Lec 1 Reading: Three Good Tools - Kathryn C. Adair, Lindsay A. Kennedy & Bryan Sexton

Question 1

How many people struggle with anxiety, depression or both?

Answer 1

Over half a billion

Question 2

How much money do mental disorders such as anxiety and depression cost globally in lost productivity each year?

Answer 2

$1 trillion

Question 3

What proportion adults have a mental illness? How many receive treatment?

Answer 3

1/5, less than half

Question 4

HCW

Answer 4

Healthcare workers

Question 5

How many HCW reach the criteria for burnout?

Answer 5

1/3 to 1/2

Question 6

Consequences of HCW burnout

Answer 6

• patient consequences (mortality, healthcare-acquired infection)
  - interferes with safe delivery of patient care
  - ability to engage with quality improvement efforts
• HCW consequences
  - marital problems
  - shorter lifespan

Question 7

Positive emotions and burnout

Answer 7

Undo cardiovascular sequelae of a emotional upheaval

Question 8

Study method

Answer 8

3 cohort studies: Three Good Things (what went well today), Gratitude Letter (about a person), Looking Forward Tool

Question 9

3GT Participation

Answer 9

Initiation: 275 HCW, 82.5% female
Completion: 146 HCW or 53%

Question 10

3GT

Answer 10

Three Good Thing: What went well today, via text over 15 days (not usual 7)

Question 11

Gold Standard in the field of burnout

Answer 11

Maslach Burnout Inventory

Question 12

3 sub-scales of burnout

Answer 12

• Emotional exhaustion (EE)
• Depersonalisation
• Personal accomplishment

Question 13

What is used to distinguish between burned-out and non-burned out work-related neurasthenia?

Answer 13

Emotional exhaustion

Question 14

Neurasthenia

Answer 14

general weakness (emotional), fatigue, emotional disturbance, irritability etc.

Question 15

Emotional Exhaustion Scale used and example prompts

Answer 15

5-item version of original 9-items
5-point scale (1 = disagree strongly), mean converted to 100-point scale, higher is more severe
e.g. “I feel frustrated by my job”
“Events at work affect my life in an emotionally unhealthy way”

Question 16

Emotional Thriving + example prompt

Answer 16

opposite of emotional exhaustion, level of flourishing
“I have a chance to use my strengths every day of work”

Question 17

SHS

Answer 17

Subjective Happiness Scale
scale of global happiness
4 items, assessed on 7-point scale e.g. “In general, I consider myself (1 = not a very happy person, 7+ a very happy person)”
“Compared to most of my peers I consider myself (1 = less happy, 7 = more happy)

Question 18

Emotional Recovery + example prompt

Answer 18

extent to which one ‘bounces back’ from emotional upheaval/adversity
“My mood reliably recovers after frustrations and setbacks”

Question 19

CES-D10

Answer 19

The Center for Epidemiological Studies Depression Scale 10-Item Version
= tool for screening for clinical depression
all prefaced with ‘during the past week, how often did this occur’
4-point scale (0 = rarely, 3 = all the time)
Summed to 30-point scale

Question 20

How was work-life balance assessed?

Answer 20

“During the past week, how often did this occur?: (skipped a meal, arrived home late etc.)”
Scale: Rarely (<1 day), Some of the time (1-2 days), Occasionally (3-4 days), All of the time (5-7 days), Not applicable

Question 21

When was the study (3GT) carried out?

Answer 21

April 2017

Question 21

What type of study is 3GT?

Answer 21

Repeated measures cohort study of a web-based 3GT intervention

Question 22

3GT Prompts

Answer 22

What went well today?
What was your role in making it happen?
x 3

Question 23

3GT Follow up periods

Answer 23

15 days, 1 month, 6 months, 12 months

Question 24

Gratitude letter

Answer 24

2 letter written in 7mins, x 2 after assessments
at baseline and 1 month after

Question 25

When was the study (gratitude letter) carried out?

Answer 25

between April 2017 and January 2018

Question 26

Looking Forward tool

Answer 26

based on hope theory and learned optimism
participants initially reflect on positive future events far into the future, then closer to the present with subsequent exposures (10, 5, 3, or 1 year away)
describe something they hoped to experience or were looking forward to
completed initially, 1 day later, 3, 7, 14, 21, 28 days later
wellbeing metrics collected at baseline, day 7 and day 28
metrics (same as 3GT + 1):
- Depression symptoms
- Emotional thriving
- Emotional recovery
- Optimism (LOT-R)

Question 27

When was the study (looking forward tool) carried out?

Answer 27

February to August 2018

Question 28

Looking Forward tool demographics

Answer 28

84.6% white
88.6% female
71.4% between 31-60yrs old

Question 29

LOT-R

Answer 29

The Life-Orientation Test-Revised
measures optimism
10-items, 4 fillers, 1-5 scale
questions e.g.
‘In uncertain times, I usually expect the best’
‘I rarely count on good things happening to me’

Question 30

did -ve or +ve measures of wellbeing improve more?

Answer 30

-ve

Question 31

limitations

Answer 31

• lack of randomised control groups (3GT and gratitude letter showed improvements compared to prior study control groups) - would help assess causality, non-intervention related effects e.g. selection bias
• attrition (bailing out), common/primary abrrier in web-based health interventions (up to 60-80%)