Caring for Children and Families in Challenging Contexts: The Role of Job Stress and Coping in Shaping Health and Social Care Professionals’ Resilience

1. Introduction

Child-focused healthcare professionals—including paediatricians, nurses, social workers, psychologists, special educators, and speech and language therapists—provide care to children aged 0–16 years and constitute the primary providers of both physical and psychosocial support to children and their families. The care of critically ill or dying children, the management of parental anxiety, the experience of secondary traumatic stress, and the navigation of complex family interactions constitute primary stressors for healthcare providers [1]. Additionally, the delivery of care to children with suspected maltreatment [2], trauma victims and victims of stressful life events [3], developmental disorders, or those at risk of developing such conditions is also complicated by heightened levels of stress within both the child and the family [4]. This stress, arising from the challenges associated with raising a child affected by such conditions, may indirectly influence the emotional well-being [5], resilience, and coping strategies of healthcare professionals, psychological processes closely associated with stress in demanding pediatric settings. Research by Scanlan and Still [6] indicates that job satisfaction among health and social care professionals is strongly associated with both turnover intention and burnout.

To the best of our knowledge, this study is the first in Greece to examine the association of individual and professional characteristics, occupational stress levels, coping strategies and resilience in health and social care professionals. We focused on child life specialists because (a) studies focusing on paediatric professionals are limited, (b) engagement with childhood entails a different impact on professionals compared to working with adult populations, and (c) the specific characteristics of the professionals’ target population may contribute to and shape the differentiation of the associations among the variables examined in the present study.

1.1. Literature Review

1.1.1. Job Stress

The World Health Organization (WHO) characterizes workplace stress as the response individuals experience when confronted with work-related demands that exceed or challenge their capacity to cope [7].

The literature identifies a broad and often difficult-to-classify range of stressors. However, the most commonly reported sources are working conditions, including tangible factors (e.g., pay, hours, physical demands) and intangible factors (e.g., exposure to unpredictable stimuli) [8].

Physicians exhibiting pronounced self-critical and perfectionistic tendencies demonstrate lower levels of conscientiousness, which in turn predict higher burnout rates through increased emotional exhaustion and depersonalization [9].

Recent studies indicate that Certified Child Life Specialists (CCLS) frequently experience substantial workplace stress and burnout [10,11]. The relationship between occupational stress and increased levels of burnout, deterioration of health, reduced job satisfaction, as well as decreased performance is widely documented [12]. According to the findings of Ginter et al. [13], the following key themes were identified as perspectives of new child life professionals referring to workplace stress and burnout. These five key themes were the unexpected presentation of burnout, the burnout triad, a child life culture permeated by burnout, the challenges of self-care, and considerations in deciding whether to remain in the child life profession.

Characteristic are the findings of the systematic review by Flynn et al. [14], which documents a high prevalence of burnout among paediatric nurses and makes clear that higher levels of fatigue are associated with increased occupational stress, thereby reinforcing the interrelated role of workload, well-being, and patient safety outcomes within this clinical context. At the same time, job satisfaction emerges as a key determinant influencing both burnout and the provision of safe clinical care.

1.1.2. Coping Strategies

The use of avoidant coping strategies, such as denying or minimizing reactions to stressors, is associated with an increased risk of compassion fatigue and burnout, as well as reduced levels of compassion satisfaction [11].

Child life healthcare professionals participating in the study conducted by Ginter et al. [13] reported employing coping strategies that involved establishing boundaries with their loved ones regarding the timing, context, and extent of discussions about their daily experiences. Similarly, Hoelscher and Ravert [10] noted that Certified Child Life Specialists experienced challenges in maintaining boundaries necessary for achieving work-life balance, although their study did not specify the particular types of boundaries involved.

The review conducted by Hurley et al. [15], which examined coping strategies employed by nurses caring for children with life-limiting and life-threatening conditions, identified four principal themes. The evolving sense of duty describes the development of emotional resilience among paediatric nurses through repeated exposure to death and suffering. Boundaries for survival refers to the strategies adopted to safeguard their emotional well-being. Strength in connection underscores the significance of teamwork and professional support, while Faith as a foundation of care highlights the role of spiritual beliefs in sustaining nurses in their professional practice.

