The Relationship Between Resilience and Nurses’ Mental Health: A Systematic Review

Authors

  • Amani Istiqomah Departement of Nurisng, Poltekkes Kemenkes Jakarta I
  • Bangun Mukti Ardi Intensive Care Unit, Airlangga University Hospital

DOI:

https://doi.org/10.33755/jkk.v12i2.1010

Keywords:

Anxiety, burnout, depression, mental health, nurses, resilience, systematic review

Abstract

Background: Nurses face chronic work-related stress burdens that lead to mental health problems such as depression, anxiety, stress, burnout, and sleep disorders, while suboptimal resilience levels may increase nurses’ mental health vulnerability.

Objective: This systematic review aimed to synthesize recent evidence on the relationship between resilience and mental health outcomes among nurses.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A structured search was conducted in Scopus, PubMed, ScienceDirect, and Web of Science to identify articles published in English between 2021 and 2025. Original quantitative studies that examined the association between resilience and mental health outcomes among nurses were included. Two reviewers independently screened the records, assessed eligibility, and resolved disagreements through discussion. Methodological quality was appraised using the Joanna Briggs Institute Critical Appraisal Checklist. Due to heterogeneity in study measures and outcomes, findings were synthesized narratively.

Results: A total of 1319 records were identified, of which 10 studies met the inclusion criteria. Resilience was consistently associated with lower levels of depression, anxiety, psychological distress, burnout, and fatigue among nurses. Higher resilience was also associated with better psychological well-being, professional quality of life, occupational adaptation, and job satisfaction. Several studies suggested that resilience functioned as a mediating factor in the relationship between occupational stressors and mental health outcomes, while burnout also emerged as an important mediator.

Conclusion: Resilience is consistently associated with more favorable mental health outcomes among nurses. However, the available evidence is limited to cross-sectional research, preventing causal inference. Strengthening resilience may represent a promising strategy to support nurses’ mental health, but future longitudinal and intervention studies are needed

References

1. Jin F, Ni S, Wang L. Occupational stress , coping strategies , and mental health among clinical nurses in hospitals : a mediation analysis. Front Public Heal. 2025;13(May):1–9.

2. Ning M, Li X, Chen Z, Yang J, Yu Q, Huang C, et al. Protocol of the Nurses ’ Mental Health Study ( NMHS ): a nationwide hospital multicentre prospective cohort study. 2025;1–8.

3. Jachmann A, Loser A, Mettler A, Exadaktylos A, Müller M, Klingberg K. Burnout, Depression, and Stress in Emergency Department Nurses and Physicians and the Impact on Private and Work Life: A Systematic Review. JACEP Open [Internet]. 2025 Apr 1;6(2). Available from: https://doi.org/10.1016/j.acepjo.2025.100046

4. Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Nurses’ burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis. J Adv Nurs [Internet]. 2021;77(8):3286–302. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14839

5. Chutiyami M, Cheong AMY, Salihu D, Bello UM, Ndwiga D, Maharaj R, et al. COVID-19 Pandemic and Overall Mental Health of Healthcare Professionals Globally: A Meta-Review of Systematic Reviews. Front Psychiatry [Internet]. 2022;Volume 12-2021. Available from: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.804525

6. Li Y, Fan R, Lu Y, Li H, Liu X, Kong G, et al. Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China. Lancet Reg Heal - West Pacific [Internet]. 2023;30(11):100618. Available from: https://doi.org/10.1016/j.lanwpc.2022.100618

7. Seo EH, Lee J hon, Macdougall A, Liu N, Hofkirchner A, Sharma S, et al. Anxiety Symptoms and Associated Psychological and Job-Related Factors Among Hospital Nurses. Psychiatry Investig. 2024;20:100–8.

8. Pachi A, Sikaras C, Melas D, Alikanioti S, Soultanis N, Ivanidou M, et al. Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model. J Clin Med [Internet]. 2025;14(4). Available from: https://www.mdpi.com/2077-0383/14/4/1145

9. Rokhman A, Hidayati N, Ubudiyah M. Psychological Condition of Nurses in the Aftermath of COVID-19 - Indonesian Nurses ’ Perspective. Babali Nurs Res. 2024;5(2):240–52.

10. Tzu- FW, Liu H, Kai- HC. Relationship between nurses ’ resilience and depression , anxiety and stress during the 2021 COVID- ­ 19 outbreak in. Nurs Open. 2023;(April 2022):1592–600.

11. Lee H fang, Id H chin H, Id FE, Id VR. Burnout, resilience, and empowerment among COVID-19 survivor nurses in Indonesia. PLoS One [Internet]. 2023;2019:1–13. Available from: http://dx.doi.org/10.1371/journal.pone.0291073

12. Bui MV, Mcinnes E, Ennis G, Foster K. Resilience and mental health nursing : An integrative review of updated evidence. Int J Ment Health Nurs. 2023;(February):1055–71.

