Resilience Training for Nurses: A Meta-Analysis

Xin Zhai, BSc; Li-na Ren, BSc; Yan Liu, BSc; Chao-jun Liu, MD; Xiao-guang Su, BSc; Bai-e Feng, BSc


Journal of Hospice and Palliative Nursing. 2021;23(6):544-550. 

In This Article


Inclusion and Exclusion Criteria

A study was included if it (a) involved a resilience training program for nurses; (b) evaluated resilience or related outcome/s by measuring it with objective instrument/s before and after resilience training; and (c) reported the outcomes in a quantitative form. A study was excluded if it (a) involved resilience training for healthcare workers other than nurses or if nurses were not predominant participants; (b) reported the resilience outcomes in nurse students; and (c) had an ethnographic design or reported nonquantifiable information.

Literature Search

For the identification of relevant studies, the literature search was conducted in electronic databases (CINAHL, Google Scholar, PubMed, Ovid, and Wiley). The literature search was conducted in February/March 2020 by using the most relevant keywords and encompassed research articles published from the date of database inception until April 2020. The literature search strategy is given in Appendix S1 Additional components of the literature search included screening of the bibliographic sections of important research and review articles and checking the links of similar articles indicated by the database search engine. Two authors conducted the literature search independently and then combined their outputs. During the selection of studies, a third author also helped in resolving disagreements.

Data Analyses

Demographic data, resilience training interventions, main training themes/contents, training schedules, assessment tools, outcome measures, and outcome data were extracted from research articles of the included studies. Meta-analyses of standardized mean differences (SMDs) were performed by using preintervention and postintervention scores of the assessment tools to generate weighted overall SMDs in resilience scores and the scores of other related indices, including stress, anxiety, depression, burnout, self-efficacy, mindfulness, well-being, and affect. Meta-analyses were performed with Stata software (version 12; Stata Corporation, College Station, Texas) using the DerSimon-Liard method. Quality assessment of the included studies was performed with the New-Castle-Ottawa Scale for the Quality Assessment of Cohort Studies. The Cochrane Risk of Bias Assessment Tool for Randomized Controlled Trials was used for the assessment of randomized studies.