Family resilience minimizes post-traumatic stress disorder: A systematic review
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Hamid" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Abdul" "apellidos" => "Wakhid" "email" => array:1 [ 0 => "abdul.wakhid2010@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Achir Yani S." "apellidos" => "Hamid" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Faculty of Nursing, Ngudi Waluyo University, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Nursing, Indonesia University, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2055 "Ancho" => 2167 "Tamanyo" => 340591 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the study selection process.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">During the period 2010–2018, there were 17,103 disaster events with more than 18 million victims, both dead, injured, suffering and displaced.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">1,2</span></a> A total of 335 people died as a result of the disaster, 969 people were injured, and surprisingly, there were 3.22 million people were displaced.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> It was still remembered Aceh tsunami disaster in 2004. Recently, earthquake in Lombok, then Palu, and last tsunami in Sunda strait.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Understanding traumatic stress in individuals is interesting to find various ways to survive.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> The trauma brought fear and disturbance, feel anxious, even after the cessation of the disaster.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">5</span></a> Young people were more likely to be affected by disasters than adults.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a> Resilience is an important concept in mental health theory and research to affect people's capacity or ability to anticipate, prepare, respond, and recover quickly from the impact of the disaster. The main purpose of this review is to investigate family resilience in the context of disaster.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Method</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study critically examines, evaluate, and synthesize literature on resilience and related constructs in family caregiving and family resilience were the support of our systematic review.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A systematic search on 5 electronic databases was published between 2014 and 2018 was performed using Proquest, MEDLINE, CINAHL, Science Direct, and Springer Link. The keywords research is: ‘family resilience’, ‘disaster’, and ‘Posttraumatic stress disorder’. The search was limited to English language and quantitative method. Studies selected for inclusion examined aspects of resilience among families with post-traumatic syndrome distress including (a) a subjective (qualitative) or objective appraisal of changes since disaster (longitudinal data); or (b) standardized scores, clinically meaningful categorization of families (e.g., based on cut-scores), or a comparison with norms or control groups. Included studies investigated family or family members who experienced post-traumatic syndrome distress.</p><p id="par0025" class="elsevierStylePara elsevierViewall">A three-phased screening process was used. Firstly, the authors found 823 articles from the search. 14 articles were removed due to duplication. Secondly, titles of the 809 articles were reviewed. 122 articles were included in the next step. Thirdly, the first author reviewed abstracts of the 122 studies. Fourthly, the author reviewed eligibility based on inclusion and exclusion criteria of 27 articles. Articles were included for further review if they dealt with the disaster, family resilience and post-traumatic syndrome distress in human populations. Finally, 11 articles were included in this study (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The first and second authors extracted data from the 11 articles in a systematic and standardized way, summarizing study characteristics and general findings. All studies were coded and then analyzed the relationship related to disaster variables, family resilience, and PTSD.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Part I: characteristics of the studies in the review</span><p id="par0035" class="elsevierStylePara elsevierViewall">The all the reviewed studies were quantitative, with most studies used cross-sectional study (54.5%), used systematic review (18.2%), and used quasi-experiment, used descriptive-analytic and used cohort study each 9.1% (<span class="elsevierStyleItalic">n</span>: 1/443; 51%); 41% used qualitative methods (<span class="elsevierStyleItalic">n</span> 1/435; marked in text with QL), and the rest used mixed methods designs (<span class="elsevierStyleItalic">n</span> 1/47; 8%; marked in text with mix). The sample size varied from 52 to 3315 families. A wide variety of time since the disaster was included in the studies, between after 12 months to 12.4 years (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Part II: narrative summary of studies that have been reviewed</span><p id="par0040" class="elsevierStylePara elsevierViewall">A narrative review was found based on four aspects of family function, namely: conflict, communication, family support, and resilience promoting the program.<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0045" class="elsevierStylePara elsevierViewall">Conflict</p><p id="par0050" class="elsevierStylePara elsevierViewall">Vulnerable traumatic experiences cause conflict between family members, families with others due to inaccuracies in discussing traumatic events.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> The results of the study found that conflict occurred due to negative interactions with family members can be the cause and consequences of PTSD symptoms experienced a conflict of 18% of respondents.</p><p id="par0055" class="elsevierStylePara elsevierViewall">On the one hand, negative interactions with family members can reflect the current family situation which is characterized by chronic conflict and difficult interpersonal relationships due to family member conflicts. Exacerbation of PTSD symptoms tends to lead to tension, disagreements, and conflicts in personal relationships.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">5</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0060" class="elsevierStylePara elsevierViewall">Communication</p><p id="par0065" class="elsevierStylePara elsevierViewall">Communication is the ability to convey and accept opinions to others. Communication affects family toughness by 9%. Improving positive communication skills to family members can also facilitate system change. Strong families will maintain or improve communication in the family in response to disasters and their communication patterns will be open, clear and effective.</p><p id="par0070" class="elsevierStylePara elsevierViewall">This communication construct was discussed in two quantitative studies. The results of the study found that the lack of communication between family members had the opportunity to increase the incidence of PTSD in families after 14 months of experiencing a disaster.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a> Communication between people is the key to the success of handling problems. The presence of all vulnerable people, including children, women, the elderly, and people with disabilities in the learning period.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.