A qualitative analysis of the Three Good Things intervention in healthcare workers

BMJ Open. 2017 Jun 13;7(5):e015826. doi: 10.1136/bmjopen-2017-015826.


Background: Intensive care unit (ICU) personnel have an elevated prevalence of job-related burn-out and post-traumatic stress disorder, which can ultimately impact patient care. To strengthen healthcare workers' skills to deal with stressful events, it is important to focus not only on minimising suffering but also on increasing happiness, as this entails many more benefits than simply feeling good. Thus, the purpose of this study was to explore the content of the 'good things' reported by healthcare workers participating in the 'Three Good Things' intervention.

Methods: In a tertiary care medical centre, a sample of 89 neonatal ICU (NICU) healthcare professionals registered for the online intervention. Of these, 32 individuals eventually participated fully in the 14-day online Three Good Things intervention survey. Daily emails reminded participants to reflect on and respond to the questions: "What are the three things that went well today?" and "What was your role in bringing them about?" To analyse their responses, we applied a thematic analysis, which was guided by our theoretical understanding of resilience.

Results: Involving more than 1300 statements, the Three Good Things responses of the 32 study participants, including registered nurses, physicians and neonatal nurse practitioners, led to the identification of three main themes: (1) having a good day at work; (2) having supportive relationships and (3) making meaningful use of self-determined time.

Conclusions: The findings show the personal and professional relevance of supportive relationships strengthened by clear communication and common activities that foster positive emotions. The Three Good Things exercise acknowledges the importance of self-care in healthcare workers and appears to promote well-being, which might ultimately strengthen resilience.

Keywords: Healthcare professionals; Positive psychology; Qualitative research; Self-care; Well-being.

MeSH terms

  • Burnout, Professional / therapy*
  • Female
  • Happiness
  • Health Personnel / psychology*
  • Health Promotion / methods*
  • Humans
  • Intensive Care Units, Neonatal
  • Male
  • Qualitative Research
  • Resilience, Psychological
  • Self Care / methods*
  • Social Values
  • Stress Disorders, Post-Traumatic / therapy*
  • Surveys and Questionnaires
  • Tertiary Care Centers
  • United States
  • Workforce