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Ci a ion: Mon o o-Fe nández, E.;
Cá denas-Gu ié ez, A.R.;
Be nal-Gue e o, A. En ep eneu ial
Resilience: A Case S udy on
Uni e si y S uden s. In . J. En i on.
Res. Public Heal h 2022,19, 2589.
h ps://doi.o g/10.3390/ije ph
19052589
Academic Edi o : Ma ía M. Mo ales
Suá ez-Va ela
Recei ed: 30 Decembe 2021
Accep ed: 21 Feb ua y 2022
Published: 23 Feb ua y 2022
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In e na ional Jou nal o
En i onmen al Resea ch
and Public Heal h
A icle
En ep eneu ial Resilience: A Case S udy on
Uni e si y S uden s
Elisabe Mon o o-Fe nández 1,* , An onio Ramón Cá denas-Gu ié ez 2and An onio Be nal-Gue e o 2
1Depa men o Communica ion and Educa ion, Facul y o Social and Human Sciences,
Uni e si y Loyola Andalucía, 41704 Se ille, Spain
2Depa men o Theo y and His o y o Educa ion and Social Pedagogy, Facul y o Educa ion Sciences,
Se ille Uni e si y, 41013 Se ille, Spain; [email p o ec ed] (A.R.C.-G.); [email p o ec ed] (A.B.-G.)
*Co espondence: emon o [email p o ec ed]
Abs ac :
En ep eneu ial esilience e e s o he capaci y o ace, o e come and p ojec onesel
a e su e ing li e e en s wi h a nega i e impac . Eme ging adul hood and he cha ac e is ics
o uni e si y li e acili a e he occu ence o s ess ul si ua ions ha can a ec well-being. The
aim o his phenomenological esea ch is o explo e he s a egic componen s o en ep eneu ial
esilience and how young uni e si y s uden s ha e shaped hei en ep eneu ial esilience a e
expe iencing nega i e li e e en s. The p esen esea ch is a mul iple case s udy ha was de eloped
h ough a mixed me hodology. The me hodological sequence was quan i a i e and quali a i e, wi h
p io i y gi en o he quali a i e phase o he esea ch. Ten uni e si y s uden s wi h high le els o
esilience we e in e iewed. The da a we e analysed using hema ic analysis. The esul s indica e
ha esilience is buil h ough in ape sonal and exope sonal p ocesses. These p ocesses make up a
se o s a egic dimensions ela ed o en ep eneu ial beha iou ha a e used o he cons uc ion o
pe sonal p ojec s.
Keywo ds:
esilience; en ep eneu ship; salu ogenesis; uni e si y s uden s; sense o cohe ence;
gene al esilience esou ces; case s udy; mixed esea ch
1. In oduc ion
Psychological esilience is a concep ually complex e m ha aises disc epancies in i s
unde s anding depending on he pe sonali y ai s, p ocesses and ou comes in ol ed [
1
–
3
].
This is co obo a ed by bibliome ic s udies ha show a b oad, di e se and agmen ed
s a e o he a [
4
,
5
]. Despi e his concep ual he e ogenei y, ce ain ecu en e ms ela ed o
esilience ha e been ex ac ed, such as coping capaci y, ad e si y, isk ac o s, s ess ul si u-
a ions, su e ing and posi i e adap a ion [6]. This e minological lis leads o an app oach
o esilience as a mul idimensional cons uc ha in ol es he combina ion o biological,
social, cul u al and psychological p ocesses [
7
] p omo ing adap a ion and esis ance o
ci cums ances ha a e de imen al o physical and psychological well-being, whe he in
he social, pe sonal, amily o wo k sphe e [8–10].
The e is a widely accep ed iew o en ep eneu ship as being di ec ly ela ed o busi-
ness and unde s ood as he p ocess o ini ia ion, c ea ion, de elopmen and managemen
o business p ojec s [
11
–
14
]. Howe e , in he educa ional con ex , en ep eneu ship has
wo di e en no ions: “en e p ise educa ion” and “en ep eneu ship educa ion” [
15
]. The
concep o “en e p ise educa ion” is ela ed o he de elopmen o gene ic skills linked
o he p ojec ion o li e in an in ini e numbe o si ua ions [
16
]. On he o he hand, he
e m “en ep eneu ship educa ion” is linked o en ep eneu ial c ea ion and business [
17
].
Gi en his dis inc ion, we adop he cons uc “en e p ise educa ion”, as i ep esen s he
adop ion o a mo e global app oach cen ed on he capaci y o ini ia e, ans o m, adap ,
ac and de elop in he ace o he oppo uni ies o di icul ies ha a ec people in hei li e
cycle [
18
]. In line wi h he p e ious esea ch [
19
–
21
], we associa e “En e p ise educa ion”
In . J. En i on. Res. Public Heal h 2022,19, 2589. h ps://doi.o g/10.3390/ije ph19052589 h ps://www.mdpi.com/jou nal/ije ph
In . J. En i on. Res. Public Heal h 2022,19, 2589 2 o 22
wi h pe sonal ini ia i e, i.e., a se o sel -ini ia ed, p oac i e and sus ainable ac ions ha a e
sus ainable o e ime and ha e he capaci y o ans o m he con ex in which he subjec
inds him/he sel [22].
The in e sec ion o en ep eneu ship and esilience has been s udied om he heo ies
o business o ganisa ion, ei he as a capabili y [
23
], p ocess [
24
], ope a ion [
25
] o esul [
26
].
None heless, all hese pe spec i es cons i u e an in e p e a ion o en ep eneu ial esilience
limi ed exclusi ely o he wo kplace. Howe e , om a mo e holis ic pe spec i e, and
ela ed o pe sonal de elopmen and g ow h, he e m en ep eneu ial esilience is ein-
e p e ed in his pape , de aching i om he exclusi e in e p e a ion o he heo ies o
business o ganisa ion and concep ualising i om he b oade cons uc ion o pe sonal iden-
i y, unde s ood as a dynamic, e olu iona y and social p ocess, in which en ep eneu ial
ini ia i e is included. The shaping o iden i y in ol es choosing, ini ia ing and ca ying ou
li e ac i i ies ha a e pa o he pe sonal expe ience. This app oach con e ges wi h lines
o esea ch ocused on goal-o ien ed human beha iou , o a p o use p ojec ion, such as
pe sonal p ojec s [
27
], pe sonal aspi a ions [
28
], pe sonal asks [
29
] o possible sel es [
30
].
