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Self‑Regulation and Heart Rate Variability Coherence: Promoting Psychological Resilience in Healthcare Leaders

    • Published: 2014
    • E. Denise Lackey
    • Ph.D. Dissertation, Faculty of Benedictine University, Degree of Doctor of Philosophy in Values-Driven Leadership, May 2014.
    • Download the complete paper, click here.


Leaders within healthcare organizations strive to promote healing modalities for patients, and a healthy milieu that will support the delivery of high-quality, evidencebased, safe, and compassionate care. Behavioral responses to increased demands, competing priorities, hierarchical turmoil, and increased customer expectations place significant demands and stress on leaders. Healthcare leaders who operate under intense or chronic stress are likely to be at greater risk for errors in communication, medication administration, and spontaneous actions that result in adverse events.

Nursing turnover and burnout result in absenteeism translating to shortages on clinical units. Missed days from work create a cost burden and pose a significant financial loss to the bottom line of the organization. Therefore, this study explored the ability of healthcare leaders to reduce negative emotional states experienced at work by gaining self-awareness, demonstrating self-regulation, and building psychological resilience. Additionally, this research studied the impact of the resilience advantage and behavior modification training offered over a six-month timeframe. A number of areas were assessed: vitality, emotional wellbeing, ability to cope with stress, workplace effectiveness and performance, intention to quit, anxiety and depression, fatigue, and physical symptoms. Pre- and post-tests were administered using the Personal and Organizational Quality Assessment—Revised 4 Scale (POQA-R4) survey questionnaire, which provides an assessment of personal health and workplace quality.

The resilience-building training improved the healthcare leaders’ capacity to become more self-aware and to recognize and self-regulate their response to stressors. Participants experienced reductions in stress, negative emotion, depression, and pressures of life and increased energy, vitality, peacefulness, and positive emotion. Results of this research suggest that the training in resilience-building and self-regulation skills may significantly benefit healthcare leaders by improving judgment, critical thinking, communication skills, and decision-making, while simultaneously reducing fatigue, anxiety, depression, anger, and resentment. Potential outcomes include fewer patient complaints, reductions in medical errors and adverse events, and decreased organizational liability. Finally, this study highlighted the value of self-regulatory and psychological resilience-building training to promote health and well-being for healthcare leaders.