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Title: Infusing Sustainable Happiness into Nursing for Positive Work Environments


1
Infusing Sustainable Happiness into Nursing for
Positive Work Environments
  • Sheila Profit, BScN, MAdEd
  • Judy Bailey, MN, RN
  • Catherine O'Brien, PhD
  • Cape Breton University

2
Literature Review
  • By 2022, Canada may have a shortage of almost
    66,000 nurses (Tomblin Murphy, Birch, Alder,
    MacKenzie, Lethbridge, Little Cook, 2009).
  • Recommendations to address this shortage include
  • developing strategies to improve retention of
    RNs,
  • improve health and well-being of RNs
  • improve the retention of nursing students
  • Over the past decade research has emerged that
    investigates the health benefits of positive
    emotions, subjective well-being (happiness) and
    life satisfaction.

3
Happiness Defined
  • Definitions vary
  • Often referred to as subjective well-being
  • Judgments of life satisfaction
  • Affect balance positive feelings and few
    negative feelings (Schimmack, 2008 cited in
    Fisher, 2010)
  • Happy or good life involves
  • doing what is right and virtuous
  • Pursuing important or self-concordant goals
  • Using and developing ones skills and talents
    regardless of how one feels at any point in time
    (Warr 2007 cited in Fisher, 2010)

4
Happiness Literature
  • Research from the field of positive psychology is
    being applied in many fields, including workplace
    wellness.
  • Positive psychology focuses on enhancing
    well-being through the study of happiness,
    subjective well-being, and life satisfaction.
  • Definitions of happiness may vary, but
    researchers have demonstrated that ones
    subjective experience of happiness corresponds
    with numerous positive health outcomes (Steptoe,
    Wardle, Marmot, 2005).
  • Happiness is often referred to as subjective
    well-being

5
Happiness and Health
  • Studies suggest that positive emotions are
    associated with longevity, lower blood pressure,
    and reduced risk of heart disease (Seligman,
    2002 Steptoe, Wardle Marmot, 2005 Veenhoven,
    2006).
  • Research published in the European Heart Journal
    followed more than 1700 Nova Scotians over ten
    years
  • those who had experienced and expressed positive
    emotions at the outset of the study had reduced
    incidence of heart disease.
  • Participants who had scored highest in terms of
    positive emotions were also less likely to be
    smokers
  • Preventive strategies could include increasing
    positive affect (Davidson, Mostofsky Whang,
    2010).

6
Happiness-Related Constructs in the Workplace
  • Job satisfaction,
  • Typical mood at work,
  • Thriving,
  • Engagement,
  • Job involvement
  • All constructs re happiness in workplace have in
    common
  • Pleasant judgments (positive attitudes) or
    pleasant experiences (positive feelings, moods,
    emotions) at work
  • These are stable over time

7
Research on Happiness and Workplace
  • Happy and satisfied people are relatively more
    successful in the workplace
  • There is a positive correlation between career
    satisfaction, self-nurturance and life
    satisfaction (Nemcek, 2007)
  • Business and health care organizations are
    recognizing a connection between employee
    happiness and enhanced productivity and improved
    outcomes (Scott, 2009).
  • Happy people earn more money, display superior
    performance and perform more helpful acts (Boehm
    Lyubominsky, 2008)
  • Happy people are more satisfied with their jobs
    than unhappy people (Boehm Lyubimsky,2008)

8
Happiness and Workplace
  • It has been assumed that the accomplishments of
    success in the workplace causes people to be
    happy.
  • Instead the evidence suggests that happiness
    preceded measures of success and that induction
    of positive affect leads to improved workplace
    outcomes (Boehm Lyubomirsky, 2008)

9
Question
  • Is it possible to teach happiness skills that can
    lead to sustained well-being?
  • Can individuals shift from a lower level of
    happiness to one that is higher and thus reap the
    health benefits?
  • Could happiness skills be used as method for
    fostering healthier lifestyles?

10
  • Many models have been proposed for learning
    happiness skills (Seligman, 2002 Foster
    Hicks, 2000 Ryan, Huta, Deci,2008)
  • Foster and Hicks have developed a happiness
    model that has been used to train more than
    5,000 nurses at the Mayo Clinic. Health
    professionals who participated in their training
    program experienced enhanced subjective
    well-being, both personally and professionally.
    Participants also develop skills that can be
    applied with clients.

