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Analysis Matrix of Resilience in the Face of Disability, Old Age and

Poverty
Andrea Crdenasa; Lucero Lpeza
a
School of Nursing, Universidad Nacional de Colombia, Bogot, Colombia
Online publication date: 26 May 2010

To cite this Article Crdenas, Andrea and Lpez, Lucero(2010) 'Analysis Matrix of Resilience in the Face of Disability, Old

Age and Poverty', International Journal of Disability, Development and Education, 57: 2, 175 189
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International Journal of Disability, Development and Education

Vol. 57, No. 2, June 2010, 175189

Analysis Matrix of Resilience in the Face of Disability, Old Age

and Poverty
Andrea Crdenas* and Lucero Lpez
School of Nursing, Universidad Nacional de Colombia, Bogot, Colombia

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International
10.1080/10349121003750760
CIJD_A_475598.sgm
1034-912X
Original
Taylor
202010
57
acardenasj@unal.edu.co
AndreaJimnez
00000June
&
and
Article
Francis
Francis
(print)/1465-346X
2010
Journal of Disability,
(online)
Development and Education

The purpose of this article is to describe the process of the development of the
Resilience Theoretical Analysis Matrix (RTAM) (or in its Spanish translation:
MATR), a tool designed to facilitate a coherent and organised approach to the
assessment of a wide spectrum of factors influencing the development of resilience in
the face of disability, old age and poverty, and the relationships among these factors.
The matrix-building process occurred in four phases: (1) research and synthesis from
three theoretical sources; (2) a comparative analysis of the theoretical sources and the
generation of the matrix dimensions for the first version of the RTAM; (3) the rearrangement of the dimensions according to the principles of cultural psychology; and
(4) the generation of the RTAM (Final Version). The process resulted in a matrix
including six processes ranging from structural processes to individual processes, and
whose horizontal or transversal axes are subjectivity, the relational perspective and the
historicalcultural perspective. Despite being a theoretical tool, the matrix constitutes a
contribution to the applied fields of health and social welfare. Its use in real cases can
inform health and social service providers about the psychological, social, political and
cultural factors that should be strengthened to promote resilience. In turn, this will
contribute to building, maintaining and restoring the health and quality of life for older
people with disabilities who live in poverty.
Keywords: disability; old age; poverty; resilience; theoretical analysis

Introduction
Old Age, Disability and Poverty as Sources of Adversity
The worlds population is undergoing a deep transformation with respect to age. As mortality and fertility rates have decreased, the distribution of the population by age has gradually
modified, driving a major demographic transition (Department of Economic and Social
Affairs of the United Nations (DESA-UN), 2007). This is reflected not only in life expectancy but also in the representation of the elderly within the general population. In this way,
at present (and in the future) not only are there a great many older people, but also they are
living to be much older than in previous decades.
Nowadays, the age distribution in developed countries is, in general, older than that in
developing countries. In Latin America and the Caribbean, the projection for those over 60
years old is expected to increase from 9% in 2005 to 24% in 2050 (DESA-UN, 2007). This
ageing process will be reflected in the 200 million over-60-year-old people that are
expected to live in the region by 2050 (Gasparini, Alejo, Haimovich, Olivieri, & Tornarolli,
2007).

*Corresponding author. Email: acardenasj@unal.edu.co

ISSN 1034-912X print/ISSN 1465-346X online
2010 Taylor & Francis
DOI: 10.1080/10349121003750760
http://www.informaworld.com

