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Burnout

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Full-Text Articles in Social and Behavioral Sciences

Expressive Arts Therapy And Oncology Care Teams, Edwige Raimbault May 2024

Expressive Arts Therapy And Oncology Care Teams, Edwige Raimbault

Expressive Therapies Capstone Theses

This literature review offers an overview of the mental health of oncology care team members, medical professionals as well as oncology floor hospital staff, and the therapeutic benefits of expressive therapies on that specific population. Working on an oncology floor means interacting with patients and their loved ones at a time of utmost suffering, uncertainty, and possible death. This environment presents risks of burnout, compassion fatigue, and a sense of isolation for the medical and non-medical professionals working with cancer patients. The results of qualitative, quantitative, and art-based studies conducted pre-and post-Covid-19 pandemic show multi-faceted and multi-layered positive impacts of …


One Stitch At A Time: Examining The Self-Care Of Art Therapists And The Potential Of Fiber Arts For Wellbeing, Elaine Chippero May 2024

One Stitch At A Time: Examining The Self-Care Of Art Therapists And The Potential Of Fiber Arts For Wellbeing, Elaine Chippero

Expressive Therapies Capstone Theses

The goal of this thesis was to understand why art therapists are particularly at risk for burnout, why it is essential for art therapists to engage artmaking for their own self-care, and why fiber crafts are particularly suited for self-care. The literature was collected and organized using reflective journaling and visual–tactile coding and then presented in the following review. The first two sections of the literature review include comprehensive definitions of burnout and self-care and how both concepts have been discussed in literature relating to the helping professions and specifically art therapists. The third section covers the historical context of …


Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez May 2024

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …


Building Trust To Extinguish Burnout: A Qualitative Study Of Hospital, State, And Federal Policies That Impact Pediatric Nurse Burnout In Connecticut, Cecelia Angelica Morello May 2024

Building Trust To Extinguish Burnout: A Qualitative Study Of Hospital, State, And Federal Policies That Impact Pediatric Nurse Burnout In Connecticut, Cecelia Angelica Morello

Senior Theses and Projects

This thesis explores how federal and state governments, as well as individual hospitals, respond or fail to respond to pediatric nurse burnout. The problem of nurse burnout is not new, and can cause nurses to make mistakes on shift, experience increased anxiety and depression, and increase risk of patient death or injury. Solutions to burnout in healthcare workers have been organized at the hospital, state, and federal government level. However, this thesis examines a lack of research on pediatric nurse burnout more specifically. After reviewing the national landscape of hospital-based solutions, short-term policy solutions, and long-term policy solutions, I examine …


Investigating The Association Between Incivility Variability And Burnout At Work, Tamia Eugene May 2024

Investigating The Association Between Incivility Variability And Burnout At Work, Tamia Eugene

Masters Theses & Specialist Projects

Incivility is a prevalent workplace stressor for many employees in the workplace. Over time, exposure to stressors may lead to increased burnout, which can be costly for organizations. However, variability in uncivil experiences may be more detrimental to employees than chronic exposure to incivility due to the uncertainty associated with it. Using previously collected data from a larger grant, I examined the direct effect of incivility variability on burnout. Specifically, I hypothesized that employees who experienced incivility frequently but sporadically will report more burnout. Furthermore, I hypothesized that a perceived organizational climate that supports civility will moderate the direct effect …


Self-Care Habits And Burnout Among County Social Workers On The Central Coast Of California, Jaclyn Boyd, Denise Ojeda May 2024

Self-Care Habits And Burnout Among County Social Workers On The Central Coast Of California, Jaclyn Boyd, Denise Ojeda

Electronic Theses, Projects, and Dissertations

Burnout, stress, and retention challenges have become pervasive issues among social workers in Child Welfare Services. The experience of stress and burnout can profoundly impact a worker's physical health and overall well-being. Implementing self-care practices, which involve attending to one's health and well-being through activities such as exercise, spiritual engagement, and hobbies, can effectively mitigate feelings of stress and burnout, fostering a positive impact on individuals. The aim of this study is to investigate the relationship between reported stress levels and self-care habits among Child Welfare Services social workers in two counties on California's central coast. To gather relevant data, …


