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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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Factors Contributing to Well‐Being Among Hospital‐Based Nurses
Hale, F. B., Lim, E., Griffin, C., & Fontenot, H. B. (2025) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.70019 · Cited by 9
Nurmeksela, A., Schavoronkoff, K., & Jokiniemi, K. S. (2025) · Journal of Nursing Management · doi:10.1155/jonm/9980485 · Cited by 19
“Previous studies have found that over half of the nurses have experienced work burnout [6, 7].”
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Potempa, K. M., Calarco, M. M., Flaherty‐Robb, M., Butterworth, S. W., Marriott, D. J., Potempa, S., Laughlin, C., Schmidt, P., Struble, L. M., Harden, K. L., et al. (2023) · BMC Family Practice · doi:10.1186/s12875-023-02162-x · Cited by 9
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BackgroundAz orvostanhallgatók számára fenntartott mentálhigiénés segítségnyújtás szerepe.
Gács, B., Tényi, T., Pálfi, K., Major, J., & Horváth-Sarródi, A. (2023) · Orvosi Hetilap · doi:10.1556/650.2023.32889 · Cited by 12
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Gratitude and Good Outcomes: Rediscovering Positivity and Perspective in an Uncertain Time
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“by generalized and uncontrollable fear accompanied by physical presentations (5).”
BackgroundMelnyk, B. M., Davidson, J. E., Mayfield, C., Zisook, S., Tucker, S., Hsieh, A. P., Cooper, A., Gray-Bauer, R., Hoying, J., Cuccia, A. F., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303425 · Cited by 10
“…© (also known as Creating Opportunities for Personal Empowerment © [COPE © ]) in the literature), which has demonstrated efficacy in reducing depression, anxiety, and suicidal ideation as well as improving healthy lifestyle behaviors in children, teens, college students and clinicians [16–24].”
BackgroundSelf-citationGrüneberg, C., Bäuerle, A., Karunakaran, S., Darici, D., Dörrie, N., Teufel, M., Benson, S., & Robitzsch, A. (2024) · JMIR Medical Education · doi:10.2196/58183 · Cited by 9
“Elevated levels of depression and anxiety among medical students and physicians exert considerable influence on personal well-being and patient safety [8], emphasizing the urgent need for targeted preventive and support programs [7,9-11].”
Li, L., Ma, X., Wu, Z., Xie, C., & Li, Y. (2025) · BMC Psychology · doi:10.1186/s40359-025-02519-0 · Cited by 9
Wang, Y., Sha, S., Lu, X., & Gu, J. (2025) · BMC Nursing · doi:10.1186/s12912-025-03409-x · Cited by 8
“The weaker Tension-Anxiety (POMS1)- Confusion-Bewilderment (POMS6) link in tertiary-A hospitals could reflect better cognitive coping strategies or institutional support buffering anxiety’s cognitive impacts [50].”
Wells, C., & Bressler, T. (2023) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0000000000000934 · Cited by 8
Keskin, G., & Yurt, E. (2024) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2023.237 · Cited by 8
Ivziku, D., Gualandi, R., Ferramosca, F. M. P., Lommi, M., Diaz, M. Y. T., Raffaele, B., Montini, G., Porcelli, B., Stievano, A., Rocco, G., et al. (2024) · SAGE Open Nursing · doi:10.1177/23779608241258564 · Cited by 12
“…and adaptability skills to handle uncertainty (Lanz & Bruk-Lee, 2017), increasing mindfulness, meditation, and other well-being activities (Melnyk et al., 2020), strengthening emotional intelligence to manage better emotions (Lartey et al., 2021), empowering nurses with professional…”
BackgroundLuangphituck, W., Boonyamalik, P., & Klainin‐Yobas, P. (2023) · JMIR Research Protocols · doi:10.2196/38597 · Cited by 8
Workplace Wellness Support Enhances Health and Mental Well-Being in Optometrists
Melnyk, B. M., Walline, J. J., Hsieh, A. P., & Helsabeck, N. P. (2025) · Clinical Optometry · doi:10.2147/opto.s500143 · Cited by 7
“Numerous respondents did not respond to the measures for depression (n = 40 [13%]), anxiety (n = 53 [17%]), and perceived stress (n = 78 [24%]).”
Self-citationHerz, M., Blaschke, S., & Gebhard, D. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.105255 · Cited by 13
Carroll, R. C. (2022) · Journal of Interprofessional Education & Practice · doi:10.1016/j.xjep.2022.100518 · Cited by 7
Contributing to a Healthier World: Exploring the Impact of Wellbeing on Nursing Burnout
Sanders, C., Burke, J., & Muzyk, A. J. (2022) · Journal of Happiness and Health · doi:10.47602/johah.v2i2.14 · Cited by 8
Gratitude as a protective factor against burnout in healthcare professionals: a systematic review
Burke, J., & O’Donovan, R. (2023) · British Journal of Healthcare Management · doi:10.12968/bjhc.2021.0163 · Cited by 9
Resilience as Safety Culture in German Emergency Medical Services: Examining Irritation and Burnout
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“A meta-analysis revealed that interventions based on mindfulness and cognitive behavioral therapy are effective in reducing stress, anxiety, and depression [65].”
