Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-19T12:02:49.407Z Has data issue: false hasContentIssue false

Developing a model of resilience in older adulthood: a qualitative meta-synthesis

Published online by Cambridge University Press:  20 February 2020

Claire A. Wilson*
Affiliation:
Department of Psychology, The University of Western Ontario, London, Ontario, Canada
Deanna Walker
Affiliation:
Department of Psychology, The University of Western Ontario, London, Ontario, Canada
Donald H. Saklofske
Affiliation:
Department of Psychology, The University of Western Ontario, London, Ontario, Canada
*
*Corresponding author. Email: cwils26@uwo.ca

Abstract

The study of resilience in an older adult population is expanding rapidly. However, most theoretical models of resilience have been developed with children or young to middle-aged adults. The objective of the present study was to review systematically the qualitative literature examining resilience in older adults, and to develop a comprehensive model of resilience in older adulthood. A qualitative meta-synthesis was conducted to review the qualitative literature examining resilience from older adults’ perspectives. An exhaustive search of the literature revealed 1,752 articles. From these articles, 34 studies meeting inclusion criteria were selected for analysis. Across the 34 studies analysed, eight themes were revealed as important for achieving resilience later in life: perseverance and determination, self-efficacy and independence, purpose and meaning, positive perspective, social support, faith and prayer, previous experience and being proactive. These themes can be organised into a four-factor model: (a) Intrapersonal Protective Factors; (b) Interpersonal Protective Factors; (c) Spiritual Protective Factors; and (d) Experiential Protective Factors. This study presents a new model of resilience in older adulthood that is grounded in qualitative literature and is relevant and appropriate for an older adult population. This research may be useful for clinicians, support workers and researchers working with older individuals through improving our understanding of what contributes to resilience later in life.

Type
Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

*Adams, JH (1997) Perspectives of the Oldest-old Concerning Resilience Across the Life Span (Doctoral dissertation). New Mexico State University, Las Cruces, New Mexico, USA. Available from ProQuest Dissertations & Theses Global (304357732).Google Scholar
*Bailey, GH (2017) ‘This is My Life and I'm Going to Live It’: A Grounded Theory Approach to Conceptualising Resilience in People with Mild to Moderate Dementia (Doctoral dissertation). The University of Edinburgh, Edinburgh, Scotland. Available from ProQuest Dissertations & Theses Global (1999216875).Google Scholar
*Bohannan-Calloway, J (2016) LGBT Baby Boomers’ Resiliency Dynamics: A Qualitative Study (Doctoral dissertation). Capella University, Minneapolis, Minnesota, USA. Available from ProQuest Dissertations & Theses Global (1860842654).Google Scholar
Bolton, KW, Praetorius, RT and Smith-Osborne, A (2016) Resilience protective factors in an older adult population: a qualitative interpretive meta-synthesis. Social Work Research 40, 171182.CrossRefGoogle Scholar
Bonanno, GA (2004) Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist 59, 2028.CrossRefGoogle ScholarPubMed
Bowling, A and Dieppe, P (2005) What is successful ageing and who should define it? British Medical Journal 331, 15481551.CrossRefGoogle Scholar
*Buggins, S (2016) The Experience of Resilience in Older People Living with Chronic Illness (Doctoral dissertation). University of Hull, Hull, England. Available from ProQuest Dissertations & Theses Global (1896027252).Google Scholar