Compassion Fatigue In Short Term Residential Therapeutic Program Settings, Sandra Gallegos May 2024

Compassion Fatigue In Short Term Residential Therapeutic Program Settings, Sandra Gallegos

Electronic Theses, Projects, and Dissertations

This study was conducted to gain further understanding on the possible effects of providing trauma informed care to traumatized children in the foster care system in a Short Term Residential Therapeutic Program (STRTP) environment. STRTP caregivers are prone to be exposed to secondary traumatic stress when working in providing direct care in this type of setting by word of mouth by the youth, placement paperwork of previous trauma and behaviors, and current maladaptive behaviors during placement. With secondary traumatic stress, caregivers are also susceptible to burnout. This study took a positivist approach and collected data from November of 2023-Febraruay 2024 …


Optimism And Spirituality On Burnout In Educators, Mackenzie Coats May 2024

Optimism And Spirituality On Burnout In Educators, Mackenzie Coats

Honors Program Projects

Burnout in educators can be attributed to high stress, increased demands, and a lack of resources, leading to high levels of turnover. Personal resources, such as optimism and spirituality, have been shown to individually have a negative correlation with burnout but have not been evaluated jointly to predict burnout in an educational setting. This research determines the relative contribution of optimism and spirituality to the three facets of burnout: emotional exhaustion, depersonalization, and reduced personal accomplishment. An electronic survey consisting of the Maslach Burnout Inventory, the Life Orientation Test-Revised, and the Spirituality at Work Scale was completed by educators of …


Exploring The Relationship Between Emotional Intelligence And Religiosity And The Experience Of Emotional Labor In Working Women, Jane Naa Koshie Acquah-Bailey Apr 2024

Exploring The Relationship Between Emotional Intelligence And Religiosity And The Experience Of Emotional Labor In Working Women, Jane Naa Koshie Acquah-Bailey

Doctoral Dissertations and Projects

Women serve crucial roles within the home as caregivers and outside the home in the workforce, where they often fill many essential support positions such as service industry workers, teachers, social workers, nurses, and human service workers. In these roles, women must often mitigate the psychosocial issues of those whom they serve, resulting in high emotional labor with subsequent deleterious effects for them. Religiosity and emotional intelligence have been demonstrated to alleviate psychosocial stressors. Current research identified on emotional intelligence and emotional labor in diverse workspaces shows ongoing development. Biblical references to emotional intelligence and religiosity in emotional management highlight …


Military Spouse Counselors: Exploring Mental Health, Resilience, Coping, And Burnout, Melinda Poteet Brinkley Apr 2024

Military Spouse Counselors: Exploring Mental Health, Resilience, Coping, And Burnout, Melinda Poteet Brinkley

Doctoral Dissertations and Projects

Military spouses (MLSPs) are an integral part of the military family and key mental health providers in military community. This study explores the mental health, resilience, coping, and burnout of MLSP counselors, counselor educators, and supervisors (CES). This study was grounded in resilience theory, investigating relationships between mental health and burnout, mediated by resilience, and conditioned by coping. An online survey was distributed through social media and email, open to MLSP counselors/CES of all branches and components of service (N = 68). This quantitative, descriptive, cross-sectional correlational research designed utilized PROCESS Models 4, 58, and 59, which determined that resilience …


A Conceptual Model Of Organizational Compassion In Healthcare, Rachel Thienprayoon, Eli Awtrey, Teresa Pestian, Beth A. Lown, Naomi Winick, Jason Kanov Apr 2024

A Conceptual Model Of Organizational Compassion In Healthcare, Rachel Thienprayoon, Eli Awtrey, Teresa Pestian, Beth A. Lown, Naomi Winick, Jason Kanov

Journal of Wellness

Introduction: In healthcare, while the suffering of patients is often evident, the suffering of clinicians receives less focus. Some sources of clinician distress are directly related to constant exposure to patient suffering, but others are caused by the health care system, and thus potentially preventable. Looking at clinician suffering through the lens of compassion fosters a new paradigm of individual, team, and organizational capabilities, and moves the responsibility to alleviate this suffering from the individual onto the organization and team. Yet research into the impact of organizational compassion in healthcare has been extremely limited.