Exploring Meditation Profiles and Predictors in Nursing Students
Johnson, A. H., Wilson, J., Magner, D., Urban, R. W., Martin, S. D., & Zhang, Y. (2022) · Journal of Holistic Nursing · doi:10.1177/08980101221102691 · Cited by 7
“Benefits of regular mindfulness meditation are seen in studies of nurses and physicians and include well-being with reductions in stress, anxiety, depression, and burnout (Melnyk et al., 2020; van der Riet et al., 2018).”
BackgroundThe Impact of Nurse Health-Coaching Strategies on Cognitive—Behavioral Outcomes in Older Adults
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“coaching on behavioral risk outcomes [6], leading to the current emphasis on health behavior science to elucidate the specific mechanism(s) of successful behavior change [1,4].”
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Shenkman, R., Diewald, L. K., Murray, M. B., & Oliver, T. L. (2023) · Nutrients · doi:10.3390/nu15234857 · Cited by 7
“Healthy lifestyle behaviors such as maintaining healthy eating habits and participation in physical activity have been associated with higher quality of life among HCWs, which has downstream implications for improved quality of care and professional performance [13,14].”
BackgroundKrisher, L. K., Boeldt, D. L., Sigmon, C. A. N., Rimel, S. E., & Newman, L. S. (2024) · American Journal of Public Health · doi:10.2105/ajph.2023.307505 · Cited by 7
Melnyk, B. M. (2023) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12642 · Cited by 7
Self-citationWesołowska-Górniak, K., Nerek, A., Serafin, L. I., & Czarkowska‐Pączek, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127221 · Cited by 6
“Interventions such as visual triggers, pedometers, and health coaching with texting increase PA [20], but tailored intervention programs and pedometer challenges are more effective than passive strategies such as educational material and lectures [14].”
BackgroundMaksutova, M., Kemp, M. T., Sharma, S. B., Shen, M. R., Leininger, L., Singer, A. A. M., Krueger, M., Kim, G. J., Kwakye, G., Alam, H. B., et al. (2023) · Journal of surgical education · doi:10.1016/j.jsurg.2023.08.009 · Cited by 6
de Bekker, A., Beijer, M., & Lemmens, L. C. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11247-x · Cited by 8
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“However, interventions aimed at improving physical health parameters like BMI or blood pressure showed limited success, due to the difficulty in making lasting lifestyle changes [37].”
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“As a result, their participation in healthy lifestyle behaviors is not prioritized [3,4].”
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“A study revealed that despite knowledge about the benefits of exercise, a significant proportion of healthcare workers fail to meet exercise recommendations, leading to a higher prevalence of IR in this group [61].”
Zhou, Y., Wong, P., Clarke, A., Jarden, R., & Pollock, W. (2025) · Australian Critical Care · doi:10.1016/j.aucc.2025.101200 · Cited by 6
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Stress Resilience Program for Health Care Professionals During a Pandemic: A Pilot Program
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“Contrary to other studies that report an improvement in resilience for participants who perform daily breathing training (Lai et al., 2020; Melnyk et al., 2020), we did not observe a significant change in resilience as measured by the BRS.”
Gil‐Almagro, F., García-Hedrera, F. J., Monge, F. J. C., & Peñacoba, C. (2024) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2024.100782 · Cited by 8
“For openness to experience, mindfulness techniques may be an appropriate tool, based on direct experience and focusing on a temporal orientation in the present moment (Melnyk et al., 2020).”
BackgroundAmaya, M., Battista, L., Melnyk, B. M., Winn, J., Johnson, N. E., & Buffington, B. C. (2020) · Building Healthy Academic Communities Journal · doi:10.18061/bhac.v4i2.7836 · Cited by 6
“8 reduce burnout, while promoting improvement in one’s physical health (Botha, Gwin, & Purpora, 2015; Farholm & Sørensen, 2016; Melnyk et al., 2020; Sharma & Rush, 2014).”
BackgroundSelf-citationBrief Mindfulness Practice Course for Healthcare Providers
Seidel, L., Dane, F. C., & CARTER, K. F. (2021) · JONA The Journal of Nursing Administration · doi:10.1097/nna.0000000000001035 · Cited by 6
Healthcare provider experiences during COVID-19 redeployment
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Gratitude journals can improve nurses' mental well-being
Cumella, K. (2022) · Nursing · doi:10.1097/01.nurse.0000884760.97338.8b · Cited by 6
Forgiveness and Religiosity Among Nurses: A Correlational Descriptive Study
Joseph, R. A., Akers, S. W., Kim, J. J., & Mullen, L. (2024) · Journal of Holistic Nursing · doi:10.1177/08980101241281760 · Cited by 5
“This is the reason why wellness programs were established in several nursing, healthcare, and academic organizations across the globe to foster self-care, especially following the pandemic (Melnyk et al., 2020).”