Carstensen, LL and Freund, AM (1994) The resilience of the ageing self. Developmental Review 14, 8192.CrossRefGoogle Scholar
*Chapman, JE (2015) An Empirical Exploration of the Long-term Effects of Childhood Trauma and the Concept of Resilience (Doctoral dissertation). Northcentral University, Prescott Valley, Arizona, USA. Available from ProQuest Dissertations & Theses Global (1728166296).Google Scholar
Charmaz, K (1983) The grounded theory method: an explication and interpretation. In Emerson, RM (ed.), Contemporary Field Research. Boston, MA: Little, Brown, pp. 109126.Google Scholar
*Cheung, CK and Kam, PK (2012) Resiliency in older Hong Kong Chinese: using the grounded theory approach to reveal social and spiritual conditions. Journal of Aging Studies 26, 355367.CrossRefGoogle Scholar
Connor, KM and Davidson, JR (2003) Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety 18, 7682.CrossRefGoogle Scholar
Cosco, TD, Kaushal, A, Richards, M, Kuh, D and Stafford, M (2016) Resilience measurement in later life: a systematic review and psychometric analysis. Health and Quality of Life Outcomes 14, 16.CrossRefGoogle ScholarPubMed
Costanzo, ES, Ryff, CD and Singer, BH (2009) Psychosocial adjustment among cancer survivors: findings from a national survey of health and well-being. Health Psychology 28, 147156.CrossRefGoogle ScholarPubMed
Critical Appraisal Skills Programme (CASP) (2018) CASP Qualitative Checklist. Available at https://casp-uk.net/wp-content/uploads/2018/03/CASP-Qualitative-Checklist-2018_fillable_form.pdf.Google Scholar
*Crummy, DB (2002) Resilience: The Lived Experience of Elderly Widowers Following the Death of a Spouse (Doctoral dissertation). University of San Diego, San Diego, California, USA. Available from ProQuest Dissertations & Theses Global (305457772).Google Scholar
*de Guzman, AB, Imperial, MYG, Javier, RRL and Kawasaki, AM (2017) As pliant as the bamboo: a grounded theory study of incarcerated Filipino elderly people's sense of resiliency. Educational Gerontology 43, 110.CrossRefGoogle Scholar
Emlet, CA, Tozay, S and Raveis, VH (2010) ‘I'm not going to die from the AIDS’: resilience in aging with HIV disease. The Gerontologist 51, 101111.CrossRefGoogle Scholar
Estabrooks, CA, Field, PA and Morse, JM (1994) Aggregating qualitative findings: an approach to theory development. Qualitative Health Research 4, 503511.CrossRefGoogle Scholar
*Felten, BS (2000) Resilience in a multicultural sample of community-dwelling women older than age 85. Clinical Nursing Research 9, 102123.CrossRefGoogle Scholar
Fletcher, D and Sarkar, M (2013) Psychological resilience: a review and critique of definitions, concepts, and theory. European Psychologist 18, 1223.CrossRefGoogle Scholar
Frankl, V (1979) Man's Search for Meaning. New York, NY: Simon & Schuster.Google Scholar
Friborg, O, Barlaug, D, Martinussen, M, Rosenvinge, JH and Hjemdal, O (2005) Resilience in relation to personality and intelligence. International Journal of Methods in Psychiatric Research 14, 2942.CrossRefGoogle ScholarPubMed
Friborg, O, Hjemdal, O, Rosenvinge, JH and Martinussen, M (2003) A new rating scale for adult resilience: what are the central protective resources behind healthy adjustment? International Journal of Methods in Psychiatric Research 12, 6576.CrossRefGoogle ScholarPubMed
Gillespie, BM, Chaboyer, W and Wallis, M (2007) Development of a theoretically derived model of resilience through concept analysis. Contemporary Nurse 25, 124135.CrossRefGoogle ScholarPubMed
