Interventions to improve mental health, well-being, physical health, and lifestyle behaviors in physicians and nurses: a systematic review
Open accessAbstract
OBJECTIVE: This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors. DATA SOURCE: A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library. STUDY INCLUSION AND EXCLUSION CRITERIA: Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers. DATA EXTRACTION: Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence. DATA SYNTHESIS: Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed. RESULTS: Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity. CONCLUSION: Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.
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Our findings were consistent with related studies that mindfulness and acceptance and commitment therapy-based interventions are effective in reducing psychological distress and depression, as well as enhancing psychological flexibility and subjective psychological wellbeing among nurses.
“Our findings were consistent with the findings of related studies that mindfulness and acceptance and commitment therapy-based interventions are effective in reducing psychological distress and depression, as well as enhancing psychological flexibility and subjective psychological wellbeing among nurses (37–39).”
From Translation, adaptation, and initial evaluation of a guided self-help intervention to reduce psychological distress among nurses during COVID-19 in China (2023) · cites this paper as [38]
The Abstract Results and Conclusions report that mindfulness-based interventions reduced stress, anxiety, and depression among physicians and nurses. The cited review does not establish the claimed effects of acceptance and commitment therapy, or improvements in psychological flexibility and subjective psychological well-being specifically among nurses. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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Increasing Critical Care Nurse Engagement of Palliative Care During the COVID-19 Pandemic
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Long COVID in the context of social determinants of health
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Self-citationEnablers and barriers to healthy eating among hospital nurses: A systematic review
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BackgroundThe mental health of healthcare workers during the COVID-19 pandemic: a narrative review
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“Although evidence-based psychological interventions are available for HCWs [37], there is a paucity of evidence about MH interventions for HCWs”
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“The unsustainability of the reduction in burnout scores is consistent with the literature on individual-level interventions for burnout [18,20,63], suggesting that these programs are necessary but not sufficient to comprehensively address the causes and consequences of burnout.”
BackgroundResultEditorial: Are We Addressing “Quiet Quitting” in Faculty, Staff, and Students in Academic Settings?
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Hospital-Based Interventions to Address Provider Grief: A Narrative Review
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“These stressors are associated with high workload, long working hours, poor supply of required resources, poor working environments, among others (2).”
BackgroundPsychological capital among clinical nurses: A latent profile analysis
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Implementing a Resilience Bundle for Emergency Nurses: An Evidence-Based Practice Project
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“In order to retain nurses and improve staffing conditions, hospital leaders must provide safe working conditions, support nurses’ health and well-being, and develop and sustain a culture of safety.(13,44,45)”
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“Systematic reviews state that stress can lead to many physical health problems such as high blood pressure, heart disease, heart attacks, asthma, and irritable bowel disease infections [14,15].”
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“30 Leadership promotion and participation is key for encouraging and supporting employees to engage in wellness activities, 31–33 therefore, a program designed specifically for managers and supervisors was provided.”
BackgroundSelf-citationPsychiatric Issues Among Health Professionals
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“This type of stress reduction is effective in different groups: medical students (Daya and Hearn 2018) and employees (Burton et al. 2017; Melnyk et al. 2020), working individuals (Slemp et al.”
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As the Pandemic Recedes, Will Moral Distress Continue to Surge?
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A comprehensive evaluation of factors affecting nurse leaders’ work-related well-being
Niinihuhta, M., Terkamo‐Moisio, A., Kvist, T. A., & Häggman‐Laitila, A. (2022) · Leadership in health services · doi:10.1108/lhs-12-2021-0098 · Cited by 24 · see citing works
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How to Address the Health of Home Care Workers: A Systematic Review of the Last Two Decades
Gebhard, D., & Herz, M. (2022) · Journal of Applied Gerontology · doi:10.1177/07334648221141084 · Cited by 22 · see citing works
“Reviews focus on a variety of outcomes, such as low back pain (Van Hoof et al., 2018), obesity (Upadhyaya et al., 2020), mental health (Melnyk et al., 2020), occupational stress (Bischoff et al., 2019), burnout (de Oliveira et al., 2019), resilience (Kunzler et al., 2020), and happiness (Gray et…”
BackgroundIntegrating wellness into curricula using the ten dimensions of wellness as a framework
Gawlik, K. S., Teall, A. M., Zeno, R., Newtz, C., Conrad, K., Kolcun, K., Bobek, H., Deerhake, A., Sullivan, K., Rengers, B., et al. (2023) · Journal of Professional Nursing · doi:10.1016/j.profnurs.2023.11.006 · Cited by 20 · see citing works
“…by excessive workloads, long work hours, isolation, increased clinical demands & moral distress that can lead to higher rates of depression, anxiety, substance use disorders, medical call to action errors and suicidality (Davidson, Proudfoot, Lee, Terterian, & Zisook, 2020; Melnyk et al., 2020).”
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“In recent years, the mental well-being of employees in several occupations has gained substantial attention [2-6].”