1.1.3. Resilience

Resilience in healthcare is a fundamental determinant of quality in healthcare delivery. It is defined as the proactive capacity of organizations, units, teams, and individuals to adapt to changes and potential challenges in routine practices, rather than merely resisting them, thereby promoting the provision of high-quality care [16]. In other words, resilience in healthcare is conceptualized as a dynamic and multi-level adaptive capacity that enables healthcare systems and professionals to respond effectively to everyday challenges while maintaining high-quality care [16]. Healthcare resilience is understood to be supported by the adaptive capacity of the healthcare system, involving the mobilization of both internal resources (e.g., sense-making, professional experience) and external resources (e.g., colleagues, professional networks, regulatory frameworks) to adjust everyday functioning. Such adaptations may include modifications to care processes in response to variability in demand or time constraints, enabling the successful resolution of complex challenges while maintaining a high standard of care [17].

The review conducted by Sheikhrabori et al. [18], which sought to examine the individual and contextual factors contributing to resilience enhancement in healthcare professions, identified coping as the primary characteristic of resilience among healthcare providers.

Resilience has been identified as a critical factor in mitigating professional burnout, enhancing healthcare professionals’ capacity for self-confidence, self-regulation, and effective stress management. Evidence further suggests that empathy and self-compassion, alongside resilience, contribute to the prevention of burnout, with healthcare practitioners exhibiting higher resilience demonstrating an increased ability to cope with occupational stress [4,19,20]. Resilience in the healthcare sector is conceptualized as a dynamic, multi-level adaptive capacity that is supported by both internal and external resources [16]. Internal resources, such as cognitive appraisal processes and adaptive coping strategies, might assist people interpret stressful situations more positively, improving their capacity to successfully deal with stress. On the other hand, maintaining adaptive functioning in stressful clinical settings requires outside resources, including social support from peers and professional networks. However, these adaptive systems may be strained by ongoing exposure to high work-related demands, and the subjective perception of these demands as stress may further erode resilience by reducing the availability and efficacy of psychological and social resources. The literature has consistently demonstrated that resilience and perceived stress are negatively correlated. Specifically, evidence from systematic reviews in healthcare populations suggests that nurses with higher occupational stress levels have decreased resilience, indicating a diminished ability to recover and adapt in extremely demanding work environments [21]. This inverse relationship emphasizes resilience as a protective psychological resource that may be weakened in environments with high emotional and organizational demands, especially in situations of extended occupational strain.

Significant gaps still exist in the growing body of worldwide research on occupational stress, coping mechanisms, and resilience among healthcare professionals, especially when it comes to pediatric care settings and interdisciplinary samples. Studies that have already been performed have mostly focused on specific professional groups, like physicians or nurses, while integrated health and social care teams that interact with children and families have received less attention. Additionally, there is still a lack of research in the Greek context, particularly when it comes to the combined analysis of resilience, coping mechanisms, and occupational stress in child-focused healthcare services. Thus, the current study intends to explore the relationships between professional and demographic traits, occupational stress levels, coping mechanisms, and resilience among healthcare and social care workers who serve pediatric populations in Greece. The study specifically aims to investigate the degree to which resilience is predicted by coping mechanisms and perceived work stress. The following hypotheses were suggested in light of the body of current literature:

• Resilience will be adversely correlated with perceived occupational stress;
• Resilience will be positively correlated with adaptive coping methods (like positive coping and social support) and negatively correlated with maladaptive coping techniques (like avoidance).
• Compared to sociodemographic and occupational factors, psychological variables - such as coping mechanisms and perceived stress - will explain a larger percentage of the variation in resilience.

2. Materials and Methods

2.1. Study Design

This study employed a quantitative, cross-sectional design and was conducted with a purposive sample of health and care professionals working with children, adolescents and their families.

