Organizational resilience and primary care nurses' work conditions and wellbeing: a multilevel empirical study in China.

Resilience is crucial for the health system better preventing and responding to public health threats and providing high-quality services. Despite the growing interest in the concept of resilience in health care, however, there is little empirical evidence of the impact of organizational resilience, especially in primary care settings. As the largest professional group in primary care, primary care nurses are taking more and more responsibilities during their daily practice, which influences both their work conditions and wellbeing. This study aims to examine the association between organizational resilience and primary care nurses' working conditions and wellbeing. Using a convenience sampling approach, we recruited 175 primary care nurses from 38 community health centers (CHCs) in four cities in China. Organizational resilience was operationalized as comprising two domains: adaptive capacity and planning capacity, and measured using a 16-item scale. The primary care nurses' working condition indicators comprised variables of psychological safety, organizational commitment, professional commitment, and self-directed learning; wellbeing indicators included depression and burnout. Hierarchical linear regression models were built for analysis. We found that the sampled CHCs have a relatively high level of organizational resilience. The organizational resilience was positively associated with the four indicators of working conditions: psychological safety (β=0.04, p<0.01), organizational commitment (β=0.38,p<0.01), professional commitment (β=0.39, p<0.01), and self-directed learning (β=0.28, p<0.01). However, organizational resilience was not significantly associated with the two wellbeing indicators. Furthermore, we found the adaptive capacity has stronger association compared with planning capacity. Therefore, primary care manager should build resilient organizations, especially the adaptive capacity, in order to enhance primary care nurses' psychological safety, commitment and learning behaviors. Further studies should also be conducted to understand the link between organizational resilience and primary care nurses' wellbeing.