Relationship between resilience and self‐care in people with chronic conditions: A systematic review and meta‐analysis

Abstract

Background Living with chronic condition(s) is difficult, due in part to the complexities of effective disease self‐care. Self‐care has been considered a challenging process according to the literature which describes multiple barriers patients with chronic conditions experience. Resilience has the potential to buffer the adversities of daily self‐care and maintain physical and emotional well‐being. No systematic review and meta‐analysis have been conducted to synthesise and quantify the relationship between resilience and self‐care across chronic conditions. Aims (1) To examine how the definitions and measurements of self‐care and resilience align with the middle‐range theory of self‐care of chronic illness (i.e. self‐care maintenance, self‐care monitoring, and self‐care management) and 3 Rs of resilience process from the society‐to‐cells framework (i.e. resistance, recovery and rebound) across different chronic conditions; and (2) to examine whether and the degree to which resilience is correlated with self‐care across different chronic conditions. Design Systematic review and meta‐analysis, following PRISMA guidelines. Methods PubMed, CINAHL, SocINDEX and PsychINFO were searched for quantitative studies published from January 2000 through July 2020. Descriptive data were summarised using numerical counting to provide an overview of the study characteristics. Definitions and measurements of self‐care and resilience were synthesised narratively based on self‐care and resilience theories. Numerical data with Pearson's product–moment correlation among observational studies were examined using meta‐analysis. Results This review included 20 articles, involving 9,269 individuals across 11 chronic conditions. Despite self‐care and resilience being defined and operationalised in a variety of ways, most definitions shared some underlying core constructs. Meta‐analysis showed a positive relationship between resilience and self‐care across chronic conditions. Findings from interventional studies indicated a bidirectional relationship between resilience and self‐care. Conclusions Overall, resilience was positively associated with self‐care in people with chronic conditions. Longitudinal and experimental studies are needed to better understand the causal relationship between resilience and self‐care. Relevant to clinical practice Resilience has the potential to buffer the adversities of daily self‐care and maintain physical and emotional well‐being. The positive relationship between resilience and self‐care found in this review provides preliminary evidence for clinicians to not only focus on reducing barriers and risk factors of self‐care but also to improve or increase patients’ resilience through various evidence‐based interventions.

Linking chronic stress to insomnia symptoms in older adults: The role of stress co‐occurrence during the pandemic

“…Learning from the hard lesson of the COVID‐19 pandemic, the nursing profession has realized how various sources of chronic stress play an important role in dictating older patients' health outcomes and self‐management. Yet, our current understanding of what interventions are needed for our aging population with multiple chronic conditions and stress proliferation is limited (Jin et al, 2022 ). This study highlights an important opportunity for future nursing research, where more intervention studies are needed to identify the effective strategies and ingredients that block stress proliferation in older adults and foster their resilience when managing multiple chronic conditions.…”

Resilience mediates the effects of self‐care activation and hope on medication adherence in heart failure patients

“…Self‐care activation‐based interventions, however, have not consistently improved HF self‐care behaviors (Hibbard et al, 2007; Meng et al, 2016; Shively et al, 2013). Because some researchers believe that resilient people are more likely to take responsibility for their health (Wagnild, 2014) and manage chronic illness more effectively (Jin et al, 2022), we propose that resilience may be a key factor that drives people with HF to take an active role in their self‐care and achieve medication adherence.…”

“…Resilience is a well‐known predictor of healthy behaviors (Jin et al, 2022; Peccoralo et al, 2020). Across the self‐care research, individuals with chronic illness who report high resilience are more likely to make better health‐related decisions, have positive adaptive coping skills, persevere despite challenges, and take responsibility for their health (Jin et al, 2022; Meraz et al, 2023; Wagnild, 2014).…”

“…Resilience is a well‐known predictor of healthy behaviors (Jin et al, 2022; Peccoralo et al, 2020). Across the self‐care research, individuals with chronic illness who report high resilience are more likely to make better health‐related decisions, have positive adaptive coping skills, persevere despite challenges, and take responsibility for their health (Jin et al, 2022; Meraz et al, 2023; Wagnild, 2014). Although there is scant evidence about the relation of resilience to medication adherence in the HF population, recent research in other chronic illness populations suggest that resilient individuals may be more likely than their non‐resilient counterparts to adhere to medications (Mendoza‐Pinto et al, 2021).…”

Psychosocial Adaptation Among Inflammatory Bowel Disease Patients and Associated Factors: A Cross-Sectional Study

“…[19][20][21] Resilience had the potential to buffer stress caused by chronic diseases and maintain patients' physical and emotional well-being. 22 Resilience had a significantly positive effect on mental health-related quality of life. 23 Specifically, a higher level of resilience predicted a greater level of adaptation among IBD patients, 24 while a lower level of resilience was associated with higher levels of anxiety and depression.…”