Resilience: Overcoming Stress and Improving Mental Health

Resilience has been described as the human capacity to face, overcome and emerge strengthened or transformed from experiences of misfortune (Garmezy, 1991). When considering the stressful life situations of an individual, there are different events that occur during one’s life that can be decisive in the activation of resilience. Studies have now shown a link between psychological resilience and various mental health outcomes such as burnout, secondary traumatic stress, depression, and anxiety (Mealer, Jones, & Moss, 2012; McGarry et al., 2013). For example, a study by Mealer et al. (2012) included 744 intensive care nurses working in the United States and found that high resilience was associated with a lower prevalence of burnout and symptoms

of anxiety. Correspondingly, a study by McGarry et al. (2013) conducted in Australia among health professionals working in a paediatric hospital, show that a low prevalence of burnout was associated with a higher level of resilience.
Regarding the connection between resilience and burnout, there have been studies conducted in multi-occupational populations (Edward, 2005; García-Izquierdo, Ramos, & García-Izquierdo, 2009; Menezes, Fernández, Hernández, Ramos, & Contador, 2006) that have shown a negative relationship between the two variables, reflecting the moderating potential that resilience has in terms of the emergence of elements of burnout. Therefore, it makes sense to insist on the relevance of encouraging this psychological capacity from the educational sphere in order to prevent the appearance of burnout and to promote maintenance of psychological health in this population of future professionals (McAllister & McKinnon, 2009). As described above, studies with various occupational groups have found that an individual’s level of psychological resilience is significantly related to burnout. Individuals who score more highly on measures of individual resilience also score more highly on measures of psychological well-functioning and vice versa.
There is also growing evidence that burnout is also linked to several internal attributes of individuals (Piedmont, 1993). Researchers affirm that these internal attributes of individuals determine how people cope or deal with external sources of stress (Hjemdal, Friborg, Stiles, Martinussen, & Rosenvinge, 2006; Kania, Meyer, & Ebersole, 2009; Lue, Chen, Wang, Cheng, & Chen, 2010). This explains why some individuals succumb to burnout in a particular work environment, while some will not. According to Lue et al. (2010), generally in most work settings, individuals tend to be more dependent on their own ability to manage the challenges they face, and less dependent on external support. In their study, resident's personal characteristics were closely related to stress and burnout. Therefore, in addition to assessing their work-related stress, exploring individual’s personal characteristics ought to also be taken into account for early identification of a person’s risk of burnout.
In a study conducted by Lo (2014), examining the stress and burnout levels and their relation with the individual and organisational resilience of the teachers from seven Social Development Schools (special schools for maladjusted students who have varied Emotional Behavioural Challenges (EBC) in Hong Kong); the question of how these EBC teachers become resilient while teaching in the challenging school environment is explored.

An explanatory model of the relation between stress, burnout and resilience as well as the factors and behaviours affecting resilience is developed. Results indicated that the stress level and burnout rate of the EBC teachers range from the moderate to high level. Lack of support, bring unprepared and overwhelmed by job responsibilities and the sense of disempowered are sources of stresses mentioned by the interviewees. It was also found that there are correlations among stress, burnout and resilience and that rational coping behaviours and positive thinking strategies are personal resources that help teachers overcome stress and burnout. Furthermore, individual resilience and organisational resilience both had significant roles in lessening the negative effects of stress and burnout. Strong support from the administrators too had a reassuring effect on these

teachers.
Gito, Ihara and Ogata (2013) studied the relationship between resilience, hardiness, depression and burnout among Japanese psychiatric hospital nurses. A 32-item ‘Resilience Scale for Nurses’ (RSN) was administered to 327 nurses employed at three psychiatric hospitals in Japan. For the purpose of evaluating burnout, the ‘Japanese version of Burnout Scale’ was used to assess the individual’s level of burnout. A total of 313 nurses responded to the questionnaire gathering a response rate of 95.7%. Negative correlations of the RSN were found with the Beck Depression Inventory (-0.26; p psychological resilience level whilst questions about burnout syndrome were measured by an adapted version of Maslach and Jackson (1982)’s scale by Ergin (1992). Findings show psychological resilience negatively affecting burnout which is concurrent with that of other previous researches. In the study, a linear negative relationship can be observed between psychological resilience and burnout to which an increase in the level of psychological resilience causes a decline in the academics burnout level. Accordingly, when the level of academic staff’s psychological resilience increases, their level of burnout also decreases. The authors further explains that those equipped with higher level of psychological resilience will without doubt be far more successful and competent when it comes to working in the organisation. Another known factor, whilst physiological resilience increases, various hormones are also secreted. These hormones will help in countering the burnout phase or stressful conditions faced by a particular individual. When faced with stress, resilient individuals evaluate this situation as an adaptive process and maintain their mental health by using effective coping strategies (Akgemci et al., 2013). Therefore, the development of academics’ psychological resilience will provide universities with significant benefits. What differs a resilient with that of a non-resilient individual is the way they react towards the same stress factors, whereby, an individual having high resiliency level would be able to control any stress factors, counter them and coping with the process.
Garcia-Izquierdoa, Ríos-Risquezb, Carrillo-Garcíab and Sabuco-Tebar (2015) in their research on the moderating role of resilience in the relationship between academic burnout and the perception of psychological health administered a battery of questionnaires among nursing students (n = 218) all of whom were in the second year of their degree at the University of Murcia (Spain).

