Resilience and Associated Factors in Pediatric Nurses

Abstract

The purpose of this dissertation was to explore pediatric nurse resilience and the contextual factors surrounding it, and propose a heuristic framework of pediatric nurse resilience. A convergent mixed-methods approach to secondary analysis was utilized and the resulting findings informed the heuristic framework. The first study explored associations between years of nursing experience, work-related committee involvement, employment status, and resilience. Existing data, which included a demographic questionnaire and the Connor-Davidson Resilience Scale, from 125 pediatric nurses was analyzed with multiple linear regression. In the second study, a focused content analysis of participant interview transcripts was conducted to generate themes, which were merged with quantitative findings to explore the contextual factors surrounding pediatric nurses with varying levels of resilience. Findings from the first study suggested that years of nursing experience, work-related committee involvement, and employment status is not significantly associated with resilience in pediatric nurses. The data did, however, demonstrate that variance in resilience increased with years of nursing experience, suggesting that nursing experience may help or hinder resilience. Five themes emerged from the focused content analysis to describe contextual factors that support or constrain nurse resilience. Three themes supportive of resilience were: 1) Sharing the Burden, 2) Support from Administration, 3) Taking a Break. Two themes were described as making resilience more difficult: 1)" Can't be a good nurse,", and 2) "Feeling like a number." A joint table that combined qualitative themes with quantitative results did not reveal any patterns, suggesting that nurses can demonstrate resilience despite the absence or presence of social support from coworkers or administrators, use of breaks as a coping mechanism, barriers to care, or feeling underappreciated. The heuristic framework, developed from study findings and extant research, presents resilience as a person-centered network of protective factors both in the environment and the individual. Within this network, protective factors may interact with and across environmental and individual levels to synergize and produce more resilience or decrease the influence of another factor on resilience. The findings and framework suggest that resilience is highly complex and individualized. Future research should utilize longitudinal and mixed-methods approaches to explore the intricacies of the relationship between protective factors and resilience in pediatric nurses.