The Association Between Personal, Relational, Organizational and National Resilience Resources and Dietitians' Well‐Being During Protracted Conflict: A Cross‐Sectional Study

ABSTRACT

Background

Resilience is a crucial protective factor for dietitians, helping them manage the negative impacts of routine stressors and crises in their daily work while maintaining their well‐being. Based on Ungar ecological model of resilience, this study aims to understand the multi‐level resilience resources that help dietitians maintain their well‐being in the context of protracted conflict.

Methods

The study employed a cross‐sectional design. Data were collected between December 2023 and February 2024 in Israel. Participants were recruited via a snowball sampling to recruit dietitians who graduated from one academic institution. An electronic flyer detailing the study's aims and a link to a Qualtrics questionnaire was emailed to them, with a request to share it with colleagues. A total of 110 participants completed the questionnaire.

Results

Hierarchical regression analysis revealed that dietitians' personal resilience and their perceptions of the preparedness of the National Nutrition Division in the Ministry of Health to handle crises were negatively associated with strain symptoms beyond the effects of stress levels and control variables (β = −0.31, p < 0.001; β = −0.17, p < 0.05, respectively). However, dietitians' coping strategies and their trust in their organization's management decisions were not significantly related to decreased stress symptoms (p > 0.05).

Conclusions

The findings highlight the importance of using an ecological framework of resilience and understanding why and under which context‐specific factors each resilience level contributes to dietitians' well‐being. Practical implications involve prioritizing systemic national preparedness support and resilience‐building programmes tailored to the unique challenges faced by dietitians.

Summary

• Dietitians' resilience is key to maintaining well‐being.

• Healthcare organizations and policymakers should consider fostering dietitians' resilience through enhanced support from professional bodies to proactively develop a crisis management plan that can be quickly and effectively deployed when needed.

• Topics such as flexible coping strategies and tools for fostering organizational commitment should be integrated into dietitians' curricula and practice.

1. Introduction

Resilience—the ability to adapt and recover quickly from adversity while maintaining well‐being—is a crucial protective factor for dietitians, helping them cope with routine stressors in their daily work and safeguarding their well‐being [1, 2, 3]. Severe crises such as the COVID‐19 pandemic and regional conflicts (e.g., the Russian‐Ukraine and Gaza wars) have intensified challenges for healthcare workers' well‐being, increasing interest in their resilience. These crises raise critical questions about how dietitians cope and adapt to extreme events [4]. Despite consensus on the importance of addressing dietitians' unique vulnerabilities and fostering resilience, research on this topic remains limited.

This study applies Ungar's socio‐ecological perspective to resilience to dietitians [5]. Accordingly, dietitians' resilience depends on proactive interactions with their environment to acquire essential personal, relational and contextual resources [5, 6] (Figure 1). As illustrated, dietitians' resilience operates at four levels: individual (personal resilience), relational (coping strategies), organizational (trust in the organization's management) and national (perceived preparedness of governmental bodies during crises, in our case the National Nutrition Division in Israel's Ministry of Health [NNDMOH]). Each level uniquely influences dietitians' well‐being beyond their overall stress levels. The following sections define dietitians' well‐being, examine common stressors in both routine and crisis situations and explore how resilience at different levels mitigates these challenges.

Figure 1.

The study model. * Preparedness of the National Nutrition Division in the Ministry of Health.

1.1. Dietitians' Occupational Well‐Being and Work Stress

Occupational well‐being refers to job satisfaction, fulfilment and health [7], encompassing physical (e.g., lower chronic disease risk), mental (e.g., reduced burnout, anxiety, depression) and behavioural health (e.g., avoiding smoking, excessive alcohol use) [7, 8]. A meta‐analysis of 12 studies reported a 40.5% global burnout prevalence among dietitians and nutritionists [9]. Furthermore, concern for dietitians' well‐being grew after two suicides highlighted mental health risks, including depression, anxiety and stress [10, 11]. Well‐being here is defined as low levels of strain symptoms that impair functioning.

