Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention.
Abstract
OBJECTIVE: Chronic occupational stress is common among health care practitioners, with potential impacts on personal mental health and staff turnover. This study investigated whether directing practitioners' attention to thankful events in work could reduce stress and depressive symptoms. METHOD: A double-blind randomized controlled trial was conducted in 5 public hospitals with follow-up to 3 months posttreatment. One hundred two practitioners were randomly assigned into 3 conditions: gratitude, hassle, and nil-treatment. Those with scheduled long leaves were excluded. Participants in the gratitude and hassle group wrote work-related gratitude and hassle diaries respectively twice a week for 4 consecutive weeks. A no-diary group served as control. Depressive symptoms (primary outcome) and perceived stress (secondary outcome) were collected at baseline, posttreatment, and 3-month follow-up. Intent-to-treat analyses were performed with mixed-effects regression. RESULTS: Significant Treatment × Time interaction effects were found for the gratitude intervention, whether it was compared with control or hassle; the general pattern was a decline in stress and depressive symptoms over time, but the rate of decline became less pronounced as time progressed. Hassle and control were basically indistinct from each other. Relative to control, the gratitude group reported lower depressive symptoms (-1.50 points; 95% CI [-2.98, -0.01]; d = -0.49) and perceived stress (-2.65 points; 95% CI [-4.00, -1.30]; d = -0.95) at follow-up. RESULTS for the comparison between gratitude and hassle were similar. CONCLUSION: Taking stock of thankful events is an effective approach to reduce stress and depressive symptoms among health care practitioners.
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Five of the thirty individually focused studies implemented interventions designed to promote a positive mindset, including gratitude journaling, choir singing and professional coaching.
“Five of the thirty individually focused studies implemented interventions designed to promote a positive mindset in participants including gratitude journaling,12 49 62 choir singing58 and professional coaching.43”
From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [12]
Postintervention, no significant interaction effects with time or other changes were found for the hassle group, suggesting it was indistinguishable from the control group.
“Postintervention, no significant interaction effects with time or other changes were found for the hassle group, suggesting it was indistinguishable from the control group.12”
From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [12]
Gratitude journaling interventions are designed to shift thoughts away from the negativity of stress and towards a more positive primary appraisal of a situation.
“Gratitude journaling interventions are designed to shift thoughts away from the negativity of stress and towards a more positive primary appraisal of a situation.12”
From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [12]
All three studies that implemented a gratitude intervention had large recruitment numbers, with the smallest sample size being 102.
“All three studies that implemented a gratitude intervention had large recruitment numbers with the smallest sample size being 102.12”
From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [12]
Cheng et al implemented a three-arm randomised control trial and overall scored the highest on the MERSQI for quality and design.
“Cheng et al12 implemented a three-arm randomised control trial and overall scored the highest on the MERSQI for quality and design.”
From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [12]
Only four studies reported statistically significant positive outcomes while implementing a large sample size, control group and postintervention follow-up.
“only four4 12 26 60 studies reported statistically significant positive outcomes while implementing a large sample size, control group and postintervention follow-up.”
From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [12]
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References 40 · Cited by 188
- Authors
- Cheng, S.-T., Tsui, P. K., & Lam, J. H. M.
- Affiliations
- Education University of Hong Kong (HK)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2015-02
- Volume
- 83
- Issue
- 1
- Pages
- 177-186
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2317911878
- Cited by
- 188
- References
- 40
- Citations by year
- 2026: 6 · 2025: 22 · 2024: 14 · 2023: 24 · 2022: 38 · 2021: 27 · 2020: 13 · 2019: 18 · 2018: 5 · 2017: 9 · 2016: 8 · 2015: 3
- FWCI
- 9.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Research Grants Council of Hong Kong (HKIEd1001-SPPR-08)
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- gratitude interventions, occupational stress, healthcare workers, depressive symptoms, perceived stress, hassles, diary writing, mental health, hospital staff
- MeSH terms
- Adult, Depressive Disorder, Double-Blind Method, Female, Follow-Up Studies, Health Personnel, Humans, Job Satisfaction, Male, Mental Health, Stress, Psychological, Treatment Outcome, Workplace, Young Adult
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