11
  • Research by Dr. Catherine OBrien with nursing
    staff and medical social workers using the
    happiness model by Foster and Hicks found a
    positive impact on
  • Participants attitudes
  • A healthy work environment
  • Nursing participants recommended that every nurse
    and nursing student would benefit from
    participating in a similar happiness workshop

12
What is Sustainable Happiness?
  • Developed by Dr. Catherine OBrien(2005) to merge
    principles of sustainability and findings from
    happiness studies in order to draw attention to
    the consequences, both positive and adverse, of
    how individuals, communities and nations pursue
    happiness
  • Sustainable happiness is happiness that
    contributes to individual, community and/or
    global well-being and does not exploit other
    people, the environment or future generations
    (OBrien, 2009).

13
Foster and Hicks Happiness Model
14
The Nine Choices Towards Happiness (Foster
Hicks)
  1. Intention the active desire and commitment to
    be happy and the decision to consciously choose
    attitudes and behaviours that lead to happiness
    over unhappiness
  2. Accountability the choice to create the life
    you want to live, to assume personal
    responsibility for your actions, thoughts and
    feelings and the emphatic refusal to blame others
    or view yourself as a victim
  3. Identification- the ongoing process of looking
    deeply within yourself to assess what makes you
    uniquely happy, apart from what you are told be
    others should make you happy

15
  • Centrality the non-negotiable insistence on
    making central to your life that which brings you
    happiness
  • Recasting - the two-step process that transforms
    problems and trauma into something meaningful,
    important and a source of emotional, energy
  • Options the decision to approach life by
    creating multiple scenarios, to be open to new
    possibilities and to adopt a flexible approach to
    lifes journey

16
  1. Appreciation the choice to appreciate deeply
    your life and the people in it and to stay in the
    present by turning each experience into something
    precious
  2. Giving the choice to share yourself with
    friends and community and to give to the world at
    large without the expectation of a return
  3. Truthfulness the choice to be honest with
    yourself and others. And not allow societal,
    workplace, or family demands to violate your
    internal contract

17
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18
Purpose of Research
  • Introduce nursing faculty and nursing students to
    the happiness literature, outlining its
    significance for personal and professional
    well-being.
  • A workshop was done with the nursing faculty
    prior to doing the research with the
  • The Foster and Hicks happiness model the
    concept of sustainable happiness an intervention
    strategy which may assist students to develop or
    re-connect to an intrinsic value system.
  • Intrinsic value orientations are associated with
    higher measures of subjective well-being
    (happiness).
  • Research question What is the impact of the
    Foster and Hicks model and sustainable happiness
    on the intrinsic values of 1st and 4th year
    nursing students ?

19
Ethics
  • This research received approval from the CBU
    Research Ethics Board
  • Funding received from the Cape Breton Health
    Research Grant Fund for 4034.00

20
Methodology
  • This was a minimal risk study.
  • Sustainable Happiness Workshops were provided to
    1st year and a 4th year experimental groups
  • No workshop initially for 1st 4th year control
    groups
  • All students provided consent to complete an
    Aspirations Index Survey Sustainable Happiness
    Survey
  • Following survey completion a random selection
    of students were interviewed

21
Workshop
  • The aim of the workshop was to provide skills to
    enhance subjective well-being
  • Video
  • Interactive exercises (listening)
  • Relating personal experiences
  • Reflecting on personality types
  • Examine intrinsic vs extrinsic rewards

22
Example of Workshop ExerciseSelf Reflection
  • Think about the happiest person you know and why
    you consider them to be happy?
  • What makes you happy?

23
Risk
  • The only potential adverse impact is that through
    the process of reflecting on happiness,
    participants may find that they become aware of
    aspects of their life, personally or
    professionally, that are not satisfactory
  • The students were provided access to support
    systems for dealing with any issues that may have
    surfaced

24
Student Participation
  • N 491 1 and N1251 designated Control Groups
  • Offered the workshop post research study for
    Control participants
  • N4912 and N1252 designated Experimental Groups
    were given the workshop

25
First Surveys
  • Consents, The Sustainable Happiness Survey and
    The Aspirations Index Survey were distributed to
    both Control Experimental Groups
  • The Aspirations Index was used with the
    permission of the authors. It measures intrinsic
    and extrinsic value orientations.
  • Voluntary
  • Coding for confidentiality and data collection

