Resilience and Thriving Among Health Professionals

  • Henriëtte S. van den Berg
Part of the Cross-Cultural Advancements in Positive Psychology book series (CAPP, volume 4)


This chapter presents an explorative study of resilience and thriving among 20 health care professionals employed in a public sector hospital in South Africa. The convenience sample consisted of 12 registered nurses and eight physicians. A phenomenological, qualitative design was used. Semi-structured focus group discussions were conducted with the participants to explore their experience of resilience and thriving in the workplace. Information was analysed using thematic content analysis. The majority of the participants reported high levels of satisfaction and engagement despite challenging work conditions. The emerging themes reflect a range of dispositional, relational, situational, and philosophical factors that contribute to their satisfaction and work engagement. The role of personal values, such as compassion for patients, nurturance, and a sense of justice, plays a role in the value-driven engagement of doctors and nurses, while positive feedback from patients and collegial relationships serves a protective role. Coping strategies used by participants include restorative leisure activities, self-care, and work-family balance. Very few differences were noted between the themes reported by doctors and nurses, respectively. Intellectual stimulation and opportunities for professional development seemed to play a stronger motivating role for the doctors, while nurses emphasized the role of positive relationships with patients. The study concludes that knowledge of factors that contribute to positive affective-motivational states and effective strategies to promote well-being are essential to sustaining high quality health service delivery.


Health Care Professional Focus Group Discussion Work Engagement Character Strength Female Nurse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Bakker, A. B., & Derks, D. (2010). Positive occupational health psychology. In S. Leka & J. Houdmont (Eds.), Occupational health psychology (pp. 194–224). Chichester, UK: Blackwell.Google Scholar
  2. Bakker, A. B., & Leiter, M. P. (2010). Where to go from here: Integration and future research on work engagement. In A. B. Bakker & M. P. Leiter (Eds.), Work engagement: A handbook of essential theory and research (pp. 181–196). New York: Psychology Press.Google Scholar
  3. Bakker, A. B., & Schaufeli, W. B. (2008). Positive organisational behaviour: Engaging in flourishing organizations. Journal of Organizational Behavior, 29, 147–154.CrossRefGoogle Scholar
  4. Balch, C. M., & Copeland, E. (2007). Stress and burnout among surgical oncologists: A call for personal wellness and a supportive workplace environment. Annals of Surgical Oncology, 14(11), 3029–3032.PubMedCrossRefGoogle Scholar
  5. Balch, C. M., & Shanafelt, T. (2010). Combating stress and burnout in surgical practice: A review. Journal of Medical Systems, 44, 29–47.Google Scholar
  6. Bamber, M. R. (2007). CBT for occupational stress in health professionals. London: Routledge.Google Scholar
  7. Bartley, M., Schoon, I., Mitchell, R., & Blane, D. (2011). Resilience as an asset for healthy development. Retrieved from forhealthydevelopment.doc
  8. Bressi, C., Manenti, S., Porcellana, M., Cevales, D., Farina, L., Feliciani, I., et al. (2008). Haemato-­oncology and burnout: An Italian survey. British Journal of Cancer, 98, 1046–1052.PubMedCrossRefGoogle Scholar
  9. Britt, T. W., Dickenson, J. M., Greene-Shortridge, T. M., & McKibben, E. S. (2007). Self-­engagement at work. In D. L. Nelson & C. L. Cooper (Eds.), Positive organizational behavior (pp. 143–158). Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
  10. Carver, C. S. (1998). Resilience and thriving: Issues, models, and linkages. Journal of Social Issues, 54(2), 245–266.CrossRefGoogle Scholar
  11. Chan, D. W. (2009). Burnout and the antithesis of burnout: Developing positive interventions for the well-being of Chinese teachers in Hong Kong. In R. V. Schwartzhoffer (Ed.), Psychology of burnout (pp. 39–62). New York: Nova Science.Google Scholar