2.2. Participants and Data Collection

A large sample of Greek professionals employed in a range of health and social care settings serving children and adolescents participated in the study. Data were collected using a structured questionnaire consisting of four parts, administered via Google Forms, which remained available online for a period of twelve months. To reduce potential sampling bias, the questionnaire was disseminated across a broad range of institutions and geographic regions throughout Greece, targeting professionals from diverse disciplines, including medicine, nursing, social work, and other health and social care-related fields. Distribution was conducted through professional networks, primarily via email mailing lists of individuals affiliated with officially recognized professional associations and organizations. The majority of participants were recruited through the second largest Pediatric Hospital in Greece “Pan. & Aglaias Kyrakou” and member bulletins of the Paediatric Association of Athens and the Hellenic Society of Pediatric Nursing, as well as through social media platforms. The final sample consisted of 202 professionals who submitted complete and valid questionnaires. Participation was voluntary, and informed consent was obtained from all participants.

2.3. Measures

2.3.1. Participants’ Socio-Demographic Profile

The first part of the questionnaire collected self-reported sociodemographic and professional characteristics of the participants.

2.3.2. The Job Stress Measure

The Job Stress Measure (JSM) is a brief 16-item self-report instrument designed to assess levels of perceived stress arising from distinct and identifiable sources within the workplace. Initially developed and applied by Judge, Boudreau, and Bretz [22] in research involving executive populations, the measure targets salient occupational demands and stressors.

The JSM evaluates dimensions including quantitative workload, time pressure, role ambiguity, organizational politics, and career-related uncertainty. Responses are recorded on a 5-point Likert-type scale, indicating the extent to which each job-related factor is experienced as stressful. This approach enables a nuanced assessment of individual patterns of occupational stress. The translation and validation of the original questionnaire for the Greek population were conducted by Sakketou et al. [23].

2.3.3. The Ways of Coping Questionnaire

The Ways of Coping Questionnaire was assessed using the revised Greek version of the Ways of Coping Questionnaire (WCQ) [24]. Originally developed by Folkman and colleagues, the WCQ evaluates cognitive and behavioral responses employed to manage the internal and external demands associated with a particular stressful situation [25]. Following translation and psychometric validation, the Greek adaptation comprises 38 items rated on a four-point Likert scale, with response options ranging from 0 (“never”) to 3 (“often”) [26]. Factor analysis identified five distinct dimensions: (a) Positive approach (11 items), reflecting positive reinterpretation and problem-focused efforts; (b) Seeking social support (6 items); (c) Prayer/Daydream (8 items), encompassing religious coping and reliance on divine assistance; (d) Avoidance/Escape (9 items), including denial and disengagement; and (e) Assertive problem solving (4 items). Scores are not aggregated into a global index; instead, mean scores are calculated for each factor, with higher values indicating more frequent use of the corresponding coping strategy [26].

2.3.4. The Connor-Davidson Resilience Scale [CD-RISK-25]

The Connor-Davidson Resilience Scale (CD-RISC 25) [27] is a 25-item self-report instrument that measures personal competence, effects of stress, acceptance of change and strong relationships, control, and spirituality. Each item is scored on a 5-point Likert scale (0 = “not true” to 4 = “true nearly all the time”). The scores from individual items are summed to give a score from 0 to 100, with higher scores reflecting greater resilience. The Greek adaptation of the Connor–Davidson Resilience Scale was developed and psychometrically validated by Tsigkaropoulou et al. [28].

2.3.5. Ethical Considerations

Following a written presentation of the study aims and procedures to participants, written informed consent was obtained from each participant prior to their involvement in the study. The study objectives and informed consent form were presented on the first page of the Google Forms questionnaire, before respondents decided whether to participate. No incentives or secondary benefits were offered to participants, and they were informed that they could withdraw from the survey at any time. The researcher emphasized that all participant information would remain confidential and would be used exclusively for research purposes.

All data were anonymized in accordance with the current European Union General Data Protection Regulation (GDPR).

