An Integrative Literature Review of Resilience in Adult Children of Alcoholics: Focusing on Operational Definitions and Moderators

Abstract

Purpose: The objective of this study was to explore operational definitions and moderators of the resilience of adult children of alcoholics (ACOA) and its associated variables. Methods: This integrative review was conducted based on a literature review method suggested by Whittemore and Knafl. Databases including PubMed, CINAHL, PsycINFO, and RISS were searched using the combinations of search terms such as; ‘adult children of alcoholics,’ ‘parental alcoholism,’ ‘resilience,’ and ‘children of alcoholics.’ Results: Seventeen studies were selected for this review. Findings of integrative reviews reported operational definitions for the resilience of ACOA and moderators. The operational definition of ACOA’s resilience is: (1) having no behavioral and emotional problem, (2) meeting social and developmental expectancies, (3) having the ability to cope with adversity, (4) having high self-concept, and (5) having a meaningful relationship. In addition, the varying environmental moderators include family communication, qualities of caring environment, parental communication, parentification, and social support. Several moderators were identified as positive effect, self-esteem, alcohol-specific coping style, locus of control, spirituality, the image of God, and dyadic cohesion in marital communication. Conclusion: Our study findings emphasize comprehensive understanding of diverse definition of resilience and moderators in developing nursing interventions to promote resilience in ACOA.