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A Psychoeducational Group Intervention for Nurses: Rationale, Theoretical Framework, and Development
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“, 2012), mindfulness (Cohen-Katz et al., 2005; Ghawadra et al., 2019; Gilmartin et al., 2017; Melnyk et al., 2020; Moody et al., 2013), or a combination of these two approaches (Joyce et al.”
BackgroundMethodInfluentialAguilar‐Latorre, A., Algorta, G. P., Navarro-Guzmán, C., Serrano-Ripoll, M. J., & Oliván‐Blázquez, B. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.954644 · Cited by 19 · see citing works
Urban, R. W., Martin, S. D., Foglia, D. C., Henson, J. S., Belz, J. N., & Bilton, V. R. (2023) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12685 · Cited by 18 · see citing works
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Well‐being in acute care nurse managers: A risk analysis of physical and mental health factors
Martin, S. D., Urban, R. W., Foglia, D. C., Henson, J. S., George, V., & McCaslin, T. (2023) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12646 · Cited by 17 · see citing works
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“Burnout in healthcare is widely reported, with over 50% of nurses reporting emotional exhaustion and burnout (Melnyk et al., 2020; Schuckhart, 2010).”
BackgroundDesafios em saúde mental durante a pandemia: relato de experiência
Minervino, A. J., de Oliveira, M. B., da Cunha, K. A. L., & Bereza, Y. T. A. (2020) · Revista Bioética · doi:10.1590/1983-80422020284428 · Cited by 17 · see citing works
“Outras medidas também têm se mos - trado eficazes, como técnicas utilizando mindfulness , a intervenção breve focada no estresse e o treinamento de resiliência 26 .”
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Connections between job satisfaction and depression, anxiety, and stress among nurses
Buivydienė, A., Rapolienė, L., Truš, M., & Jakavonytė-Akstinienė, A. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1548993 · Cited by 16 · see citing works
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“Examples of this are high blood pressure, heart disease, heart attacks, asthma, and irritable bowel disease infections [13], while negative mental health can cause burnout, depression, emotional exhaustion, and fatigue [14].”
BackgroundZhang, Y., Li, Y., Jiang, T., & Zhang, Q. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04869-8 · Cited by 15 · see citing works
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“Systematic reviews conducted prior to the pandemic discuss various interventions that improve health and mental wellbeing in HCWs [23, 24].”
BackgroundPilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers
Roche, K., Mulchan, S. S., Ayr-Volta, L., Elias, M., Brimacombe, M. B., Morello, C., & Hinderer, K. A. (2023) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2023.02.002 · Cited by 14 · see citing works
“Research supports that cognitive-behavioral interventions help reduce or offset anxiety and depression in HCWs (Cole et al., 2021; Melnyk et al., 2020).”
Making a Case for Whole Person Health
Herman, P. M., Pitcher, M. H., & Langevin, H. M. (2024) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130241293642 · Cited by 14 · see citing works
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“Breathing exercises are another intervention mentioned in the literature (Melnyk et al. 2020).”
Hassan, D., Patel, K., Peddemul, A., Sikandar, R., Kahlon, S. S., Nair, S., Sreedevi, T. K., Rathinavelu, S., & Alfonso, M. (2022) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2022.101206 · Cited by 14 · see citing works
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Shaping the Nursing Profession Postpandemic Through Reconstructed Leadership Practices
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Raderstorf, T., Barr, T. L., Ackerman, M., & Melnyk, B. M. (2020) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12451 · Cited by 14 · see citing works
“To improve the population health of clinicians to ensure quality health care, it is essential for healthcare leaders to create cultures of wellness and implement evidence-based programs (e.g., anonymous mental health screening, cognitive-behavioral therapy-based skills building and mindfulness programs, and gratitude…”
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Emotional Freedom Technique (EFT): Tap to relieve stress and burnout
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Experiences of renal healthcare practitioners during the COVID-19 pandemic: a multi-methods approach
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“, psychologists or psychiatrists) are limited but should be carefully considered accounting for perceived stigma [45].”
BackgroundPandemic perspectives from the frontline—The nursing stories
Polinard, E. L., Ricks, T. N., Duke, E. S., & Lewis, K. (2022) · Journal of Advanced Nursing · doi:10.1111/jan.15306 · Cited by 12 · see citing works
Melnyk, B. M., Davidson, J. E., Tucker, S., Tan, A., Hsieh, A. P., Cooper, A., Mayfield, C., & Hoying, J. (2025) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.70042 · Cited by 12 · see citing works
“…and healthcare workforce is imperative, along with the provision of mental health counselors and evidence-based interventions, such as mindfulness (Melnyk et al. 2020; Ramachandran et al. 2023) and cognitive-behavioral therapy-based programs like MINDBODYSTRONG, which can also be used…”
Self-citationKong, L., Lu, T., Chen, Z., & Zhang, H. (2023) · BMC Nursing · doi:10.1186/s12912-023-01453-z · Cited by 13 · see citing works
“…complex interpersonal relationships, negative stimulation due to the pain and death of patients, stress caused by worrying about errors and accidents [12] and physical and mental fatigue caused by frequent shift work [13] are all risk factors affecting the physical and mental health of nurses.”
