Outcomes, mechanisms and contextual factors of positive psychology interventions for health workers: a systematic review of global evidence

Abstract

Background Interventions using positive psychology (PP), which build on positive qualities of healthcare personnel and institutions, could potentially enhance organisational performance in healthcare. The aim of this systematic review was to identify if PP interventions have an impact on organisational performance of healthcare personnel, and if so, how this impact can be achieved. We developed a logic model to explain the impact of PP interventions on organisational performance. Methods We searched Web of Science, Medline, Psychinfo, Embase, Scopus and CINAHL (from inception until March 2019) and references of included articles to identify studies that evaluated the impact of a PP intervention for health personnel. Study quality was assessed using the SQUIRE checklist for quality improvement studies. Data were extracted about study details, setting, participants, intervention, method of evaluation and results. Outcomes, mechanisms and contexts were coded in nVivo. Data synthesis was guided by Lewis’ theory of the impact of PP interventions on organisational performance and Kneale et al.’s method for logic model development. Collected data were integrated into a logic model explaining initial inputs, processes, and intermediate outcomes of PP interventions that lead to improved organisational performance in healthcare settings. Results We retrieved 4638 articles and identified five through references of included articles of which 29 studies (31 articles) met our inclusion criteria. Most articles were of low quality (n = 19) and outcome measures varied widely. We identified 54 different outcomes of PP interventions, including ‘improved well-being’ and ‘improved interaction and support’. Forty-nine mechanisms were identified including ‘recognising and reframing negative interpretations’. Twenty four contextual factors were identified of which seven acted as barriers. ‘Managerial support’ was a facilitator mentioned in eight studies. All identified outcomes, mechanisms and contextual factors were integrated into a logic model explaining how interventions using PP can impact organisational performance in healthcare. Conclusion Few identified outcomes were statistically significant, however, trends in both quantitative and qualitative outcomes show that PP interventions can increase well-being and interaction and support and thus improve organisational performance in healthcare. The developed logic model can be used in the implementation and evaluation of interventions using PP for health personnel.

Mixed method evaluation of a learning from excellence programme for community health workers in Neno, Malawi

“…CHW leadership and MK identified the following outcomes for CHWs in the Neno District: (i) motivation, including general motivation, organisational commitment, and job satisfaction; and (ii) perceived supervision, which was similar to supportive mentorship. Motivation was chosen as it had been previously identified as a potential outcome of LfE or interventions like LfE [ 22 , 24 ]. Perceived supervision was selected due to the previously identified ‘breaking down of hierarchies’, ‘feeling of community and ‘high-quality relationships’ [ 22 , 24 ], and the expectation that LfE could lead to supportive mentorship.…”

“…Motivation was chosen as it had been previously identified as a potential outcome of LfE or interventions like LfE [ 22 , 24 ]. Perceived supervision was selected due to the previously identified ‘breaking down of hierarchies’, ‘feeling of community and ‘high-quality relationships’ [ 22 , 24 ], and the expectation that LfE could lead to supportive mentorship. We chose not to include more than ten questions to keep the questionnaire short, to encourage the busy CHWs to fully participate.…”

“…The quantitative and qualitative data were triangulated into a logic model, explaining how LfE can impact CHWs in Neno District. We adapted a logic model developed in a previous study [ 24 ] and assessed if the contextual factors, mechanisms, and outcomes of this evaluation converged with the developed logic model or if they diverged, in which case the logic model was adapted accordingly. The initial logic model is presented in supplementary file 2 .…”

“…This paper also evaluates the impact of a co-designed LfE programme on CHW motivation, including job satisfaction and perceived supervision. To explain how the co-designed LfE intervention impacts CHW performance we adapted a logic model, as designed in earlier studies [ 23 , 24 ]. The logic model was adapted with the help of realist informed methodology: we identified context-mechanism-outcome (CMO) configurations explaining how interventions like LfE could potentially impact CHWs in Neno District.…”

Editorial: Positive Psychology in Healthcare Professionals

“…Thus, healthcare professionals need positive psychological resources to copy with the stressful situations in workplaces worldwide (Liu et al, 2012 ; Tian et al, 2020 ; Bazargan-Hejazi et al, 2021 ). Current positive psychology research mainly focuses on boosting the positive emotions and capabilities of health workers, as well as supportive interpersonal relationships and organizational environments via exploring and cultivating a variety of positive psychological resources (Bazargan-Hejazi et al, 2021 ; Kletter et al, 2021 ). In recent years, there is increasing evidence that positive psychological resources can promote physical and mental health, and stimulate positive work attitudes and behaviors among healthcare professionals (Liu et al, 2012 ; Tian et al, 2020 ; Yang et al, 2020 ; Yang and Wu, 2021 ).…”