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Cited by 135Healthcare professionals’ stress and burnoutStress and Burnout ResearchOccupational Health and Burnout

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

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Sexton, J Bryan, Adair, Kathryn C·2019·BMJ Open
DOI 10.1136/bmjopen-2018-022695PMC PMC6475256
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Abstract

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.

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Cited by

Sorted by citations

Authors
Sexton, J. B., & Adair, K. C.
Affiliations
  • Duke University (US)
  • Duke University Health System (US)
Corresponding author
Sexton, J Bryan
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2019-03
Volume
9
Issue
3
Pages
e022695
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2018-022695
PMC
PMC6475256
OpenAlex
W2923530273
Cited by
135
References
22
Citations by year
2026: 4 · 2025: 13 · 2024: 20 · 2023: 20 · 2022: 22 · 2021: 30 · 2020: 25 · 2019: 1
FWCI
26.59
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
gratitude interventions, healthcare worker well-being, burnout, emotional exhaustion, depression, work-life balance, happiness, online intervention, brief psychological intervention, attrition
MeSH terms
Work-Life Balance, Burnout, Professional, Depression, Female, Happiness, Health Personnel, Health Promotion, Humans, Male, Pilot Projects, Prospective Studies, Surveys and Questionnaires, Qualitative Research, Resilience, Psychological

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