Three Good Tools: Positively reflecting backwards and forwards is associated with robust improvements in well-being across three distinct interventions

Adair, Kathryn C.; Kennedy, Lindsay A.; Sexton, J. Bryan

doi:10.1080/17439760.2020.1789707

Cited by 49 publications

(93 citation statements)

References 37 publications

(47 reference statements)

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“…The survey includes a 5-item derivative of the Maslach Burnout Inventory emotional exhaustion domain (henceforth burnout ). 29 , 30 , 31 , 32 , 33 , 34 While the Maslach Burnout Inventory is the gold standard for burnout measurement, a meta-analysis found that the other 2 domains of burnout, depersonalization and personal accomplishment, consistently produced smaller coefficient α estimates than emotional exhaustion. 35 In addition, emotional exhaustion is more psychometrically robust in discriminating between burnout and nonburnout outpatients suffering from work-related neurasthenia.…”

Section: Methodsmentioning

confidence: 99%

Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records

et al. 2021

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Key Points Question What is the association of clinician sex, use of the electronic health record (EHR), and work culture with clinician burnout? Findings This cross-sectional study of 1310 clinicians found burnout to be more prevalent in women, attending physicians, and advanced practice providers. Multivariate modeling of burnout identified local work culture accounting for 17.6% variance compared with only 1.3% variance for EHR metrics. Female sex independently contributed more to likelihood of clinician burnout and significantly interacted with work culture domains of commitment and work-life balance. Meaning These findings suggest that clinician sex and local work culture may contribute more to burnout than the EHR.

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Section: Methodsmentioning

confidence: 99%

Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records

et al. 2021

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“…The primary outcome of burnout was evaluated using a widely used [ 16 , 18 , 21 – 23 ] 5-item derivative of the emotional exhaustion scale of the Maslach Burnout Inventory [ 24 ], shown to have excellent psychometric properties [ 16 – 18 , 21 , 25 ], external validity [ 22 , 23 , 25 ], and is responsive to interventions [ 16 – 18 ]. According to a psychometric meta-analysis, of the three sub-scales of burnout (emotional exhaustion, depersonalization, and personal accomplishment), emotional exhaustion consistently produces the largest and most consistent Cronbach alpha estimates [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…To reduce participant respondent burden, we used a 5-item derivative of the original 9-item scale. This 5-item version is reliable (Cronbach α = 0.92) [ 16 – 18 , 21 , 22 , 25 ], predicts the prevalence of disruptive behaviors as well as symptoms of depression [ 27 ] and is associated with HCW work-life balance [ 27 ]. HCW emotional exhaustion assessments with this 5-item version are also associated with improvement readiness (the capacity of HCWs to initiate and sustain quality improvement initiatives) [ 25 ] and the use of Patient Safety Leadership WalkRounds [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…HCW emotional exhaustion assessments with this 5-item version are also associated with improvement readiness (the capacity of HCWs to initiate and sustain quality improvement initiatives) [ 25 ] and the use of Patient Safety Leadership WalkRounds [ 21 ]. Importantly, HCW assessments using this scale are consistently responsive to interventions [ 16 – 18 , 21 ]. For this study, we will use the terms burnout to describe the general phenomenon and emotional exhaustion in conjunction with its measurement.…”

Section: Methodsmentioning

confidence: 99%

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Randomized controlled trial of the “WISER” intervention to reduce healthcare worker burnout

et al. 2021

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Objective Test web-based implementation for the science of enhancing resilience (WISER) intervention efficacy in reducing healthcare worker (HCW) burnout. Design RCT using two cohorts of HCWs of four NICUs each, to improve HCW well-being (primary outcome: burnout). Cohort 1 received WISER while Cohort 2 acted as a waitlist control. Results Cohorts were similar, mostly female (83%) and nurses (62%). In Cohorts 1 and 2 respectively, 182 and 299 initiated WISER, 100 and 176 completed 1-month follow-up, and 78 and 146 completed 6-month follow-up. Relative to control, WISER decreased burnout (−5.27 (95% CI: −10.44, −0.10), p = 0.046). Combined adjusted cohort results at 1-month showed that the percentage of HCWs reporting concerning outcomes was significantly decreased for burnout (−6.3% (95%CI: −11.6%, −1.0%); p = 0.008), and secondary outcomes depression (−5.2% (95%CI: −10.8, −0.4); p = 0.022) and work-life integration (−11.8% (95%CI: −17.9, −6.1); p < 0.001). Improvements endured at 6 months. Conclusion WISER appears to durably improve HCW well-being. Clinical Trials Number NCT02603133; https://clinicaltrials.gov/ct2/show/NCT02603133

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“…The work-life climate scale evaluates individual differences in work-life infraction behaviors and has been shown to have good psychometrics when administered to health care workers [ 10 , 11 , 29 , 32 ]. The scale prompt asks During the past week, how often did this occur ?…”

Section: Methodsmentioning

confidence: 99%

Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers

2020

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Background Emotional exhaustion (EE) in health care workers is common and consequentially linked to lower quality of care. Effective interventions to address EE are urgently needed. Objective This randomized single-exposure trial examined the efficacy of a gratitude letter–writing intervention for improving health care workers’ well-being. Methods A total of 1575 health care workers were randomly assigned to one of two gratitude letter–writing prompts (self- vs other focused) to assess differential efficacy. Assessments of EE, subjective happiness, work-life balance, and tool engagement were collected at baseline and 1-week post intervention. Participants received their EE score at baseline and quartile benchmarking scores. Paired-samples t tests, independent t tests, and correlations explored the efficacy of the intervention. Linguistic Inquiry and Word Count software assessed the linguistic content of the gratitude letters and associations with well-being. Results Participants in both conditions showed significant improvements in EE, happiness, and work-life balance between the intervention and 1-week follow-up (P<.001). The self-focused (vs other) instruction conditions did not differentially predict improvement in any of the measures (P=.91). Tool engagement was high, and participants reporting higher motivation to improve their EE had higher EE at baseline (P<.001) and were more likely to improve EE a week later (P=.03). Linguistic analyses revealed that participants high on EE at baseline used more negative emotion words in their letters (P=.005). Reduction in EE at the 1-week follow-up was predicted at the level of a trend by using fewer first-person (P=.06) and positive emotion words (P=.09). No baseline differences were found between those who completed the follow-up assessment and those who did not (Ps>.05). Conclusions This single-exposure gratitude letter–writing intervention appears to be a promising low-cost, brief, and meaningful tool to improve the well-being of health care workers.

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Three Good Tools: Positively reflecting backwards and forwards is associated with robust improvements in well-being across three distinct interventions

Cited by 49 publications

References 37 publications

Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records

Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records

Randomized controlled trial of the “WISER” intervention to reduce healthcare worker burnout

Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers

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