  12. Cresswell, J. W., Hanson, W. E., Plano, V. L. C., & Morales, A. (2007). Qualitative research designs: Selection and implementation. The Counseling Psychologist, 35(2), 236–264.CrossRefGoogle Scholar
  13. Department of Health. (2006). Report on HIV and syphilis prevalence survey South Africa 2006. Pretoria, South Africa: Department of Health.Google Scholar
  14. Fritz, C., & Sonnentag, S. (2006). Recovery, well-being, and performance related outcomes: The role of workload and vacation experiences. Journal of Applied Psychology, 91, 936–945.PubMedCrossRefGoogle Scholar
  15. Gillespie, M., & Melby, V. (2003). Burnout among nursing staff in accident and emergency and acute medicine: A comparative study. Journal of Clinical Nursing, 12, 842–851.PubMedCrossRefGoogle Scholar
  16. Jackson, D., Firtko, A., & Edenborough, M. (2007). Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: A literature review. Journal of Advanced Nursing, 60(1), 1–9.PubMedCrossRefGoogle Scholar
  17. Knoop, R. (2010). Work values and job satisfaction. Journal of Psychology, 128(6), 683–690.CrossRefGoogle Scholar
  18. Lin, B. Y., Hsu, C. C., Chao, M., Luh, S., Hung, S., & Breen, G. (2008). Physician and nurse job climates in hospital-based emergency departments in Taiwan: Management and implications. Journal of Medical Systems, 32(4), 269–281.PubMedCrossRefGoogle Scholar
  19. Luthans, F., Vogelsang, G. R., & Lester, P. B. (2006). Developing the psychological capital of resiliency. Human Resource Development Review, 5(1), 25–44.CrossRefGoogle Scholar
  20. Luthans, F., Yousseff, C. M., & Avolio, B. J. (2007). Psychological capital: Developing the human competitive edge. New York: Oxford University Press.Google Scholar
  21. Masten, A. S. (2001). Ordinary magic: Resilience processes and development. American Psychologist, 56(3), 227–238.PubMedCrossRefGoogle Scholar
  22. Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2, 425–444.CrossRefGoogle Scholar
  23. Masten, A. S., & Reed, M. J. (2005). Resilience in development. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 74–89). New York: Oxford University Press.Google Scholar
  24. Naudé, J. L., & Rothmann, S. (2006). Work-related well-being of emergency workers in Gauteng. South African Journal of Psychology, 36(1), 63–81.CrossRefGoogle Scholar
  25. Neumann, W. L. (1997). Social research methods: Qualitative and quantitative approaches. Boston: Allyn & Bacon.Google Scholar
  26. Nickel, S., & Quintini, G. (2002). The recent performance of the UK labour market. Oxford Review of Economic Policy, 18(2), 202–220.CrossRefGoogle Scholar
  27. O’Leary, V. E. (1998). Strength in the face of adversity: Individual and social thriving: Broadening the paradigm beyond illness to health. Journal of Social Issues, 54, 425–446.CrossRefGoogle Scholar
  28. O’Leary, V. E., & Ickovics, J. R. (1995). Resilience and thriving in response to challenge: An opportunity for a paradigm shift in women’s health. Women’s Health Summer, 1(2), 121–142.Google Scholar
  29. Park, N., Peterson, C., & Seligman, M. E. P. (2004). Strengths of character and well-being. Journal of Social and Clinical Psychology, 23(5), 603–619.CrossRefGoogle Scholar
  30. Peterson, C., & Park, N. (2004). Classification and measurement of character strengths: Implications for practice. In A. Linley & S. Joseph (Eds.), Positive psychology in practice (pp. 433–446). New York: Wiley.Google Scholar
  31. Pillay, Y. (2001). The impact of South Africa’s new constitution on the organisation of health services in post-apartheid era. Journal of Health Politics and Law, 26(4), 747–766.CrossRefGoogle Scholar
  32. Polk, L. (1997). Toward a middle-range theory of resilience. Advanced Nursing Science, 19, 1–13.Google Scholar
  33. Ramirez, A. J., Graham, J., Richards, M. A., Cull, A., & Gregory, W. M. (1996). Mental health of hospitals consultants: The effects of stress and satisfaction at work. Lancet, 347, 724–728.PubMedCrossRefGoogle Scholar