The study was conducted in accordance with the Declaration of Helsinki and approved by the Scientific Council of “Panagiotis & Aglaia Kyriakou” Children's Hospital of Athens, Greece (14120/09.08.2021) as well as from the Board of Directors of the same Hospital (15060/31.08.2021).

2.4. Statistical Methods

Continuous variables, such as questionnaire scores, were presented as means (M) and standard deviations (SD), whereas categorical variables were reported as frequencies (n) and percentages (%). Skewness and kurtosis indices, along with the Kolmogorov–Smirnov and Shapiro–Wilk tests, as well as visual inspection of histograms and Q–Q plots, were used to assess the normality of continuous variables. Based on these assessments, the use of parametric statistical methods was considered appropriate. The internal consistency of the research instruments was evaluated using Cronbach’s alpha coefficient.

Associations between categorical variables were analyzed using chi-square (χ²) tests, with effect sizes estimated using Cramer’s V. Differences between groups were examined using independent-samples t tests for two-group comparisons and one-way analyses of variance (ANOVA) for comparisons involving more than two groups. When significant differences were identified, post hoc analyses were conducted using Tukey’s HSD test. The assumption of homogeneity of variances was assessed using Levene’s test. To enhance the stability and interpretability of the analyses, selected demographic and occupational variables (e.g., age, profession, and work setting) were recoded into broader categories. Pearson correlation coefficients (r) were calculated to examine linear relationships between continuous variables.

Multiple linear regression analyses were conducted using the enter method to examine the relationships among resilience (CD-RISC-25), work stress (JSM), and coping strategies (Ways of Coping Questionnaire subscales), while controlling for relevant demographic and occupational variables. In addition, hierarchical multiple regression analyses were performed to assess the incremental contribution of work stress and coping strategies to the prediction of resilience, with variables entered in theoretically informed blocks. The order of variable entry was theoretically informed by stress, coping, and resilience frameworks. Specifically, the Transactional Model of Stress and Coping [29] posits that resilience is shaped by individuals’ appraisal and coping processes in response to stress, suggesting that demographic and contextual factors represent more distal influences, whereas coping strategies and perceived stress are more proximal determinants. In addition, resilience theory emphasizes the role of protective factors and stress exposure in adaptive functioning [30]. Based on these perspectives, variables were entered hierarchically as follows: contextual characteristics (Step 1), coping strategies (Step 2), and perceived work stress (Step 3). All regression models were examined for agreement with key assumptions, including linearity, normality of residuals, homoscedasticity, independence of errors (assessed using the Durbin–Watson statistic), and absence of multicollinearity (assessed using VIF and tolerance values). No substantial violations of these assumptions were observed.

All statistical analyses were performed using IBM SPSS Statistics (Version 24.0), and the level of statistical significance was set at α = .05.

3. Results

3.1. Participants’ Profile and Chi-Square Analyses

Table 1 presents the demographic and professional characteristics of the study sample. A total of 202 healthcare and related professionals participated in the study, the majority of whom were female (n = 149, 73.8%). The largest age group was 35-54 years (n = 114, 56.4%), and most participants were married (n = 131, 64.9%). Over half of the sample (n = 104, 51.4%) held postgraduate qualifications (Master’s or doctoral degrees), while 49.0% (n = 99) reported more than 16 years of professional experience.

The sample consisted of physicians (including consultants and residents), nurses, and psychosocial professionals, categorized for analytical purposes into three groups: medical (45.0%), nursing (23.8%), and psychosocial (31.2%). Regarding employment characteristics, 46.5% of participants were permanent employees, 52.0% worked in hospital settings, and 27.2% held leadership positions. Overall, the sample comprised predominantly mid-career, highly educated professionals working mainly in hospital environments.

