ArticleInternational journal of nursing studies advances2026
Association between resilience and nurses' professional autonomy across care contexts in the post-pandemic period: a nationwide cross-sectional survey in Japan.
Article in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The COVID-19 pandemic has placed substantial demands on nurses and may have affected their professional autonomy. However, how resilience is associated with nurses' professional autonomy across different care contexts in the post-pandemic period remains unclear. Objective: This study aimed to examine the association between resilience and nurses' professional autonomy when caring for patients with COVID-19 and patients without COVID-19, and to compare professional autonomy across these care contexts. Design: We conducted a nationwide cross-sectional online survey from June to September 2024. Settings: Nurses were recruited from 18 special-functioning and regional medical care support hospitals across Japan; the hospitals were randomly selected for invitation. Participants: A total of 483 nurses participated in the study. Methods: Nurses assessed their professional autonomy in both care contexts using the validated 28-item Nurses' Professional Autonomy Scale. Resilience was measured using the 10-item Connor-Davidson Resilience Scale. Paired Results: Professional autonomy scores were significantly lower when caring for patients with COVID-19 than when caring for patients without COVID-19 (Cohen's d = 0.33, p < 0.001). All five factors were also significantly lower in the COVID-19 care context (p < 0.001). Resilience was positively associated with professional autonomy in both care contexts. This association remained significant when caring for patients with COVID-19 even after adjusting for professional autonomy when caring for patients without COVID-19. Resilience was positively associated with all five factors of professional autonomy in both non-COVID-19 and COVID-19 care contexts (all p < 0.001). Resilience remained significantly associated with three factors of professional autonomy when caring for patients with COVID-19, Performance (β = 0.074, p = 0.037), Abstract judgment (β = 0.148, p < 0.001), and Independent judgment (β = 0.144, p < 0.001), but not with Cognition or Concrete judgment. Conclusions: Resilience was associated with nurses' professional autonomy across care contexts. These findings suggest that resilience may be particularly relevant to higher-order and self-directed aspects of professional autonomy in clinical practice. Supporting resilience may help maintain professional autonomy under both routine and high-demand conditions.
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