title: Resilience of primary healthcare professionals working in challenging environments: a focus group study.
abstract: BACKGROUND
  The modern primary healthcare workforce needs to be resilient. Early research framed professional resilience as avoiding 'burnout'; however, more recent literature has introduced the concept of positive adaptation to professional challenges, which results in individuals thriving in their role.
  
  
  OBJECTIVE
  To explore what primary health professionals working in challenging environments consider to be characteristics of resilience and what promotes or challenges professional resilience.
  
  
  METHODS
  A qualitative focus group in north east Scotland.
  
  
  METHODS
  Five focus groups were held with 20 health professionals (six GPs, nine nurses, four pharmacists, and a practice manager) based in rural or deprived city areas in the north east of Scotland. Inductive thematic analysis identified emerging themes.
  
  
  RESULTS
  Personal resilience characteristics identified were optimism, flexibility and adaptability, initiative, tolerance, organisational skills, being a team worker, keeping within professional boundaries, assertiveness, humour, and a sense of self-worth. Workplace challenges were workload, information overload, time pressures, poor communication, challenging patients, and environmental factors (rural location). Promoters of professional resilience were strong management support, teamwork, workplace buffers, and social factors such as friends, family, and leisure activities.
  
  
  CONCLUSIONS
  A model of health professional resilience is proposed that concurs with existing literature but adds the concept of personal traits being synergistic with workplace features and social networks. These facilitate adaptability and enable individual health professionals to cope with adversity that is inevitably part of the everyday experience of those working in challenging healthcare environments.
authors.affiliation: Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Catriona
authors.initials: C
authors.lastname: Matheson
authors.affiliation: Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Helen D
authors.initials: HD
authors.lastname: Robertson
authors.affiliation: Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
authors.affiliation: Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Lisa
authors.initials: L
authors.lastname: Iversen
authors.affiliation: Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen.
authors.forename: Peter
authors.initials: P
authors.lastname: Murchie
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007400:Interprofessional Relations; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D055500:Resilience, Psychological; D012606:Scotland; D017132:Workplace / Q000523:psychology*
keywords: health professionals; multiple deprivation; primary care; qualitative research; resilience, psychological.; rurality