Resilience and sense of agency among healthcare professionals during crisis.
Frontiers in Public Health · 2026-01-01 · Observational study
Abstract
BACKGROUND AND OBJECTIVES: Healthcare professionals (HCPs) are central to emergency response, and their effectiveness depends not only on clinical expertise but also on psychological resources. Strengthening these resources may sustain workforce capacity and safeguard care under crisis conditions. This study examined the contribution of psychological capital-particularly resilience-to perceived agency among Israeli HCPs during mass casualty incidents and violent conflict after 7th of October 2023. The objective was to assess whether psychological resources predict perceived effectiveness beyond traditional factors, with implications for preparedness, organisational support, and policy. Findings may inform interventions relevant to resource-restricted environments and adaptable to developing countries. METHODS: The study was designed as an observational-cross-sectional study, conducted using encrypted online questionnaires distributed via QR codes in trauma centres, dispatch stations, and professional forums. Participants were qualified physicians, surgeons, nurses, paramedics, and EMTs providing patient care during the conflict. Instruments measured psychological capital (PCQ-24), resilience (CD-RISC 10), and perceived agency (RSES). RESULTS: 204 HCPs participated (mean age 37.4, SD = 11.6; 61.8% male). Psychological capital (r = 0.387, p < 0.001) and resilience (r = 0.485, p < 0.001) were strongly associated with agency, surpassing prior experience. Paramedics/EMTs reported higher agency than nurses/physicians (p < 0.001). Spirituality also predicted agency (β = 0.142, p = 0.022). CONCLUSION: Psychological capital and resilience are key determinants of HCPs' perceived agency in crises. Embedding resilience-building into public health systems, alongside organisational and policy measures, may enhance workforce readiness across conflict, disaster, and health threats. These findings are especially relevant to resource-limited settings, where psychological preparedness may be a cost-effective means to support frontline staff and sustain delivery.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Clinician perspective · Terror attacks & active shooter events · Military & tactical · Paramedics & EMTs
Related articles
- Care under attack: a qualitative study of healthcare system disruption and health worker resilience during airstrikes on Lebanon. (BMJ Glob Health, 2026)
- Tactical Emergency Medical Services in Copenhagen, Denmark: A mixed methods design study introducing a new concept. (Acta Anaesthesiol Scand, 2025)
- Preparedness and experiences of healthcare professionals during the Hajj mass gatherings: a qualitative study. (BMC Health Serv Res, 2026)
- Emergency medical services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program. (Prehosp Disaster Med, 2014)
- Canadian operational and emotional prehospital readiness for a tactical violence event. (Prehosp Disaster Med, 2010)
- Willingness to Work during a Terrorist Attack: A Case-Study of First Responders during the 9/11 World Trade Centre Terrorist Attacks (Paramedicine, 2008)