Chi-square analyses were conducted to examine associations between professional characteristics and key study variables. No statistically significant association was observed between gender and professional category (medical, nursing, psychosocial), χ²(2) = 0.80, p = .671, indicating a similar distribution of professional groups across males and females. A statistically significant association was found between professional category and employment status, χ²(4) = 62.30, p < .001, Cramer’s V = .393, indicating a moderate-to-large effect size. Physicians were more likely to be self-employed, nurses predominantly held permanent positions, and residents were mainly contract-based employees.

A strong and statistically significant association was also identified between professional category and working setting, χ²(4) = 146.44, p < .001, Cramer’s V = .602, indicating a large effect size. Nurses were primarily hospital-based, psychosocial professionals were mainly employed in psychosocial/educational services, while physicians were distributed between hospital and community settings. Finally, a statistically significant association was observed between professional category and educational level, χ²(6) = 40.15, p < .001, Cramer’s V = .315, indicating a moderate effect size. Physicians and psychosocial professionals were more likely to hold postgraduate qualifications, whereas nurses were more frequently concentrated at lower educational levels.

3.2. Descriptive Statistics and Internal Consistency of Study Variables

Table 2 presents the descriptive statistics and internal consistency coefficients for all study variables (N = 202). Overall, participants reported a moderate level of work stress (M = 49.95, SD = 11.68), while resilience scores were relatively high (M = 68.32, SD = 13.10). Regarding coping strategies, mean scores indicated moderate use of positive coping (M = 2.10, SD = 0.47) and social support (M = 2.07, SD = 0.55), whereas avoidance (M = 1.60, SD = 0.50) and daydreaming (M = 1.51, SD = 0.64) were reported at lower levels. All variables demonstrated acceptable distributions, with skewness and kurtosis values falling within generally acceptable limits (approximately ±1), suggesting no major deviations from normality.

Internal consistency analyses indicated good to excellent reliability for most scales. Specifically, the Job Stress Scale (JSM; 16 items) demonstrated very high reliability (Cronbach’s α = 0.891), as did the CD-RISC resilience scale (25 items; α = 0.893). Among the coping subscales, reliability was good for positive coping (α = 0.830) and daydreaming (α = 0.813), and acceptable for social support (α = 0.733). The avoidance subscale showed marginal reliability (α = 0.684), suggesting cautious interpretation in subsequent analyses. Due to low internal consistency (Cronbach’s α = 0.540), the assertiveness subscale was excluded from further analyses, as it did not meet the minimum acceptable reliability threshold for research use in the present sample.

3.3. Associations Between Demographic Factors, Work Stress, Resilience, and Coping Strategies

A series of independent-samples t-tests and one-way ANOVAs were conducted to explore whether study variables differed across demographic and professional characteristics. Overall, most psychological variables showed no meaningful variation across sociodemographic groups. No gender differences were found in work stress, resilience, positive coping, daydreaming, or avoidance coping. However, women reported significantly higher perceived social support than men, t(200) = -2.94, p = .004. Age was related to two variables. Significant differences were found for resilience, F(2, 199) = 3.53, p = .031, and positive coping, F(2, 199) = 7.56, p = .001. Younger participants (under 34 years) reported lower resilience than those aged 35–54 years (p = .034), and also lower positive coping compared to both older groups (p ≤ .004). No other age-related differences were observed.

In terms of professional category, most variables did not differ significantly, with the exception of avoidance coping, F(2, 199) = 5.72, p = .004. Nurses reported higher levels of avoidance coping compared to psychosocial professionals (p = .003). Work setting, educational level, and marital status were not associated with any of the study variables.

Finally, work experience showed a more specific pattern: it was associated with both work stress, F(2, 199) = 3.21, p = .043, and positive coping, F(2, 199) = 4.87, p = .009. Participants with moderate experience reported higher work stress than those with low experience (p = .019), while those with higher experience reported greater positive coping than both lower-experience groups (p ≤ .036). No differences were found for resilience or the remaining coping strategies.

Pearson correlations were used to explore how the main study variables relate to each other. Overall, resilience showed the most consistent associations with other psychological constructs. Work stress showed a small, but significant negative relationship with resilience, r = -.21, p = .003 meaning that higher resilience was associated with lower perceived stress at work. At the same time, work stress was not meaningfully related to coping strategies or social support in this sample.