Clinical stressors significantly impact dietitians' well‐being [12], with high stress and burnout resulting from patient care demands, administrative burdens and the emotional toll of chronic illness cases [13, 14]. Additional challenges include lack of recognition, unrealistic expectations, financial strain and work‐life disruptions [15, 16, 17]. A review found dietitians experience heightened stress due to heavy workloads, limited autonomy and poor managerial support [18]. During crises, these issues worsen, as dietitians play a key role in disaster nutrition [19]. COVID‐19 intensified stress, increasing anxiety, depression and job dissatisfaction, pushing some to consider leaving the profession [20, 21]. Contributing factors included expanded roles in COVID‐19 patient treatment, job insecurity, reduced hours, telehealth transitions [22], changing protocols [23, 24] and infection concerns [20]. Resilience may help dietitians navigate these stressors and protect their well‐being. The following sections examine resilience levels and their role in mitigating stress during crises.

1.2. Dietitians' Resilience and Reduced Strain Symptoms

At the individual level (Figure 1), personal resilience in dietetics is viewed as either a stable trait or a trainable skill, enabling dietitians to adapt, cope and recover from adversity [2, 3]. This study treats it as a stable trait that protects against adversity, fostering well‐being. Though research on dietitians' resilience is still emerging, evidence links higher personal resilience among healthcare professionals to better psychological well‐being and reduced burnout [25]. Naja et al. found that greater resilience correlated with lower job turnover intentions and mitigated workplace stress in clinical and community settings, allowing dietitians to sustain well‐being despite high‐pressure environments [20, 26]. These findings suggest that personal resilience enhances dietitians' well‐being beyond their perceptions of work stress.

The relational level of resilience (Figure 1) suggests that dietitians' use of effective coping strategies is linked to higher well‐being and lower levels of strain symptoms [27]. Coping strategies help individuals manage physical, emotional and psychological stress [27] and are categorized as engagement strategies, which involve confronting adversity, or disengagement strategies, which aim to limit exposure [28]. Engagement strategies improve long‐term well‐being, while disengagement strategies may provide temporary relief but lead to long‐term issues [29]. Coping strategies can also be problem‐focused, addressing the stressor directly or emotion‐focused, regulating emotional responses [27].

An Australian survey of dietitians in public acute care settings found that most used effective coping strategies, such as debriefing with colleagues and spending time with friends (engagement‐in‐emotion strategies). However, 18% relied on disengagement strategies like absenteeism, and 24% reported using alcohol to cope [30]. Research on healthcare workers shows that problem‐focused coping (e.g., time management, professional development, addressing stressors) is linked to higher job satisfaction and well‐being, particularly in high‐stress environments [31]. In contrast, avoidance‐based coping (e.g., procrastination, denial) is associated with poorer well‐being, higher burnout and job dissatisfaction, as seen in studies of nurses and physicians during COVID‐19 [32]. These findings suggest that dietitians' engagement with coping strategies enhances well‐being beyond their perceptions of work stress and personal resilience.

The third level of resilience (Figure 1) refers to resources derived from dietitians' trust in their organization's management, which enhances resilience and reduces strain beyond personal and relational resilience. Organizational trust is the belief that the organization acts in employees' best interests, provides support and maintains transparency [33]. Research on this relationship is still emerging, but initial findings suggest that high trust in leadership increases job security, emotional well‐being and job satisfaction while reducing burnout [14]. In contrast, low trust correlates with higher stress, job dissatisfaction, anxiety and depression, often due to lack of transparency, poor support and ineffective communication [14, 18]. Trust is particularly crucial during crises, helping employees navigate challenges and enhancing organizational agility [34, 35]. While specific studies on dietitians are limited, research on other healthcare professionals shows that trust in organizational crisis responses, such as during COVID‐19, positively impacted well‐being [36]. These findings suggest that dietitians' trust in their organization's management contributes to well‐being beyond work‐related stress and lower levels of individual and relational resilience.

