Abstract

Nurses, as the largest population in the healthcare service, play a critical role in achieving global health equity to sustain the health of the entire population (1). They are key when providing care in health promotion, disease prevention, treatment, and rehabilitation across diverse populations and clinical settings (2). However, nurses face significant challenges, and the COVID-19 pandemic has exacerbated their situations. Specifically, nursing shortages have a significant impact on frontline nurses, contributing to a heavy workload and unsafe practice, and placing them at a high risk of burnout, stress, fatigue, and ill health, thereby increasing turnover (3, 4).

Research shows that resilience can help nurses enhance their ability to deal with work adversity, adapt to the work environment quickly, and increase their inner strength to move forward (5). A systematic review, conducted prior to the COVID-19 pandemic, identified that four job demand factors (e.g., burnout, depression), six job resource factors (e.g., social support, self-efficacy), and ten demographic factors were associated with resilience (6). Therefore, studying nurse resilience and its associated factors may help nurses enhance their wellbeing, enabling them to provide the best healthcare services to reduce health inequality globally. However, it is unclear what factors are associated with resilience during and after the COVID-19 pandemic.

Based on our 2019 publication, this systematic review searched articles from CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, published between 2018 and 2024. We included 59 cross-sectional studies and identified 20 job demand factors, 32 job resource factors, and 16 demographic factors (7), using a meta-analysis and narrative synthesis approach. This review identified an increased number of associated factors with resilience, indicating the multiple-dimensional nature of resilience and the complexity of nurses’ situations. The evidence suggests that it is paramount to develop strategies for nurses’ wellbeing and ultimately improve the quality of patient care. Resilience education should be implemented at the individual, workplace, and organisational levels to establish a healthy work environment, enabling nurses to work more effectively towards achieving worldwide health equity, which aligns with the global strategic directions (8).

Notes

References:

1. World Health Organisation. State of the world’s nursing 2025: Investing in education, jobs, leadership and service delivery. Geneva; 2025 [cited 2025 Oct 9]. Available from: https://iris.who.int/server/api/core/bitstreams/a4173924-a18f-49b6-8bd1-9c2a4a098980/content.

2. National Academies of Science, Eengineer, and Medicine. The future of nursing 2020-2030: Charting a path to achieve health equity. Washington DC: The National Academies Press; 2021.

3. Kelly LA, Gee PM, Butler RJ. Impact of nurse burnout on organizational and position turnover. Nursing Outlook. 2021;69(1):96-102.

4. Zheng J, Feng S, Feng Y, Wang L, Gao R, Xue B. Relationship between burnout and turnover intention among nurses: A network analysis. BMC Nursing. 2024;23:921.

5. Kim EY, Chang SO. Exploring nurse perceptions and experiences of resilience: A meta-synthesis study. BMC Nursing. 2022;21(1):1-14.

6. Yu F, Raphael D, Mackay L, Smith M, King A. Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies. 2019;93:129-40.

7. Yu F, Raphael D, Mackay L, Smith M, Fernandez R. Personal and work-related factors associated with nurse resilience: An updated systematic review using meta-analysis and narrative synthesis. International Journal of Nursing Studies. 2025;166:105054.

8. World Health Organisation. Global strategic directions for nursing and midwifery 2021-2025. Geneva; 2021 [cited 2025 Oct 9]. Available from: https://iris.who.int/server/api/core/bitstreams/11723bae-3fd4-46f0-a4ea-9dc8fd153667/content.

Description

Focus: Clinical

Status: Completed Work/Project

Our systematic review updated the 2019 publication regarding personal and work-related factors associated with nurse resilience. We searched five databases and identified 59 articles published between 2018 and 2024, which collectively reported 68 factors associated with resilience. This review provides evidence that it is paramount to invest in resilience education at the individual, workplace, and organisational levels to enhance their wellbeing and establish a healthier work environment.

Author Details

Fiona Yu, PhD; Deborah Raphael, PhD; Lisa Mackay, PhD; Melody Smith, PhD; Ritin Santiago Fernandez, PhD

See attached slide deck for further author details.

Sigma Membership

Xi Omicron at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Other

Keywords:

Workforce, Health Equity or Social Determinants of Health, Psychological Adaptation, Psyhcological Burnout, Psychology Nurses, Psychological Resilience, Social Support

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

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

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-22

Click above link to access the slide deck.

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Enhancing Resilience for Well-Being to Reduce Health Inequity in Global Nursing Professionals

Toronto, Ontario, Canada

Nurses, as the largest population in the healthcare service, play a critical role in achieving global health equity to sustain the health of the entire population (1). They are key when providing care in health promotion, disease prevention, treatment, and rehabilitation across diverse populations and clinical settings (2). However, nurses face significant challenges, and the COVID-19 pandemic has exacerbated their situations. Specifically, nursing shortages have a significant impact on frontline nurses, contributing to a heavy workload and unsafe practice, and placing them at a high risk of burnout, stress, fatigue, and ill health, thereby increasing turnover (3, 4).

Research shows that resilience can help nurses enhance their ability to deal with work adversity, adapt to the work environment quickly, and increase their inner strength to move forward (5). A systematic review, conducted prior to the COVID-19 pandemic, identified that four job demand factors (e.g., burnout, depression), six job resource factors (e.g., social support, self-efficacy), and ten demographic factors were associated with resilience (6). Therefore, studying nurse resilience and its associated factors may help nurses enhance their wellbeing, enabling them to provide the best healthcare services to reduce health inequality globally. However, it is unclear what factors are associated with resilience during and after the COVID-19 pandemic.

Based on our 2019 publication, this systematic review searched articles from CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, published between 2018 and 2024. We included 59 cross-sectional studies and identified 20 job demand factors, 32 job resource factors, and 16 demographic factors (7), using a meta-analysis and narrative synthesis approach. This review identified an increased number of associated factors with resilience, indicating the multiple-dimensional nature of resilience and the complexity of nurses’ situations. The evidence suggests that it is paramount to develop strategies for nurses’ wellbeing and ultimately improve the quality of patient care. Resilience education should be implemented at the individual, workplace, and organisational levels to establish a healthy work environment, enabling nurses to work more effectively towards achieving worldwide health equity, which aligns with the global strategic directions (8).