Intersections between rural women’s resilience and quality of life: a mixed-methods study

Silva, Bruno Neves da; Santos, José Luís Guedes dos; Riquinho, Deise Lisboa; Miranda, Francisco Arnoldo Nunes de; Souza, Nilba Lima de; Pinto, Erika Simone Galvão

doi:10.1590/1518-8345.5671.3521

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Brasil

Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 30 • 2022 • https://doi.org/10.1590/1518-8345.5671.3521 copy

Intersections between rural women’s resilience and quality of life: a mixed-methods study ^* * Paper extracted from master’s thesis “Intersecções entre qualidade de vida e resiliência em mulheres rurais: estudo de métodos mistos”, presented to Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the intersections between rural women’s quality of life and resilience.

Method:

convergent mixed methods design in which a cross-sectional quantitative study is triangulated with a qualitative study guided by Oral History. Data were collected concomitantly, using a socio-demographic form, Resilience Scale, Medical Outcomes Study 36-Item Short-Form Health Survey, and open-ended interviews. The analysis was based on descriptive and inferential statistics and inductive thematic analysis, which was integrated later.

Results:

an association was found between the social aspects domain of quality of life and a moderate level of resilience related to the characteristics of life in rural areas. The integration of results enabled verifying that these two constructs (which mutually influence each other) are mediated by protective factors, resilience developed by the rural women, such as spirituality and the formation of social support, enchantment, and a feeling of belonging to their context.

Conclusion:

by developing protective factors, rural women develop a resilient behavior that favors their quality of life. Identifying these factors enables the development of psychosocial interventions to promote rural women’s health.

Descriptors:
Women; Rural Areas; Psychological Resilience; Quality of Life; Rural Health; Health Promotion

Variable	Minimum	Maximum	Mean	p*
PF	30	100	77.36	0.445
RP	0	100	55.46	0.675
Bodily pain	0	100	62.64	0.304
GH	10	95	53.74	0.631
Vitality	25	95	68.28	0.426
SF	25	100	73.22	0.046
RE	0	100	61.68	0.184
MH	28	100	72.97	0.236