The final level of resilience, depicted in Figure 1, examines resilience at the national level, specifically how dietitians' perceptions of NNDMOH preparedness for crises influence their resilience and strain symptoms. Organizational preparedness is the ability to anticipate, respond to, and recover from crises, involving key elements such as crisis planning, resource availability, leadership, transparent communication and employee training [37]. Preparedness not only mitigates immediate crisis effects but also supports psychological well‐being, resilience and stress reduction [37]. According to Kelloway, when dietitians perceive the NNDMOH as well‐prepared, they feel reassured, reducing fear and encouraging worry control proactively managing risks through problem‐solving. In contrast, perceived inadequate preparedness leads to fear control, characterized by avoidance and denial, which negatively impacts well‐being [37, 38]. Although research on dietitians' perceptions of national preparedness is limited, preliminary findings suggest that a supportive, resource‐equipped organizational culture helps reduce stress by providing adequate staffing, professional development and recognition [14]. Studies on other healthcare professionals during COVID‐19 indicate that perceived institutional preparedness was linked to higher resilience and lower strain symptoms [36].

Taken together, this study aims to investigate the multifaceted nature of resilience among dietitians, focusing on how individual, relational, organizational and national‐level resources contribute to their well‐being during crises. By addressing the gap in the literature regarding dietitians' experiences during extreme events and the role of resilience, we hope to provide valuable insights for improving their support and coping strategies. Accordingly, our hypotheses were:

• 1.Dietitians' perceived stress would be positively associated with their strain symptoms.
• 2.Dietitians' personal resilience would be negatively associated with their levels of strain symptoms.
• 3.Dietitians' engagement‐in‐problem‐solving/emotional coping strategies would be negatively associated with strain symptoms, whereas dietitians' disengagement in‐problem‐solving/emotional coping strategies would be positively associated with these symptoms.
• 4.Dietitians' trust in their organization's management would be negatively associated with their strain symptoms.
• 5.Dietitians' perceptions of the NNDMOH's preparedness for war would be negatively associated with their strain symptoms.

2. Methods

2.1. Design

A cross‐sectional study was conducted from December 2023 to February 2024 in Israel during the 7th of October war [39].

2.2. Participants

The study included 110 participants who were recruited via a snowball sample method. The inclusion criteria for the study were: dietitians with a minimum of 6 months in the workplace and 1 year in the profession. G*Power calculations indicated that, to achieve a medium effect size (f ² = 0.15) with a power of at least 0.80 and a significance level of 0.05, the required sample size should be at least 92 participants.

2.3. Procedure

Dietitians who had graduated from one academic institution were invited to participate in the study via an electronic flyer sent to their email address. It described the study's aims and then gave directions to access an electronic link to an online questionnaire sent from Qualtrics. They were asked to fill out a questionnaire that included validated scales, with no open questions (on their stress, personal resilience, coping strategies, trust in the organization's management, perceived preparedness of the NNDMOH and strain symptoms). The questionnaire was piloted with 15 dietitians to ensure clarity and suitability for the sample. While respondents found it clear to understand, they noted that using one of the questionnaire sections (the NASA Task Load Index [40]) without anchors was challenging. Consequently, we added anchors ranging from 1 (low) to 20 (high) to the NASA Task Load Index.

After completing the questionnaire, which took approximately 20 min, participants were asked to pass it on to other dietitians they know or work with including those who had graduated from other institutions. By doing so, we were able to build a sample of dietitians from a variety of perspectives including age, gender, tenure, workplace and geographical location.

2.4. Measures

Perceived stress was measured using the NASA Task Load Index [40], assessing the subjective workload stemming from multi‐source demands, including mental, physical, temporal, frustration, effort and performance stressors. Each demand was assessed on a Likert‐type scale (ranging from 1 = a very low extent to 20). An example item is ‘How fast and stressful has the last week been?’ (Cronbach's α = 0.75).

