Cultivating health resilience in Singapore: a qualitative study from the perspectives of community-dwelling adults and care providers
Lixia Ge, Wan Fen Yip, Andy Hau Yan Ho, Eric Chua, Pann Pei Chieh, Ian Yi Onn Leong, Ringo Moon-Ho Ho, Woan Shin TanIntroduction
Individuals vary in their capacity to adapt and respond to health adversities. Resilient people are better able to regain functioning following health adversity. This study explored the factors that support individuals in overcoming health-related challenges, drawing on perspectives from multiple stakeholders.
Methods
An interpretive systemic approach was adopted to understand the multidimensional nature of health resilience. Semistructured interviews were conducted with 65 community-dwelling adults (including caregivers), alongside 11 focus group discussions involving 53 healthcare and social care professionals. Thematic analysis, guided by the Resilience Framework and an interpretive-systemic lens, was used to identify key processes and resources shaping health resilience.
Results
We identified seven overarching themes (with 18 subthemes) central to navigating health challenges: (1) personal dispositions and meaning-making (4 subthemes), (2) psychobehavioural adjustment (4), (3) health literacy for care navigation (2), (4) social support and relational anchors (2), (5) care affordability and financial security (2), (6) accessibility of and experience in healthcare systems (2) and (7) availability of and access to social support services (2). Findings indicate that participants cultivated health resilience by actively engaging personal, social and systemic resources. Meaning-making and psychobehavioural adjustment emerged as important internal mechanisms, which were themselves enabled or constrained by external relational and systemic factors.
Conclusions
Health resilience is a dynamic, multidimensional process influenced by interlinked intrapersonal, relational and systemic factors. Moving beyond trait-based understandings, our findings provide a culturally grounded perspective essential for designing holistic, person-centred health systems and public health strategies, particularly for ageing societies with rising chronic disease burdens.