Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers.
Abstract
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.
Type
Journal articleSubject
HumansCohort Studies
Prospective Studies
Emotions
Internet
Health Personnel
Female
Male
Psychological Distress
Permalink
https://hdl.handle.net/10161/23681Published Version (Please cite this version)
10.2196/15562Publication Info
Adair, Kathryn C; Rodriguez-Homs, Larissa G; Masoud, Sabran; Mosca, Paul J; & Sexton,
J Bryan (2020). Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being
Intervention for Health Care Workers. Journal of medical Internet research, 22(5). pp. e15562. 10.2196/15562. Retrieved from https://hdl.handle.net/10161/23681.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Kathryn C. Adair Boulus
Program Manager
I am the Assistant Director of Well-being and Research at the Duke Center for Healthcare
Safety and Quality. My research and talks examine the topic of healthcare worker well-being.
Various lines of research examine the psychology of burnout and resilience, interpersonal
relationships, self-compassion, mindfulness, tools to enhance well-being, and improving
safety culture. For more info, <a href="https://drive.google.com/file/d/1HIciiRBM7RwiBU7l
Sabran Masoud
House Staff
Paul Joseph Mosca
Associate Professor of Surgery
My research focuses on three areas. One is the development of more effective and entirely
novel treatments for melanoma. I have a special interest in immunotherapy, novel targeted
molecular therapies, and regional chemotherapy for advanced melanoma of the arm or
leg. Another area of interest is palliative surgery for cancer with an emphasis on
understanding the optimal role and application of this type of surgery in the care
of advanced malignancy. A third area of interest is quality and patient
John Bryan Sexton
Associate Professor in Psychiatry and Behavioral Sciences
Alphabetical list of authors with Scholars@Duke profiles.

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info