All o hem a e linked o he na a i e cons uc ion o pe sonal iden i y, inco po a ing
no only he i al cha ge o pas and p esen expe iences, bu also he di ec ion and man-
agemen o expec a ions [
31
]. In his way, we concep ualise en ep eneu ial esilience
no only as he abili y o ace and manage li e’s ad e si ies e icien ly and e ec i ely
( esilience), bu also o p ojec he sel in o he u u e, h ough he implemen a ion o
s a egies ela ed o en ep eneu ial o ien a ion and beha iou [
32
,
33
]. The inco po a ion o
en ep eneu ial beha iou in o esilience p ocesses p omo es he con igu a ion o pe sonal
p ojec s, aspi a ions and a eas, whe e nega i e episodes in li e a e adequa ely in eg a ed
(en ep eneu ship), con igu ing a cong uen biog aphical na a i e.
En ep eneu ial esilience is amed wi hin he salu ogenic model. This heo y ocuses
on he o igins and esou ces o heal h-p omo ing and in e p e s s a es o well-being as a
con inuum anging om absolu e heal h o p o ound disease s a es. The cen al concep
o he salu ogenic model is he sense o cohe ence (SOC) and i is concei ed as a global
o ien a ion ha exp esses he deg ee o which one has a pe asi e, endu ing ye dynamic
sense o con idence ha : (1) he s imuli coming om he in e nal and ex e nal en i on-
men in he cou se o li e a e s uc u ed, p edic able and explainable (comp ehensibili y);
(2) he esou ces
a e a ailable o one o mee he demands posed by hese s imuli (manage-
abili y); and (3) hese demands a e challenging, wo hy o in es men and commi men
(meaning ulness) [
34
]. SOC is a key concep in he de elopmen o esilience unde ad e se
ci cums ances [35–37].
In u n, he salu ogenic model is composed o a second cons uc : gene alised esis ance
esou ces (GRRs). GRRs a e de ined as he se o pe sonal, social o con ex ual esou ces and
ac o s ha minimise o coun e ac he s esso s o e e yday li e by acili a ing adap a ion
and coping in he ace o ad e se li e ci cums ances [
38
]. Al hough no conclusi e, esea ch
indica es ha he e is mu ual eedback be ween SOC and GRRs, a ou ing well-being and
heal h, which means ha he use o GRRs con ibu es o a s eng hened SOC and, likewise,
a s eng hened SOC implies a be e use o GRRs [39,40].
Howe e , i is well es ablished ha s esso s nega i ely a ec he s a e o heal h and
well-being. In his ega d, in [
34
,
41
] s esso s a e g ouped in o h ee b oad g oups: ch onic
s esso s, majo li e e en s and daily hassles. This esea ch ocuses on he second g oup
o s esso s, unde s ood as li e e en s o nega i e impac s, which p o oke a homeos a ic
disequilib ium on people’s well-being a some poin in hei li e cycle [31–42].
The cha ac e is ics o he uni e si y en i onmen and he con luence o eme ging
adul hood [
43
] make i possible o young uni e si y s uden s o be subjec ed o a ious
s esso s, such as he explo a ion o p o essional iden i y, amily independence, a g ea e
deg ee o au onomy and esponsibili y, exac ing academic demands, o amily and pe sonal
expec a ions [
44
]. Fu he mo e, a s udy by he Wo ld Heal h O ganisa ion on he p e a-
lence and dis ibu ion o men al diso de s in i s -yea uni e si y s uden s e ealed ha
1 in 3 s uden s
(31.4%) su e ed some men al diso de in he i s academic yea a uni e -
In . J. En i on. Res. Public Heal h 2022,19, 2589 3 o 22
si y and in 1 ou o 5 cases (20.4%) he diso de s caused de elopmen al p oblems, no only
a he academic le el bu also a ec ing social li e, pe sonal ela ionships and wo k [
45
,
46
].
In he Spanish con ex , knowledge abou how s esso s a ec he well-being o uni e si y
s uden s is no a widesp ead ield o s udy, al hough some s udies do exis . In ela ion o
he p e alence o majo dep ession, in [
47
] dep ession is epo ed o be highly p e alen
in a sample o uni e si y s uden s, wi h 8.7% o majo dep essi e episodes, wi h he mos
common symp oms being a dep essed mood (81.3%) and sleep dis u bance (79.2%). In a
mo e ecen s udy o emale uni e si y s uden s, he esul s showed ha 18.1%, 22.8% and
13.5% had se e e/ e y se e e le els o dep ession, anxie y and s ess, espec i ely [
48
].
Along he same lines, i is concluded in [
49
] ha one hi d o Spanish uni e si y s uden s
epo ha ing su e ed om a common men al diso de in he las yea , and one hi d o
hem epo a se e e impai men o hei unc ioning. In addi ion, i is ound in [
50
] ha
21% o s uden s pe sis in suicidal idea ion one yea a e s a ing hei uni e si y s udies.
This esea ch indica es ha he uni e si y s age is a c i ical pe iod o he ansi ion o
adul hood ha is no ee o s esses, which unde mine s uden s’ heal h and well-being,
bo h he well-being o s uden s and hei en ep eneu ial pe o mance in he de elopmen
o hei li e p ojec s. While he e is esea ch on esilience and coping wi h s esso s in he
uni e si y con ex [
51
–
54
], he e a e no s udies on en ep eneu ial esilience, in he sense
o pe sonal g ow h and de elopmen , bu a he di ec ly ela ed o he o ganisa ion and
c ea ion o companies [
55
]. Pe sonal g ow h as an en ep eneu ial p ocess is linked o he
well-known concep o “en ep eneu ial o ien a ion” [
56
–
59
], which in u n is associa ed
wi h pe o mance heo y [
60
]. This heo y includes cumula i e esea ch on s a egy and
e e s o h ee dimensions: inno a ion, isk- aking and p oac i i y [
61
]. Applied o indi-
iduals (i could also be applied o o ganisa ions), he p ocess o en ep eneu ial pe sonal
g ow h adds o he me e esilience o hose s a egic componen s ha make up a speci ic
disposi ion owa ds en ep eneu ial beha iou , ela ed o habi ual asks and he necessa y
adjus men s equi ed by he con ex s in which he ac ion akes place [
62
]. In a way, pe sonal
en ep eneu ial g ow h highligh s, as wi h he en ep eneu ial o ien a ion cons uc [
63
],
he links be ween en ep eneu ial a i udes and en ep eneu ial beha iou s [
64
,
65
]. In he
academic en i onmen , in which we ha e conduc ed he esea ch, we could add some
o he s a egic dimensions ha cha ac e ise he p ocess o pe sonal en ep eneu ial g ow h:
sel -con idence (con idence in ela ion o ce ain pe sonal a ibu es), au onomy (abili y o
ac wi h one’s own c i e ia and independen ly), pe se e ance (pe se e ance in achie ing
goals), achie emen o ien a ion (p e e ence o aking esponsibili y and he submi ing o
e alua ion o esul s) and p oblem sol ing (a p ocess o dealing wi h di icul ies). F om a
salu ogenic pe spec i e, he aim o his esea ch is o explo e he s a egic componen s o
he en ep eneu ial p o ile o en young uni e si y s uden s and how hey ha e shaped
hei en ep eneu ial esilience a e expe iencing nega i e li e e en s (NLEs).