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176

A. Crdenas and L. Lpez

In Colombia, the growth of the older population has also been constantly increasing.
While in 1975 people over 65 years old represented 4.6% of the general population, and
5.1% in 2000, the last census data in 2005 showed an increase to 6.31%. The 2025
projection for the older population is 10.5% (Departamento Administrativo Nacional de
Estadistica (DANE), 2008).
Old age is a period of adaptation as there is a gradual change in mental and physical
health, and restrictions emerge in accommodating daily activities and social participation
(Consedine, Magai, & Krivoshekova, 2005; Hardy, Concato, & Gill, 2004; Nygren et al.,
2005). Difficulties in accessing social and health services are added to the above-mentioned
problems (Becker & Newsom, 2005). The combination of these adverse factors causes a
high proportion of older people who may be described as disabled. In Colombia, the
proportion of those who are over 65 years old and who also have a disability is 27%
(DANE, 2007). In around one-half of the Latin American countries, this ageing occurs in a
context where more than 40% of the older people live in poverty. In Colombia, the percentage is 40.49% (DESA-UN, 2007).
The arrival of old age comes with the aforementioned changes, but additionally
implies a series of personal losses, among them social status, death of significant others
(Nygren et al., 2005), loss of independence (Consedine et al., 2005), feelings of a loss
of personal control and the reduction of social support (Walsh, 2005).
In Latin America, poverty, disability, and old age are closely related to feelings of
vulnerability and loss of well-being, which in turn lead to greater impoverishment (Lpez,
2003). In Colombia, older people with disabilities grow older in conditions of poverty as a
result of a life of deprivation, limited access to a health system, limited employment opportunities and limited access to a pension. The family absorbs the economic and social impact
of these conditions while the government takes only a very minor role in ensuring an ageing
process of security and dignity.
Despite the complex and gloomy situation described above, there are individuals who
are able to develop processes that allow them to cope with, adapt to and succeed in facing
these stressful and adverse situations. Such an individual would be described as resilient
(Hardy, Concato, & Gill, 2004).
Resilience from an Ecological Perspective
One of the main challenges for researchers working in the area of resilience has been
achieving consensus on the concepts definition (Waller, 2001). Despite the variability and
difficulty that defining the concept generates, in this article resilience will be understood as
the set of social and intra-psychological processes making possible access to psychophysical welfare despite adversities (Melillo, Soriano, Mendez, & Pinto, 2004, p. 46).
Adoption of this definition is consistent with an understanding of resilience that goes
beyond the intra-individual level and the static conception traditionally associated with
resilience. This understanding is an accurate reflection of its origin in the field of psychology. Although this discipline recognises the importance of culture, it points to universal
features of development of human psychology, giving a place to culture, at most, as an independent variable (Manciaux, 2003). Thus, a number of researchers have explored the characteristics of resilience from a systems approach that considers family, community and
cultural values (Ehrensaft & Tousignant, 2003).
However, it is also possible to approach resilience from an ecological perspective,
and to consider factors from multiple social levels; namely, the same levels from which
the adversity that individuals have to confront arises. Nowadays, there is a growing

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Analysis Matrix of Resilience

177

acknowledgement that resilience is multidimensional and multidetermined, and that it