Resilience, on the other hand, was clearly related to more adaptive psychological resources. It showed a strong positive relationship with positive coping, r = .735, p < .001, and a moderate positive relationship with social support, r = .384, p < .001. This pattern suggests that more resilient individuals tend to rely more on constructive coping strategies and also feel more supported socially.

Positive coping was also positively associated with social support, r = .462, p < .001, meaning that people who use more adaptive coping strategies also tend to perceive stronger support from others. Interestingly, positive coping also showed smaller but still significant links with both daydreaming, r = .335, p < .001, and avoidance coping, r = .232, p = .001. Finally, daydreaming and avoidance coping were strongly connected to each other, r = .603, p < .001, suggesting that these two more disengaged coping styles often go hand in hand.

3.4. Hierarchical Multiple Regression Analysis (Resilience as Dependent Variable)

A hierarchical multiple regression analysis was conducted to examine the extent to which demographic and work-related characteristics, coping strategies, and work stress predict resilience. Predictors were entered in theoretically determined sequential blocks, using the enter method. In Step 1, demographic and occupational variables (work experience, profession, employment type, and work environment) were entered into the model. The model was not statistically significant, F(6,195) = 1.32, p = .252, explaining only 3.9% of the variance in resilience (R² = .039, Adjusted R² = .009). None of the predictors reached statistical significance, indicating that sociodemographic and work-related factors did not meaningfully contribute to resilience.

In Step 2, coping variables (positive coping, social support, and avoidance) were added. This step resulted in a substantial and statistically significant improvement in model fit, F(9,192) = 27.42, p < .001, with explained variance increasing to 56.2% (R² = .562, Adjusted R² = .542). Positive coping emerged as a strong positive predictor of resilience (β = .725, p < .001), while avoidance coping showed a small negative association (β = -.103, p = .042). Social support was not a significant predictor.

In Step 3, work stress was entered into the model. The final model remained statistically significant, F(10,191) = 26.95, p < .001, explaining 58.5% of the variance in resilience (R² = .585, Adjusted R² = .564). In the final model, positive coping remained the strongest predictor of resilience (β = .714, p < .001), while work stress was a significant negative predictor (β = −.154, p = .001), indicating that higher levels of perceived stress were associated with lower resilience. Avoidance coping showed a marginal effect (p = .085), whereas social support and demographic/work variables remained non-significant (Table 3).

All assumptions for multiple regression were adequately met. Multicollinearity was not present (Tolerance = .47-.92; VIF = 1.05-2.08). The Durbin-Watson statistic indicated independence of residuals (DW = 1.86). Examination of standardized residuals (-2.71 to 2.44) suggested no serious outliers, and residual distribution indicated acceptable normality and homoscedasticity.

4. Discussion

To the best of our knowledge, in this study, we conducted the first investigation in Greece examining the association between demographic and professional characteristics, levels of occupational stress, coping strategies, and resilience, with particular focus on healthcare child life specialists. This contribution is noteworthy given the growing understanding that resilience is a dynamic process characterized by continual interactions between individual resources and contextual demands.

In the present study, health and social care child life specialists reported a moderate level of work-related stress. Statistical analysis revealed a significant association between years of professional experience and work stress. Specifically, participants with moderate levels of experience reported higher stress compared to those with less experience. Consistent with these results, Izdebski et al. [31], reported that mid-career professionals (6–10 years of service) were 2.6 times more likely to experience burnout compared to their early-career or senior counterparts. With regard to work stress and burnout levels among employees, particular in child protection and welfare institutions, data from reliable studies support that individuals with more than one year of experience exhibited higher levels of burnout [32,33]. Possibly, professionals in the early stages of their careers are more strongly oriented toward learning and gaining experience, whereas those at more advanced stages may have already demonstrated their professional competence and established their value in the workplace. Professionals approaching approximately ten years of experience are often considered to be at a critical point in their career development, characterized by heightened aspirations and self-imposed expectations as they seek to consolidate their professional standing. Furthermore, as work experience accumulates, professionals may progressively assume increased responsibilities in decision-making processes. Consequently, they may be at increased risk of experiencing occupational stress and burnout. This pattern is consistent with resilience approaches in healthcare, which emphasize that extended exposure to high job demands can disrupt the balance of available internal and external resources, undermining adaptive ability over time [16].