Approach: Our conceptual model of organizational …


Balancing Expansion And Exhaustion: Burnout In The Basic Communication Course, Nicholas T. Tatum, Jeffrey T. Child Apr 2024

Balancing Expansion And Exhaustion: Burnout In The Basic Communication Course, Nicholas T. Tatum, Jeffrey T. Child

Basic Communication Course Annual

In this forum, the pressing issue of burnout in the basic communication course is discussed as demand for this course continues to grow, posing challenges for administrators and instructors. The forum examines potential causes and consequences of burnout with a primary focus on the well-being of those involved. It aims to advocate proactive measures, including addressing director positions, supporting graduate teaching assistants, and tackling part-time faculty issues, emphasizing the importance of addressing burnout to ensure the course's future and uphold its quality.


The Causes Of Burnout Between Individual And Group Athletes From The Point Of View Of The Trainers, Lina Hussein, Qusai Al-Yasen Mar 2024

The Causes Of Burnout Between Individual And Group Athletes From The Point Of View Of The Trainers, Lina Hussein, Qusai Al-Yasen

Jordan Journal of Applied Science-Humanities Series

This study aimed to identify the causes of burnout between individual and group athletes from the point of view of the trainers, The sample of the study consisted of (16) trainers and coaches from national teams for individual and group teams, (15) coaches, (1) trainer, The questionnaire was used as a data collection tool, consisting of (37) words distributed on (5) axes: Pressure of the sports training process, pressures of sports competition, pressure of the sports coach, external pressures (Athlete's lifestyle, environmental factors), The results of the study showed that the areas of causes of burnout in the athletes of …


The Relationship Between Stress Mindset And Burnout In College Athletes, Amber M. Shipherd, Creighton Avery, Sarah Gomez, Kelly B. Renner Mar 2024

The Relationship Between Stress Mindset And Burnout In College Athletes, Amber M. Shipherd, Creighton Avery, Sarah Gomez, Kelly B. Renner

Journal of Athlete Development and Experience

High levels of stress can result in college athletes experiencing symptoms of burnout, and electing to terminate their sport participation. Research suggests there may be a relationship between athlete burnout and one’s view of stress (Avery et al., 2022). The purpose of this study was to examine the relationship between stress mindset and burnout in college athletes, while controlling for gender, coping self-efficacy, and perceived stress. College athletes (N = 118) completed measures of stress mindset, athletic burnout, coping self-efficacy, and perceived stress via online survey software. Non-parametric partial correlations were conducted to determine relationships between variables while controlling …


“I Have Nothing Left To Give” A Phenomenological Study Of Secondary Traumatic Stress And Burnout In Urban School Teachers Related To The Socioeconomic Issues, Childhood Trauma, And Low Academic Performance Of Urban Students, Melissa Elizabeth Grazette Feb 2024

“I Have Nothing Left To Give” A Phenomenological Study Of Secondary Traumatic Stress And Burnout In Urban School Teachers Related To The Socioeconomic Issues, Childhood Trauma, And Low Academic Performance Of Urban Students, Melissa Elizabeth Grazette

Doctoral Dissertations and Projects

This study examines the shared experiences of secondary traumatic stress and burnout in urban schoolteachers in Washington, D.C. This study focuses on the experiences of teachers working in a low-performing school in a low-income neighborhood and working with students with trauma as it relates to their experiences with secondary traumatic stress and burnout symptoms. This study focused on the lived experiences of ten urban schoolteachers in Washington, D.C. The teacher participants served a school population of 68% at risk of negative socioeconomic barriers such as exposure to violence, poverty, drugs, and an increased likelihood of exposure to trauma. The hermeneutic …


