title: Physical disease and resilient outcomes: a systematic review of resilience definitions and study methods.
abstract: BACKGROUND
  Findings from physical disease resilience research may be used to develop approaches to reduce the burden of disease. However, there is no consensus on the definition and measurement of resilience in the context of physical disease.
  
  
  OBJECTIVE
  The aim was to summarize 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 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 2 reviewers, with disagreements being resolved by a third reviewer. The results were combined using a narrative technique.
  
  
  RESULTS
  Of 2280 articles, 12 met the inclusion criteria. Of these studies, 1 was of high quality, 9 were of moderate quality, and 2 were low quality. The common findings were that resilience involves maintaining healthy levels of functioning following adversity and that it is a dynamic process not a personality trait. Studies either assessed resilience based on observed outcomes or via resilience measurement scales. They either considered physical disease as an adversity leading to resilience or as a variable modifying the relationship between adversity and resilience.
  
  
  CONCLUSIONS
  This work begins building consensus as to the approach to take when defining and measuring physical disease resilience. Resilience should be considered as a dynamic process that varies across the life-course and across different domains, therefore the choice of a resilience measure should reflect this.
authors.affiliation: Chronic Disease Research Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK (MCJ, MAC, CB). Electronic address: marjorie.johnston@nhs.net.
authors.forename: Marjorie C
authors.initials: MC
authors.lastname: Johnston
authors.affiliation: Academic Primary Care, University of Aberdeen, Aberdeen, UK (TP, CDB, AE, LI).
authors.forename: Terry
authors.initials: T
authors.lastname: Porteous
authors.affiliation: Chronic Disease Research Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK (MCJ, MAC, CB).
authors.forename: Michael A
authors.initials: MA
authors.lastname: Crilly
authors.affiliation: Academic Primary Care, University of Aberdeen, Aberdeen, UK (TP, CDB, AE, LI).
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Burton
authors.affiliation: Academic Primary Care, University of Aberdeen, Aberdeen, UK (TP, CDB, AE, LI).
authors.forename: Alison
authors.initials: A
authors.lastname: Elliott
authors.affiliation: Academic Primary Care, University of Aberdeen, Aberdeen, UK (TP, CDB, AE, LI).
authors.forename: Lisa
authors.initials: L
authors.lastname: Iversen
authors.affiliation: School of Education, University of Aberdeen, King׳s College, Aberdeen, UK (KM).
authors.forename: Karen
authors.initials: K
authors.lastname: McArdle
authors.affiliation: Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK (AM).
authors.forename: Alison
authors.initials: A
authors.lastname: Murray
authors.affiliation: School of Psychology, University of Aberdeen, Kings College, Old Aberdeen, UK (LHP).
authors.forename: Louise H
authors.initials: LH
authors.lastname: Phillips
authors.affiliation: Chronic Disease Research Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK (MCJ, MAC, CB).
authors.forename: Corri
authors.initials: C
authors.lastname: Black
mesh_terms: D000208:Acute Disease / Q000523:psychology*; D002908:Chronic Disease / Q000523:psychology*; D006801:Humans; D055500:Resilience, Psychological