With respect to professionals` coping strategies, present study`s findings indicated a moderate level of use for positive coping and social support. In contrast, lower levels were observed for avoidance and daydreaming. Statistical analyses showed significant relationships of the health professionals’ coping strategies with demographic factors and psychosocial variables.

Gender was identified as a significant predictor of social support, with women reporting notably higher levels of perceived social support compared to men. Consistent with this finding, the study by Kneavel [34], which examined the quality and quantity of social support in relation to gender, age, perceived stress, and coping, likewise found that females reported greater quality of social support. According to Taylor’s Tend and Befriend theory [35], females are more likely to adopt a “tending and befriending” stress response strategy, which involves seeking and engaging with social support networks during stressful situations. This increased reliance on social support networks may contribute to the development of larger support systems and a higher perceived quality of social support.

We also found a positive correlation between healthcare professionals’ age, work experience and positive coping. Participants under 34 years of age reported lower levels of positive coping than both older age groups. Age differences in coping strategies are well documented. The study by Chen et al. [36] clearly demonstrates an age-related shift in coping patterns, with younger adults using less adaptive coping strategies. Additionally, the study by Beier [37], largely confirmed that age is positively linked to both effective coping strategies and a greater sense of personal accomplishment. On the other hand, participants with higher levels of experience reported greater positive coping than both lower-experience groups. The study by Huang et al. [38], corroborating the findings of the present study, underscores the association between coping style and factors such as gender and work experience. Specifically, women and participants with greater work experience were more likely to adopt positive coping strategies compared to men and those with less work experience.

A significant positive correlation was also observed between positive coping and the social support subscale, indicating that individuals who employ more adaptive coping strategies also tend to perceive greater support from others. Interestingly, positive coping also showed smaller but still significant links with both daydreaming and avoidance coping.

Avoidance coping appears to be associated with profession, with nurses reporting higher levels of avoidance coping compared with psychosocial professionals. Studies examining the relationship between profession and avoidance coping converge in showing that it is the most frequently used strategy among surgical nurses [39]. Avoidance coping and daydreaming were also strongly connected to each other, suggesting that these two more disengaged coping styles often go “hand in hand”.

In this study, the median overall resilience score among health and social care child life specialists was relatively high. Statistically significant differences were observed between age and resilience levels. Participants under the age of 34 reported lower resilience compared to those aged 35–54 years. Similarly, a study conducted among healthcare professionals in Taiwan during the post-pandemic period, found that younger individuals demonstrated lower levels of resilience [40]. Age is consistently associated with resilience, with younger individuals representing a higher-risk group characterized by lower levels of resilience. In contrast, older healthcare professionals often have greater clinical experience and are therefore better equipped to manage stress in rapidly evolving clinical environments [40,41].

Work stress showed a small, but significant negative relationship with resilience, meaning that higher resilience was associated with lower perceived stress at work. Resilience demonstrates a strong association with burnout and it functions as a protective factor by facilitating effective stress management. The cultivation of resilience has been shown to mitigate burnout both directly and indirectly, while simultaneously promoting improved mental health outcomes among healthcare professionals [40]. According to the study conducted by Pedro Ferreira et al. [42], a 1% increase in resilience is correlated with a 1.7% decrease in emotional exhaustion (EE) and depersonalization (DP), as well as an approximate 5% increase in personal accomplishment (PA).

