Resilience, the 6th Vital Sign: Conceptualizing, Contextualizing, and Operationalizing All Six Vital Signs  

作　　者：Rose E. Constantino Betty J. Braxter Chi Ching Vivian Hui Larissa C. Allen Lillian J. Wolfe Katherine H. Endres Jezyl Cempron Cutamora Laurence L. Garcia Daisy R. Palompon Kathleen Thimsen Brayden N. Kameg Margarete L. Zalon Rose E. Constantino;Betty J. Braxter;Chi Ching Vivian Hui;Larissa C. Allen;Lillian J. Wolfe;Katherine H. Endres;Jezyl Cempron Cutamora;Laurence L. Garcia;Daisy R. Palompon;Kathleen Thimsen;Brayden N. Kameg;Margarete L. Zalon(Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA;Undergraduate Affairs, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA;The Hong Kong Polytechnic University, Hong Kong, China;School of Nursing, Adjunct Faculty at the University of Pittsburgh, Pittsburgh, PA, USA;School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA;Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA;College of Nursing, Cebu Normal University, Cebu City, Philippines;School of Nursing, University of Nevada, Las Vegas, USA;Department of Health and Community Systems, University of Pittsburgh, PA, USA;Department of Nursing, University of Scranton, Scranton, PA, USA)

机构地区：[1]Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA [2]Undergraduate Affairs, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA [3]The Hong Kong Polytechnic University, Hong Kong, China [4]School of Nursing, Adjunct Faculty at the University of Pittsburgh, Pittsburgh, PA, USA [5]School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA [6]Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA [7]College of Nursing, Cebu Normal University, Cebu City, Philippines [8]School of Nursing, University of Nevada, Las Vegas, USA [9]Department of Health and Community Systems, University of Pittsburgh, PA, USA [10]Department of Nursing, University of Scranton, Scranton, PA, USA

出　　处：《Health》2024年第7期657-673,共17页健康（英文）

摘　　要：There are five vital signs that healthcare providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the American Heart Association, and other specialty organizations, however, the sixth vital sign (resilience) which adopts the measure of immune resilience is suggested in this paper. Resilience is the ability of the immune system to respond to attacks and defend effectively against infections and inflammatory stressors, and psychological resilience is the capacity to resist, adapt, recover, thrive, and grow from a challenge or a stressor. Individuals with better optimal immune resilience had better health outcomes than those with minimal immune resilience. The purpose of this paper is to conceptualize, contextualize, and operationalize all six vital signs. We suggest measuring resilience subjectively and objectively. Subjectively, use a 5-item guided interview revised from the Connor-Davidson Resilience Scale (CDRC), a scale of 10 items. The revised CDRC scale is a 5-item scale. The scale is rated on a 5-point Likert scale from 0 (not true) to 4 (true all the time). The total score ranges from 0 to 20, with higher total scores indicating greater resilience. The scale demonstrated good construct validity and internal consistency (α = 0.85) during the development of the scale. The CD-RISC had a good Cronbach’s alpha level of 0.85. The Revised CD-RISC can be completed in 2 - 4 minutes. To measure resilience objectively, we suggest using Immune Resilience (IR) levels, the level of resilience to preserve and/or rapidly restore immune resilience functions that promote disease resistance and control inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metrics that quantify the balance between CD8 and CD4 T-cell levels and gene expression signatures tracking longevity-associated immunocompetence and mortality- or entropy-associated inflammation. IR deregulation is potentially reversible by decreasing inflamThere are five vital signs that healthcare providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the American Heart Association, and other specialty organizations, however, the sixth vital sign (resilience) which adopts the measure of immune resilience is suggested in this paper. Resilience is the ability of the immune system to respond to attacks and defend effectively against infections and inflammatory stressors, and psychological resilience is the capacity to resist, adapt, recover, thrive, and grow from a challenge or a stressor. Individuals with better optimal immune resilience had better health outcomes than those with minimal immune resilience. The purpose of this paper is to conceptualize, contextualize, and operationalize all six vital signs. We suggest measuring resilience subjectively and objectively. Subjectively, use a 5-item guided interview revised from the Connor-Davidson Resilience Scale (CDRC), a scale of 10 items. The revised CDRC scale is a 5-item scale. The scale is rated on a 5-point Likert scale from 0 (not true) to 4 (true all the time). The total score ranges from 0 to 20, with higher total scores indicating greater resilience. The scale demonstrated good construct validity and internal consistency (α = 0.85) during the development of the scale. The CD-RISC had a good Cronbach’s alpha level of 0.85. The Revised CD-RISC can be completed in 2 - 4 minutes. To measure resilience objectively, we suggest using Immune Resilience (IR) levels, the level of resilience to preserve and/or rapidly restore immune resilience functions that promote disease resistance and control inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metrics that quantify the balance between CD8 and CD4 T-cell levels and gene expression signatures tracking longevity-associated immunocompetence and mortality- or entropy-associated inflammation. IR deregulation is potentially reversible by decreasing inflam

关 键 词：CONCEPTUALIZATION CONTEXTUALIZATION OPERATIONALIZATION Body Temperature Pulse RESPIRATION Blood Pressure Pain RESILIENCE 

分 类 号：R73[医药卫生—肿瘤]