2. Ma e ials and Me hods
2.1. Resea ch Design
This esea ch is a mul i-case s udy [
66
,
67
] ha was de eloped h ough a mixed me hod-
ology [
68
] using quan i a i e (RS-14 es ) and quali a i e (in e iews) ins umen s. Bib-
liome ic esea ch [
69
,
70
] e eals ha mixed esea ch me hods a e widely used in en-
ep eneu ship s udies and co obo a es hei me hodological e ec i eness, i espec i e
o he esea ch sequences implemen ed [
71
,
72
], as hey enable: (1) a mo e comp ehen-
si e iew o p ocesses and esul s, (2) an inc ease in alidi y, (3) an imp o emen in he
in e p e a ion o esul s and (4) he gene a ion and in eg a ion o mo e de ailed and ex-
plana o y knowledge [73–75]. The esea ch design was based on he p inciples o p io i y
and sequen iali y, wi h he quali a i e me hod being p ima y (QL) and he quan i a i e
me hod seconda y (q ). The esea ch equency was quan i a i e and quali a i e. Thus, he
s udy was s uc u ed in wo esea ch phases: q
→
QL [
76
]. The quan i a i e phase (1) was
implemen ed h ough a desc ip i e and selec i e non-expe imen al s udy [
77
] o de e mine
he deg ee o esilience o he pa icipan s and o selec he subjec s wi h he highes le els
In . J. En i on. Res. Public Heal h 2022,19, 2589 4 o 22
o esilience. The quali a i e phase (2) and cen al co e o he esea ch was de eloped
unde he phenomenological and in e p e a i e app oach [
78
], based on he explo a ion,
in e p e a ion and na a i e unde s anding o he pa icipan s’ li e expe iences, h ough he
memo ies and easoning o hei own pe sonal ajec o ies [
79
]. In ou case, his app oach
aims o in e p e and unde s and how people gi e meaning and signi icance o NLEs in
he p ocess o building en ep eneu ial esilience. In e en ional s udies in ol ing animals
o humans, and o he s udies ha equi e e hical app o al, mus lis he au ho i y ha
p o ided app o al and he co esponding e hical app o al code.
2.2. Sampling and Pa icipan s
In o de o selec he pa icipan s, a non-p obabilis ic con enience and pu posi e
sampling was used [
80
], ollowing hese inclusion c i e ia: (1) he pa icipan s belonged o
he Pedagogy and Teaching Deg ees o he Uni e si y o Se ille, (2) hey had iden i ied a
leas one NLE acco ding o he Li e E en s Checklis o he DSM-5 [
81
] and (3) hey had ob-
ained e y high sco es (90–99) on he Resilience Scale (RS-14), he esilience measu emen
ins umen . Following he sampling cycle [
82
], he pa icipan sample (quan i a i e phase)
consis ed o 276 subjec s who comple ed he RS-14 es and he eal sample (quali a i e
phase) consis ed o he 10 pa icipan s wi h he highes sco es on he RS-14 es .
2.3. Da a Collec ion Tools
The da a collec ion ins umen s selec ed in his esea ch a e disagg ega ed acco ding
o he phases o mixed esea ch (q -QL).
Quan i a i e phase (q ): he le el o esilience was measu ed wi h he Resilience Scale
(RS-14) [
83
], alida ed in Spanish [
84
]. This consis ed o 14 i ems wi h a 7-poin Like scale
(“comple ely disag ee” = 1, “comple ely ag ee” = 7). The SR-14 was made up o a single
ac o ( esilience), e lec ing he o iginal dimensions o Pe sonal Compe ence (11 i ems) and
Accep ance o sel and li e (3 i ems). The psychome ic p ope ies o he RS-14 a e adequa e
wi h an o e all scale in e nal consis ency (α0.79) [84].
This scale was used o he selec ion o pa icipan s unde he ollowing c i e ia:
(1) he scale was alida ed by Spanish uni e si y s uden s showing adequa e in e nal
consis ency (
α
0.79) and obus alidi y wi h signi ican co ela ions wi h he esilience
scale CD- RISC [
3
]. (2) The RS-14 was used in di e en s udies in uni e si y popula-
ions [
85
,
86
].
(3) P e ious
s udies we e ca ied ou wi h his esilience scale in he en-
ep eneu ial ield [
87
,
88
]. (4) In he Spanish con ex , he e is a lack o ins umen s ha
measu e he in ape sonal ac o s o en ep eneu ial esilience in he uni e si y popu-
la ion. In his espec , in he ini ial ins uc ions o comple ing he scale, he ollowing
indica ion was in oduced o he comple ion o he i ems: “As an en ep eneu ial pe -
son I
conside ha . . .
”. In his way, pa icipan s esponded o he SR-14 om an en-
ep eneu ial pe spec i e, as in o he s udies on esilience and en ep eneu ship [
89
]. These
c i e ia ensu e he alidi y o he choice o SR-14 o his s udy.
