The Nurses’ Coping Resource Inventory (N-CRI): A Salutogenic Framework for Holistic Nurse Burnout Resilience

Abstract

Background Burnout represents a global workforce crisis that undermines holistic nurse wellbeing, care quality and workforce retention, especially in low-resource health systems. Although sense of coherence (SOC) and adaptive coping promote resilience, holistic and salutogenic frameworks remain underutilized. Objectives To examine nurses’ coping strategies and intervention preferences through Antonovsky's SOC and develop the nurses’ coping resource inventory (N-CRI), an empirically grounded, middle-range conceptual framework for burnout resilience. Methods An explanatory sequential mixed-methods study was conducted with 97 nurses at a Kenyan referral hospital. Quantitative descriptive statistics and qualitative thematic analysis mapped findings to SOC dimensions (comprehensibility, manageability, and meaningfulness). Results Adaptive coping predominated: spiritual practices (74.2%), peer support (67.0%), and cognitive reframing (62.9%), with maladaptive strategies rare (≤13.4%). Meaningfulness emerged strongest, yet manageability was limited by institutional gaps. Nurses prioritized structural burnout interventions, including safe staffing, fair remuneration, and work–life balance. The N-CRI organizes interdependent systemic, interpersonal, and individual holistic coping resources that mobilize generalized resistance resources and strengthen SOC to foster holistic resilience. Conclusion Holistic nurse burnout resilience reflects the interplay of organizational, relational, and individual healing resources, not individual coping alone. The N-CRI offers a concise, adaptable framework for holistic assessment, multilevel interventions, and policy supporting sustainable workforce wellbeing.