13. Ayu D, Wadhanti P, Rahayu U, Yulianita H. Resiliensi perawat rawat inap , instalasi gawat darurat , dan intensive care unit. Holistik J Kesehat. 2025;19(3):410–7.

14. Baskin RG, Bartlett R. Healthcare worker resilience during the COVID-19 pandemic: An integrative review. J Nurs Manag [Internet]. 2021;29(8):2329–42. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jonm.13395

15. Pien LC, Wang CH, Cheng WJ, Lin YH, Chou KR, Hsu CY. The Relationship Between Resilience and Mental Health Status Among Nurses With Workplace Violence Experiences: A Cross-Sectional Study. Int J Ment Health Nurs [Internet]. 2025;34(1):e13497. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.13497

16. Neumann JL, Mau LW, Virani S, Denzen EM, Boyle DA, Boyle NJ, et al. Burnout, Moral Distress, Work-Life Balance, and Career Satisfaction among Hematopoietic Cell Transplantation Professionals. Biol blood marrow Transplant J Am Soc Blood Marrow Transplant. 2018 Apr;24(4):849–60.

17. Zhai X, Ren L na, Liu Y, Liu C jun, Su X guang, Feng B e. Resilience Training for Nurses: A Meta-analysis. J Hosp Palliat Nurs [Internet]. 2021;23(6). Available from: https://journals.lww.com/jhpn/fulltext/2021/12000/resilience_training_for_nurses__a_meta_analysis.9.aspx

18. Delgado C, Roche M, Fethney J, Foster K. Mental health nurses’ psychological well-being, mental distress, and workplace resilience: A cross-sectional survey. Int J Ment Health Nurs [Internet]. 2021;30(5):1234–47. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12874

19. Chen SY, Yan SR, Zhao WW, Gao Y, Zong W, Bian C, et al. The mediating and moderating role of psychological resilience between occupational stress and mental health of psychiatric nurses: a multicenter cross-sectional study. BMC Psychiatry [Internet]. 2022;22(1):1–11. Available from: https://doi.org/10.1186/s12888-022-04485-y

20. Lara-Cabrera ML, Betancort M, Muñoz-Rubilar CA, Novo NR, De las Cuevas C. The mediating role of resilience in the relationship between perceived stress and mental health. Int J Environ Res Public Health. 2021;18(18):1–10.

21. Suazo Galdames I, Molero Jurado M del M, Fernández Martínez E, Pérez-Fuentes M del C, Gázquez Linares JJ. Resilience, Burnout and Mental Health in Nurses: A Latent Mediation Model. J Clin Med. 2024;13(10).

22. Hasan A, Alsulami A. Mediating Role of Resilience and its Impact on Psychological Well-Being, and Mental Distress among Mental health Nurses. SAGE Open Nurs. 2024;10.

23. Peng M, Xu M, Yang H, Zhang Q, Lai L, Liu Y, et al. Relationships between emotional intelligence, mental resilience, and adjustment disorder in novice nurses: a cross-sectional study in China. Front Public Heal. 2025;13.

24. Foster K, Shakespeare-Finch J, Shochet I, Maybery D, Bui MV, Steele M, et al. Psychological distress, well-being, resilience, posttraumatic growth, and turnover intention of mental health nurses during COVID-19: A cross-sectional study. Int J Ment Health Nurs [Internet]. 2024;33(5):1543–52. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.13354

25. Alonazi O, Alshowkan A, Shdaifat E. The relationship between psychological resilience and professional quality of life among mental health nurses: a cross-sectional study. BMC Nurs [Internet]. 2023;22(1):1–13. Available from: https://doi.org/10.1186/s12912-023-01346-1

26. Chura S, Saintila J, Mamani R, Ruiz Mamani PG, Morales-García WC. Predictors of Depression in Nurses During COVID-19 Health Emergency; the Mediating Role of Resilience: A Cross-Sectional Study. J Prim Care Community Heal. 2022;13.

27. Labrague LJ. Pandemic fatigue and clinical nurses’ mental health, sleep quality and job contentment during the covid-19 pandemic: The mediating role of resilience. J Nurs Manag. 2021;29(7):1992–2001.

Downloads

Published

2026-04-24

How to Cite

Istiqomah, A., & Ardi, B. M. (2026). The Relationship Between Resilience and Nurses’ Mental Health: A Systematic Review. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 12(2), 231–241. https://doi.org/10.33755/jkk.v12i2.1010