</span><p id="par0075" class="elsevierStylePara elsevierViewall">Family support</p><p id="par0080" class="elsevierStylePara elsevierViewall">Family support can be demonstrated by various forms of support, psychological support and social support of 54.5%. Family resilience involves more than managing stressful conditions, carrying burdens, or surviving an ordeal/exams they experience.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> Families with resilience are expected to maintain or increase support in response to disasters. Family support is discussed in four quantitative studies. The beneficial effects of social support in maintaining mental health regardless of stressful experiences have in line with these findings, less perceived social support was, relative to the resilient class, associated with membership in the PTSD and high distress class.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> There was an association between utilization of psychosocial support and experiencing earthquake-related PTSD symptoms was significant who received psychosocial support were experiencing earthquake-related PTSD symptoms 2 months post-disaster.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> Social support obtained by victims of the earthquake after 6 years showed surprising results, that 46% received low social support.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4.</span><p id="par0085" class="elsevierStylePara elsevierViewall">Resilience promoting program</p><p id="par0090" class="elsevierStylePara elsevierViewall">The study found that 3 studies reported that families of disaster victims needed support to increase disaster preparedness to prevent depression and PTSD (27.2%). The intervention programs used different approaches (positive psychology techniques, CBT, transformational coping, acceptance and commitment therapy, mindfulness, interpersonal therapy, attention and interpretation therapy, relaxation and diaphragmatic breathing).<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a> These findings replicate previous results of the study who also found a four-class solution with very similar symptom profiles as the optimal fit for their data.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> Findings of both studies, therefore, indicate that among people exposed to trauma and loss, subgroups are separable both by symptom severity and dominance of a particular syndrome (e.g. some with PTSD).<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3,15</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The psychosocial support system has a very important role in protecting individuals against disasters and their effects. The family-based approach is one of the important approaches to implementing psychosocial support programs in disasters. In this approach, the family's desire to control and manage crises is the main focus in education that supports the family's role in dealing with psychosocial problems.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> Exploration of the effects of interventions reveals that participation increases disaster preparedness decreases depression and symptoms associated with PTSD and increases awareness to help others in a social context.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> Resilience promoting programs determined with certain output by the target, including building awareness to help other people, sharing information about disaster preparedness, and establishing self-copying mechanisms.</p></li></ul></p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">While the authors acknowledge and understand individual resilience, little is known about family resilience after the experience of facing disasters. To advance this field of research, subsequent work must be theory-based, match measurement indicators with indicators of interest (i.e., include all family members), and use appropriate statistical methods to collect data from each family member in the family, to provide an overview more clearly how the resilience that needs to be built is based on the perspective of each family member according to their age level (children, adolescents, adults, retirees and the elderly).<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">15</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">A study showed the interaction between resilience and social support significantly contributed to the explained variance (<span class="elsevierStyleItalic">p</span> < 0.01), with the results indicating that resilience had a positive effect on QOL and that social support was a moderator for the positive resilience effects on QOL.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">This review concludes that there are several obstacles. We consider family resilience as the ability to recover and recover from previous conditions (normal family psychosocial conditions before a disaster) and optimal family function within the family.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> However, data regarding family functions before a disaster occurs, longitudinal data that check changes in family function from time to time after experiencing a disaster are rarely found.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">8</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Ability to conclude the resilience of families facing disasters is also hampered by the lack of studies that use this framework as a basis for their research approach. Other conceptualizations of family resilience cannot be applied to the existing literature. For example, various theories of family resilience<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> do not see family functioning as an attractive goal. Conversely, family functions are conceptualized as a process or means to achieve family resilience.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> In this model, other results are evidence of resilience, such as the ability of families to succeed in meeting future challenges,<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a> to maintain family units, or to promote the development of individual members.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">18,19</span></a> These results are rarely if ever, assessed in the context of a disaster. The definition of other resilience in the context of handling PTSD is rarely conducted research that is associated with the formation of family resilience as a caregiver who treats family members who have PTSD.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Limitations</span><p id="par0120" class="elsevierStylePara elsevierViewall">In addition to the problems mentioned above, certain characteristics of the research base make it very difficult to draw strong conclusions. Variations from quantitative studies with various designs, some use control groups and some not use. Besides, almost all studies rely on reports of the emergence of PTSD with signs of depression even though there are known weaknesses associated with this method. The assessment of observations on family interactions is needed in improving our understanding of family defense adaptation in the face of disasters experienced.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Suggestions for future research</span><p id="par0125" class="elsevierStylePara elsevierViewall">Further research should be focused on family-level responses to various disasters by adopting a family resilience model. Research with a mixed-method design, is needed to assess the various relevant constructs including the characteristics of the sample, the psychosocial abilities possessed by the sample, and the process of functioning in the family that is aligned with the family toughness model.