  34. Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to ­psychiatric disorder. The British Journal of Psychiatry, 147, 598–611.PubMedCrossRefGoogle Scholar
  35. Schaufeli, W. B., Bakker, A. B., & Salanova, M. (2006). The measurement of work engagement with a short questionnaire: A cross national study. Educational and Psychological Measurement, 66(4), 701–716.CrossRefGoogle Scholar
  36. Schulte, P., & Vainio, H. (2010). Well-being at work – Overview and perspective. Scandinavian Journal of Work, Environment and Health, 36(5), 422–429.PubMedCrossRefGoogle Scholar
  37. Seligman, M. E. P. (2005). Positive psychology, positive prevention and positive therapy. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 3–12). New York: Oxford University Press.Google Scholar
  38. Shanafelt, T. D., Balch, C. M., Bechamps, G. J., Russle, T., Dyrbye, L., Satele, D., et al. (2009). Burnout and career satisfaction among American surgeons. Annals of Surgery, 250(3), 463–471.PubMedGoogle Scholar
  39. Smit, J. (2006). The influence of coping and stressors on burnout and compassion fatigue among health care professionals. An unpublished doctoral dissertation, Department of Psychology, University of the Free State, Bloemfontein, South Africa.Google Scholar
  40. South African Government Website. (2009). Free state province. Retrieved from
  41. Spreitzer, G. M., Lam, C. F., & Fritz, C. (2010). Engagement and human thriving: Complimentary perspectives on energy and connections to work. In A. B. Bakker & M. P. Leiter (Eds.), Work engagement: A handbook of essential theory and research (pp. 132–146). New York: Psychology Press.Google Scholar
  42. Spreitzer, G. M., & Sutcliffe, K. M. (2007). Thriving in organizations. In D. L. Nelson & C. L. Cooper (Eds.), Positive organizational behavior (pp. 74–85). Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
  43. Spreitzer, G. M., Sutcliffe, K. M., Dutton, J., Sonenshein, S., & Grant, A. M. (2005). A socially embedded model of thriving at work. Organization Sciences, 16(5), 537–549.CrossRefGoogle Scholar
  44. Strümpfer, D. J. W. (2005). Standing on the shoulder of giants: Notes on early positive psychology (psychofortology). South African Journal of Psychology, 3(1), 21–25.CrossRefGoogle Scholar
  45. Tveito, T. H., & Eriksen, H. R. (2008). Integrated health programme: A workplace randomized controlled trial. Journal of Advanced Nursing, 65(1), 110–119.PubMedCrossRefGoogle Scholar
  46. Van den Berg, H. S., Bester, C. L., Janse Van Rensburg-Bonthuyzen, E., Engelbrecht, M., Hlophe, H., & van Rensburg, H. C. J. (2006). Burnout and compassion fatigue in professional nurses: A study in PHC facilities in the free state, with special reference to the antiretroviral treatment programme. Bloemfontein, South Africa: Centre for Health Systems Research and Development, University of Free State.Google Scholar
  47. Van Niekerk, J. P. (2006). Doctors as migratory labourers. South African Medical Journal, 96(3), 155.Google Scholar
  48. Van Rensburg, H. C. J. (2004). The health professions and human resources for health – Status, trends and care issues. In H. C. J. Van Rensburg (Ed.), Health and health care in South Africa (pp. 316–376). Pretoria, South Africa: Van Schaik.Google Scholar
  49. Walker, L., & Gilson, L. (2004). “We are bitter but we are satisfied”: Nurses as street-level bureaucrats in South Africa. Social Science & Medicine, 59, 1251–1261.CrossRefGoogle Scholar
  50. Weiss, H. M. (2002). Deconstructing job satisfaction: Separating evaluations, beliefs and affective experiences. Human Resource Management Review, 12, 173–194.CrossRefGoogle Scholar
  51. Xanthopoulou, D., Bakker, A. B., Demerouti, E., & Schaufeli, W. B. (2009). Reciprocal relationships between job resources, personal resources, and work engagement. Journal of Vocational Behavior, 74, 235–244.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Post Graduate School, Research DevelopmentUniversity of the Free StateBloemfonteinSouth Africa

Personalised recommendations