We are in awe of the frontline healthcare workers within the NHS and health and social care settings, particularly during the coronavirus pandemic, but these groups of workers consistently operate in environments which have high levels of burnout and stress, poorer mental and emotional health and high levels of sickness absence. Here, Dr Fiona Holland, Senior Lecturer in Psychology at the University of Derby, discusses whether a positive psychology intervention could make a difference for those working in healthcare settings and be applicable across a range of workplaces.
So, what does working in the environment mean for healthcare workers wellbeing? I supervised the research of University of Derby graduate, Lu Wood. In her study, conducted for her MSc in Behaviour Change, she recruited workers within NHS mental health settings to notice good things in their days/across their week, and express gratitude for others.
The results showed positive changes in people’s perceptions of wellbeing and relationships and increased levels of gratitude and recognition of others. I think this project can give us all some ideas for simple activities we can do to help promote our own wellbeing and our relationships with others, and the gratitude tasks that could be implemented within any team or on an individual basis.
The benefits of gratitude
Gratitude is a feeling and expression of thankfulness whereby an individual notices and appreciates life’s positives. It can also be considered a state generated when an act of kindness is experienced. The use and experience of gratitude is effective because it helps people to repeatedly consider positive experiences and think about their environments in more appreciative ways.
Gratitude has been shown to benefit health and wellbeing in many ways. It can:
- Increase people’s feelings of contentment, hope, pride, optimism, and satisfaction
- Improve sleep quality and reduce blood pressure
- Cultivate citizenship, moral cohesion, and societal closeness
- Motivate individuals to initiate or sustain engagement in selfless and helpful acts for others.
Within workplace environments, gratitude interventions have also yielded positive results, such as:
- Reducing stress and depressive symptoms
- Reducing workplace toxicity
- Employees feeling happier and healthier
- Improving staff retention
- Staff being more caring and communicating more positively with one another.
Gratitude in healthcare settings
In healthcare settings, studies have found that when service-users expressed gratitude to nurses, nurses’ feelings of personal accomplishment were heightened, work demands were perceived more favourably, and stress declined. Lu’s study added to these findings.
Her four-week qualitative pilot study recruited NHS staff workers from regional mental health teams. They expressed their thanks/appreciation to their colleagues either in person, via email, on a post-it/small note, and/or via a letter. Additionally, once per week they wrote three good things that had happened during that time. After the intervention, they were interviewed, and transcripts of these were analysed.
The themes revealed that the staff observed an increase in positive emotion from people who received their gratitude notes, and this had a clear impact upon their own happiness. One participant reported that it ‘made me feel good that I had helped brighten someone’s day’. They also noticed a positive impact on resilience and stress management e.g. one participant noted they felt that it‘helped buffer some of the everyday stresses’, another stated: ‘it was a lovely way to start the day and made me feel more positive’. Participants also found that practicing the ‘three good things that week’ gratitude task enhanced their mood. One reported ‘you feel good and this feeling stays with you’.
Gratitude is good for our relationships
Another benefit the participants reported was enhanced relationships with others. These were noticed in more positive written communications and in-person interactions. For example, one participant noted that ‘email and text communications provoked longer interactions and the tone of emails was more positive.’ Face-to-face interactions became ‘more open’ and helped to build more meaningful conversations beyond the usual ‘hellos’ as it ‘open[ed] up other dialogue whether it’s a work topic or more personal.’There was also an improvement in inter-personal relationships, and ‘more of a bond’ was formed between colleagues as a result of the gratitude intervention.
Participants also recognised the role that appreciation played in the workplace and the ripple effect this had, e.g. one participant noticed that ‘people seemed to feel more confident in their work when thanked [and] feel better about their own abilities.’
Participants noticed how their life outside of work benefitted from their expressions of gratitude within the workplace. Participants said they went home ‘feeling happy’, were ‘less moany’ to their families and ‘able to wind down easier’. There also seemed to be a spill-over effect, and some participants noticed they were more aware of, and more likely to express gratitude within their home environment. One participant noted: ‘I was more grateful for things that my partner does, I was more thoughtful about giving gratitude’. This supports and adds to the existing literature that suggests organisational gratitude can have a wider influence on people’s lives.
What we learned about gratitude
As a pilot study, Lu’s research shows great promise. The activities were seen to be feasible by the busy NHS participants and future research will hopefully build upon these positive findings. From a practical point of view, there are some useful learnings:
- Writing down three good things we notice each day or even over the course of the week can be beneficial
- Expressing gratitude to others can have positive effects on both the giver and receiver’s mood and morale
- Expressing gratitude and noticing good things can have a positive spill-over effect in other areas of life.
So, why not give this a try? These practices don’t have to take up much time, they can be woven into busy working days and weeks, and hold great promise in fostering more healthy individuals, employees and workplaces.