What Are the Common Themes of Physician Resilience? A Meta-Synthesis of Qualitative Studies.

Nurhanis Syazni Roslan,Asrenee Ab Razak,Nor Izzah Ahmad Shauki,Muhamad Saiful Bahri Yusoff,Karen Morgan

doi:10.3390/ijerph19010469

Abstract

In the practice of medicine, resilience has gained attention as on of the ways to address burnout. Qualitative studies have explored the concept of physician resilience in several contexts. However, individual qualitative studies have limited generalizability, making it difficult to understand the resilience concept in a wider context. This study aims to develop a concept of resilience in the context of physicians’ experience through a meta-synthesis of relevant qualitative studies. Using a predetermined search strategy, we identified nine qualitative studies among 450 participants that reported themes of resilience in developed and developing countries, various specialties, and stages of training. We utilized the meta-ethnography method to generate themes and a line-of-argument synthesis. We identified six key themes of resilience: tenacity, resources, reflective ability, coping skills, control, and growth. The line-of-argument synthesis identified resilient physicians as individuals who are determined in their undertakings, have control in their professional lives, reflect on adversity, utilize adaptive coping strategies, and believe that adversity provides an opportunity for growth. Resilient physicians are supported by individual and organizational resources that include nurturing work culture, teamwork, and support from the medical community and at home. Our findings suggest that resilience in physicians is dynamic and must be supported not only by physician-directed interventions but also by organization-directed interventions.

Highlights

The complex system of patient care requires physicians to endure long hours, keep electronic medical records, manage administrative work burdens, and deal with public health crises such as the coronavirus 2019 (COVID-19) pandemic [1]
An example is a previous meta-synthesis that identified four common themes of resilience across 21 resilience scales in various populations: commitment to deal with adversity, control, resourcefulness, and growth [30]. Building on this conceptual framework, the present study aims to develop a conceptualization of the resilience construct in the context of physicians through a synthesis of the findings from relevant qualitative studies
The findings from the meta-synthesis signals that repetitive explorative studies in the context of physicians yielded a similar framework of resilience

Summary

Introduction

The complex system of patient care requires physicians to endure long hours, keep electronic medical records, manage administrative work burdens, and deal with public health crises such as the coronavirus 2019 (COVID-19) pandemic [1]. A longitudinal study showed that physicians were twice as likely to experience burnout compared with the general population, with an increasing trend between 2011 and 2014 [2]. A recent systematic review of 182 studies across 45 countries reported the prevalence of burnout ranging from. 0% to 80.5% [3] Such worrying prevalence was not limited to burnout and other mental health issues, such as depression and anxiety [4,5]. A recent meta-analysis reported a high prevalence of burnout, depression, anxiety, stress, and post-traumatic stress disorder during the recent COVID-19 pandemic [6].

Objectives

Methods

Results

Discussion

Conclusion