Trial reportJournal of medical Internet research2020
Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers.
Trial report in Journal of medical Internet research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Addressing Health Care Workers' Mental Health: A Systematic Review of Evidence-Based Interventions and Current Resources.American journal of public health · 2024Pooled it
- Individual-level interventions for reducing occupational stress in healthcare workers.The Cochrane database of systematic reviews · 2023Pooled it
- A Mobile App-Based Gratitude Intervention's Effect on Mental Well-Being in University Students: Randomized Controlled Trial.JMIR mHealth and uHealth · 2025Trial
- Well-Being Outcomes of Health Care Workers After a 5-Hour Continuing Education Intervention: The WELL-B Randomized Clinical Trial.JAMA network open · 2024Trial
- Trial
- Effects of a Nurse-Manager Dualistic Intervention (NMDI) Program on Work Engagement and Job Crafting of ICU Burnout Nurses: A Quasi-Experimental Study.Journal of nursing management · 2024Trial
- Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: A randomized clinical trial of WISER.Frontiers in public health · 2022Trial
- Randomized controlled trial of the "WISER" intervention to reduce healthcare worker burnout.Journal of perinatology : official journal of the California Perinatal Association · 2021Trial
- The Effect of Gratitude on the Mental Health of Healthcare Workers as Measured by Burnout and Depression.Journal of lifestyle medicine · 2026Review
- Reducing Nurses' Emotional Exhaustion and Turnover Intentions: The Role of Prosocial Orientation and Perceived Patient Gratitude in a Moderated Mediation Model.Journal of nursing management · 2025Article
- Evidence of validity and reliability of a scale to evaluate gratitude toward the organization in the Peruvian context.Frontiers in psychology · 2025Article
- Self-compassion letter tool for healthcare worker well-being: a qualitative descriptive analysis.BMJ open · 2024Article
- Enhancing Respiratory Therapists' Well-Being: Battling Burnout in Respiratory Care.Respiratory care · 2023Review
- A new look at an old well-being construct: evaluating the psychometric properties of 9, 5, and 1-item versions of emotional exhaustion metrics.Frontiers in psychology · 2023Article
- Emotional Exhaustion Among US Health Care Workers Before and During the COVID-19 Pandemic, 2019-2021.JAMA network open · 2022Article
- The Association between Well-being Behaviors and Resilience in Health Care Workers.Western journal of nursing research · 2022Article
- The language of healthcare worker emotional exhaustion: A linguistic analysis of longitudinal survey.Frontiers in psychiatry · 2022Article
- Personal and Professional Factors Associated With Work-Life Integration Among US Physicians.JAMA network open · 2021Article
- Maternal and neonatal health care worker well-being and patient safety climate amid the COVID-19 pandemic.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records.JAMA network open · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEmotional exhaustion (EE) in health care workers is common and consequentially linked to lower quality of care. Effective interventions to address EE are urgently needed.
objectiveThis randomized single-exposure trial examined the efficacy of a gratitude letter-writing intervention for improving health care workers' well-being.
methodsA 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.
resultsParticipants 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).
conclusionsThis 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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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.