Abstract

Background: Nursing shortages and increased workforce turnover have significantly increased nurses’ workloads, thus increasing the risk of burnout and stress, particularly during the COVID-19 pandemic. A systematic review published in 2019 suggested that resilience could act as a buffer to adversity; however, the factors associated with resilience during and after this global pandemic have not been identified.

Objectives: To identify personal and work-related factors associated with nurse resilience, including the period during and after the COVID-19 pandemic.

Design: Systematic review.

Data Sources: The search was conducted between January and February 2024 in the following databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, using the key terms ‘resilience’, ‘hardiness’, ‘work’, ‘employ’, ‘occupation’, ‘job’, and ‘nursing’.

Review Methods: Quantitative studies with English full text, published between 2018 and 2024, were selected if they assessed resilience and its associated factors among nurses providing direct patient care. Two authors independently completed the data selection process. Studies with quality assessment grades of 3 or above were included for final analysis. A meta-analysis was utilised for the mean resilience levels from studies using the same measures of resilience, and a narrative synthesis was performed for the demographic and work-related factors. Results: Fifty-nine cross-sectional studies with a quality assessment score of 3 or above were included. Forty- seven studies were included in a meta-analysis, which reported an estimated mean resilience level of 20.69 using a random-effects model (95 % CI [18.53, 22.85], z = 18.79, p < 0.0001, I 2 =95.1 %). Twenty studies with the Connor Davidson Resilience Scale (CD-RISC)-25 and five with the CD-RISC-10 were meta-analysed for the mean resilience levels of 62.85 (95 % CI: [55.60, 70.10], z = 16.97, p < 0.0001, I 2 CI: [20.85, 31.83], p < 0.0001, I 2 =31.70 %) and 26.34 (95 % = 0 %), respectively. A low mean resilience level was identified. Sixteen demographic factors were identified as associated with resilience. Twenty job demand factors negatively associated with resilience were determined and categorised into exhaustion, psychological factors, and work challenges. Thirty-two job resource factors positively related to resilience were identified and classified into the following categories: psychological factors, leadership, work performance, well-being and quality of life, and social and organisational support.

Conclusions: Understanding the job demand and resource factors can help organisations minimise the risks and develop institutional strategies to protect nurses from the negative impact of COVID-19 or future pandemics on nurses’ well-being.

Notes

Open Access Details:

This is an open access article originally published under the terms of a Creative Commons License, which permits the Sigma Repository to post a copy in its collections. The license is attached to this item record; please click on the license for further details.

Original Article Citation:

Yu, Fiona, et al. “Personal and work-related factors associated with Nurse Resilience: An updated systematic review using meta-analysis and narrative synthesis.” International Journal of Nursing Studies, vol. 166, June 2025, p. 105054, https://doi.org/10.1016/j.ijnurstu.2025.105054.

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Author Details

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Sigma Membership

Xi Omicron at-Large

Type

Article

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Mixed/Multi Method Research

Keywords:

Adaptation, Employment, Hardiness, Health Occupation, Hospital, Job Satisfaction, Nursing Staff, Psychological Resilience, Resilience

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Publisher

Elsevier

Version

Publisher's Version

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All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

External Review: Previously Published Material

Acquisition

Publisher-submission

Date of Issue

2026-01-13

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