can be better understood as a product of transactions within and between multiple
systemic levels across time (Walsh, 2005, p. 12). The relationship between human
beings and adversity, the source of resilience, is neither linear nor unidirectional, hence
people can be influenced by and also influence unfavourable life conditions. This
perspective is relatively new in the study of resilience, and invites an interdisciplinary
effort to explore the articulation between psychological processes and those of the nonpsychological environment (Waller, 2001, p. 291).
Understanding resilience requires an analysis of the impact that adverse and protective
factors arising from different systemic levels have on people. Consequently, it is necessary
to consider that risk and protective factors can arise from psychological, familial, community and social systems. Within an ecosystem, these risk and protective factors are dynamic.
They are not fixed features and their effect is only evident in the context of their interaction
and according to the meaning that each individual gives to a certain factor (Waller, 2001).
Jessor (1993 cited in Waller, 2001, p. 294) contends that: research on psychosocial development that ignores contextual conditions of chronic and concentrated adversity limits our
understanding of development in general, and of resilience in particular.
Identification of such a wide variety of factors influencing the development of resilience is only possible if one starts from a theoretical model that allows knowledge about
interrelationships and interdependence between individuals and social levels to be
described. Phenomena can be observed and analysed, and the results can inform science
and official policy (Bronfenbrenner, 2002). The aim of this article is to describe the process
used to create a theoretical tool that will identify this process and analyse the factors
involved in a coherent and organised way. The tool has been named the Resilience
Theoretical Analysis Matrix (RTAM) or in its Spanish translation: Matriz de Anlisis
Terico de la Resiliencia (MATR).
Method
The process of building the RTAM comprised four phases.
Phase 1. Search and Synthesis of Theoretical Sources
In the context of the Ecological Transactional Resilience Model (Waller, 2001), the development of RTAM arose from analysing the models or approaches of three authors: Urie
Bronfenbrenner (2002), author of the Ecology of Human Development perspective; Laura
Polk (1997), who suggested a middle range theory of resilience from within the discipline
of nursing; and Froma Walsh (2005), who focused on strengthening familial resilience.
These theoretical approaches were selected for two reasons: first, they start from a systemic
perspective, referring to all levels of context with which individuals interact and which
affect resilience; and, second, they place special value on cultural factors in the development of resilience. Table 1 provides a brief synthesis of each of the theoretical approaches
to resilience, detailing their main ideas, the levels of analysis, and a definition.
Phase 2. A Comparative Analysis of the Theoretical Sources and the Generation of the
Dimensions for the First Version of the RTAM
A careful reading of the three theoretical sources and an examination of their main features
led to the discovery of a number of similarities. These comprised: theoretical support based
in Systems Theory; consideration of interactions between individuals and their contexts as

Main ideas

From this perspective, development is conceived of as a

continuous process of mutual adaptation and
accommodation between individuals and their physical,
social, class and cultural environments. Environment is
defined as something that expands beyond the immediate
situations that affect the development of people. It
includes interconnections between these environments
and external influences that arise from wider
environments. So, topologically, environment is
considered as a series of concentric structures, where each
structure is contained in the following. These structures
are called the micro-, meso-, exo- and macrosystems.
From this perspective, there is a reciprocal relationship
between the individual and the environment. It is also
evident that culture and subjectivity are determinants for
peoples development.

Theory

Ecology of Human
Development
(Bronfenbrenner, 2002)

Table 1. A synthesis of the three theoretical approaches to resilience.

Individuals experience an environment with particular

physical and material characteristics. The word
experience is used in this definition, because not
only are objective conditions of the environment
important, but also the ways such properties are
perceived by people are important (Bronfenbrenner,
2002).

The interrelationship between two or more

environments in which individuals actively take part.
For instance, between family, work and social life. A
mesosystem is a microsystems system
(Bronfenbrenner, 2002).
One or more environments that do not include
individuals as active participants. Factors and vice
versa that affect what happens in an environment
(Bronfenbrenner, 2002).
Interconnected systems in which ideological patterns
and organisation of social institutions common to a
particular culture or subculture are manifested.
Includes a system of beliefs and values supporting
those patterns. Political, economic and cultural
systems are features of the macrosystem
(Bronfenbrenner, 2002).

Microsystem

Mesosystem

Macrosystem

Exosystem

Definition

Levels of analysis

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A. Crdenas and L. Lpez

Main ideas

Based in the paradigm of simultaneousness in nursing

science, Newman (1990; quoted by Polk, 1997) argues
that a human being is more than the sum of their parts.
People change mutually and simultaneously with their
environment in a rhythmic and interactive process of
increasing complexity. Polk (1997) proposes a conceptual
synthesis as an attempt to clarify inconsistencies and
variability in the conceptualisation of resilience.
Such a conceptual synthesis departs from the supposition
that if the force of fluctuation to a system is great enough,
then that system is forced to change, moving through a
period of temporary chaos to a new, higher level of
organization and functioning (Prigogine et al., 1997,
quoted in Polk, 1997). This is the process that was mainly
described as resilience. This process is viable because of
the synergistic relationship between four patterns:
dispositional, situational, relational and philosophical.
This model facilitates exploration of the meanings
individuals assign to adverse experiences. This aspect
shows that the author gives importance to subjectivity not
only for resilience itself, but also for health enhancement.

