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A qualitative analysis of the Three Good Things intervention in healthcare workers
  1. Karin Rippstein-Leuenberger1,2,
  2. Oliver Mauthner1,
  3. J Bryan Sexton3,
  4. Rene Schwendimann1
  1. 1 Institute of Nursing Science, Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
  2. 2 Kantonsspital Baselland, Liestal, Switzerland
  3. 3 Duke Patient Safety Center, Duke University Health System, Durham, North Carolina, USA
  1. Correspondence to Dr. Rene Schwendimann; rene.schwendimann{at}


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.

  • Positive psychology
  • Well-being
  • Healthcare professionals
  • Self-care
  • Qualitative research

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  • Contributors KR-L, OM and RS contributed to study conception, data analysis and interpretation. JBS contributed to study site management, data collection, analysis and interpretation. KR-L was responsible for manuscript drafting and editing. All authors contributed to manuscript drafting appraisal, revision and editing and read and approved the final manuscript.

  • Funding The study received no specific financial support from any public, commercial, or not-for-profit funding agencies.

  • Competing interests None declared.

  • Ethics approval Duke University Hospital Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional study data are available.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.