experience of chronic pain have been personality profiles and, related to them, resilience. In chronic pain, resilience refers to both the ability to go back and the repetition of problems. In this field, however, there is no reference to whether resilience is related to personality profi les. Previous studies have addressed the issue of personality profiles related to chronic pain. The objective of this studie is to replicate previously found profi les, determine the differential capacity of the personality profiles evaluated through the Big Five Model (FFM) and describe their relationship with the adaptation to the disease in patients with chronic pain. Material and method: The personality dimensions (NEO-FFI) are evaluated on the sample of 494 patients diagnosed with chronic pain who attend the Multidisciplinary Unit for Pain Treatment of the Consortium of the General University Hospital of Valencia, for the first time, resilience (CDRISC-10), coping (CAD-R) and quality of life (SF-36). Results: Cluster analysis yields types of personality profi les: resilient and overcontrolled or vulnerable. Subsequently, using a ROC curve, the cutoff point = 25 of the resolution measure that allows separating the resilient group from the vulnerable group was determined, clearly observing the differences in coping and quality of life in favor of the resilient group. Conclusion: From the cut-off point of the CDRISC-10 questionnaire, the use of coping strategies and the impact on the quality of life of the personality profile of the resilient group can be differentiated from the vulnerable one, which implies a clear saving of time and patient evaluation overload

Resilience as a translational endpoint in the treatment of PTSD.

Resilience is a neurobiological entity that shapes an individual's response to trauma. Resilience has been implicated as the principal mediator in the development of mental illness following exposure to trauma. Although animal models have traditionally defined resilience as molecular and behavioral changes in stress responsive circuits following trauma, this concept needs to be further clarified for both research and clinical use. Here, we analyze the construct of resilience from a translational perspective and review optimal measurement methods and models. We also seek to distinguish between resilience, stress vulnerability, and posttraumatic growth. We propose that resilience can be quantified as a multifactorial determinant of physiological parameters, epigenetic modulators, and neurobiological candidate markers. This multifactorial definition can determine PTSD risk before and after trauma exposure. From this perspective, we propose the use of an 'R Factor' analogous to Spearman's g factor for intelligence to denote these multifactorial determinants. In addition, we also propose a novel concept called 'resilience reserve', analogous to Stern's cognitive reserve, to summarize the sum total of physiological processes that protect and compensate for the effect of trauma. We propose the development and application of challenge tasks to measure 'resilience reserve' and guide the assessment and monitoring of 'R Factor' as a biomarker for PTSD.