Healthcare Workers' Well-Being: A Systematic Review of Positive Psychology Interventions

Given persistent occupational stressors and multiple challenges in the delivery of healthcare, there is an increased focus on the well-being of healthcare workers. Responding to these challenges will require a multipronged approach, focusing on system level, organization, and individual actions. Positive psychology interventions (PPIs) represent a promising area for individual action. This systematic review indicates that PPI, delivered via many methods, holds promise for improving the well-being of healthcare workers, although there is a clear need for additional randomized controlled trials utilizing defined and standardized outcome measures. In this review, the most commonly evaluated PPIs were mindfulness-based or gratitude-based interventions. These were delivered via different methods, with many administered in the workplace and commonly in the form of courses ranging from two days to eight weeks. Researchers documented measurable improvements in multiple studied outcomes, noting reductions in symptoms of depression, anxiety, burnout, and stress. Some interventions increased well-being, job and life satisfaction, self-compassion, relaxation, and resilience. Most studies emphasized that these are simple, accessible, low-cost interventions. Limitations included some nonrandomized or quasi-experimental designs, alongside generally small sample sizes and varying methods of intervention delivery. Another concern is the lack of standardized outcome assessments and long-term follow-up data. As almost all studies included were performed before the pandemic, further research will be required post-pandemic. Overall, however, PPI shows promise as one arm of a multipronged approach to improving the well-being of healthcare workers.

Impact of WeChat-based 'three good things' on turnover intention and coping style in burnout nurses

BACKGROUND

Few studies have considered functions of nurses' positive personality and behaviours on addressing their turnover intention.

AIMS

To explore the effects of WeChat-based 'three good things' (3GT) on burnout nurses' turnover intention and coping styles.

METHODS

A randomized controlled trial. 73 nurses were included in the intervention group (n = 33) and the control group (n = 40). The intervention group received WeChat-based 3GT. Turnover intention and coping style were measured before and after the intervention.

RESULTS

WeChat-based 3GT effectively reduced turnover intention and negative coping style (each p < .05). Positive coping style was promoted after the intervention (p < .05). Time effects as well as intervention and time interactions were significant in turnover intention and negative coping style (each p < .05).

CONCLUSION

Benefits of WeChat-based 3GT on turnover intention and coping style in burnout nurses were found. Nurses experienced lower levels of turnover intention and negative coping style and increased the usage of positive coping style after the intervention.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should incorporate 3GT intervention with popular social communication programmes to improve nurses' coping strategies towards clinical issues and maintain the stability of nursing teams.

Forty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work-life balance and happiness

OBJECTIVES

High rates of healthcare worker (HCW) burn-out have led many to label it an 'epidemic' urgently requiring interventions. This prospective pilot study examined the efficacy, feasibility and evaluation of the 'Three Good Things' (3GT) intervention for HCWs, and added burn-out and work-life balance to the set of well-being metrics.

METHODS

228 HCWs participated in a prospective, repeated measures study of a web-based 15-day long 3GT intervention. Assessments were collected at baseline and 1, 6 and 12-month post-intervention. The primary measure of efficacy was a derivative of the emotional exhaustion subscale of the Maslach Burnout Inventory. The secondary measures were validated instruments assessing depression symptoms, subjective happiness, and work-life balance. Paired samples t-tests and Cohen's d effect sizes for correlated samples were used to examine the efficacy of the intervention.

RESULTS

3GT participants exhibited significant improvements from baseline in emotional exhaustion, depression symptoms and happiness at 1 month, 6 months and 12 months, and in work-life balance at 1 month and 6 months (effect sizes 0.16-0.52). Exploratory subgroup analyses of participants meeting 'concerning' criteria at baseline revealed even larger effects at all assessment points (0.55-1.57). Attrition rates were similar to prior 3GT interventions.

CONCLUSION

3GT appears a promising low-cost and brief intervention for improving HCW well-being.

ETHICS AND DISSEMINATION

This study is approved by the Institutional Review Board of Duke University Health System (Pro00063703). All participants are required to give their informed consent prior to any study procedure.

Do positive psychology exercises work? A replication of Seligman et al. (2005)

OBJECTIVES

The current work replicated a landmark study conducted by Seligman and colleagues (2005) that demonstrated the long-term benefits of positive psychology exercises (PPEs). In the original study, two exercises administered over 1 week ("Three Good Things" and "Using your Signature Strengths in a New Way") were found to have long-lasting effects on depression and happiness (Seligman, Steen, Park, & Peterson, 2005).

DESIGN

These exercises were tested here using the same methodology except for improvements to the control condition, and the addition of a second "positive placebo" to isolate the common factor of accessing positive, self-relevant constructs. This component control design was meant to assess the effect of expectancies for success (expectancy control), as well the cognitive access of positive information about the self (positive placebo).

RESULTS

Repeated measures analyses showed that the PPEs led to lasting increases in happiness, as did the positive placebo. The PPEs did not exceed the control condition in producing changes in depression over time.

CONCLUSIONS

Brief, positive psychology interventions may boost happiness through a common factor involving the activation of positive, self-relevant information rather than through other specific mechanisms. Finally, the effects of PPEs on depression may be more modest than previously assumed.