Table 3 Summary of measuring instruments of the included studies

Resilience

Name of Measuring Instrument

Domains

Number of Items

Rating Scale

Validity in Instrument

Reliability in Instrument

Study

Internal Reliability Measures Across Included studies

the Connor Davidson Resilience Scale (CDRS)

ability to tolerate painful experiences

−25 items/10 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: Analysis of data from subjects in the general population sample yielded five factors whose eigenvalues were, respectively, 7.47, 1.56, 1.38, 1.13, and 1.07.

-Convergent Validity: negative correlation with the Perceived Stress Scale (PSS-10) (Pearson r = −0.76, P<.001);

negative correlation with the Sheehan

Disability Scale (SDS) (Pearson r= −0.62,

P <.0001);

the Sheehan Social Support Scale (SSS) correlated significantly with the CD-RISC(Spearman r =0.36, P<.0001).

-Discriminant Validity: not significantly correlated with the ASEX at baseline

(r= −0.34, P=.11) or at endpoint (r= −0.30, P=.21)

-Internal Consistency: Cronbach’s α for the full scale was 0.89 for Group 1 and item-total correlations ranged from 0.30 to 0.70.

-Test-retest: The mean (sd) CD-RISC scores at time 1 [52.7 (17.9)] and time 2 [52.8 (19.9)] demonstrated a high level of agreement, with an intraclass correlation coef ficient of 0.87.

Carr et al.

(2013) [7]

α=0.89

Eweida et al.

(2023) [19]

α=0.88

Fikretoglu et al.

(2019) [21]

T1: α=0.85

T2: α=0.91

T3: α=0.93

Wild et al.

(2020) [61]

α=0.93

the Brief Resilience Scale (BRS)

perceived stress, depression, and active coping

−6 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: The results for each sample revealed a one-factor solution accounting for 55–67% of the variance (Samples 1–4 = 61%, 61%, 57%, 67%, respectively). The loadings ranged from.68 to.91.

-Convergent Validity: positively correlated with the resilience measures, optimism, social support, active coping, positive reframing and purpose in life, and negatively correlated with pessimism, alexithymia, negative interactions, behavioral disengagement, denial, and self-blame.

-Discriminant Validity: “resilience” measures were almost always related in the expected direction with the outcomes, with the exception that ego resiliency was only marginally related to less negative affect.

-Internal Consistency: Internal consistency was good, with Cronbach’s

alpha ranging from 0.80–0.91

-Test-retest: The BRS was given twice in two samples with a test-retest reliability (ICC) of.69 for one month in 48 participants from Sample 2 and.62 for three months in 61 participants from Sample 3.

Christopher et al.

(2016) [12]

Pre-MBRT：α=0.87

Post-MBRT：α=0.90

Kaplan et al.

(2017) [30]

Pre-MBRT：α=0.87

Post-MBRT：α=0.90

Marks et al. (2017) [47]

Not report

the Emergency Medical Services Resilience Scale (EMSRS)

job motivation, communication challenges, social support, calmness at the incident scene, self-management or self-care, and consequences of stress

−31 items

−5-point Likert scale

-Content validity: 13 items were omitted (P < 0.63) and the SCVI/Ave was 0.96. In the CVI assessment, four items were omitted. The factor analysis with varimax rotation was used and 10 items were eliminated due to their lack of compatibility with the desired factor.

-Construct validity: Six factors had values higher than one. This six-factor structure accounted for 51.82% of the total variance.

-Internal Consistency:

The internal consistency of the scale was calculated with a Cronbach's alpha coefficient of 0.91 and a theta coefficient of 0.97. The ICC of the EMSRS was 0.851 and the ICC of its dimensions ranged from 0.72 to 0.87.

-Test-retest: ICC=0.851

Ebrahimian et al.

(2021) [17]

α=0.91

Resilience Scale(RS)

personal competence and acceptance of self and life

−25 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: The various items loaded onto six different factors with an Eigenvalue greater than 1, which confirms that the RS can have a five or even a six-factor structure.

-Convergent &Discriminant Validity: There was a significant moderate positive correlation between the entire RSnl and the BRSnl, and a significant moderate positive correlation between the entire RSnl and the AAQ II, and there was a significant strong positive correlation between the BRSnl and the AAQ II.

-Internal Consistency: Cronbach’s alpha ranges from.87 to.95.

Meulen et al. (2017)

 [50]

α=0.93

the Mental Toughness Questionnaire-48 (MTQ-48)

Challenge, Commitment, Control, and Confidence

−48 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: S-Bχ² (1074) = 2599.046, p <.001, RCFI =.623, RNNFI =.604, SRMR =.070, RMSEA =.054, 90% CI [.052,.057]

-Internal Consistency: The scale demonstrated adequate internal reliability for the subscales of commitment, confidence abilities and confidence interpersonal, but not for challenge, control-emotion and control-life.