Theory

Synthesis of the
concept of resilience
(Polk, 1997)

Table 1. (Continued).
Definition
This pattern refers to physical and ego-related
psychosocial attributes that contribute to the
manifestation of resilience. Psychosocial attributes are
characteristics reflective of personal competence and a
sense of self, while physical attributes are the
constitutional and genetic factors that enter into the
development of resilience (Polk, 1997, p. 4).
Characteristics of roles and relationships influencing
resilience. Includes both intrinsic and extrinsic aspects
of close relationships and those with wider social
support network (Polk, 1997, p. 4).

Conceptualisation of this pattern and its components is

derived mainly from the stress appraisal and coping
theory by Lazarus and Folkman (1986).
This pattern is displayed through personal beliefs,
such as those allowing extraction of a positive sense to
adverse events, or conviction that life has an aim and
coherence.

Levels of analysis
Dispositional
pattern

Relational pattern

Situational pattern

Philosophical
pattern

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Analysis Matrix of Resilience

179

Belief systems

Organisational
patterns

Communication
processes

Family resilience is referred to as the confrontation and

adaptation process within the family as a functional unit
(Walsh, 2005, p. 14).
The origin of this approach is based in the competence
paradigm whose purpose is to understand how all families,
in their diversity, can survive oppressive stress and affirm
their potential for self-healing and growth from the crisis
(Walsh, 2005).

Complexity in the familys functioning needs to be

considered within the ecological niche of each family, in
which multiple socio-cultural aspects are combined, such
as ethnicity, social class, religion, family structure, gender
roles, sexual orientation, and stage in their lives (Falicov,
2005, quoted in Walsh, 2005).

It is very useful to organise such processes in a conceptual

structure comprising three domains: belief systems,
organisational patterns, and communication processes.

Familial Resilience
Strengthening Model
(Walsh, 2005)

Levels of analysis

Main ideas

Theory

Table 1. (Continued).

Beliefs are lenses through which we observe the world

and they influence what we see and what we do not
(Walsh, 2005, p. 44).
Belief systems include cultural values, convictions,
attitudes, tendencies and assumptions that combine to
form a set of basic premises that produce emotional
reactions, inform decisions and guide actions. The
main beliefs in familial resilience can be organised in
three areas: ability to extract meaning from adversity,
positive perspective (potentiality and ratifying
chance), and transcendental and spiritual beliefs
(Walsh, 2005).
It is necessary that families mobilise resources, resist
stress and reorganise themselves to adapt to adverse
conditions in order to master crises and persistent
adversity. Familial organisational patterns define
relationships and regulate behaviour, are maintained
by external and internal rules, and are reinforced by
cultural and familial belief systems. The main
processes of familial resilience related to
organisational patterns are flexibility, connection, and
social and economic resources.
Communication can be widely defined as information
interchange, socio-emotional problem solving, and
instrumental practice (Walsh, 2005).
Three aspects of communication are key to familial
resilience: clarity, open emotional expression, and
cooperation in problem resolution.

Definition

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A. Crdenas and L. Lpez

Analysis Matrix of Resilience

181

a main source for the development of resilience; multidimensionality; and a central role was
given to subjectivity.
In addition to these similarities, the particular contributions from each source support
Galendes view that:

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resilience evokes the idea of complexity and integration: complexity of real processes in
which life develops; integration of these levels which science separates for their knowledge
but having an integrated existence in human experience, in biological mechanisms of body,
psychological life and social and cultural existence. (Galende, 2004, p. 35; translated, original
in Spanish)