The respective scales used were the Connor-Davidson Resilience Scale (CD-RISC) 10 scale for the measurement of resilience, the burnout scale MBI, and the 12-Item General Health Questionnaire (GHQ-12) questionnaire to assess psychological health. It was found that resilience and emotional exhaustion (i.e. a component of burnout) and self-efficacy as well as with psychological health all had significant relationships. Resilience was seen to have played a moderating role on psychological health in emotionally exhausting (burnout) situations. Students who indicated having a higher level of resilience also obtained higher scores in academic efficacy and lower scores in emotional exhaustion, thus illustrating the negative relationship between resilience and burnout. Students in this sample who showed a higher level of resilience were seen to experience less burnout. Therefore, the obtained results indicate, in practice, the need to foster learning of this psychological capacity with the aim of preventing the development of burnout syndrome by improving the students’ level of resilience. This finding

nonetheless is only representative of nursing students at the University of Murcia (Spain) due to the researchers employing a convenience sample, hence may not be generalized to other populations across the globe.
In a study by Howard and Johnson (2004), they examined ‘resilient’ teachers’ strategies for coping with burnout in their day-to-day teaching in disadvantaged Australian schools by means of a qualitative study using semi-structured interviews. Findings found that teachers who adopted a resilience nature, were the ones who relentlessly coped well with serious stress. For this study, participants named ‘a sense of agency’, ‘pride in achievements’, ‘strong support group’ and ‘competence in areas of personal importance’ as their chief defensive factors in coping with burnout. All these factors were found to be strong features in interview and in general terms, these protective factors and processes appear consistent with the coping skills identified by larger scale studies (Borg & Falzon, 1990; Cockburn, 1996). Apart from that, all the participants were of the agreement that what made them resilient was learnt. Teachers who worked within the advantaged schools are predisposed to burnout just as those working in the disadvantaged areas are. This study suggests that protective factors that can make a real difference in teachers’ lives are in fact learnable.
In investigating factors which promote resilience and protect against burnout, Olson, Kemper and Mahan (2015) administered a cross-sectional survey to first-year paediatric and medicine-paediatric residents (n=45) of a large Midwestern urban children’s hospital. Factors included that of emotional intelligence, empathy, self-compassion, and mindfulness. Instruments used in the study were the Emotional Social Competency Inventory, the Jefferson Scale of Physician Empathy, Five Facet Mindfulness Questionnaire, Neff’s Self-Compassion Scale (short-form), Smith’s Brief Resilience Scale and the Maslach Burnout Inventory Human Services Survey. Results showed a minority (40%) of residents fulfilling one or more of the standards for burnout. Physician empathy and emotional intelligence were not significantly correlated with burnout or resilience whereas self-compassion and mindfulness were positively related with resilience and negatively linked with burnout. It was found that many residents endorsed burnout and mindfulness and self-compassion were associated with resilience and may promote resilience as well as protect these trainees against burnout. Furthermore, results indicated that both mindfulness and self-compassion were positively associated with higher resilience and less emotional exhaustion (a dimension of burnout); thus indicating mindfulness and self-compassion may be attractive factors for training these residents. This investigation suggests that both mindfulness and self-compassion may be the shields in protecting professionals’ personal health and well-being against such predicaments as burnout.
From the above studies, it can be concluded that occurrences of burnout within the workplace among individuals are likely to lessen if one was to be imbued with the appropriate level of resilience. When individuals have high resilience imbued within them; they are more likely to experience lesser burnout or are able to cope and are more likely to respond to such adversity or stressful events in a healthy way. Individuals with a high level of resilience tend to “bounce back” after challenges, coping well upon faced with adversity; while also growing stronger and better along the way. Although for the most part, negative associations were found in previous studies in regards to burnout and resilience, there still remains a necessity to investigate further the relationship between all the burnout components with that of academicians’ level of resilience within the Malaysian university context. This is due to the overwhelming challenges and increased institutional changes faced by these academicians. This thus serves as one of the primary aims of the research study.