Coping strategies were assessed with the Coping Strategy Inventory Short Form (CSISF) [29]. Sixteen‐item (rated on a 5‐point Likert‐type scale ranging from 1 = never to 5 = always) (Cronbach's α = 0.79). Four items assessed engagement‐in‐problem‐coping strategies (EP), for example, ‘I make a plan of action and follow it’ (Cronbach's α = 0.49); four items assessed disengaged‐in‐problem (DP)‐coping strategies, for example, ‘I hope the problem will take care of itself’ (Cronbach's α = 0.46); four items assessed engaged‐in‐emotion (EE) coping strategies, for example, ‘I let my feelings out to reduce the stress’ (Cronbach's α = 0.67); and four items assessed disengaged‐in‐emotion (DE) coping strategies, for example, ‘I try to spend time alone’ (Cronbach's α = 0.44).

Personal resilience was measured with the Brief Resilience Scale (BRS) [41]. Participants rated their agreement with six items on a 5‐point Likert‐type scale (1 = Totally disagree to 5 = Totally agree). An example item is ‘I am not easily discouraged by failures’ (Cronbach's α = 0.83).

Trust in the organization's management was measured with the 15‐item scale [42]. Dietitians were asked to rate on a Likert‐type scale (ranging from 1 = not at all to 7 = to a very high extent) the degree they could trust in the workplace. An example item is ‘the workplace's management could be trusted in helping me solve problems that occurred during the war’ (Cronbach's α = 0.95).

The NNDMOH perceived preparedness to respond to the war was assessed with a preparedness scale [37]. The respondents were asked to rate each item on a 5‐point Likert‐type scale ranging from 1 = strongly disagree to 5 = strongly agree. An example item is ‘the Nutrition division took appropriate steps to protect dietitians’ (Cronbach's α = 0.96).

Strain symptoms were assessed with the Shona Symptom Questionnaire SSQ‐14 [43]. Items are rated on a 5‐point Likert‐type ranging from 1 = not at all to 5 = always. An example item ‘I had stomach aches’ (Cronbach's α = 0.85).

Control variables included sociodemographic data of gender, family status (age, seniority, ethnicity, education level and main workplace), as these variables were identified in previous studies as relevant to perceived stress [44, 45].

2.5. Ethical Considerations

The research protocol was approved by the Tel‐Hai Academic college ethics committee approval number 19‐6/2023. The participant information sheet and consent form stated that participants had the right to withdraw from the study without consequence and that responses were confidential.

2.6. Data Analysis

The IBM SPSS statistics software version 27 for Windows was used to carry out the data analysis. Since the Qualtrics system required all items to be completed before proceeding, missing data were not possible. To detect potential outliers, we performed data validation checks, including range and logical consistency assessments. No extreme or implausible values were found, confirming the data set's accuracy for analysis. Descriptive statistics, such as frequencies, means and standard deviations, were used for demographic data and the main study variables. To test our hypotheses, Pearson correlations were calculated to provide preliminary support, and a multiple hierarchical regression analysis was conducted to assess the unique contribution of a set of variables above and beyond the variables defined in previous steps.

3. Results

The research questionnaire was completed by 110 dietitians. The socio‐demographic characteristics of the participants are described in Table 1. Ninety‐four percent of the respondents were female, their age ranged from 28 to 67 years (Mean = 44, SD = 10.4). Fifty‐six percent of the dietitians held a bachelor's degree; 42% had a master's degree and the rest had a doctorate (1%). Ninety‐two percent were employees, while the rest were self‐employed.

Table 1.

Participants’ characteristics.

Gender
Female	94%
Age (years)
Mean	44
SD	10.4
Range	28–67
Education
BSc	56%
MSc	43%
PhD	1%
Workplace
General Hospital	25%
Community	21%
Geriatric	20%
Psychiatric	5%
Rehabilitation	6%
Self‐employed	8%
Other	15%
Family status
Married	79%
Single	21%

Generally, dietitians rated their mean level of strain symptoms as moderate (Mean = 2.53; SD = 0.59) (Table 3). Whereas 77.9% of the dietitians ranked their mean level of symptoms as moderate (between 2 and 3), 22.1% rated it as moderately high (between 3.07 and 3.80). The most prevalent strain symptoms were thinking too much, impairment of functioning, lack of concentration and fatigue. As for their stress levels, dietitians rated their mean level of perceived stress as moderate (Mean = 10.54; SD = 3.29), with the most perceived stress stemming from mental overload (Table 2). Additionally, dietitians rated their mean level of personal resilience as moderate (Mean = 3.17; SD = 0.48).