In the context of such a statement, the authors examined, in a coherent and organised way,
the wide spectrum of factors thought to influence the development of resilience identified
in the three sources. The common aspects of the three sources were identified, as well as
those referred to by only one source. Doing so allowed all the levels of context to be examined with respect to their possible effect on resilience. This resulted in the identification of
six dimensions and their respective definitions. Table 2 presents the components from the
three sources, together with the dimensions that resulted from the analysis. It is important
to mention that the emerging dimensions have a close relationship with their original theories, although some of them have been enriched by some elements from the other theories.
The terms structure, pattern or system were changed to process, which is in line
with definitions of resilience that refer to a process. Furthermore, the matrix makes evident
that the interactions occur throughout time and their effects are cumulative.
Phase 3. Reorganisation of the RTAM Dimensions According to the Principles of
Cultural Psychology
Cultural psychology refers to the study of cultures role in the mental life of human beings
(Cole, 1999, p. 1). Cole argued that culture is constitutive of the mind and for that reason
culture and general context are determinant on psychological processes (1999, p. 12). In
line with Coles ideas, we proceeded to reorganise the matrix in such a way that any analysis
could be started at the broadest levels of context, advancing towards the ones closer to the
individual. Table 3 displays the six dimensions that comprised the final version of the RTAM.
Phase 4. Generation of the RTAM (MATR) (Final Version)
Considering that resilience can be better understood as a product of transactions within and
between multiple systemic levels (Walsh, 2005), the final phase of the RTAM-building
process involved the generation of a tool that took into account intersystemic interactions.
Thus, factors in the framework referring to relational processes are influenced, among
other processes, by cultural processes or vice versa. Table 4 presents the final version of
the RTAM (MATR). Using the principle of Cartesian coordinates, the adverse factors and
resources that arise due to the influence of intrasystemic relationships are located in the
main diagonal (shadowed area). Cells located above the main diagonal refer to the adversity
and intersystemic resources. Cells placed below the main diagonal are not used because
their use would duplicate information, as the relationships between systems are reciprocal.
An Example of the Application and Use of the RTAM (MATR)
The RTAM was created and used in a qualitative study by Crdenas (2008). The aim of this
study was to describe the manifestations of resilience in four older people who resided in
Bogota, Colombia, in situations of disability and poverty. The study used Oral Life History

Macrosystem

Exosystem

Mesosystem

Microsystem

Ecology of Human
Development

Philosophical pattern

Situational pattern

Relational pattern

Arrangement pattern

Synthesis of the concept

of resilience

Belief systems

Organisational processes

Communication processes

Familial Resilience
Strengthening Model

Individual processes: Bio-psycho-social characteristics of the individual

that interact with environmental characteristics (Polk, 1997). They include:

biomedical characteristics (health-illness process and functioning),

psychological characteristics (emotional, cognitiveself-perception

and behavioural), and

socio-demographic characteristics (age, gender, education).

Relational processes: Characteristics of activities, roles and relationships
people experience in their immediate environment (Bronfenbrenner, 2002),
especially those of family, who are supported by communicative processes
and organisational rules influenced by beliefs and cultural practices (Walsh,
2005).
Coping processes: Cognitive and behavioural actions that constantly
change, developed to manage specific internal and/or external demands.
Appraised by individuals as exceeding or overflowing their resources
(Lazarus & Folkman, 1986). The appraisal is based on the individuals
belief systems.
Mesosystem: Interrelationships of two or more environments in which the
individual actively participates (Bronfenbrenner, 2002). Contributes to
resilience arising from familychurch or familycommunity relationships,
for instance.
Cultural processes: Meaning systems that allow individuals to make sense
of adverse events to cope and implement consequent actions required for
their management (Walsh, 2005).

Dimension

Table 2. Comparative chart of central elements of the theories for development of the theoretical analysis matrix.

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182
A. Crdenas and L. Lpez

Ecology of Human
Development

Table 2. (Continued).

Synthesis of the concept

of resilience

Familial Resilience
Strengthening Model

These systems include beliefs, cultural values and practices. The main
beliefs in familial resilience can be organized in three areas:

ability to extract meaning from adversity;

positive perspective (potentiality and ratifying possibility); and

transcendental religious and spiritual beliefs.

Structural processes: Characteristics of social and institutional structures
and official policies at a macro level impacting daily life (Bronfenbrenner,
2002). They contribute to increased resilience.