Quali a i e phase (QL): Unde s anding how en ep eneu ial esilience is o med was
s udied h ough in-dep h in e iews based on a semi-s uc u ed sc ip [
90
]. The de elop-
men o he i s in e iew sc ip was based on he a ailable li e a u e [
91
–
93
]. Subsequen ly,
he in e iew sc ip was subjec ed o he judgemen s o en expe s who analysed i s alidi y
and ele ance. The expe s we e selec ed o hei ecognised academic and p o essional
backg ounds in he ield o esilience and we e d awn om he academic and he apeu-
ic sec o s. In he academic sec o , 6 expe s wi h a leas 2 publica ions on esilience
in indexed jou nals we e selec ed, and in he he apeu ic sec o 4, p o essionals wi h a
leas 5 yea s o expe ience in he de elopmen o he apies we e chosen. Finally, he
in e iew sc ip was comp ised o h ee hema ic blocks wi h a o al o 87 ques ions: pe -
sonal e en s (
11 ques ions
), esilience (41 ques ions), and esilien en ep eneu ial iden i y
(
35 ques ions
). An in e iew is he ins umen used o cha ac e ise he en ep eneu ial
p o ile o he esilien people selec ed in he quan i a i e phase. An in e iew allowed us o
In . J. En i on. Res. Public Heal h 2022,19, 2589 5 o 22
disco e he s a egic componen s ha p edispose owa ds en ep eneu ial beha iou and
how hey we e o med.
O e all, he applica ion o he SR-14 in he quan i a i e phase only in ol es he
selec ion o highly esilien pa icipan s. In he quali a i e phase, we used he in e iew
as he main ins umen o in o ma ion collec ion o map he s a egic dimensions ha
cha ac e ise pe sonal en ep eneu ial g ow h and he p ocesses o how en ep eneu ial
esilience was achie ed. In his way, he quali a i e da a collec ed will be c ucial o de ine
he s a egic dimensions o he en ep eneu ial pe sonal g ow h p ocess.
2.4. Da a Collec ion
P io o he beginning o he esea ch, au ho isa ion was eques ed om he Dean
o he Facul y o Educa ion Sciences o ca y ou he s udy. Subsequen ly, an e-mail was
sen o he eaching s a o he Bachelo ’s Deg ees in Pedagogy and P ima y Educa ion
explaining he aim o he esea ch and eques ing access du ing hei eaching hou s o
collec da a using he RS-14 scale (quan i a i e phase). A se o wel e eache s ag eed
o collec quan i a i e da a om bo h deg ees. The da a collec ion ook place du ing he
mon h o Oc obe 2020 and he s uden s we e in o med o he pu pose o he esea ch,
o hei olun a y pa icipa ion and o he con iden ial and anonymous p ocessing o
da a o exclusi ely scien i ic use. The pa icipan s in he quan i a i e phase ga e hei
w i en in o med consen . Once he da a om he RS-14 scale had been collec ed, he
da a we e emp ied and he subjec s we e classi ied acco ding o he le el o esilience o
he o al sco es ob ained on he RS-14 scale in o: e y high (90–99), high (80–89), no mal
(70–79),
low (60–69)
and e y low (50–59). In he quali a i e phase, he 25 pa icipan s wi h
he highes sco es on he RS-14 scale we e selec ed. They we e hen con ac ed by e-mail
o in-dep h semi-s uc u ed in e iews. O hese 25 po en ial pa icipan s, 19 eplied
a i ma i ely o pa icipa e in he quali a i e phase. Howe e , nine o hem inally declined
o pa icipa e in he in e iews o wo k and pe sonal- ela ed easons. The in e iews
we e ca ied ou by he i s au ho du ing he mon h o No embe 2020 in an o ice o
he Facul y o Educa ion Sciences. P io o he in e iews, he pa icipan s we e in o med
abou he pu pose o he in e iews and he scien i ic p ocedu e o be ollowed in he da a
p ocessing. The in e iews we e eco ded and las ed be ween 60 and 90 min each, ending
when he e was a sa u a ion o da a [94].
2.5. Da a Analysis
In he quan i a i e phase, a desc ip i e pe cen age analysis and a s udy o he mean
sco es ob ained on he RS-14 scale we e ca ied ou using he SPSS e sion 27 (IBM Co p,
A monk, NY, USA) p og amme. F om phenomenological and in e p e a i e epis emology,
he quali a i e da a we e analysed ia hema ic analysis. This me hod o analysis “is
no wed o any p e-exis ing heo e ical amewo k and so i can be used wi hin di e en
heo e ical amewo ks (
. . .
). Thema ic analysis can be an essen ialis o ealis me hod,
which accoun s o he expe iences, meanings and eali ies o he pa icipan s” [
95
]. The
hema ic analysis o he da a p o ided by he in e iews ollowed he phases desc ibed
in he me hodological guide o [
95
]: i s , he in e iews we e ansc ibed e ba im by
wo esea che s, and each in e iew was lis ened o a leas h ee imes, achie ing a high
deg ee o accu acy in he ansc ip ions. Subsequen ly, a hi d esea che checked all
he ansc ibed in e iews o accu acy. Second, a p ocess o eading and e- eading he
in e iews was ca ied ou and wo independen esea che s gene a ed he ini ial codes in
ela ion o he semi-s uc u ed in e iew sc ip . Once he i s h ee in e iews had been
coded, oge he wi h a hi d esea che , he lis o codes was ag eed upon by elimina ing,
e o mula ing and adding ce ain codes. The coding was ca ied ou wi h he A las. i.
7.0 p og amme
(Scien i ic So wa e De elopmen GmbH, Be lin, Ge many). Thi d, once
he lis o eme ging codes was compiled, po en ial hemes ela ed o he “li ed expe iences”
o en ep eneu ial esilience we e iden i ied and o ganised in o a s uc u e o main hemes

In . J. En i on. Res. Public Heal h 2022,19, 2589 6 o 22
and sub- hemes based on hei p e alence and ep esen a i eness. Fou h, he esea che s
e iewed and ag eed on he selec ion and o ganisa ion o he hemes and sub- hemes.
Finally, he hema ic s uc u e was de ined and nomina ed, i.e., he ex ual exce p s
o each heme we e iden i ied and he essen ial aspec s ha would in eg a e each heme
and sub- heme we e de e mined. To do his, he hemes hemsel es and hei ela ionship
wi h he o he hemes we e conside ed. Th ough his p ocess, he NLEs we e in e p e ed
and unde s ood. The quali y o he esea ch was ensu ed by applying he ollowing p o-
cedu es [
96
,
97
]: (1) c edibili y was ensu ed by in-dep h e ision o he da a, along wi h
compa ing da a be ween esea che s ( iangula ion); (2) dependabili y was ensu ed by us-
ing pa icipan -iden i ying keys and desc ibing da a analysis echniques; (3) ans e abili y
was main ained by using pu posi e sampling, as well as desc ibing he pa icipan s and
da a collec ion in de ail; and (4) con i mabili y was ob ained by analysing he da a wi h
A las. i. 7.0 and checking he in o ma ion om he in e iews wi h he pa icipan s.
