JMIR Publications

ABSTRACT

Background:

Healthcare is highly complex and can be both emotionally and physically challenging. This can lead healthcare workers to develop compassion fatigue and burnout, which can negatively affect their well-being and patient care. Higher levels of resilience can potentially prevent compassion fatigue and burnout. Strategies that enhance resilience include: gratitude, exercise, and mindfulness.

Objective:

The purpose of this study was to determine if a three-week daily resiliency practice, prompted via a gratitude, exercise, and mindfulness smartphone app, impacts professional quality of life, physical activity, happiness level, of healthcare workers in a newborn intensive care unit setting.

Methods:

Sixty-five participants from a level III Newborn Intensive Care Unit at a regional hospital in the western United States completed this study. The Professional Quality of Life Scale, Physical Activity Vital Sign, and Subjective Happiness Score instruments were utilized to evaluate the effects of the mHealth intervention. Dependent paired t-tests were utilized to evaluate participant pre- and post-intervention instrument scores. Multiple imputation was used to predict scores of participants who practiced an intervention but did not complete the three instruments post-intervention.

Results:

Dependent t-tests using the original data showed that participants, as a whole, significantly improved in burnout (t = 2.30, P = .03), secondary trauma stress (t = 2.11, P = .04), and happiness (t = -3.72, P < .001) scores. Compassion satisfaction (t = -1.94, P = .06) and exercise (t = -1.71, P = 0.10) were trending towards significance. Using the original data, only the gratitude intervention group experienced significant improvements (compassion satisfaction, burnout, and happiness), likely due to higher number of participants in this group. Analysis using imputed data showed that participants, as a whole, had significant improvements in all areas: compassion satisfaction (t = -4.08, P < .001), burnout (t = 3.39, P = .001), secondary trauma stress (t = 4.08, P < .001), exercise (t = -3.19, P = .002), and happiness (t = -3.99, P < .001). Looking at the intervention groups separately using imputed data, the gratitude group had significant improvements in compassion satisfaction, burnout, secondary trauma stress, and happiness; the exercise group had significant improvements in secondary trauma stress and exercise; and the mindfulness group had significant improvements in compassion satisfaction and happiness.

Conclusions:

Phone app delivery of resilience-enhancing interventions is a potentially effective intervention model for healthcare workers. A potential barrier for mHealth strategies are the technical issues that can occur with this type of intervention. Additional longitudinal and experimental studies with larger sample sizes need to be completed to better evaluate this modality.