Adjustments To Social Work Practice During The Covid-19 Adjustments To Social Work Practice During The Covid-19 Pandemic In North Carolina: Effects On Burnout And Commitment Pandemic In North Carolina: Effects On Burnout And Commitment, Aaron Brown, Jayme E. Walters, Aubrey E. Jones, Lara Cates Feb 2024

Adjustments To Social Work Practice During The Covid-19 Adjustments To Social Work Practice During The Covid-19 Pandemic In North Carolina: Effects On Burnout And Commitment Pandemic In North Carolina: Effects On Burnout And Commitment, Aaron Brown, Jayme E. Walters, Aubrey E. Jones, Lara Cates

Social Work Faculty Publications

Since the onset of the COVID-19 pandemic, the demand for social workers in the U.S. and abroad has increased. There is demand for more social workers in North Carolina due to ongoing and increasing mental health, substance use disorder, and child welfare needs. COVID-19 has taken a toll on the personal and professional lives of social workers, and research is needed to understand the pandemic’s effects on burnout and commitment among social workers. The present study sought to understand how the COVID-19 pandemic affected the personal and professional lives of social workers practicing in North Carolina and to determine how …


Stress, Resiliency, And Burnout Among Counseling Leaders, Adriana Bovee Feb 2024

Stress, Resiliency, And Burnout Among Counseling Leaders, Adriana Bovee

Journal of Social, Behavioral, and Health Sciences

Leaders in the counseling profession face many demands. The purpose of this quantitative regression analysis study was to determine if there was a predictive relationship between the independent variables of stress and resiliency and dependent variables of burnout, emotional exhaustion, depersonalization, and personal accomplishment among leaders in the counseling profession. Transformational leadership theory and resilience theory were applied as the theoretical framework of this study, and the cross-sectional data collection method was used. Data were collected through anonymous online surveys from a purposive sample of 75 counseling leaders. Data analysis methods included descriptive statistics and multiple linear regressions. Results indicated …


A Phenomenological Study On The Contributors Of Compassion Fatigue With Substance Use Disorder Counselors During The Covid-19 Pandemic, Jennifer A. Galvano Feb 2024

A Phenomenological Study On The Contributors Of Compassion Fatigue With Substance Use Disorder Counselors During The Covid-19 Pandemic, Jennifer A. Galvano

Doctoral Dissertations and Projects

This phenomenological study aimed to understand the experience of compassion fatigue in substance use counselors in Western New York during the COVID-19 pandemic. Many studies have reviewed burnout, compassion fatigue, and secondary trauma and have discussed the outcomes of their unmanaged effects on healthcare professionals. Few have focused directly on the impact that key contributors of compassion fatigue have on substance abuse disorder (SUD) counselors. This qualitative study is designed to support substance abuse counselors’ mental health and well-being. Counselors are exposed to clashing situations such as turnover, larger caseloads, client trauma, regulations, lack of training, lack of understanding of …


Gender Differences In Compassion Fatigue And Burnout Among Sheriff's Deputies, Charity Creech Feb 2024

Gender Differences In Compassion Fatigue And Burnout Among Sheriff's Deputies, Charity Creech

Doctoral Dissertations and Projects

Law enforcement has a long and sordid history with mental health. Recently researchers have begun to dissect the effect of professional and occupational stressors on LEOs. I focused on secondary constructs, compassion fatigue and burnout, that contribute to mental health concerns. Compassion fatigue (CF) and burnout (BO) have been studied most thoroughly in medical settings, but less so in law enforcement settings. While most researchers study law enforcement as a genderless mass, I hypothesized that there is a gender difference in burnout and compassion fatigue levels among Sheriff Deputies (SD). Research aimed to identify how gender differences can contribute to …


Medical School Middle Managers Learning To Successfully Work With Leadership To Navigate Organizational Change, Elizabeth G. Smith Feb 2024

Medical School Middle Managers Learning To Successfully Work With Leadership To Navigate Organizational Change, Elizabeth G. Smith