Girtler, N, Casari, EF, Brugnolo, A, Cutolo, M, Dessi, B, Guasco, S, Olmi, C and De Carli, F (2010) Italian validation of the Wagnild and Young Resilience Scale: a perspective to rheumatic diseases. Clinical & Experimental Rheumatology 28, 669678.Google Scholar
Glaser, BG (1978) Advances in the Methodology of Grounded Theory: Theoretical Sensitivity. Mill Valley, CA: Sociology Press.Google Scholar
Glaser, BS and Strauss, A (1967) The Discovery of Grounded Theory. Chicago, IL: Aldine.Google Scholar
Goins, RT, Gregg, JJ and Fiske, A (2013) Psychometric properties of the Connor-Davidson Resilience Scale with older American Indians: the native elder care study. Research on Aging 35, 123143.CrossRefGoogle ScholarPubMed
Gooding, PA, Hurst, A, Johnson, J and Tarrier, N (2011) Psychological resilience in young and older adults. International Journal of Geriatric Psychiatry 27, 262270.CrossRefGoogle ScholarPubMed
*Grandbois, DM and Sanders, GF (2009) The resilience of Native American elders. Issues in Mental Health Nursing 30, 569580.CrossRefGoogle ScholarPubMed
Hannes, K and Macaitis, K (2012) A move to more systematic and transparent approaches in qualitative evidence synthesis: update on a review of published papers. Qualitative Research 12, 402442.CrossRefGoogle Scholar
*Harders, RJ (2002) Understanding Resilience in Rural Farm Elders: A Phenomenological Study (Doctoral dissertation). University of South Dakota, Vermillion, South Dakota, USA. Available from ProQuest Dissertations & Theses Global (305558681).Google Scholar
Hardy, SE, Concato, J and Gill, TM (2004) Resilience of community-dwelling older persons. Journal of the American Geriatrics Society 52, 257262.CrossRefGoogle ScholarPubMed
*Harris, PB (2008) Another wrinkle in the debate about successful aging: the undervalued concept of resilience and the lived experience of dementia. International Journal of Aging & Human Development 67, 4361.CrossRefGoogle ScholarPubMed
*Hassani, P, Izadi-Avanji, FS, Rakhshan, M and Majd, HA (2017) A phenomenological study on resilience of the elderly suffering from chronic disease: a qualitative study. Psychology Research and Behavior Management 10, 5967.CrossRefGoogle Scholar
Heisel, MJ and Flett, GL (2008) Psychological resilience to suicide ideation among older adults. Clinical Gerontologist 31, 5170.CrossRefGoogle Scholar
*Higgins, A, Sharek, D and Glacken, M (2016) Building resilience in the face of adversity: navigation processes used by older lesbian, gay, bisexual and transgender adults living in Ireland. Journal of Clinical Nursing 25, 36523664.CrossRefGoogle ScholarPubMed
Hjemdal, O, Friborg, O, Stiles, TC, Rosenvinge, JH and Martinussen, M (2006) Resilience predicting psychiatric symptoms: a prospective study of protective factors and their role in adjustment to stressful life events. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice 13, 194201.CrossRefGoogle Scholar
Hrostowski, S (2013) Resilience in aging gay men and lesbians in the southern United States. In Li, Y (ed.), Global Aging Issue and Policies. Springfield, IL: Charles C. Thomas Publishers, pp. 269291.Google Scholar
*Hrostowski, S and Rehner, T (2012) Five years later: resiliency among older adult survivors of Hurricane Katrina. Journal of Gerontological Social Work 55, 337351.CrossRefGoogle ScholarPubMed
*Janssen, BM, Van Regenmortel, T and Abma, TA (2011) Identifying sources of strength: resilience from the perspective of older people receiving long-term community care. European Journal of Ageing 8, 145156.CrossRefGoogle ScholarPubMed
Jensen, LA and Allen, MN (1996) Meta-synthesis of qualitative findings. Qualitative Health Research 6, 553560.CrossRefGoogle Scholar
