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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 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]
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“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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Blake, H., Mancini, H., Coyne, E., Cooper, J. E., & Stanulewicz, N. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-10730-9 · Cited by 15
“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
“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 16
Doedens, P., Kiel‐Clayton, L. M., Daams, J. G., & de Haan, L. (2025) · International Journal of Mental Health Nursing · doi:10.1111/inm.70016 · Cited by 14
“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
Shanafelt, T. D., Trockel, M., Wang, H., Mayer, T. A., & Athey, L. A. (2022) · Journal of Healthcare Management · doi:10.1097/jhm-d-22-00012 · Cited by 18
Shaping the Nursing Profession Postpandemic Through Reconstructed Leadership Practices
Grubaugh, M., & Bernard, N. (2022) · Nursing Administration Quarterly · doi:10.1097/naq.0000000000000514 · Cited by 14
Raderstorf, T., Barr, T. L., Ackerman, M., & Melnyk, B. M. (2020) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12451 · Cited by 14
“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…”
BackgroundSelf-citationLoMauro, A., Molisso, M. T., Mameli, F., Ruggiero, F., Ferrucci, R., Dellarosa, C., Aglieco, G., Aliverti, A., Barbieri, S., & Vergari, M. (2022) · Frontiers in Systems Neuroscience · doi:10.3389/fnsys.2022.923576 · Cited by 13
Emotional Freedom Technique (EFT): Tap to relieve stress and burnout
Blacher, S. (2023) · Journal of Interprofessional Education & Practice · doi:10.1016/j.xjep.2023.100599 · Cited by 17
Experiences of renal healthcare practitioners during the COVID-19 pandemic: a multi-methods approach
Keaveney, C. M., Reid, J., Carswell, C., Bonner, A., de Barbieri, I., Johnston, W. C., Maxwell, A. P., O’Riordan, J., Strini, V., WALSH, I. K., et al. (2021) · BMC Nephrology · doi:10.1186/s12882-021-02500-0 · Cited by 13
“, 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
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 19
“…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
“…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
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 16
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
Schwartz‐Mette, R. A., Sapp, M., & Strout, K. A. (2025) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.70031 · Cited by 11
“Along with cognitive behavioral interventions, MBIs appear most effective for reducing stress and burnout for nursing populations (Melnyk et al. 2020).”
Su, J. J., Dai, Z., Wu, Y., Liu, X., Ren, T., Liu, X., Zhang, L., Fu, J., Chen, X., Xiao, W., et al. (2023) · QJM · doi:10.1093/qjmed/hcad188 · Cited by 12
Bentulila, Y., Lev-Shalem, L., Cohen, B., & Adler, L. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02310-x · Cited by 11
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
“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
“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 20
Application of the model of leadership influence for health professional wellbeing during COVID-19
CARTER, K. F., & Bogue, R. J. (2022) · Nursing Outlook · doi:10.1016/j.outlook.2022.02.010 · Cited by 11
Major, A., & Hlubocky, F. J. (2021) · medRxiv · doi:10.1101/2021.01.03.21249166 · Cited by 11
Kimura, K., Inoue, K., Ando, T., & Ito, M. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-10258-4 · Cited by 10
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
Self-citationBoß, L., Ross, J., Reis, D., Pischel, S., Mallwitz, T., Brückner, H., Tanner, G., Nissen, H., Kalon, L., Schümann, M., et al. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.105076 · Cited by 11
Zhao, B., Deng, X., & Zhou, Z. (2025) · BMC Psychology · doi:10.1186/s40359-025-02838-2 · Cited by 14
“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
“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
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
“The Chinese version was translated and tested by Yu Hua [31], showing good reliability and validity.”
Metadata
- 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
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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
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