Table 3.

Means, standard deviations (SD) and the correlation matrix of the research variables.

Characteristics		M	SD	1	2	3	4	5	6	7	8	9	10
1	Strain symptom	2.53	0.6	1
2	Seniority	15.55	11.20	−0.16	1
3	Perceived stress	10.54	3.29	0.44**	0.10	1
4	Personal resilience	3.17	0.48	−0.44**	0.09	−0. 24*	1
5	Problem engagement	3.76	0.44	−0.27**	0.14	−0.14	0.39**	1
6	Disengagement problem	3.59	0.7	0.09	0.16	−0.13	0.13	0.21*	1
7	Emotional engagement	2.59	0.69	0.33**	−0.33**	0.04	−0.28**	−0.13	−0.11	1
8	Emotional disengagement	3.07	0.57	0.32**	0.00	0.26**	−0.40**	−0.34**	−0.30**	0.29**	1
9	TOM	4.65	1.11	−0.15	0.00	−0.20*	0.15	0.00	0.28**	−0.45	−0.14	1
10	NNDMOH	3.18	0.91	−0. 26**	0.00	−0.12	0.05	−0.04	0.21*	−0.04	0.04	0.37**	1
Correlation Heatmap Colour Scale (−0.7 to +0.7)
−0.7		−0.5		−0.3		0		0.3		0.5		0.7

Abbreviations: M, mean; NNDMOH, National Nutrition Division in Ministry of Health; SD, standard deviation; TOM, trust in the organization's management.

*p < 0.05

**p < 0.01.

Table 2.

Strain symptoms.

Symptoms	Mean (SD)
Tearfulness	2.88 (1.13)
Poor sleep	2.84 (1.17)
Difficulty in enjoying daily activities	2.00 (1.00)
Perceptual symptoms	2.17 (1.06)
Suicidal ideas	1.12 (0.49)
Fatigue	3.55 (0.99)
Stomach‐ache	2.06 (1.16)
Impairment of functioning	3.55 (0.99)
Difficulty making decisions	2.42 (1.01)
Thinking too much	3.88 (0.80)
Lack of concentration	3.36 (0.87)
Being startled	2.15 (1.03)
Irritability	2.59 (1.02)
Disturbing dreams	2.48 (1.13)

Note: The ratings are on a scale from 1 = not at all, to 5 = always.

The correlation matrix in Table 3 provides partial support to the research model: Personal resilience, problem‐solving engagement and the NNDMOH's preparedness were negatively correlated with dietitians' strain symptoms, whereas emotional engagement and disengagement coping strategies were positively correlated with them. In addition, a significant correlation was found between trust in the organization and dietitians' strain symptoms.

Table 4 presents the results of a hierarchical linear regression analysis for predicting strain symptoms perceptions from the control variables and resilience levels. Of the control variables (Table 4 Model 1: controls), only gender (β = −0.21; p < 0.05) and seniority (β = −0.22; p < 0.05) were significantly related to strain symptoms. More strain symptoms occurred among women than men, and with decreasing seniority. About 8% of the variance in the dietitians' perceived strain symptoms was explained by gender and seniority. In line with hypothesis 1, perceived stress was positively linked to perceived strain symptoms (β = 0.50; p < 0.001), contributing to about 25% of the explained variance in the dietitian's perceived strain symptoms (Table 4, Model 2: stressors). In line with hypothesis 2, personal resilience was significantly and negatively linked to perceived strain symptoms (β = −0.31; p < 0.001), contributing to an additional 9% of the explained variance in the dietitian's perceived strain symptoms (Table 4 Model 3: personal resilience resources). In contrast to our hypotheses 3 and 4, none of the dietitian's coping strategies nor perceived trust in the organization's management were significantly related to dietitians' strain symptoms (Table 4, Models 4 & 5). However, in line with hypothesis 5, the perceived preparedness of the NNDMOH to cope with the crisis was negatively linked with strain symptoms (β = −0.17; p < 0.05), contributing another 3% to the explained variance in the dietician's strain symptoms (Table 4, Model 6: National resilience resources).

