Understanding resilience in the context of midwifery : A concept analysis

Background. Resilience has been heralded as an essential characteristic to thrive in the complex work environments of the 21st Century. While resilience is not a new concept, it continues to be described with a high degree of variation, creating misunderstanding. In particular, there is need for greater clarity and understanding regarding resilience contextualised to midwifery. Aim. To define the concept of resilience in the context of midwifery. Method. A concept analysis guided by the Walker and Avant eight-step framework was undertaken. A comprehensive literature search was undertaken of the five databases: Medline, PubMed, Nursing and Allied Health, Embase and Google Scholar. Search terms comprised 'resilience', 'midwifery', 'concept analysis' and 'midwifery students'. These terms were broadened to include 'nursing' and 'nursing students' due to a lack of literature in the midwifery context. A focus group with six third-year midwifery students was also conducted to provide midwifery context specific real life cases for the concept analysis. Ethics approval was gained from the university's Human Research Ethics Committee. Findings. The defining attributes of resilience contextualised to midwifery included social support, self-efficacy and optimism encompassing reflection. The analysis identified that the most common antecedents of resilience in this context were perceived stress or adversity. The consequences of being resilient in midwifery were an effective coping or adaptive capacity and a positive mental health status. Conclusion. Resilience in the context of midwifery is defined as a dynamic process to overcome perceived adversity andr stress that draws upon internal and external sources, to achieve effective coping/adaptive capacity and wellbeing. These findings provide a basis for further research and offer strategies to strengthen resilient behaviour for midwives and midwifery students.