Physical disease and resilient outcomes: a systematic review of resilience definitions and study methods

Background
Findings from physical disease resilience research may be used to develop approaches to reduce the burden of disease. However, there is no consensus as to the definition and measurement of resilience in the context of physical disease.
Objective
The aim was to summarise the range of definitions of physical disease resilience and the approaches taken to study it in studies examining physical disease and its relationship to resilient outcomes.
Methods
Electronic databases were searched from database inception to March 2013 for studies in which physical disease was assessed for its association with resilient outcomes. Article screening, data extraction and quality assessment were carried out independently by two reviewers with disagreements resolved by a third reviewer. Results were combined using a narrative technique.
Results
Of 2280 articles, 12 met the inclusion criteria. One study was high quality, nine studies were moderate quality and two were low quality. Common findings were that resilience involves maintaining healthy levels of functioning following adversity and is a dynamic process not a personality trait. Studies either assessed resilience based upon observed outcomes or via resilience measurement scales. Studies either considered physical disease as an adversity leading to resilience or as a variable modifying the relationship between adversity and resilience.
Conclusion
This work begins building consensus as to the approach to take in defining and measuring physical disease resilience. Resilience should be considered as a dynamic process which varies across the life-course and across different domains, therefore the choice of resilience measure should reflect this.