Doctor of Education Program Dissertations

There is a lapse in research exploring middle managers at medical schools during an organizational change. The purpose of this qualitative phenomenological study was to examine the perceptions of middle managers during an organizational change to mitigate burnout and build resilience. The literature reviewed explored how stressors from organizational changes may impact medical school middle managers, leading to feeling less secure about their position and increasing middle managers’ stress leading to burnout. For an organizational change to be successful, middle managers must build trust with their staff, communicate with middle managers, and engage middle managers in the change process. Burnout …


Understanding The New Stress Factors Affecting Teachers' Burnout: A Scoping Review, Joby Thomas, Marc Eric S. Reyes Jan 2024

Understanding The New Stress Factors Affecting Teachers' Burnout: A Scoping Review, Joby Thomas, Marc Eric S. Reyes

Makara Human Behavior Studies in Asia

The teaching profession is extremely vulnerable to burnout. The sudden outbreak of the COVID-19 pandemic posed new threats and changed the educational environment as well as the perceptions and values of the teachers. The traditional in-person learning approach was quickly replaced by distant online learning to continue education. As schools re-opened, a new educational platform, the hybrid learning model, evolved by fusing the two learning models. The high expectations on teachers to swiftly adopt new teaching methods—often without the required resources or training—exacerbated their exhaustion. We conducted a scoping review to determine the new stress factors causing teachers' burnout following …


Mindfulness Based Interventions To Reduce Burnout And Ptsd Symptoms In Critical Care Nursing, Kelly A. Pellegrino, Libby M. Colley, Carly R. Fazendin, Emma R. Parrotta, Mollie Johnson Jan 2024

Mindfulness Based Interventions To Reduce Burnout And Ptsd Symptoms In Critical Care Nursing, Kelly A. Pellegrino, Libby M. Colley, Carly R. Fazendin, Emma R. Parrotta, Mollie Johnson

Non-Thesis Student Work

Within the medical field, nursing is a career that can be very taxing on both one’s physical and mental wellbeing, especially in regards to critical care. The life-threatening situations and strenuous work that critical care nurses are met with everyday make them especially susceptible to struggling with burnout, compassion fatigue, and PTSD-like symptoms. This not only puts their own safety at risk, but the safety of their patients as well. This raises the question: In critical care nursing, does the utilization of mindfulness based interventions, compared to no intervention, aid in the reduction of nursing burnout and PTSD symptoms? In …


Workplace Wellbeing And Sense Of Mattering Among Small And Medium Enterprise Workers In Canada, Kyle Smilovsky Jan 2024

Workplace Wellbeing And Sense Of Mattering Among Small And Medium Enterprise Workers In Canada, Kyle Smilovsky

Theses and Dissertations (Comprehensive)

Small and Medium Enterprises (SME) are an under researched area when it comes to workplace wellbeing in Canada. The current research used the Job-Demands Resource Framework (JD-R) to study how a Community Psychology concept, sense of mattering, relates to workload, and indicators of wellbeing (i.e., burnout and flourishing). Specifically, this study tested whether sense of mattering moderates the association between workload and both burnout and flourishing. Moderated mediation models were also tested to see if workload is indirectly associated with burnout and flourishing through distress, while being moderated by sense of mattering. Questionnaires were administered to 2,500 Canadian SME workers …


Adjustments To Social Work Practice During The Covid-19 Pandemic In North Carolina: Effects On Burnout And Commitment, Aaron R. Brown, Jayme E. Walters, Aubrey E. Jones, Lara Cates Jan 2024

Adjustments To Social Work Practice During The Covid-19 Pandemic In North Carolina: Effects On Burnout And Commitment, Aaron R. Brown, Jayme E. Walters, Aubrey E. Jones, Lara Cates

Journal of Human Services: Training, Research, and Practice

Since the onset of the COVID-19 pandemic, the demand for social workers in the U.S. and abroad has increased. There is demand for more social workers in North Carolina due to ongoing and increasing mental health, substance use disorder, and child welfare needs. COVID-19 has taken a toll on the personal and professional lives of social workers, and research is needed to understand the pandemic’s effects on burnout and commitment among social workers. The present study sought to understand how the COVID-19 pandemic affected the personal and professional lives of social workers practicing in North Carolina and to determine how …