2.6. E hical Conside a ions
This esea ch was app o ed and e iewed, including e hical aspec s, by he commi ee
o he Spanish Minis y o Science and Inno a ion and he S a e Resea ch Agency o he
Spanish Go e nmen unde e e ence numbe PID2019-104408GB-I00.
3. Resul s
3.1. Quan i a i e S udy
3.1.1. Socio-Demog aphic Cha ac e is ics o he Pa icipan s
Two hund ed and se en y-six s uden s om he Facul y o Educa ion Sciences a
he Uni e si y o Se ille pa icipa ed in he s udy by comple ing he RS-14 scale. The
socio-demog aphic cha ac e is ics o he pa icipan s a e shown in Table 1. The pa icipan s
ha e a mean age o 21 yea s (SD = 3.20) and he age ange is be ween 18 and 45 yea s. The
highes pe cen age o he pa icipan s a e emale (87.7%), compa ed o a lowe pe cen age
o males (12.3%). This e y dispa a e pe cen age dis ibu ion be ween men and women
is a consequence o he eminisa ion o he deg ees in Educa ion Sciences in he Spanish
uni e si y con ex [
98
]. Da a om he Na ional Ins i u e o S a is ics show ha in he
academic yea 2020/21 he pe cen age o women en olled was 77.8% compa ed o 22.2%
o men. Simila ly, his dis ibu ion also occu s in he Facul y o Educa ion Sciences a he
Uni e si y o Se ille, whe e he o al numbe o women en olled co esponds o 71.68% as
opposed o 28.32% o men. The composi ion o he sample by yea was as ollows: i s yea
(54.7%), second yea (14.1%) and ou h yea (31.2%). As o he dis ibu ion by deg ee, he
pe cen ages ob ained we e 41.3% in p ima y educa ion and 58.7% in pedagogy.
Table 1. Socio-demog aphic cha ac e is ics o he pa icipan s (n= 276).
Cha ac e is ics Nº o Pa icipan s (n) Pe cen age (%)
Age, m. 21 23.6
18–45 yea s old 276 100
Gende
Male 34 12.13
Female 242 87.7
Le el o educa ion a uni e si y
Fi s yea 151 54.7
Second yea 39 14.1
Fou h yea 86 31.2
G ade
P ima y Educa ion 114 41.3
Pedagogy 162 58.7
In . J. En i on. Res. Public Heal h 2022,19, 2589 7 o 22
3.1.2. Pa icipan s’ Responses Rela ed o Resilience Le el
The RS-14 scale consis ing o ou een i ems was used o assess he s uden s’ le el o
esilience, as can be seen in Table 2. High sco es we e ob ained o all he i ems s udied, he
mean being be ween 4.03 and 6.29. Among he high sco es, i ems 14 (“in an eme gency, I
am someone people can us ”) (42.4%), 13 (“I am p oud o he hings I ha e achie ed”)
(44.9%), 12 (“I can usually ind some hing o laugh abou ”) (47.8%) and 11 (“my li e has
meaning”) (48.9%) s and ou . In con as , an inc ease in low-sco ing esponses is obse ed
o i ems 1 (“I gene ally ake hings in my s ide”) (15.9% and 19.9%), 2 (“I am no a aid o
di icul ies because I ha e expe ienced hem in he pas ”) (8.7% and 12.7%) and 3 (“I am a
pe son wi h adequa e sel -es eem”) (7.6% and 12.2%). The es o he i ems ha e high mean
sco es, app oxima ely be ween 4.5 and 5.5.
Table 2. Pa icipan s’ esponses ela ed o esilience le el.
Resilience Le el
Deg ee o Ag eemen n(%)
1=To ally Disag ee
7 = To ally Ag ee
1 2 3 4 5 6 7 A e age
1. I gene ally ake hings in my s ide 10
(3.6)
44
(15.9)
55
(19.9)
63
(22.8)
46
(16.7)
39
(14.1)
19
(6.9) 4.03
2. I am no a aid o di icul ies because
I ha e expe ienced hem in he pas
9
(3.3)
24
(8.7)
35
(12.7)
63
(22.8)
61
(22.1)
57
(20.7)
27
(9.8) 4.53
3. I am a pe son wi h
adequa e sel -es eem
3
(1.1)
21
(7.6)
31
(11.2)
64
(23.2)
78
(28.3)
56
(20.3)
23
(8.3) 4.64
4. I eel I can handle many si ua ions
a once
1
(0.4)
10
(3.6)
28
(10.1)
61
(22.1)
97
(35.1)
61
(22.1)
18
(6.5) 4.8
5. I am esolu e and de e mined 1
(0.4)
13
(4.7)
32
(11.6)
55
(19.9)
86
(31.2)
59
(21.4)
30
(10.9) 4.84
6. Sel -con idence helps me h ough
di icul imes
1
(0.4)
15
(5.4)
36
(13.0)
48
(17.4)
77
(27.9)
57
(20.7)
42
(15.2) 4.9
7. When I am in a di icul si ua ion,
I can usually ind a way ou
0
(0)
2
(0.7)
5
(1.8)
33
(12.0)
68
(24.6)
128
(46.4)
40
(14.5) 5.58
8. I am a disciplined pe son 1
(0.4)
2
(0.7)
11
(4.0)
24
(8.7)
67
(24.3)
105
(38.0)
66
(23.9) 5.66
9. I usually manage in one way
o ano he
0
(0)
1
(0.4)
6
(2.2)
20
(7.2)
68
(24.6)
113
(40.9)
68
(24.6) 5.78
10. I ake an in e es in hings 0
(0)
2
(0.7)
3
(1.1)
16
(5.8)
60
(21.7)
99
(35.9)
96
(34.8) 5.95
11. My li e has meaning 1
(0.4)
1
(0.4)
1
(0.4)
13
(4.7)
53
(19.2)
90
(32.6)
117
(42.4) 6.09
12. I can usually ind some hing o
laugh abou
0
(0)
1
(0.4)
4
(1.4)
12
(4.3)
56
(20.3)
79
(28.6)
124
(44.9) 6.1
13. I am p oud o he hings
I ha e achie ed
0
(0)
1
(0.4)
0
(0)
8
(2.9)
38
(13.8)
97
(35.1)
132
(47.8) 6.27
14. In an eme gency, I am someone
people can us
0
(0)
0
(0)
2
(0.7)
8
(2.9)
32
(11.6)
99
(35.9)
135
(48.9) 6.29
3.1.3. Resilience Le els
The esilience sco es we e dis ibu ed in o he ollowing ca ego ies: “Ve y low
(
50–59 poin s
)”, “Low (60–69 poin s)”, “No mal (70–79 poin s)”, “High (80–89 poin s)”
and “Ve y high (90–99 poin s)”, as shown in Table 3. The majo i y o he pa icipan s,
64.5%, ob ained an o e all sco e on he scale wi hin he alue “High”, showing a posi i e
pe cep ion o hei le el o esilience. Fu he mo e, 26.4% o s uden s sco ed in he “Ve y
High” ange, while only 9.1% was in he “No mal” ange. The e o e, he majo i y o he
s uden s ag eed ha , in gene al, hey had a high le el o esilience.