Wiisak, J., Suikkala, A., Leino‐Kilpi, H., Stolt, M., Suhonen, R., & Koskinen, S. (2024) · International Journal of Older People Nursing · doi:10.1111/opn.70005 · Cited by 7
Transforming Nursing Practices: A Comprehensive Review of Performance Improvement Strategies
Rostami, V., Hatam, N., Bahrami, M. A., Rakhshan, M., & Shokri, A. (2025) · Health Science Reports · doi:10.1002/hsr2.70804 · Cited by 5
“Our study aligns with Melnyk's findings that comprehensive mental health resources help prevent burnout and increase job satisfaction [68].”
Mobile apps, AI, and teletherapy: a comprehensive review of digital mental health tools for nurses
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“48 Therefore, how to improve the current situation of serious nurse burnout deserves the attention of scholars and health professionals.”
Liu, J., Liu, Q., Ji, L., Yang, Y., Zhang, R., Yu, D., Luo, G., & Sun, D. (2024) · Depression and Anxiety · doi:10.1155/da/5727506 · Cited by 9
“Furthermore, the pre-existing global shortage of nurses, coupled with burnout experienced by nearly 50 % of nurses before the pandemic, exacerbates the challenges faced during the COVID-19 crisis [11].”
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“These findings are supported by several systematic reviews of individual-facing programs (Melnyk et al., 2020; Panagioti et al., 2017; West, Dyrbye, Erwin, and Shanafelt, 2016).”
BackgroundHavaei, F., Tang, X., Adhami, N., Kaulius, M., Boamah, S. A., & McMillan, K. (2023) · Nursing Open · doi:10.1002/nop2.2005 · Cited by 5
“In the short-term, nurse leaders can also implement evidence-based anxiety, stress, and depression (Melnyk et al., 2020).”
BackgroundLiu, W., Wang, Q., Zheng, D., Mei, J., Lu, J., Chen, G., Wang, W., & Ding, F. (2024) · Journal of Medical Internet Research · doi:10.2196/45422 · Cited by 5
Effectiveness of wellness program interventions to improve physician wellness: a systematic review
Kolobaric, N., Milone, B., Salman, M., Buh, A. W., Biyani, N., Wafy, G., Fung, S. G., Scott, M., Kiska, R., Kang, R., et al. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12934-z · Cited by 5
“Promoting physician wellness benefits both their health and the quality of patient care, contributing to a sustainable healthcare workforce [3, 18–23].”
Leveraging System-wide Well-being and Resiliency in Higher Education During the COVID-19 Pandemic
Amaya, M., & Melnyk, B. M. (2020) · Building Healthy Academic Communities Journal · doi:10.18061/bhac.v4i1.7656 · Cited by 5
“Recent systematic reviews and studies support that cognitive behavior therapy/skills building, mindfulness-based stress reduction programs, and other strategies, such as deep breathing, journaling, and expressing gratitude significantly impact positive mental health, while promoting improvement in one’s physical healt…”
BackgroundSelf-citationEmotional Hazards of Nurses' Work
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“2,3,5 4-6 Research conducted in China involving 52,592 par-ORIGINAL ticipants revealed that 43.83% of nurses exhibited depressive symptoms.”
InfluentialRetallic, N., Fylan, F., Rountree, L., Bentley, S., & Elliott, D. B. (2025) · Optometry and Vision Science · doi:10.1097/opx.0000000000002294 · Cited by 4
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Physician Mental Health: Understanding Physician Burnout and Solutions for Well-Being
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Self-efficacy in Clinical Nurse Specialists During the COVID-19 Pandemic
Greenwood, W. D., & Bishop, P. (2023) · Clinical Nurse Specialist · doi:10.1097/nur.0000000000000753 · Cited by 4
Bailey, A., Sawyer, A. T., Tao, H., Durr, L. I., Lajeunesse, A., Sabapathy, R., & Hall, T. L. (2023) · Journal of Wellness · doi:10.55504/2578-9333.1186 · Cited by 3
“This may be a barrier for busy physicians and APPs, and the retreat format could potentially integrate the methods and topics of longer evidence-based interventions [19, 42, 69].”
BackgroundInfluentialPrado, L. M. B., Mesa-Rodríguez, P., & García-Perea, M. D. (2023) · JMIR mhealth and uhealth · doi:10.2196/49302 · Cited by 6
Zheng, H., Rong, H., Meng, L., Wang, S., Nie, C., & Gu, X. (2024) · Acta Neurologica Belgica · doi:10.1007/s13760-024-02504-1 · Cited by 4
“With the progress of society and the rapid development of the medical industry, the psychological pressure on grass-roots medical staff, especially new doctors, is increasing rapidly [1–3].”
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“In addition to affirming that cognitive behavioral therapy and mindfulness interventions have demonstrated success in reducing stress and depression, their review also suggests brief bouts of deep breathing and gratitude may be beneficial.(3,13) Melnyk’s authorship team was full of RN’s, MD’s and clinicians and I’m ho…”
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“The Covidence software has seen success in prior systematic reviews by allowing researchers to parse through and review large quantities of publications that may not have been possible without the aid of technology (Fuentes et al., 2019; Melnyk et al., 2020).”
Effects of Mindfulness practice on work stress: a study with professionals in Primary Health Care
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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
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.
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