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Implications for clinical practice</span><p id="par0130" class="elsevierStylePara elsevierViewall">Firstly, studies must focus on the impact of disasters to assess stability of family functions and family functions. Secondly, health workers assist to families to aware possibility of cultural differences, must consider families in a larger socio-ecological context, and pay attention to subgroups that may be at high risk. Finally, psychosocial support in the family after disaster needs to be carried out continuously and scheduled to be free from the psychosocial impacts.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusion</span><p id="par0135" class="elsevierStylePara elsevierViewall">There is evidence for family resilience after the disaster in many domains of family functioning but there are subsets of families that may struggle with the challenges posed by disaster. Further research conducted from the perspective of family resilience theory is needed to close gaps in the literature, refine family resilience models, and provide clear guidelines for integrating these data into clinical practice.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interest</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1329561" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1225136" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Method" ] 4 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Part I: characteristics of the studies in the review" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Part II: narrative summary of studies that have been reviewed" ] ] ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Limitations" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Suggestions for future research" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Implications for clinical practice" ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Conclusion" ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflict of interest" ] 11 => array:2 [ "identificador" => "xack459086" "titulo" => "Acknowledgments" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-27" "fechaAceptado" => "2019-12-16" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1225136" "palabras" => array:3 [ 0 => "Disaster" 1 => "Family resilience" 2 => "Post-traumatic stress disorder" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study aimed to systematically examine the factors associated with family resilience to minimize the risk of post-traumatic stress disorder (PTSD) due to disasters.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Systematic reviews were carried out using the PRISMA model. The articles were collected from 5 database sources including Proquest, MEDLINE, CINAHL, Science Direct, and Springer Link. The keywords used are family resilience, post-traumatic stress disorder, and disaster. Inclusion criteria include English language, quantitative study, articles published from 2014 to 2018. The author found review of 823 articles, finally selected 11 articles that meet the inclusion criteria.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Family resilience was affected by conflict (18.1%), communication (9%), family support (54.5%), and improvement in resilience programs (27.2%).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Psychosocial support in the family after the family experiencing a disaster needs to be carried out continuously and scheduled.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the International Conference of Indonesian National Nurses Association (ICINNA 2019). Full-text and the content of it is under responsibility of authors of the article.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2055 "Ancho" => 2167 "Tamanyo" => 340591 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the study selection process.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No. \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Authors \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Findings \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cohen, Goldberg<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a>Country not display \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resilience promoting program \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Zokaeefar, Mirbeigi<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a>Iran \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CommunicationResilience promoting program \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Heeke, Stammel<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a>Columbia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ConflictResilience promoting program \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nickerson, Liddell<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resilience promoting program \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nguyen, Chatters<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">5</span></a>USA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Conflict \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sakuma, Takahashi<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a>Japan \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Communication \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Akhter, Sarkar<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">9</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resilience promoting program \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Welton-Mitchell, James<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a>Nepal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resilience promoting program \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thordardottir, Gudmundsdottir<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a>Iceland \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Family support \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wang and Xu<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a>China \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Family support \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wang and Xu<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a>China \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Family support \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2278984.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Results of study selection.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0100" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Building resilience: the relationship between information provided by municipal authorities during emergency situations and community resilience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O. 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The" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pmed.1000097" "Revista" => array:5 [ "tituloSerie" => "PLoS Med" "fecha" => "2009" "volumen" => "6" "paginaInicial" => "e1000097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19621072" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0135" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resilience in family caregiving for people with dementia: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Á. Teahan" 1 => "A. Lafferty" 2 => "E. McAuliffe" 3 => "A. Phelan" 4 => "L. O'Sullivan" 5 => "D. 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