In . J. En i on. Res. Public Heal h 2022,19, 2589 8 o 22
Table 3. Dis ibu ion o pa icipan s acco ding o le el o esilience.
Resilience Le el Poin s in he Scale n(%)
Ve y low 50–59 0 (0)
Low 60–69 0 (0)
No mal 70–79 25 (9.1)
High 80–89 178 (64.5)
Ve y high 90–99 73 (26.4)
3.2. Quali a i e S udy
3.2.1. Demog aphic Cha ac e is ics o he Pa icipan s
Quali a i e da a we e ob ained h ough in-dep h in e iews and we e analysed com-
p ehensi ely, adop ing a biog aphical na a i e app oach. Ten pa icipan s we e in e -
iewed, as summa ised in Table 4. The pa icipan s sco ed be ween 90 and 98 poin s on
he RS-14 scale. The majo i y o he pa icipan s we e women (7), compa ed o a small
numbe o men (3). The mean age o he pa icipan s was 26 yea s (SD =4.9), he age ange
being be ween 21 and 37 yea s. Wi h ega d o unde g adua e deg ees, he majo i y we e in
pedagogy (7), compa ed o hose in p ima y educa ion (3). The pa icipan s we e en olled
in he ou h yea (5), second yea (1) and i s yea (4). Finally, among he Nega i e Li e
Episodes (NLE) hey expe ienced, amily p oblems and illnesses s and ou .
Table 4. Cha ac e is ics o he pa icipan s (n= 10).
Subjec Sco e
RS-14 Sex Age Unde g adua e
Deg ees Cou se NLEs
S1P98E37SM
98 Female 37 Pedagogy Fou h 12
S2P94E25SM
94 Female 25 Pedagogy Fou h 12
S3P93E32SV
93 Male 32 Pedagogy Fou h 17
S4P92E26SV
92 Male 26 P ima y Educa ion Second 12
S5P92E24SM
92 Female 24 Pedagogy Fou h 14
S6P92E23SV
92 Male 23 Pedagogy Fi s 13 & 17
S7P91E25SM
91 Female 25 Pedagogy Fou h 13 & 17
S8P91E22SM
91 Female 22 Pedagogy Fi s 13 & 17
S9P90E30SM
91 Female 24 P ima y Educa ion Fi s 15
S10P90E21SM
90 Female 21 P ima y Educa ion Fi s 8
No e 1: S = subjec , P = sco e on he RS-14 scale, E = age and Sex = male o emale. No e 2: i ems iden i ied in he
LEC 5 [
62
]: 8 = sexual assaul , 12 = li e- h ea ening inju y o illness, 13 = se e e human su e ing, 15 = sudden
acciden al dea h, 17 = any auma ic e en (pa icipan s ha e indica ed b oken amily and po e y).
3.2.2. Shaping En ep eneu ial Resilience
The in o ma ion om he in e iews indica es he se o p ocesses implemen ed
a e he eme gence o he NLEs. The s uc u al hema ic analysis was composed o
wo main hemes and ou sub- hemes, espec i ely, ca ego ised in o in ape sonal and
exope sonal (Table 5):
3.2.3. Resilience Shaping P ocesses
The esilience o young uni e si y s uden s was shaped by in ape sonal p ocesses,
such as cogni i e, emo ional and beha iou al p ocesses on he one hand, and exope sonal
p ocesses, such as social suppo , on he o he hand.
Cogni i e P ocesses
The pe cep ion o he s imuli as NLEs was gene alised ac oss all he pa icipan s. The
assessmen o he se e i y o ad e se e en s is unique o pe sonal subjec i i y and is closely
ela ed o he a ailabili y o he pe son’s esou ces. When he demands o haza ds exceed
pe sonal esou ces, ad e se expe iences a e e alua ed wi h a high deg ee o se e i y. The
uni e si y s uden s in e iewed desc ibe ha in he ace o ad e se expe iences, such as
In . J. En i on. Res. Public Heal h 2022,19, 2589 9 o 22
sexual abuse, e minal illness, abandonmen o amily b eakdown o he dea h o pa en s in
acciden s, hey ha e no had su icien esou ces o manage NLEs. Pa icipan S10P90E21SM
na a es ha she has “su e ed sexual abuse by a e y close ela i e, om
he age o 6 o 14 ( . . . )
I
didn’ know wha o do, I didn’ know wha was happening and I didn’ know how o ac , I was
a child who didn’ unde s and any hing”. S6P92E23SV desc ibes he lack o esou ces o
adequa ely manage he NLE: “I wi nessed my a he bea ing my mo he and e bally humilia ing
he on many occasions, ad nauseam. I also expe ienced my b o he ’s schizoph enic c ises, which
we e b u al. And la e , I had o ake ca e o my mo he who su e ed om bipola diso de . All his
pushed me beyond my limi s, I couldn’ cope any mo e”. Simila ly, he es o he pa icipan s
desc ibed he lack o pe sonal esou ces and hei pe cep ion o he se e i y o hei ad e se
expe iences as NLEs.
Table 5. Themes and sub- hemes.