Spouse Violence In Case Of Police Officers In Puerto Rico: Violence In Police Families, Jorge Ismael Suarez Jan 2024

Spouse Violence In Case Of Police Officers In Puerto Rico: Violence In Police Families, Jorge Ismael Suarez

Theses and Dissertations

This applied dissertation was designed to explore the relationship between factors related to police work and whether these factors help predict domestic violence in a sample of officers of the Puerto Rico Police. The following factors were explored in this study: external burnout, alcohol abuse, department withdrawal, and authoritarian spillover. This study was based on a previous study by Johnson et al. (2005), which revealed that violence exposure and domestic violence among police officers are linked according to four mediation chains. The mediation chain was a model implemented by the authors to determine the influence of burnout, authoritarian spillover, alcohol …


The Relation Between Disordered Eating And Perceived Stress, Tori E. Byars Jan 2024

The Relation Between Disordered Eating And Perceived Stress, Tori E. Byars

Electronic Theses and Dissertations

Disordered eating behavior encompasses a spectrum of maladaptive eating patterns, including emotional eating, binging, restricting, and other similar behaviors. Perceived stress is the extent that an individual perceives their demands exceed their ability to cope. Existing research has demonstrated a positive relation between high ratings of perceived stress and disordered eating behaviors (King et al., 2009; Skead et al., 2018). The current study aimed to expand this research by examining the relation between disordered eating and stress in students, workers, and those who partake in both commitments. Utilizing a single survey, participants completed assessments including the Perceived Stress Scale, the …


The Relationship Of Workplace Support, Job Control, And Burnout In Nurses, Shannon A. Mccleery Jan 2024

The Relationship Of Workplace Support, Job Control, And Burnout In Nurses, Shannon A. Mccleery

Antioch University Full-Text Dissertations & Theses

Nurses are the most likely group of healthcare workers to develop burnout. Previous research identified supervisory support, job control, and decision-making ability in the workplace as protective factors against burnout. There was a gap in the literature regarding the relationship between burnout in nurses and their experience of support, control, and decision-making during the COVID-19 pandemic. Reducing and preventing burnout in nurses is important due to the nursing shortage and concerns of attrition rates. This quantitative study examined the relationship of emotional support, instrumental support, job control, and decision-making opportunities in the workplace to burnout in hospital-based nurses. Measures used …


Qualitative Study Exploring The Risk Factors Of Burnout: Pennsylvania Social Work Professionals In Child Welfare, Nicole Ukaegbu Dec 2023

Qualitative Study Exploring The Risk Factors Of Burnout: Pennsylvania Social Work Professionals In Child Welfare, Nicole Ukaegbu

Social Work Doctoral Dissertations

Burnout is a concern that impacts many professionals in the workplace. This study focused on the risk factors of burnout for social work professionals in Pennsylvania’s child welfare industry. The study was conducted with 10 professionals at children and youth services (CYS) agencies in Pennsylvania, where each of the professionals were interviewed to gain perspective on the problem of burnout. This study used a qualitative approach and was rooted in grounded theory to unravel the findings.

Four risk factor themes, nine risk factor subthemes, and two additional findings themes were generated during the data analysis process. Findings from the 10 …


The Cost Of Creating Therapeutic Relationships: A Phenomenological Study, Robert D. January Dec 2023

The Cost Of Creating Therapeutic Relationships: A Phenomenological Study, Robert D. January

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe how licensed counselors address vicarious trauma and burnout when working with individuals exposed to trauma. This study involved ten licensed professionals from diverse settings including clinics, private practices, and non-profit organizations. Constructive Self-Development Theory guided this study, which defines how traumatic experiences influence a person’s sense of identity. This theory is particularly relevant to this qualitative study because it explains the challenges faced by professional counselors who interact with trauma survivors and acts as a guide toward solutions for preventing counselors from experiencing vicarious trauma and burnout. Snowball sampling was used …


Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker Dec 2023

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …