Resilience in healthcare workers: a global scoping review and evidence gap mapping of climate change-related health literacy and attitudes influencing adaptive practice

Abstract Aim Climate change poses increasing challenges for healthcare systems, with healthcare workers (HCWs) at the frontline of acute events and chronic stressors. This scoping review aims to synthesise empirical evidence on climate-related health literacy, beliefs, and attitudes among healthcare workers and to examine the factors that influence their resilience and adaptive practices. Subject and methods This review followed the Joanna Briggs Institute framework and PRISMA-ScR guidelines. Seven electronic databases (PubMed, MEDLINE, Scopus, Web of Science, EMBASE, CINAHL, and PsycINFO) were systematically searched for quantitative, qualitative, and mixed-methods studies published between 2014 and 2025. Data were extracted using standardised forms and synthesised through descriptive and thematic analysis. The protocol was pre-registered on OSF ( https://doi.org/10.17605/OSF.IO/2F9S3 ). Results Thirty-one studies met the inclusion criteria. HCWs generally demonstrated moderate-to-high climate-health literacy and positive attitudes towards engagement; however, the translation of these attitudes into adaptive practice remained limited. Resilience was insufficiently explored across studies. Key facilitators of adaptive practice and resilience identified in the review included competency-based training, supportive leadership, operational tools, organisational culture, and cross-sector collaboration. Barriers comprised fragmented governance, resource constraints, high workloads, and limited access to training. Conclusion This review highlights that climate change influences HCWs’ adaptive capacity and resilience; however, critical gaps remain in translating climate-health literacy, beliefs, and attitudes into sustained adaptive and resilient practice. Strengthening HCWs’ resilience requires coordinated, multi-level interventions (workforce development, strengthened governance, and integration of climate considerations into health systems). These efforts are essential to ensure resilient, adaptive, and sustainable healthcare delivery amid escalating climate-related challenges.