Thinking With Community: A Critique of Resilience and Well-being

Ojukwu, Emmanuela; Phillips, J. Craig; Vance, David E.; Caine, Vera

doi:10.1097/jnc.0000000000000328

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…We acknowledge that "resilience" and "self-care" have become triggering concepts during the pandemic, given that HCPs have often reported feeling abandoned by multisectoral leaders and often have very little time or energy to devote to wellness [37,52]. Our team agrees that the liability of resilience capacity building should not be shirked and misdirected to the very individuals who are suffering, but rather promoted, procured, and advocated for by health systems leadership and policy makers.…”

Section: Discussion and Future Directions: Meaning Is Necessary But N...mentioning

confidence: 89%

The Critical Need for a Meaning-Centered Team-Level Intervention to Address Healthcare Provider Distress Now

Rosa

Roberts

Schlak

et al. 2022

IJERPH

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COVID-19 has unveiled and amplified the burnout, grief, and other forms of distress among healthcare providers (HCPs) that long preceded the pandemic. The suffering of the healthcare workforce cannot be simply and sufficiently addressed with a single psychotherapeutic intervention. Nevertheless, the National Academies of Sciences, Engineering, and Medicine Studies recommended prioritizing interventions that generate an increased sense of meaning in life and in work to reduce burnout and cultivate clinician wellbeing. Despite their guidance, there is a dearth of interventions for HCPs specifically targeting meaning and purpose as an avenue to reduce HCP distress. In a time when such an intervention has never been more essential, Meaning-Centered Pyschotherapy (MCP), a brief, evidence-based intervention designed for patients with advanced cancer may be key. This piece describes the principles underlying MCP and how it might be adapted and applied to ameliorate burnout among HCPs while providing a rationale to support future empirical studies in this area. Importantly, the systemic factors that contribute to the emotional and mental health burdens of HCPs are discussed, emphasizing the need for systems-level changes that are needed to leverage the potential outcomes of MCP for HCPs.

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Section: Discussion and Future Directions: Meaning Is Necessary But N...mentioning

confidence: 89%

The Critical Need for a Meaning-Centered Team-Level Intervention to Address Healthcare Provider Distress Now

Rosa

Roberts

Schlak

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Resilience is the capacity to withstand or to recover quickly from difficulties [ 78 ] and African American/Black and Latino PLWH clearly evidence resilience. Resilience is generally conceptualized as an individual or community-level attribute [ 79 ]. However, scholars have recently begun to question the construct of resilience in the context of systemic racism, arguing that how the term is applied can be biased, stigmatizing, and pathologizing [ 80 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, scholars have recently begun to question the construct of resilience in the context of systemic racism, arguing that how the term is applied can be biased, stigmatizing, and pathologizing [ 80 ]. The main argument is that racial/ethnic minority individuals and communities are expected to be resilient or thought to be in need of resilience support, but this framework does not consider larger socio-ecological structures and systemic racism that undermine individuals or communities [ 79 , 80 ]. Although there may be an argument for the importance of resilience, ironically, the need for resilience tends to obscure the causal factors that deem it necessary in the first place [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding why racial/ethnic inequities along the HIV care continuum persist in the United States: a qualitative exploration of systemic barriers from the perspectives of African American/Black and Latino persons living with HIV

Filippone,

Serrano,

Campos

et al. 2023

Int J Equity Health

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Background Racial/ethnic inequities along the HIV care continuum persist in the United States despite substantial federal investment. Numerous studies highlight individual and social-level impediments in HIV, but fewer foreground systemic barriers. The present qualitative study sought to uncover and describe systemic barriers to the HIV care continuum from the perspectives of African American/Black and Latino persons living with HIV (PLWH) with unsuppressed HIV viral load, including how barriers operated and their effects. Methods Participants were African American/Black and Latino PLWH with unsuppressed HIV viral load (N = 41). They were purposively sampled for maximum variability on key indices from a larger study. They engaged in semi-structured in-depth interviews that were audio-recorded and professionally transcribed. Data were analyzed using directed content analysis. Results Participants were 49 years old, on average (SD = 9), 76% were assigned male sex at birth, 83% were African American/Black and 17% Latino, 34% were sexual minorities (i.e., non-heterosexual), and 22% were transgender/gender-nonbinary. All had indications of chronic poverty. Participants had been diagnosed with HIV 19 years prior to the study, on average (SD = 9). The majority (76%) had taken HIV medication in the six weeks before enrollment, but at levels insufficient to reach HIV viral suppression. Findings underscored a primary theme describing chronic poverty as a fundamental cause of poor engagement. Related subthemes were: negative aspects of congregate versus private housing settings (e.g., triggering substance use and social isolation); generally positive experiences with health care providers, although structural and cultural competency appeared insufficient and managing health care systems was difficult; pharmacies illegally purchased HIV medication from PLWH; and COVID-19 exacerbated barriers. Participants described mitigation strategies and evidenced resilience. Conclusions To reduce racial/ethnic inequities and end the HIV epidemic, it is necessary to understand African American/Black and Latino PLWH’s perspectives on the systemic impediments they experience throughout the HIV care continuum. This study uncovers and describes a number of salient barriers and how they operate, including unexpected findings regarding drug diversion and negative aspects of congregate housing. There is growing awareness that systemic racism is a core determinant of systemic barriers to HIV care continuum engagement. Findings are interpreted in this context.

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“I'm positively positive”: Beyond individual responsibility for resilience amongst older adults living with HIV

Vorobyova

Tuyl

Cardinal

et al. 2022

SSM - Qualitative Research in Health

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Thinking With Community: A Critique of Resilience and Well-being

Cited by 5 publications

References 14 publications

The Critical Need for a Meaning-Centered Team-Level Intervention to Address Healthcare Provider Distress Now

The Critical Need for a Meaning-Centered Team-Level Intervention to Address Healthcare Provider Distress Now

Understanding why racial/ethnic inequities along the HIV care continuum persist in the United States: a qualitative exploration of systemic barriers from the perspectives of African American/Black and Latino persons living with HIV

“I'm positively positive”: Beyond individual responsibility for resilience amongst older adults living with HIV

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