Page 41 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

14 Chapter 1. Psychosocial Consequences of Wounds

resilience as an intrinsic ability, which prevents the typical
distress response to stressful events. Thus resilience is a per-
sonality trait, which protects people from stress. However,
there is increasing recognition of the role that resilience
might play in chronic illness (Trivedi et al. 2011 ). This view
conceptualises resilience as a resource which allows us to
recover more quickly from stressful events or illness experi-
ences. Thus rather than seeing resilient individuals as those
who have immunity to illness, this approach accepts that
everyone, even resilient individuals, will experience transitory
distress during a stressful event such as diagnosis of chronic
illness. The difference between the resilient and the vulnera-
ble individual, is that the resilient person will make a speedy
recovery, whilst the vulnerable one may maintain a position
of stress. If we accept this definition of resilience – that it is
an attribute which aids speedy recovery – then resilience
becomes something that can be moderated in order improve
patient outcomes.
Resilience has been linked to another personality trait –
optimism. Optimism provides a predisposition to expect posi-
tive outcomes. This is a trait which has been linked to faster
recovery from acute illness episodes such as heart surgery
(Scheier et al. 1999 ) and better coping in longer term prob-
lems such as breast cancer (Carver, et al. 1993 ). It has also
been linked to conscientiousness, which is defined as the
tendency to act dutifully, be self-disciplined and to aim for
achievement (McCrae and John 1992 ). Conscientiousness has
also been associated with longer survival in the chronically ill
(Christensen et al. 2012 ). Furthermore, there is evidence that
resilience is enhanced by social relationships.
This link between resilience and social support may
provide the mechanism by which to moderate resilience,
since social support – the presence of caring supportive
relationships – has been found to foster positive outcomes in
a number of chronic illnesses. Searle and colleagues ( 2005 )
found for example that interacting with other patients pro-
vided a good source of social support; sharing personal expe-
riences of living with diabetes, provided patients with a sense
of camaraderie and identity. There is evidence that from case