Meulen et al. (2017)

 [50]

α=0.91

the General Health Questionnaire-12 (GHQ-12)

psychological distress and social dysfunction factors

−12 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: The validity of the GHQ as shown by its linear associations with independent clinical assessments (typically r = 0.70 or greater). The factor structure of the GHQ have typically yielded a large general factor, with three more subsidiary ones.

-Internal Consistency & Test-retest: The development studies showed that the full scale exhibited high internal consistency and good retest reliability over a period of 6 months.

Cohn et al.

(2008) [13]

α=0.87–0.89

the Response to Stressful Experiences Scale (RSES)

meaning-making and restoration, active coping, cognitive flexibility, spirituality, and self-efficacy

−22 items

−5-point Likert scale

-Content validity: All corrected item-total correlations, again for 20 of the 22 items, exceeded 0.45.

-Construct validity: These 5 factors accounted for over 53% of the total variability in item responses.

-Convergent Validity: Correlating moderately to moderately high (coeffi cients of 0.61 and 0.81) with scores on the CD-RISC, and with DRS-15 was only 0.38.

-Discriminant Validity Weakly related to individual differences in responding to highly stressful events, including scores on the Combat Experiences Scale (coeffi cients of 0.01, −0.18, and 0.02) and MMPI-2 RF Lie Scale (coefficient of 0.19).

-Concurrent Validity: Those scoring higher on the RSES tended to score higher on measures of Unit Support (coeffi cient of 0.38) and Postdeployment Social Support (coeffi cients of 0.36 and 0.56).

-Internal Consistency & Test-retest: The resulting 22-item scale demonstrated sound internal consistency (a = 0.91–0.93) and good tes--retest reliability (r = 0.87).

Johnson et al. (2014)

 [29]

Not reported

the Global Assessment Tool (GAT)

emotional, family, social, spiritual fitness and organizational context

−140 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: Items cohered as intended into the domains of concern to the CSF program. Spiritual fitness items (e.g., “My life has a lasting meaning”) and family fitness items (e.g.,“My family supports my decision to serve in the Army”)

respectively loaded on and indeed defined their own separate factors.

-Convergent Validity: In almost all cases, items derived from a given scale converged with one another.

-Internal Consistency: Alpha coefficients for

scales exceeding.80

Lester et al.

(2011) [37]

α>0.80

the Immediate Self-Administered Questionnaire

recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions; tachycardia; muscle tension; difficulty relaxing; difficulty falling or staying asleep; feeling fear; feeling guilty; needing help after the medical response; and needing to talk with someone in private

−9 items

-yes or no option for each item

-Content: The items from 1 to 7 are based on the Diagnostic and Statistical Manual of Mental Disorders, Fouth Edition, Text Revision.The eighth and ninth items are the active needs from healthcare providers.

Not reported

Ke et al.

(2017) [32]

Not reported

Coping

Name of Measuring Instrument

Domains

Number of Items

Rating Scale

Validity in Instrument

Reliability in Instrument

Study

Internal Reliability Measures Across Included studies

the Brief COPE

active coping, planning, positive reframing, acceptance, humour, religion, emotional support, instrumental support, self-distraction, denial, venting, substance use, behavioural disengage- ment, and self-blame

−28 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: all items contribute with their respective factor with loadings greater than the recommended minimum of 0.40.

-Convergent & Discriminant Validity: Higher coefficients are observed between instrumental support and emotional support (r = 0.65) and between active coping and planning (0.56).

-Internal Consistency: Cronbach’s alpha for the total scale is adequate exceeds the minimum value of 0.60.

Cohn et al.

(2008) [13]

α>0.50

Skeffington et al.

(2016) [57]

α=0.74–0.96

the Coping Style Questionnaire

problem-solving, self-blaming, helpseeking, fantasy, avoidance and rationalization.

−62 items

−2-point Likert scale

-Content validity: not reported

-Construct validity: The six factors with eigenvalues greater than were extracted, and then the absolute value of the factor load above 0.35 (including 0.35) was proposed to form six homogeneous coping factors.

-Internal Consistency: not reported

-Test-retest: The retest correlation coefficients are: R1=0.72; R2=0.62; R3=0.69;R4=0.72;R5=0.67;R6=0.72.

Bian et al.

(2011) [5]

α=0.75–0.89

the Ways of Coping Inventory

problem-solving and seeking support

−66 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: The 27 items classified as problem-focused, 21, or 78%, correlated more strongly with the first empirical factor. Of the 41 items classified as emotion-focused, 28, or 68%, were correlated more strongly with the second empirical factor.