BackgroundHoying, J., Terry, A., Kelly, S. A., & Melnyk, B. M. (2023) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12686 · Cited by 14 · see citing works
Self-citationHealth Behaviors and Health-Related Quality of Life in Female Medical Staff
Niestrój-Jaworska, M., Dębska, M., Polechoński, J., & Tomik, R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19073896 · Cited by 12 · see citing works
Daily healthy habits to reduce stress and increase longevity
Dyer, K. A. (2022) · Journal of Interprofessional Education & Practice · doi:10.1016/j.xjep.2022.100593 · Cited by 12 · see citing works
Schwartz‐Mette, R. A., Sapp, M., & Strout, K. A. (2025) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.70031 · Cited by 11 · see citing works
“Along with cognitive behavioral interventions, MBIs appear most effective for reducing stress and burnout for nursing populations (Melnyk et al. 2020).”
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Thaprawat, P., Greene, M. T., Saint, S. K., Kasatpibal, N., Fowler, K. E., & Apisarnthanarak, A. (2022) · American Journal of Infection Control · doi:10.1016/j.ajic.2022.06.011 · Cited by 12 · see citing works
“Prior studies have shown the benefits of self-care practices (such as mindfulness, yoga, and spirituality) on reducing healthcare worker burnout, stress, and anxiety.(24-30) Our survey indicated that most infection preventionists find importance in both individual selfcare practices and spirituality for promoting well…”
Littzen, C. O. R., Dolan, H., Norton, A., Bethel, C., May, J. T., & Rainbow, J. G. (2023) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2023.100127 · Cited by 11 · see citing works
“Gratitude practices have been shown to help with nurses ’ mental health (Melnyk et al., 2020).”
BackgroundWhitehead, D., Hamidi, Y., Ebrahimi, H., Hazavehei, S. M. M., & Moghadam, S. M. K. (2023) · Health Services Insights · doi:10.1177/11786329231193792 · Cited by 11 · see citing works
Application of the model of leadership influence for health professional wellbeing during COVID-19
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Implementation of Coaching to Address Burnout in Emergency Clinicians
Hines-Stellisch, K., Gawlik, K. S., Teall, A. M., & Tucker, S. (2024) · Journal of Emergency Nursing · doi:10.1016/j.jen.2024.06.007 · Cited by 10 · see citing works
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Zhao, B., Deng, X., & Zhou, Z. (2025) · BMC Psychology · doi:10.1186/s40359-025-02838-2 · Cited by 14 · see citing works
“These healthy behaviors can significantly improve an individual’s physical health, reduce the risk of lifestyle diseases, and a good physical health status and lifestyle habits can effectively alleviate psychological stress and ANX [60, 61].”
Burnout in Nurses of an Intensive Care Unit during COVID-19: A Pilot Study in Portugal
Almeida, C., & Poeira, A. (2023) · Healthcare · doi:10.3390/healthcare11091233 · Cited by 10 · see citing works
“In addition, the investment and implementation of mental well-being strategies and psychological interventions should be prioritized and encouraged to improve the health of nurses [40].”
BackgroundUsing Text Messages to Support Nurse Well-being
Kelly, L. A., Schaeffer, R., Roe, S., & Buchda, V. L. (2021) · Nursing Administration Quarterly · doi:10.1097/naq.0000000000000490 · Cited by 10 · see citing works
Lu, Q., Wang, M., Zuo, Y., Tang, Y., Zhang, R., & Zhang, J. (2025) · BMC Nursing · doi:10.1186/s12912-025-02796-5 · Cited by 9 · see citing works
“The Chinese version was translated and tested by Yu Hua [31], showing good reliability and validity.”
- Authors
- Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B.
- Affiliations
- The Ohio State University (US)
- University of North Carolina at Chapel Hill (US)
- Illinois Department of Health, Chicago IL, USA
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Melnyk, Bernadette Mazurek
- ORCID
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2020-04-27
- Volume
- 34
- Issue
- 8
- Pages
- 929-941
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- PMC
- PMC8982669
- OpenAlex
- W3020257396
- Cited by
- 364
- References
- 44
- Citations by year
- 2026: 55 · 2025: 74 · 2024: 62 · 2023: 75 · 2022: 50 · 2021: 34 · 2020: 12 · 2017: 1
- FWCI
- 8.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- National Institute of Nursing Research (T32NR007091, T32NR014225)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- physician well-being, nurse well-being, mental health interventions, physical activity interventions, lifestyle habits, mindfulness-based interventions, cognitive behavioral therapy, stress reduction, anxiety, depression, gratitude interventions, deep breathing, pedometers
- MeSH terms
- Humans, Life Style, Mental Health, Nurses, Physicians, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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