*Johnson, CC (2005) A Retrospective Study: The Development of Resilience Among Black American Women Aged 85 Years and Older Residing in the Philadelphia Metropolitan Area (Doctoral dissertation). University of Delaware, Newark, Delaware, USA. Available from ProQuest Dissertations & Theses Global (304992636).Google Scholar
Jorm, AF and Jolley, D (1998) The incidence of dementia: a meta-analysis. Neurology 51, 728733.CrossRefGoogle ScholarPubMed
Kearney, MH (1998) Ready-to-wear: discovering grounded formal theory. Research in Nursing & Health 21, 179186.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
*Kinsel, B (2005) Resilience as adaptation in older women. Journal of Women & Aging 17, 2339.CrossRefGoogle ScholarPubMed
*Kok, AA, van Nes, F, Deeg, DJ, Widdershoven, G and Huisman, M (2018) ‘Tough times have become good times’: resilience in older adults with a low socioeconomic position. The Gerontologist 58, 843852.CrossRefGoogle Scholar
Kwong, K, Du, Y and Xu, Q (2015) Healthy aging of minority and immigrant populations: resilience in late life. Traumatology 21, 136144.CrossRefGoogle Scholar
Lamond, AJ, Depp, CA, Allison, M, Langer, R, Reichstadt, J, Moore, DJ, Golshan, S, Ganiats, TG and Jeste, DV (2008) Measurement and predictors of resilience among community-dwelling older women. Journal of Psychiatric Research 43, 148154.CrossRefGoogle ScholarPubMed
*Li, J, Xu, L and Chi, I (2018) Challenges and resilience related to aging in the United States among older Chinese immigrants. Aging & Mental Health 22, 15481555.CrossRefGoogle ScholarPubMed
Liebenberg, L and Moore, JC (2018) A social ecological measure of resilience for adults: the RRC-ARM. Social Indicators Research 136, 119.CrossRefGoogle Scholar
Liebenberg, L, Ungar, M and Vijver, FVD (2012) Validation of the child and youth resilience measure-28 (CYRM-28) among Canadian youth. Research on Social Work Practice 22, 219226.CrossRefGoogle Scholar
Liu, DW, Fairweather-Schmidt, AK, Burns, RA and Roberts, RM (2015) The Connor-Davidson Resilience Scale: establishing invariance between gender across the lifespan in a large community based study. Journal of Psychopathology and Behavioral Assessment 37, 340348.CrossRefGoogle Scholar
*Lou, VW and Ng, JW (2012) Chinese older adults’ resilience to the loneliness of living alone: a qualitative study. Aging & Mental Health 16, 10391046.CrossRefGoogle ScholarPubMed
Luthar, SS, Cicchetti, D and Becker, B (2000) The construct of resilience: a critical evaluation and guidelines for future work. Child Development 71, 543562.CrossRefGoogle ScholarPubMed
*Manning, LK and Bouchard, L (in press) Encounters with adversity: a framework for understanding resilience in later life. Aging & Mental Health. Available online doi:10.1080/13607863.2019.1594162.Google Scholar
Masten, AS and Garmezy, N (1985) Risk, vulnerability, and protective factors in the developmental psychopathology. In Lahey, BB and Kazdin, AE (eds), Advances in Clinical Child Psychology, Vol. 8. New York, NY: Plenum Press, pp. 151.Google Scholar
Masten, AS and Wright, MO (2009) Resilience over the lifespan. In Reich, JW (ed.), Handbook of Adult Resilience. New York, NY: Guilford Press, pp. 213237.Google Scholar
*Melici, B (2016) Ego Integrity and Resilience: The Human Experience Across the Life Span Delineated by Erikson's Eighth Stage of Psychosocial Development (Doctoral dissertation). The Chicago School of Professional Psychology, Chicago, Illinois, USA. Available from ProQuest Dissertations & Theses Global (1830471133).Google Scholar
Moher, D, Liberati, A, Tetzlaff, J and Altman, DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine 151, 264269.CrossRefGoogle ScholarPubMed
Nakashima, M and Canda, ER (2005) Positive dying and resiliency in later life: a qualitative study. Journal of Aging Studies 19, 109125.CrossRefGoogle Scholar