-Convergent & Discriminant Validity: The correlations between the P- and E-scales in these administrations were.35 (N = 81),.52 (N = 63), and.44 (N = 83). The mean correlation was.44.

-Internal Consistency: The mean alpha coefficient for the two adminis- trations of the P-scale was 0.80 and for the E- scale,0.81.

Maunder et al. (2010) [49]

α=0.73

Social Support

Name of Measuring Instrument

Domains

Number of Items

Rating Scale

Validity in Instrument

Reliability in Instrument

Study

Internal Reliability Measures Across Included studies

the Social Support Rating Scale

objective support,

perceived support, and the use of support

−10 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: not reported

-Predictive Validity: There was a moderate correlation between the scale prediction outcome and the physical health outcome.

-Internal Consistency: not reported

-Test-retest: The total score consistency was R=0.92 (P<0.01), and the consistency of each item was between 0.89 and 0.94.

Bian et al.

(2011) [5]

α=0.89–0.93

the Social Provisions Scale

Seeking Social Support, Planful Problem Solving, and Positive Reappraisal

−66 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: Factor analysis has confirmed a six-factor structure that corresponds to the six social provisions. The six social provisions in combination accounted for 66% of the variance in scores on the UCLA Loneliness Scale.

-Discriminant Validity: Analyses of data from a college student sample have supported the discriminant validity of the Social Provisions Scale against relevant measures of mood (e.g., depression), personality (i.e., neuroticism, introversion-extraversion), and social desirability.

-Internal Consistency: Internal consistency for the total scale score is relatively high, ranging

from.85 to.92 across a variety of populations. Alpha coefficients for the

individual subscales range from.64 to.76.

Powell

et al. (2016) [55]

α=0.92

the Social Participation scale and the Social Support Scale

social support in home and work

−10 items totally

−7-point/3-point Likert scale

The Social Participation scale:

-Content validity: not reported

-Construct validity: The individual items of the DFI have been shown to reliably load on a single factor.

The Social Support Scale: Detailed information is provided in the table below.

The Social Participation scale:

-Internal Consistency: The Cronbach's a for the present sample was 0.80.

The Social Support Scale: Detailed information is provided in the table below.

Wild et al.

(2020) [61]

Social Participation：α=0.92

Social Support (Home)：α=0.77

Social Support (Work)：α=0.83

the Emergency Medical Services Resilience Scale (EMSRS)

-Social Support: social support

−31 items

−5-point Likert scale

-Content validity: 13 items were omitted (P < 0.63) and the SCVI/Ave was 0.96. In the CVI assessment, four items were omitted. The factor analysis with varimax rotation was used and 10 items were eliminated due to their lack of compatibility with the desired factor.

-Construct validity: Six factors had values higher than one. This six-factor structure accounted for 51.82% of the total variance.

-Internal Consistency:

The internal consistency of the scale was calculated with a Cronbach's alpha coefficient of 0.91 and a theta coefficient of 0.97. The ICC of the EMSRS was 0.851 and the ICC of its dimensions ranged from 0.72 to 0.87.

-Test-retest: ICC=0.851

Ebrahimian et al. (2021) [17]

α=0.91

the Social Support Questionnaire

-Social Support: availability and satisfaction

−6 items

−6-point Likert scale

-Content validity: not reported

-Construct validity: Two factors were found to account for 71, 14% of the overall variance. All the items load onto their original subscales with loading values of 0.70 or greater in each case.

-Internal Consistency: Cronbach’s alpha coeffi cients of reliability of

the total SSQ6 is 0.885.

Skeffington et al.

(2016) [57]

Not reported

Mindfulness

Name of Measuring Instrument

Domains

Number of Items

Rating Scale

Validity in Instrument

Reliability in Instrument

Study

Internal Reliability Measures Across Included studies

the Five Facet Mindfulness Questionnaire

-Mindfulness:observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience

−39 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: Results of the initial EFA yielded 26 factors with eigenvalues greater than 1.0 and accounting for 63% of the total variance. Facet loadings for the final model differed, on average, by only two one hundredths (.02). Fit indices for this model were CFI =.96, NNFI =.94, and RMSEA =.07

-Convergent &Discriminant Validity: All correlations were in the expected directions, and all but one (MQ with openness to experience) were statistically significant.

-Internal Consistency: The following alpha coefficients were obtained for the

five mindfulness questionnaires, suggesting good internal consistency: MAAS =.86, FMI =.84, KIMS =.87,

CAMS =.81, MQ =.85 (ns = 595–613).