Table 4.

Hierarchical regression analysis for predicting dietitians’ strain symptoms from various resilience levels and above and beyond stress and socio‐demographic characteristics.

	Model 1: controls	Model 2: stressors	Model 3: personal resilience resources	Model 4: relational resilience resources	Model 5: organizational resilience resources	Model 6: national resilience resources
	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)
Gender	−0.21 (0.27)*	−0.34 (0.23)*	−0.24 (0.22)*	−0.02 (0.22)*	−0.21 (0.23)*	−0.18 (0.22)*
Family status	−0.08 (0.010)	−0.15 (0.09)	−0.18 (0.08)	−0.14 (0.08)	−0.14 (0.90)	−0.14 (0.08)
Seniority	−0.22 (0.00)*	−0.29 (0.00)*	−0.0.26 (0.00)*	−0.22 (0.00)*	0.22 (0.00)*	−0.22 (0.000)*
Ethnicity	−0.12 (0.00)	−0.13 (0.09)	−0.0.34 (0.08)	−0.01 (0.08)	−0.09 (0.77)	0.08 (0.08)
Perceived stress		0.50 (0.02)***	0.43 (0.01)***	0.42 (0.01)***	0.42 (0.15)***	0.41 (0.00)**
Personal resilience			−0.31 (0.10)***	−0.20 (0.11)*	−0.20 (0.11)*	−021 (0.11)*
Problem‐solving engagement				−0.12 (0.12)	−0.12 (0.12)	−0.09 (0.12)
Problem‐solving disengagement				0.17 (0.07)	0.17 (007)	0.17 (0.07)
Emotional engagement				0.12 (0.07)	0.12 (0.07)	0.12 (0.07)
Emotional disengagement				0.15 (0.01)	0.10 (0.10)	0.11 (0.11)
TOM					0.00 (0.43)	0.06 (0.44)
NNDMOH's preparedness						−0.17 (0.05)*
F	F = 2.16	F = 9.49**	F = 11.4**	F = 8.87**	F = 7.89**	F = 8.06**
Sig. F change	0.79	< 0.01	< 0.0.01	< 0.01	< 0.01	< 0.01
R square	0.08	0.33	0.42	0.49	0.49	0.52

Abbreviations: NNDMOH, National Nutrition Divisions in Ministry of Health; TOM, Trust in the Organization's Management.

^* p < 0.05

^** p < 0.01

^*** p < 0.001.

4. Discussion

Dietitians' resilience is essential to ensure their adaptability, job satisfaction and capacity to provide high‐quality patient care under stress [46, 47]. By applying the socio‐ecological model of resilience [5], this study uncovers the personal, interpersonal and professional resources that help dietitians maintain their well‐being under crisis. We found that about 22% of dietitians in our sample reported experiencing symptoms of strain to a moderately high degree. The most prevalent strain symptoms were thinking too much, impairment of functioning, lack of concentration and fatigue. This is concerning, as these symptoms harm both the dietitian's own well‐being and patients care, thereby highlighting the mutual relationship between well‐being and professional functioning.

The findings align with previous studies showing the dietitians' perceptions of stress were associated with their strain symptoms. Yet, the limited research to date providing quantitative data on dietitians' strain symptoms makes it challenging to compare these symptoms across institutions, countries and between crisis and routine periods. Furthermore, the findings underscored the crucial role of personal resilience as a resource that mitigates the adverse effects of stress [48]. About a third of dietitians exhibited low personal resilience. However, consistent with prior research identifying resilience as crucial for coping with adversity [20], higher resilience was linked to better well‐being and fewer strain symptoms, regardless of stress levels [49, 50]. These findings add to the limited research on dietitians' resilience during crises. Insights from COVID‐19 highlighted its importance, with some dietitians fearing permanent change in their lives [24, 26]. In such uncertain and rapidly shifting conditions, resilience is a vital personal resource [51].