Dimension

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Analysis Matrix of Resilience

183

184
Table 3.

A. Crdenas and L. Lpez

RTAM rearrangement of the dimensions.

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Theoretical dimension
Structural processes: Characteristics of social and institutional structures and official policies at a
macro level impacting daily life (Bronfenbrenner, 2002). They contribute to increased resilience.
Cultural processes: Meaning systems that allow individuals to make sense from adverse events in
order for them to cope and implement consequent actions required for their management (Walsh,
2005). These systems include beliefs, cultural values and practices. The main beliefs in familial
resilience can be organised in three areas:

ability to extract meaning from adversity;

positive perspective (potentiality and ratifying possibility); and

transcendental religious and spiritual beliefs.

Mesosystem: Interrelationships of two or more environments in which the individual actively
participates (Bronfenbrenner, 2002). Contributes to resilience arising from familychurch or family
community relationships, for instance.
Coping processes: Cognitive and behavioural actions that constantly change; developed to manage
specific internal and/or external demands. Appraised by individuals as exceeding or overflowing their
resources (Lazarus & Folkman, 1986). The appraisal is based on the individuals belief systems.
Relational processes: Characteristics of activities, roles and relationships people experience in their
immediate environment (Bronfenbrenner, 2002), especially family, who are supported by
communicative processes and organisational rules influenced by beliefs and cultural practices
(Walsh, 2005).
Individual processes: Bio-psycho-social characteristics of the individual that interact with
environmental characteristics (Polk, 1997). They include:

biomedical characteristics (health-illness process and functioning);

psychological characteristics (emotional, cognitiveself-perception and behavioural); and

socio-demographic characteristics (age, gender, education).

(Meihy, 2005) as the method of data collection and Leiningers Phases of Ethnonursing as
the qualitative analysis technique (Leininger, 2006). Factors comprising major themes and
categories resulting from the qualitative data analysis were paired within the RTAM. This
pairing facilitated the organisation of the wide spectrum of factors that emerged from the
different contextual levels. This allowed the mapping of the factors that influenced the individuals development of resilience. Table 5 displays the outcomes of applying the RTAM.

Conclusions
The use of the RTAM (MATR) in the Crdenas (2008) study provided evidence that resilience in older people in a situation of disability and poverty was a highly complex phenomenon that arose as a result of multiple transactions among diverse levels of context in which
the individuals were immersed.
Examination of each different influence on resilience separately prevents any interactions among the factors from being considered. This difficulty is partially overcome by use
of the RTAM (MATR). However, the RTAM only allows the relationship between two
systemic levels to be considered at a time. This limitation of the Matrix could lead to the
creation of a model that allows for the simultaneous analysis of relationships among three
or more systemic levels and an examination of their effects on the development of resilience
in older people in a situation of disability and poverty.
Research results obtained using the RTAM in the Crdenas (2008) study suggest the
existence of a relationship among resilience, health and well-being. This finding opens the
way to demonstrate to social and health services providers the importance of strengthening

Structural processes
Cultural processes
Mesosystem
Coping processes
Relational processes
Individual processes

Cultural processes

Mesosystem

Coping processes

Relational processes

Individual processes

Adversity Resources Adversity Resources Adversity Resources Adversity Resources Adversity Resources Adversity Resources

Structural processes

Table 4. RTAM/MATR.

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Analysis Matrix of Resilience

185

Individual processes

Coping processes
Relational processes

Mesosystem

Cultural processes

Structural processes
Public assistance
Subsidised Health
Scheme
Technical Aids Bank

Public assistance not

particularised

Lack of caring policies

Resources

Poverty

Adversity

Structural processes

Ruralurban
migration

Adversity

Confidence in Divine
Will

Resources

Cultural processes

Table 5. Example of application of RTAM (MATR) (from Crdenas, 2008, p. 126).

