A systematic review of resilience in the physically ill

Background: Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness.

Objective: We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience.

Methods: An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness.

Results: A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of, and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found.

Discussion: These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.