*Neary, SR (1997) Room to Maneuver: Preserving Choice in Resilient Old Age (Doctoral dissertation). Available from ProQuest Dissertations & Theses Global (304354939). Boston College, Boston, Massachusetts, USA.Google Scholar
*Nelson-Becker, HB (2006) Voices of resilience: older adults in hospice care. Journal of Social Work in End-of-life and Palliative Care 2, 87106.CrossRefGoogle ScholarPubMed
Netuveli, G, Wiggins, RD, Montgomery, SM, Hildon, Z and Blane, D (2008) Mental health and resilience at older ages: bouncing back after adversity in the British Household Panel Survey. Journal of Epidemiology and Community Health 62, 987991.CrossRefGoogle ScholarPubMed
Niitsu, K, Houfek, JF, Barron, CR, Stoltenberg, SF, Kupzyk, KA and Rice, MJ (2017) A concept analysis of resilience integrating genetics. Issues in Mental Health Nursing 38, 896906.CrossRefGoogle ScholarPubMed
Noblit, GW and Hare, RD (1988) Meta-ethnography: Synthesizing Qualitative Studies. Newbury Park, CA: Sage.CrossRefGoogle Scholar
Nygren, B, Aléx, L, Jonsén, E, Gustafson, Y, Norberg, A and Lundman, B (2005) Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. Aging and Mental Health 9, 354362.CrossRefGoogle ScholarPubMed
*Ottmann, G and Maragoudaki, M (2015) Fostering resilience later in life: a narrative approach involving people facing disabling circumstances, carers and members of minority groups. Ageing & Society 35, 20712099.CrossRefGoogle Scholar
*Pathike, W, O'Brien, AP and Hunter, S (2017) Moving on from adversity: an understanding of resilience in rural Thai older people. Aging and Mental Health 23, 311318.CrossRefGoogle ScholarPubMed
Patton, MQ (2002) Qualitative Research and Evaluation Methods, 3rd Edn. Thousand Oaks, CA: Sage.Google Scholar
Pentz, M (2005) Resilience among older adults with cancer and the importance of social support and spirituality-faith: I don't have time to die. Journal of Gerontological Social Work 44, 322.CrossRefGoogle Scholar
Pierini, D and Stuifbergen, AK (2010) Psychological resilience and depressive symptoms in older adults diagnosed with post-polio syndrome. Rehabilitation Nursing 35, 167175.CrossRefGoogle ScholarPubMed
*Pieters, HC (2016) ‘I'm still here’: resilience among older survivors of breast cancer. Cancer Nursing 39, 2028.CrossRefGoogle Scholar
*Price, P, Kinghorn, J, Patrick, R and Cardell, B (2012) ‘Still there is beauty’: one man's resilient adaptation to stroke. Scandinavian Journal of Occupational Therapy 19, 111117.CrossRefGoogle Scholar
Prince-Embury, S (2006) Resiliency Scales for Adolescents: A Profile of Personal Strengths. San Antonio, TX: Harcourt Assessment.Google Scholar
Prince-Embury, S (2014) A three-factor model of personal resilience and related assessment. In Prince-Embury, S and Saklofske, D (eds), Resilience Interventions for Youth in Diverse Populations. New York, NY: Springer, pp. 2557.CrossRefGoogle Scholar
Prince-Embury, S, Saklofske, DH and Nordstokke, DW (2017) The resiliency scale for young adults. Journal of Psychoeducational Assessment 35, 276290.CrossRefGoogle Scholar
Prince-Embury, S, Saklofske, DH and Vesely, KV (2015) Measures of resiliency. In Boyle, GJ, Saklofske, DH and Matthews, G (eds), Measures of Personality and Social Psychology Constructs. San Diego, CA: Elsevier/Academic Press, pp. 290321.CrossRefGoogle Scholar
*Reinschmidt, KM, Attakai, A, Kahn, CB, Whitewater, S and Teufel-Shone, N (2016) Shaping a stories of resilience model from urban American Indian elder's narratives of historical trauma and resilience. American Indian and Alaska Native Mental Health Research 23, 6385.CrossRefGoogle Scholar