Negative stereotypes toward

older people in community

Disability qualification and

associated bureaucracy

Public assistance
beneficiary
Subscription to
Subsidised Health
Scheme
Knowledge of
bureaucratic processes
God as a mediator in
medical treatment

Resources

Mesosystem

Low quality health services

Adversity

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A. Crdenas and L. Lpez

Resources

Individual processes

Relational processes

Coping processes

Mesosystem

Appropriate
technology
Caring prevents personal
development of caring
person

Violent and unsafe

neighbourhoods

Social support network

provides emotional and
instrumental support

Family cohabitation

Downstream comparison

Visits from members of

religious and non-religious
institutions

Familial caring: reward

Gender role flexibility

Central role of mother in

family
Charity

Machism
Caring centred in a unique
family member

Sons and daughters

investments for old age

Marianism

Frequent sadness and

crying
Suicidal behaviour
Low self-efficacy

Little expectation of
recovering offered by
health system

Adversity

Resources

Self-perception of positive health

Realistic expectations

Re-meaning of loneliness

Optimism and humour as means of

socialisation

Knowledge of bureaucratic
procedures
Efforts to keep mobility and
functionality
Active roles in relationships

Combined locus of control

Hope
Spiritual preparation for death
Making own decisions in face of
treatment options

Partial acceptance of stereotypes

Cultural health care

Critical position in the face of

religion

God as a source of
support to cope with
adversity
Resilience in the face
of stereotypes

Adversity

Individual processes

Cultural processes

Resources

Relational processes

Critical sense facing structural

factors

Adversity

Coping processes

Structural processes

Table 5. (Continued).

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A. Crdenas and L. Lpez

the processes related to developing resilience. This in turn may lead to the building, maintenance and restoration of health and quality of life in populations of elderly people.
RTAM makes an important contribution to the transition from the biomedical model
centred in notions of deficit to a more comprehensive paradigm in which mental health is
considered in a positive way and as the result of multiple contextual interactions (World
Health Organisation, 2004). It is suggested that information gained through the use of the
RTAM may be helpful in the design of programmes that promote resilience, and thus
mental health. Such programmes should incorporate elements from all of the context levels,
although special emphasis might be given to strengthening personal skills, consolidating
supporting environments, empowerment, involvement and intersectorial action. Thus,
resilience is often understood at the individual level, and is a socio-historical, dynamic, and
very complex process. It can be understood as multidimensional and multidetermined.
The process of development of the RTAM is the first step in the generation of an instrument for evaluating the processes related to resilience in older people. Such an instrument
that employs an ecological model of resilience and that gives a protagonist role to subjectivity could make an important contribution to theory and practice. In the fields of social
and health welfare, it would be an accessible, easily understood tool that could be used by
service providers. As an instrument with an ecological approach, it could be applied to
populations from different cultural and economic contexts and also to different age groups.
Finally, in spite of the evidence shown in this article, it is important to consider the implications of resilience-promotion strategies. Such strategies are not substitutes for social,
professional, financial and government actions that might improve the objective life circumstances of people. Personal and cultural strengths are not enough to overcome adverse
circumstances such as a lack of security and inequity. Solutions to problems must come from
tackling the social, political, economic, historical and cultural forces, the consequences of
which directly affect individuals. Solutions demand joint actions from actors who contribute
to the adverse outcomes, including, of course, individuals and their communities.
Acknowledgments
Language barriers were overcome by the careful translation from Spanish into English by
our friend in Argentina, Andrea Reschini. Additional editing of the language was undertaken by the Guest Editor, Edward Helmes and the journals Editor, Christa van Kraayenoord. The research reported in this article included Andrea Crdenas masters thesis in
Public Health entitled Resilience against Aging, Disability and Poverty: Life Oral
History and the projects of the research group Cultural Health Care at the School of
Nursing at the Universidad Nacional de Colombia. This thesis was awarded a meritorious
mention by the Council of the Faculty of Medicine, Universidad Nacional de Colombia.
The research group received financial support from the Colombian Institute for the
Development of Science and Technology, COLCIENCIAS and the School of Nursing at
the Universidad Nacional de Colombia (11010416453). No restrictions have been imposed
on free access to, or publication of, the research data.
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