Main topic	QUAN results	QUAL results	Combination of mixed method
Integration	Associations between the level of resilience and the SF-36 domains (Mann-Whitney test)	Themes and excerpt from the thematic analysis	Meta-inferences
Intersections between resilience and QoL	No statistically significant association was found between the level of resilience ( =129.14) and the SF-36 (p=0.445) PF domain* ( =77.36)	Rural life as a promoter of resilience and QoL [...] we got here, as the history says, at our age today, we’ve suffered a lot in the country, worked a lot, as men did, you know? But everyone was happy, I was happy, I won’t say I wasn’t, I think I was happier than I am today [...] (Joaquina Margarida).	Divergence The women reported that physical strain demanded by rural labor is a positive intervenient factor in their health and QoL (even though work has also been related to disease), and being enchanted with the rural life was a protective factor for the development of resilience, which conflicts with a lack of statistical significance between the level of resilience and the SF-36 PF domain found in the Mann-Whitney test.
	No statistically significant association was found between a moderate level of resilience ( =129.14) and the SF-36 (p=0.675) RP domain^† ( =55.46)	Rural life as a promoter of resilience and QoL [...] You may note that people like me, who’ve worked in the countryside, are strong, won’t fall easily [...] (Francisca Margarida).	Divergence The rural women’s concepts indicate that even though they faced limitations that impeded their activities, they were able to prevail, revealing resilience even when dealing with obstacles, which also conflicts with the lack of statistical significance found in the Mann-Whitney test.
	No statistically significant association was found between a moderate level of resilience ( =129.14) and the SF-36 (p=0.304) pain domain ( =62.64)	Rural life as a promoter of resilience and QoL [...] even now I feel like going to work in the countryside... but I can’t because of my pains [...] (Sebastiana Margarida).	Divergence Bodily pain stands out as a factor that limits everyday activities of these rural women, impeding them from doing their work, though they see it as a source of resilience so that their pain is a fact that negatively interferes in their QoL. This finding also conflicts with the lack of statistical significance in the Mann-Whitney test.
	No statistically significant association was found between a moderate level of resilience ( =129.14) and SF-36 (p=0.631) GH domain‡ ( =53.74)	Concepts on health and QoL My health is terrible, but I make it seem not so terrible because when I have problems, I put them in God’s hands and ask Him to give me strength to overcome them [...] (Tereza Margarida).	Divergence Protective factors such as spirituality promote resilience among rural women enable them to develop coping strategies to deal with unfavorable health conditions, also differently from what was found in the Mann-Whitney test, which did not present any statistical significance between the level of resilience and the SF-36 GH domain.
	No statistically significant association was found between the level of resilience ( =129.14) and the SF-36 (p=0.426) vitality domain ( =68.28)	Concepts on health and QoL When I used to work in the countryside, I had quality of life, health and courage; I worked in the field on Saturday many times, sometimes there were dance parties on Saturday night, and I’d go, and was brave enough. I guess that people who work in the countryside are healthier (Sebastiana Margarida).	Divergence Bravery, a synonym of vitality and energy, is alluded by the rural women as coming from their everyday work, permeated by protective factors that culminate in resilient processes, also contrasting with the lack of statistical significance verified by the Mann-Whitney test.
	No statistically significant association was found between a moderate level of resilience ( =129.14) and the SF-36 (p=0.046) SF domain^§ ( =73.22)	Rural life as a promoter of resilience and QoL [...] There is tranquility on the farm, you trust the people you know, we help each other in times of need [...] (Francisca Margarida).	Convergence The establishment of social support networks with the community was a protective factor revealed in the reports of rural women, which promoted resilience and QoL, corroborated by the statistical significance found in the Mann-Whitney test.
	No statistically significant association was found between the level of resilience ( =129.14) and the SF-36 (p=0.184) RE domain^\|\| ( =61.68)	Rural life as a promoter of resilience and QoL [...] Whenever I have problems, I put them in God’s hand and ask Him strength to overcome them [...] so, I’ve always found a solution for my problems (Tereza Margarida).	Divergence Protective factors such as spirituality and hope (closely linked to the role emotional domain) promote resilience that leads rural women to overcome daily challenges and enjoy greater QoL, which diverges from the lack of statistical significance found in the Mann-Whitney test.
	No statistically significant association was found between a moderate level of resilience (=129.14) and the SF-36 (p=0.236) MH domain^¶ (=72.97)	Rural life as a promoter of resilience and QoL I’m anxious, but when something makes me anxious, I deal with it, you know? I’m strong, won’t fall apart… Even if I’m sick, I won’t break easily, you have to hold your head up high, and whenever you have a problem, always see both sides [...] (Raimunda Margarida).	Divergence Rural women find ways to live with quality based on their hope and resilient attitude, despite their psychosocial problems like anxiety, and keep their level of psychological well-being by facing obstacles from more than one perspective. However, the association between resilience and mental health was not statistically significant in the Mann-Whitney test.
	Relationship between the level of resilience and the SF-36 domains (multiple linear regression)	Themes and excerpts from the thematic analysis	Meta-inferences
	The linear regression analysis with the SF-36 domains as independent variables predicted 14.1% of the variance in the level of resilience, which was a dependent variable (R²=0.141; F=1.60; p=0.004).	Rural life as a promoter of resilience and QoL I guess I’m resilient because I’ve suffered a lot where I came from [...] I experienced many hardships and obstacles, but I thank God for going through all these; I guess that I’m an overcomer. I’ve faced so much, but still, I moved on (Tereza Margarida).	Magnification The rural women’s understanding shows that the adversities they face in their daily lives and work contributed to their health and QoL, working as protective factors that promote resilience processes. The QoL domains in the regression model corroborate these resilience processes, which positively feedback these women’s health.

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[1] Corresponding author:
Bruno Neves da Silva. E-mail: enfbneves@gmail.com