Christopher et al.

(2016) [12]

Pre-MBRT：α =0.82

Post-MBRT：α =0.88

Kaplan et al.

(2017) [30]

Pre-MBRT：α =0.82

Post-MBRT：α =0.88

Stanley et al. (2011) [59]

Not reported

Stress and Burnout

Name of Measuring Instrument

Domains

Number of Items

Rating Scale

Validity in Instrument

Reliability in Instrument

Study

Internal Reliability Measures Across Included studies

the Perceived Stress Scale (PSS)

-Stress and Burnout:how often participants

experience specific thoughts, feelings, or difficulties related to stress

−4 items

−5-point Likert scale

-Content validity: not reported

-Construct validity: the two-factor structure for the PSS-14 accounted for less than 50% of the total variance.

-Criterion Validity: PSS was strongly

correlated with only the mental component of health status as measured by the Medical Outcomes StudyeShort Form 36.

-Internal Consistency: The reported Cronbach’s alpha was <.70 in

half of the six studies in which the PSS-4 was evaluated.

-Test-retest reliability :The test-retest reliability of the PSS was assessed in met the criterion of >.70.

Christopher et al.

(2016) [12]

Pre-MBRT：α =0.69

Post-MBRT：α=0.68

Mahaffey

et al.

(2021) [42]

α=0.88–0.91

Powell

et al. (2016) [55]

α=0.85

Stanley et al. (2011) [59]

Not reported

Generalized Anxiety Disorder Scale (GAD-7)

-Stress and Burnout:anxiety level

−7 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: There was a strong association between increasing GAD-7 severity scores and worsening function on all 6 SF-20 scales.

-Convergent &Discriminant Validity: The Beck Anxiety Inventory (r = 0.72) and the anxiety subscale of the Symptom Checklist-90 (r = 0.74).

The GAD-7 correlated most strongly with mental health (0.75), followed by social functioning (0.46), general health perceptions (0.44), bodily pain (0.36), role functioning (0.33), and physical functioning (0.30).

-Internal Consistency: Cronbach α =.92.

-Test-retest reliability : intraclass correlation = 0.83

Fikretoglu et al.

(2019) [21]

T1: α=0.87

T2: α=0.89

T3: α=0.92

the Emergency Medical Services Resilience Scale (EMSRS)

-Stress and Burnout:calmness at the incident scene and consequences of stress

−31 items

−5-point Likert scale

-Content validity: 13 items were omitted (P < 0.63) and the SCVI/Ave was 0.96. In the CVI assessment, four items were omitted. The factor analysis with varimax rotation was used and 10 items were eliminated due to their lack of compatibility with the desired factor.

-Construct validity: Six factors had values higher than one. This six-factor structure accounted for 51.82% of the total variance.

-Internal Consistency:

The internal consistency of the scale was calculated with a Cronbach's alpha coefficient of 0.91 and a theta coefficient of 0.97. The ICC of the EMSRS was 0.851 and the ICC of its dimensions ranged from 0.72 to 0.87.

-Test-retest: ICC=0.851

Ebrahimian et al. (2021) [17]

α=0.91

the Depression Anxiety Stress Scales (DASS)

-Stress and Burnout:depression, anxiety and stress

−42 items/21 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: GFI= 0.92、AGFI=0.90，NFI=0.87、CFI =0.88、IFI =0.88、RFI =0.85、TLI =0.86，RMSEA = 0.065.

-Convergent &Discriminant Validity: There was a moderate correlation among the dimensions (0.577–0.691), and a high correlation between the dimensions and the total scale (0.805–0.897).

-Internal Consistency: The internal consistency of the depression, anxiety, and stress subscales was 0.77, 0.79, and 0.76, respectively, and the internal consistency coefficient of the total scale was 0.89.

Skeffington et al.

(2016) [57]

Not reported

the Old Lenbuth Burnout Inventory (OLBI)

-Stress and Burnout:exhaustion and disengagement

−16 items

−4-point Likert scale

-Content validity: not reported

-Construct validity: The fitting index of the model did not reach the 0.90 standard, and subscales exhaustion and disengagement had an estimated correlation of.52.

-Convergent Validity: All items of Exhaustion (of both instruments) loaded significantly on an Exhaustion factor, while the items of Cynicism and of Disengagement had significant loadings on an Attitudes factor.

-Intercorrelation: All scales exhibited reliabilities greater than 0.70.

Christopher et al.

(2016) [12]

Pre-MBRT：α = 0.85

Post-MBRT；α = 0.88

Kaplan et al.

(2017) [30]

Pre-MBRT：α = 0.85

Post-MBRT；α = 0.88