JMIR Publications

ABSTRACT

Background:

Emotional exhaustion (EE) in healthcare workers is common and consequentially linked to lower quality of care. Effective interventions to address EE are urgently needed.

Objective:

The current randomized single-exposure trial examined the efficacy of a gratitude letter writing intervention for improving healthcare worker well-being.

Methods:

1,575 healthcare workers were randomly assigned to one of two gratitude letter writing prompts (self- vs. other-focused) to assess differential efficacy at bit.ly/grattool. Assessments of EE, subjective happiness, work-life balance, and tool engagement were collected at baseline and one-week post-intervention. Participants received their EE score at baseline as well as quartile benchmarking scores. Paired samples t-tests, independent t-tests, and correlations explored the efficacy of the intervention. Linguistic Inquiry 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 one-week follow-up. The self- (vs. other-) focused instruction conditions did not differentially predict improvement in any of the measures. Tool engagement was high, and participants reporting higher motivation to improve their EE had higher EE at baseline and were more likely to improve EE a week later. Linguistic analyses revealed that participants high on EE at baseline used more negative emotion words in their letters. Reduction in EE at the 1-week follow-up was predicted at the level of a trend by using fewer first person and positive emotion words. No baseline differences were found between those who completed the follow-up assessment versus those who did not.

Conclusions:

This single-exposure gratitude letter intervention appears to be a promising low-cost, brief, and meaningful tool to improve the well-being of healthcare workers.