Themes Sub-Themes Codes
Resilience capaci y
building p ocesses
In ape sonal
Cogni i e p ocesses
Pe cep ion
E alua ion
Adap a ion
Con ol
Flexibili y
Emo ional p ocesses
Knowledge
Regula ion
Exp ession
Conduc ual p ocesses
App oach
A oidance
Re-e alua ion
Rein e p e a ion
Accep a ion
Exope sonal Social suppo
p ocesses
Explici
Implici
S a egic
en ep eneu ial
dimensions om
he NLEs
In ape sonal
Basic le el
Inno a ion o c ea i i y
P oac i i y o ini ia i e
Risk- aking
Speci ic le el
Au onomy
Pe se e ance
P oblem sol ing
Sel -con idence
Achie emen o ien a ion
Fu u e p ojec ion
p ocesses o he sel
In ape sonal
Pe sonal objec i es
Academic
Wel a e
Labou
Rela ional
Pe sonal e o s
Academic
Wel a e
Labou
Rela ional
Pe sonal p ojec s
Res uc u ing
Typology
E alua ion
Ranking
Exope sonal Con ex ual a iables Economic
Ma e ial
In . J. En i on. Res. Public Heal h 2022,19, 2589 16 o 22
GRRs o he pe sonal u u e a e he NLEs. [
114
]. Al hough hey all ha e hei deg ee
o impo ance, sel -con idence as a cen al elemen in he salu ogenic model akes on a
p eponde an ele ance, since he componen s o SOC, comp ehensibili y, manageabili y and
meaning ulness, a e media ed by he deg ee o con idence in ecognising s esso s, coping
wi h he demands o hose s esso s h ough he a ailable esou ces and he commi men
o o e coming challenges [115].
In he hi d momen , he u u e p ojec ion o he sel unde lies he ques ion o wha
happens when NLEs a e success ully aced and o e come. In gene al, a wide ange o
new possibili ies opens up o he pa icipan s. The expe iences o he uni e si y s uden s
in e iewed indica e ha he e is a p o ound ans o ma ion o he sys em o belie s, alues,
a i udes and beha iou s p io o he NLEs. Acco ding o hem, his in e nal change
allowed hem o obse e new oppo uni ies and achie e a li e wi h a g ea e deg ee o
meaning ulness. P e ious esea ch explo ed how nega i e expe iences p omo e a meaning ul
li e [116,117].
The hi d momen is cha ac e ised by he implemen a ion o he s a egic dimensions
o en ep eneu ial beha iou , enabling he p ojec ion o he u u e sel [
118
] and he con-
s uc ion o li e p ojec s [
119
], h ough pe sonal goals and e o s [
120
]. Howe e , a e
he momen o educa ional impac and sel -imp o emen , he pa icipan s explici ly mani-
es ed he acqui ed en ep eneu ial s a egies, i is no less ue ha , in he hi d momen o
u u e p ojec ion o he sel , hey de eloped s a egic en ep eneu ial dimensions ela ed o
isk- aking (basic le el) and achie emen o ien a ion (speci ic le el) o he achie emen
o hei objec i es, goals and pe sonal p ojec s. I would be di icul o unde s and he im-
plemen a ion o pe sonal p ojec s wi hou a ce ain deg ee o isk- aking and achie emen
o ien a ion. Wi h he de elopmen and implemen a ion o he s a egic dimensions, he pa -
icipan s buil up a pe sonal goal s uc u e, di e en ia ing be ween ocal and ins umen al
goals [
121
]. Bo h ypes o goals we e cons i u ed by he pa icipan s h ough in insic and
iden i ied mo i a ions, i.e., hey chose he goals and objec i es ha ep esen hei sys em
o belie s, alues and a i udes [
122
]. These a e so-called sel -conco dan goals [
123
]. Recen
esea ch co obo a es how he choice o pe sonal goal conco dance gene a es op imism and
well-being [
124
]. The sel -conco dan goals selec ed by he pa icipan s a e linked o: i s ,
main aining and de eloping pe sonal well-being; second, academic o p o essional de el-
opmen ; and hi d, os e ing quali y in e -pe sonal ela ionships. The achie emen o hese
objec i es implies a deep commi men on he pa o he pa icipan s, which is e lec ed in
he pe sonal e o s hey made owa ds hei a ainmen . Unde lying hese pe sonal e o s
a e he s a egic dimensions acqui ed du ing he momen o sel -imp o emen . In spi e o
hei pe sonal e o s, he pa icipan s a e awa e ha he e a e con ex ual esou ces, which
a e con enien in o de o achie e hei goals, and ma e ial and inancial esou ces.
Dis inguishing be ween ocal and ins umen al goals [
121
] also implies he di e ence
be ween i s - and second-o de p ojec s [
125
]. In he pa icipan s’ na a i es, we can
dis inguish how hey elabo a ed i s -o de p ojec s o achie e ce ain ins umen al goals
ha would acili a e he de elopmen o second-o de pe sonal p ojec s, which a e aimed
a ocal goals o sel -conco dan objec i es. Thus, he pa icipan s cons uc hei pe sonal
p ojec s hie a chically. S udies on Spanish uni e si y s uden s suppo his hie a chical
concep ion o pe sonal p ojec s in eme ging adul hood [
126
]. In his sense, i is common
o all he pa icipan s o es ablish a hie a chy, whe e second-o de p ojec s, which guide
i s -o de p ojec s, a e de ined as being di ec ed owa ds pe sonal de elopmen , g ow h
o well-being. I is no su p ising ha he e ec o he pe sonal p ojec s cons i u ed a e
he NLEs on well-being is conside ed as posi i e by he pa icipan s. This no ion o he
posi i e e ec o pe sonal p ojec s was indica ed by ea ly s udies on li e sa is ac ion and he
o ganisa ion o pe sonal p ojec s [
127
]. Finally, in he p ojec ion o he sel h ough pe sonal
p ojec s, he pa icipan s ecognise he alue o he s a egic dimensions o en ep eneu ial
beha iou acqui ed in he implemen a ion o hei pe sonal p ojec s. In his sense, all
he na a i e da a indica e ha he implemen a ion o in ape sonal GRRs, in his case,
he s a egic dimensions, enable a mo e solid con igu a ion o he SOC. The desc ibed

In . J. En i on. Res. Public Heal h 2022,19, 2589 17 o 22
s a egic dimensions a ou a be e comp ehensibili y, manageabili y and meaning ulness o
hei pe sonal p esen and u u e. In his sense, he acqui ed s a egic dimensions o m
he co e o he en ep eneu ial beha iou ha accompanies esilien p ocesses. I is e en
possible o de ine an en ep eneu ial p o ile o he esilien pe son con igu ed by his se o
s a egic dimensions linked o en ep eneu ial beha iou .