Resnick, BA and Inguito, PL (2011) The Resilience Scale: psychometric properties and clinical applicability in older adults. Archives of Psychiatric Nursing 25, 1120.CrossRefGoogle ScholarPubMed
*Rogerson, M (2009) Theory in Activity, Aging, and Resilience (Doctoral dissertation). University of Calgary, Calgary, Alberta, Canada. Available from ProQuest Dissertations & Theses Global (304844342).Google Scholar
Rutter, M (1985) Resilience in the face of diversity: protective factors and resistance to psychiatric disturbance. British Journal of Psychiatry 147, 598611.CrossRefGoogle Scholar
Schreiber, R, Crooks, D and Stern, PN (1997) Qualitative meta-analysis. In Morse, JM (ed.), Completing a Qualitative Project: Details and Dialogue. Thousand Oaks, CA: Sage, pp. 311326.Google Scholar
Southwick, SM, Bonanno, GA, Masten, AS, Panter-Brick, C and Yehuda, R (2014) Resilience definitions, theory, and challenges: interdisciplinary perspectives. European Journal of Psychotraumatology 5, 114.CrossRefGoogle ScholarPubMed
Stainton, A, Chisholm, K, Kaiser, N, Rosen, M, Upthegrove, R, Ruhrmann, S and Wood, SJ (2019) Resilience as a multimodal dynamic process. Early Intervention in Psychiatry 13, 725732.CrossRefGoogle ScholarPubMed
Strauss, AL (1987) Qualitative Analysis for Social Scientists. New York, NY: Cambridge University Press.CrossRefGoogle Scholar
Strauss, A and Corbin, J (1994) Grounded theory methodology. Handbook of Qualitative Research 17, 273285.Google Scholar
*Thomas, CL (2012) Exploring resiliency factors of older African American Katrina survivors. Journal of Evidence-based Social Work 9, 351368.CrossRefGoogle ScholarPubMed
Tong, A, Flemming, K, McInnes, E, Oliver, S and Craig, J (2012) Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology 12, 181189.CrossRefGoogle ScholarPubMed
Ungar, M (2008) Resilience across cultures. British Journal of Social Work 38, 218235.CrossRefGoogle Scholar
United Nations (2015) World population prospects: the 2015 revision, key findings and advance tables. Department of Economic and Social Affairs, Population Division, United Nations, Working Paper ESA/P/WP.241.Google Scholar
von Eisenhart Rothe, A, Zenger, M, Lacruz, ME, Emeny, R, Baumert, J, Haefner, S and Ladwig, KH (2013) Validation and development of a shorter version of the resilience scale RS-11: results from the population-based KORA–age study. BMC Psychology 1, 2532.CrossRefGoogle ScholarPubMed
*Wagnild, G and Young, HM (1990) Resilience among older women. Journal of Nursing Scholarship 22, 252255.CrossRefGoogle ScholarPubMed
Wagnild, GM and Young, HM (1993) Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement 1, 165178.Google ScholarPubMed
Wild, K, Wiles, JL and Allen, RES (2013) Resilience: thoughts on the value of the concept for critical gerontology. Ageing & Society 33, 137158.CrossRefGoogle Scholar
*Wiles, JL, Wild, K, Kerse, N and Allen, RE (2012) Resilience from the point of view of older people: ‘There's still life beyond a funny knee’. Social Science & Medicine 74, 416424.CrossRefGoogle ScholarPubMed
Wilson, CA (2016) The Relationship Between Emotional Intelligence, Resiliency, and Mental Health in Older Adults: The Mediating Role of Savouring (Master's thesis). The University of Western Ontario, London, Ontario, Canada.CrossRefGoogle Scholar
Windle, G (2011) What is resilience? A review and concept analysis. Reviews in Clinical Gerontology 21, 152169.CrossRefGoogle Scholar
Windle, G, Bennett, KM and Noyes, J (2011) A methodological review of resilience measurement scales. Health and Quality of Life Outcomes 9, 826.CrossRefGoogle ScholarPubMed
Wolff, JL, Starfield, B and Anderson, G (2002) Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of Internal Medicine 162, 22692276.CrossRefGoogle ScholarPubMed