Defining resilience for global healthcare workforce: A narrative review

The objectives of the review were to examine commonly used definitions of resilience in the healthcare domain, analyse these definitions through the socio-ecological framework and identify the different dimensions of resilience relevant to healthcare workers. A systematic search was conducted in the MEDLINE database, and screening was performed at two levels. Data were extracted from the selected studies using Excel spreadsheets. Definitions of resilience were extracted from 54 included studies. The highest number of studies focused on health worker resilience (n=35), followed by studies on the general population and organizational well-being (n=19). Based on the socio-ecological model, the definitions of resilience at micro-, meso- and macro-levels were summarized. Resilience is the ability to adapt or recover from stressors using a positive approach to achieve well-being, and positive health and social outcomes. Similarly, resilience at the meso- and macro-levels, is the ability of an individual, community or systems to adapt to or withstand hardship, and even thrive despite adversity as well as recover from stressors using a positive approach to achieve favourable health outcomes before, during, after and beyond any given event. The analysed literature was closely aligned with the broader domain of healthcare systems. This review provides a description of resilience through different dimensions such as time of occurrence of the event, and type of exposure or response. A systems-based approach is critical for comprehending and enhancing resilience, as opposed to reductionist definitions. This approach emphasizes integrating multiple disciplines to study and describe resilience, rather than seeking a single definition.