5. Towa ds a Model o En ep eneu ial Resilience
Based on he salu ogenic pa adigm, we composed some guidelines ha ou line a
comp ehensi e model o en ep eneu ial esilience. F om he pa icipan s’ na a i es, we
obse ed how se e e s ess ul si ua ions ha e a high p obabili y o ha ing a nega i e
impac on physical and men al well-being. Nex , we desc ibe he cons i uen elemen s o
a comp ehensi e model o how en ep eneu ial esilience is con igu ed in o de o ace
ad e si y and build li e p ojec s. The i s block would be he momen o impac o NLEs
and would be made up o beha iou al, emo ional, cogni i e and social suppo p ocesses.
The second block would be cons i u ed by educa ional imp o emen in which he subjec s
would lea n he se o s a egic dimensions o en ep eneu ial beha iou . The hi d block
would be cha ac e ised by en ep eneu ial pe sonal g ow h h ough he implemen a ion o
he s a egic dimensions, acili a ing he cons uc ion o li e p ojec s.
This s uc u e would ha e a dynamic, in eg a i e and p og essi e cha ac e ha
would be cha ac e ised by he e olu ion o he subjec o e a empo al con inuum om
he appea ance o he NLEs o he u u e p ojec ion, passing h ough educa ional imp o e-
men . A each o hese momen s, in e pe sonal and exope sonal GRRs would be iden i ied,
o med and used. This model would e lec how he use o he in ape sonal and exope -
sonal esou ces by he pa icipan s in luences he consolida ion o a SOC, which, in u n,
in luences he use o he GRRs. Unde lying his s uc u e is he app oach o he na a i e
cons uc ion o iden i y, h ough au obiog aphical mnemonic p ocesses (memo ies and
easoning) ha acili a e he gene a ion o a empo al sel -awa eness o e ime, as well as a
cohe en sense o iden i y.
6. Limi a ions and Fu u e Resea ch
In his esea ch, con enience sampling was selec ed. RS-14 was used o he selec ion
o he pa icipan s and only he da a we e analysed desc ip i ely. The pa icipan s we e
selec ed exclusi ely om he Facul y o Educa ion. Consequen ly, he s udy has limi a ions
in e ms o gene alisabili y. Howe e , he s udy was p ima ily ca ied ou using a phe-
nomenological and in e p e a i e app oach. The small numbe o cases selec ed and he
quali a i e na u e o he da a analysed acili a ed an in-dep h unde s anding o wha he
s a egic dimensions o en ep eneu ial beha iou a e and how en ep eneu ial esilience
is o med in uni e si y s uden s. The s udy explo ed a possible en ep eneu ial p o ile in
esilien uni e si y s uden s bu did no explo e he con ex ual GRRs ha hey ha e wi hin
he uni e si y con ex . In his espec , i is necessa y o highligh he lack o quan i a i e
ins umen s conce ning en ep eneu ial esilience. Pe haps he s a egic dimensions o
en ep eneu ial beha iou desc ibed in he s udy would cons i u e possible ac o s o
u u e psychome ic es s ela ed o he subjec . Fu he mo e, he concep o GRRs could be
e ised, unde s anding i no only as a se o pe sonal, social o con ex ual esou ces ha
minimise he s esso s o e e yday li e, acili a ing adap a ion and coping in he ace o
ad e se li e ci cums ances [
38
], bu also as he possibili y o gene a ing and implemen ing
s a egic dimensions ha p omo e en ep eneu ial beha iou s ha a ou he cons uc ion
o li e p ojec s. This econcep ualisa ion o he GRRs, inco po a ing he s a egic dimensions
o en ep eneu ial beha iou could ake he o m o a model o en ep eneu ial esilience in
he uni e si y popula ion.
7. Conclusions
This esea ch was de eloped by aking in o accoun he salu ogenic model, wi h
he aim o inding ou he s a egic en ep eneu ial dimensions ha a e pa o esilien
In . J. En i on. Res. Public Heal h 2022,19, 2589 18 o 22
p ocesses and unde s anding how en ep eneu ial esilience is o med om he poin o
iew o uni e si y s uden s. To his end, he s a egic en ep eneu ial dimensions and hei
con ibu ion o he pe sonal p ojec s o esilien uni e si y s uden s we e iden i ied. The
indings o he s udy con ibu e i s ly o he design o quan i a i e ins umen s on he
p o ile o he esilien en ep eneu ; second, o he econcep ualisa ion o he GRRs by in-
oducing he componen o s a egic dimensions o en ep eneu ial beha iou ; and inally,
o he design and conc e isa ion o he model o en ep eneu ial esilience in eme ging
adul hood.
Au ho Con ibu ions:
All au ho s ook pa in he design o he s udy. The esea ch p oposal was
de eloped by E.M.-F., A.R.C.-G. and guided by A.B.-G. Concep ualisa ion, E.M.-F., A.R.C.-G. and A.B.-
G.; me hodology, E.M.-F., A.R.C.-G. and A.B.-G.; so wa e, E.M.-F., A.R.C.-G. and A.B.-G.; alida ion,
E.M.-F., A.R.C.-G. and A.B.-G.; o mal analysis, E.M.-F., A.R.C.-G. and A.B.-G.; in es iga ion, E.M.-F.,
A.R.C.-G. and A.B.-G.; esou ces, E.M.-F., A.R.C.-G. and A.B.-G.; da a cu a ion, E.M.-F., A.R.C.-G. and
A.B.-G.; w i ing—o iginal d a p epa a ion, E.M.-F., A.R.C.-G. and A.B.-G.; w i ing— e iew and
edi ing, E.M.-F., A.R.C.-G. and A.B.-G.; isualisa ion, E.M.-F., A.R.C.-G. and A.B.-G.; supe ision,
E.M.-F., A.R.C.-G. and A.B.-G.; p ojec adminis a ion, E.M.-F., A.R.C.-G. and A.B.-G.; unding
acquisi ion, E.M.-F., A.R.C.-G. and A.B.-G. All au ho s ha e ead and ag eed o he published e sion
o he manusc ip .
Funding:
This publica ion is pa o he I+D+i p ojec PID2019-104408GB-I00, unded by MCIN/
AEI/10.13039/501100011033/.
In o med Consen S a emen :
In o med consen was ob ained om all subjec s in ol ed in
he s udy
.
Da a A ailabili y S a emen : No applicable.
Acknowledgmen s:
We hank all he pa icipan s o aking hei p ecious ime and pa icipa ing in
his s udy.
Con lic s o In e es :
The au ho s decla e no con lic o in e es . The unde s had no ole in he design
o he s udy; in he collec ion, analyses, o in e p e a ion o da a; in he w i ing o he manusc ip , o
in he decision o publish he esul s.
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