Resilience in nursing: The role of internal and external factors.

Recent evidence shows that resilience can buffer the negative impact of workplace stressors on nurses and is linked to favourable patient outcomes. However, the comparative effectiveness of different contributing factors to nurses' resilience has not yet been examined. Our objective was to examine and compare the impact of individual characteristics, external factors and coping strategies on nurses' resilience. A descriptive cross-sectional study was conducted. Data were collected from 1,012 Greek nurses working in eight hospitals in northern Greece. Resilience, anxiety and depression, were measured using existing validated self- report instruments. In terms of coping strategies, this study used the "Mental Preparation Strategies Scale" to assess the mental preparation strategies employed by nurses before the beginning of their shift. Educational level, anxiety and the overall use of mental preparation strategies were the main predictors of nurse's resilience ([F = 52.781, p = 0.000, R  = 0.139, Adjusted R  = 0.137]). Resilient nurses were better educated {(b = 0.094. 95% confidence interval [CI] 0.038, 0.162)}, had lower anxiety ([b = -0.449, 95% CI -0.526, -0.372]) and used more often mental preparation strategies before the beginning of their shift ([b = 0.101, 95% CI 0.016, 0.061]). Findings provide information about which subgroups of nurses are more vulnerable in terms of resilience, i.e. less educated nurses, or nurses working in internal medicine wards.