Resilience was strongly associated with more adaptive psychological resources. Specifically, it demonstrated a robust positive relationship with positive coping and a moderate positive association with social support. This pattern suggests that individuals with higher levels of resilience are more likely to employ constructive coping strategies and to perceive greater availability of social support. In this context, resilience can be considered the outcome of a dynamic balance between internal cognitive-emotional resources and external social support.

The findings of hierarchical multiple regression analysis indicated that demographic and occupational characteristics alone do not meaningfully account for variability in resilience, suggesting that resilience is more strongly influenced by modifiable psychological processes. The substantial increase in explained variance following the inclusion of coping strategies highlights their central role, with positive coping and social support likely acting as protective factors, while avoidance may function as a maladaptive mechanism. The addition of work stress produced an increase in explained variance, indicating that although stress is a significant predictor, its impact on resilience may be partially mediated or buffered by coping strategies. Overall, the final model explains a considerable proportion of variance in resilience, underscoring the importance of targeting adaptive coping strategies in interventions aimed at enhancing resilience, particularly in child life specialists. Taken together, these findings reinforce a consistent pattern in the healthcare literature: psychological resources such as adaptive coping and social support operate as protective factors, but chronic work stress is a major risk factor for decreased resilience.

The systematic review by Yu et al. [21], consistent with the present findings, indicates that coping skills, social support, self-efficacy, job satisfaction, job retention, and overall well-being are positively associated with nurse resilience. In contrast, factors such as work-related stress, burnout, post-traumatic stress disorder, and workplace bullying demonstrate negative associations with resilience [21]. The negative correlation between stress and resilience is well established in the literature [43,44,45,46,47,48,49,50,51,52], indicating that higher levels of perceived stress are associated with lower levels of resilience. From this standpoint, resilience emerges as an adaptable and intervention-sensitive construct, emphasizing the significance of improving adaptive coping mechanisms and social support systems within healthcare organizations.

5. Strengths and Limitations of This Study

Based on the available evidence, this is the first study in Greece to examine the association between individual and professional characteristics, dimensions of occupational stress, coping strategies, and resilience among health and social care child life specialists. The study sample comprises a broad spectrum of healthcare professionals (physicians, nurses) as well as psychosocial care professionals (social workers, psychologists, and special education professionals), which constitutes a significant strength of the research design. Most related studies tend to focus on a single professional group, most commonly physicians or nurses. The inclusion of special education professionals represents an innovation, as does the focus on practitioners working with children and their families.

Although an overrepresentation of both women and physicians is observed—something partly expected given this specific healthcare context—the categories of nurses and psychosocial professionals are nearly counterbalanced and numerically comparable to the predominant physician group.

Furthermore, the participating professionals were drawn from diverse work settings (hospital and clinical environments, community health contexts, and educational settings), which further strengthens the study. Finally, the use of hierarchical multiple regression analysis as the selected method for analyzing the research data yielded a relatively high proportion of explained variance (approximately 60.0%) in the study’s dependent variable.

6. Conclusions

The findings of the present study highlight several factors associated with occupational stress, coping and resilience among healthcare professionals. Gender emerged as a significant factor associated with social support, while positive coping was found to be related to age, work experience, and specific WCQ subscales, including social support, daydreaming, and avoidance; additionally, professional role was shown to influence coping avoidance and daydreaming. Resilience was associated with age, work stress, positive coping, and social support, with positive coping identified as the strongest positive predictor of resilience, whereas work stress constituted a significant negative predictor, indicating that higher perceived stress is associated with lower levels of resilience.

Overall, the results underscore the urgent need for targeted interventions aimed at identifying healthcare professionals at increased risk, reducing occupational stress, and strengthening adaptive coping strategies and resilience within health and social care settings. Furthermore, the importance of cultivating protective factors is emphasized, such as positive interpersonal relationships among professionals, which are associated with reduced occupational stress, higher job satisfaction, and greater use of effective coping strategies, particularly in pediatric healthcare settings. Additionally, the necessity of promoting and actively strengthening key predictive and protective factors of resilience—such as emotional intelligence and empathy among child-care professionals—by health and psychosocial care systems is highlighted.