Contrary to our model, the findings did not support a link between dietitians' coping strategies and reduced strain symptoms. This may be due to our study design, which examined these associations over and above personal resilience. Perhaps personal resilience overshadowed the effects of coping strategies, given that resilience itself is defined as the ability to cope with adversity [41]. Indeed, a zero‐level correlational analysis showed that, as expected, problem‐focused engagement coping strategies were associated with fewer strain symptoms. Another explanation for this unexpected finding is that dietitians may lack the knowledge or ability to use coping strategies effectively. This is somewhat supported by the correlational results showing that using emotion‐focused engagement or disengagement coping strategies were associated with higher strain symptoms. Emotion‐focused coping may provide immediate relief but often fails to address the underlying stressor, potentially leading to increased stress over time [49]. Furthermore, ineffective emotional coping, such as avoidance or self‐blame, can exacerbate stress symptoms by creating a cycle of negative emotional responses without addressing the root causes of stress [50].

Our findings indicated that while dietitians' trust in their organization's management was not related to decreased strain symptoms, their trust in the professional authority—specifically, the perception that the NNDMOH is prepared to handle wartime threats was negatively associated with strain symptoms, contributing 3% of the explained variance in the dietitians' strain symptoms above and beyond their perceived stress and personal and relational resilience. The fact that this level of resilience had only modest contribution should not diminish its perceived utility to dietitians, as even a small preventive effect can have a substantial impact at the organizational level [51].

In contrast to previous studies [36, 52], dietitians seem to derive resilience resources from their professional authority rather than from the organization. Observing dietitians' ethical code and academic curriculum, these findings suggest that dietitians, like other allied health professionals, receive strong training focused on professional commitment with less emphasis on organizational affiliation. This is evident from an examination of the dietitians' code of ethics [53], which, at best, directs dietitians to collaborate with interprofessional team members for patient benefit but often lacks significant emphasis on organizational dynamics [14]. Instead, dietitians appear to draw resilience from their professional authority, with a belief in their readiness to address wartime challenges, fostering a sense of stability and safety.

4.1. Study Strengths and Limitations

This study provides a valuable reference for examining the associations of dietitians' stress, strain and resiliency sources, especially during crises. The findings encourage the use of standardized measures to enable comparisons across organizations, countries and between crises and routine periods, advancing research in this field.

However, the cross‐sectional design limits understanding of the dynamics of stress, resilience and well‐being as events unfold. Additionally, the low internal reliability of relational resilience scales may bias findings, though low alpha values may stem from a limited number of items rather than invalidity [54]. Future studies should test the model in different contexts, such as other global crises and diverse organizational settings.

5. Conclusion

This study examined dietitians' resilience through an ecological lens, revealing that 22% reported moderately high strain symptoms, including overthinking, impaired functioning, lack of concentration and fatigue. Personal resilience and the perceived preparedness of the NNDMOH emerged as key resources for mitigating stress. However, other resilience factors, such as coping strategies and trust in the organization's management, were not significantly linked to reduced strain symptoms.

Practical implications include fostering dietitians' resilience through enhanced workplace wellness, and mentoring programmes and support from professional authorities like the NNDMOH [9]. Clear communication and visible preparedness can provide stability and reduce stress. Training programmes should focus on evidence‐based coping skills, particularly problem‐focused strategies, to address gaps in stress management. Additionally, aligning organizational policies with dietitians' professional and ethical standards may better support their resilience, ultimately improving job satisfaction, well‐being, and patient care during crises.

Author Contributions

Galia Sheffer‐Hilel and Anat Drach‐Zahavy conceptualized and designed the study. Galia Sheffer‐Hilel and Sigal Tepper collected the data, which were analyzed by Galia Sheffer‐Hilel. Galia Sheffer‐Hilel wrote the first draft with contributions from Anat Drach‐Zahavy. All authors contributed to the manuscript and approved the final version for submission.

Ethics Statement

The research protocol was approved by Tel‐Hai Academic college ethics committee approval number 19‐6/2023.

Conflicts of Interest

The authors declare no conflicts of interest.

1. Peer Review

The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/jhn.70073.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.