26
Second Surveys
  • Completed by the Experimental Groups N4912 and
    N1252 in class 1 week following the workshop

27
Third Surveys
  • The Sustainable Happiness Survey and The
    Aspirations Index Survey were distributed to both
    Control Experimental Groups during the last
    class of the term (3 months following 1st survey)

28
Interviews
  • Student interviews conducted
  • Random selection of students both control
    experimental
  • 6-10 Interviews Experimental
  • 2-3 Interviews Control

29
Results of the Research
30
Aspirations Index Survey57 questions ( a b),
measured 11 domains
  • Money
  • Image
  • Popularity
  • Conformity
  • Self-acceptance
  • Affiliation
  • Community
  • Health
  • Spirituality
  • Hedonism
  • Safety

31
Sample of Questions for AI Survey
  • Money Domain
  • I will have many expensive possessions
  • Importance 1 2 3 4 5
    6 7 8 9
  • not at all a little
    moderate very extremely
  • Chances 1 2 3 4 5
    6 7 8 9
  • very low low
    moderate high very high
  • Self Acceptance Domain
  • The things I do will make other peoples lives
    better
  • Importance 1 2 3 4 5
    6 7 8 9
  • not at all a little
    moderate very extremely
  • Chances 1 2 3 4 5
    6 7 8 9
  • very low low
    moderate high very high

32
Questions for Sustainable Happiness SurveyPrior
to the Sustainable Happiness workshop I often
engaged in the following activities
  • __attempting to buy local products
  • __checking where products are made
  • __mindfulness
  • __spending time with friends
  • __spending time with my family
  • __using the Foster Hicks happiness model
  • __attempting to reduce my consumption
  • __Other (please describe)
  • __carpooling
  • __water conservation
  • __expressing appreciation
  • __walking
  • __composting
  • __purchasing fair trade products
  • __energy conservation
  • __counting my blessings
  • __ using public transit
  • __physical exercise
  • __eating nutritious food

33
Data Analysis of AI SH Surveys
  • 1st year Experimental 33 students (198 surveys)
  • 1st year control 37 students ( 148 surveys)
  • 4th year Experimental 21 students (126 surveys)
  • 4th year Control 25 students (100 surveys)
  • SPSS, Descriptive Statistics, Mean, Grand Mean,
    Anova

34
Interview Questions - Experimental
  • What was your experience of the workshop while
    you were attending?
  • realized the biggest thing I need to change-
    recycling driving- Im carpooling now and
    recycling- less use of water bottles- Im saving
    money, that makes me happier- I remember the
    animal types, I was in a big group of dolphins-
    the surveys are what I remember most- I learned
    from the surveys
  • I wanted to do the natural highs more
    often-expressing gratitude-made a point of
    appreciating parents-thought it was cool to think
    about happiness

35
Interview Questions- Experimental
  • Following the workshop, did you experience any
    positive (or adverse) short term impact on your
    life personally?
  • Yes, I am someone who is stressed- found I
    started to use me language rather than you in
    relationships- take responsibility instead of
    blaming-expressing appreciation more

36
Interview Questions-Control
  • Identified experiences as a nursing student as
    very stressful
  • Indicated limited awareness of relationship b/t
    happiness, health and well being

37
Ongoing Analysis of Results
  • Need to integrate the concept of sustainable
    happiness and happiness skills throughout the
    program and not rely on just ½ day workshop
  • Happiness literature has implications for
    personal, unit and organizational level

38
  • The concepts of Sustainable Happiness can make a
    positive impact on at least 3 levels
  • Personal
  • Practice Work Environment
  • Client Outcomes

39
References
  • Boehm, J. K. Lyubominsky, S. (2008) Does
    happiness promote career success? Journal of
    Career Assessment, 16 (1) 101-106.
  • Davidson, K. W. Mostofsky, E.. Whang, W. (2010,
    February) Don't worry, be happy positive affect
    and reduced 10-year incident coronary heart
    disease The Canadian Nova Scotia Health Survey.
    European Heart Journal.
  • Diener, E., Emmons, R., Larsen, J., Griffin, S.
    (1985). The satisfaction with life scale. J
    Personality Assessment, 49(1), 71-75. 
  • Fisher, C. D. (2010). Happiness at work.
    International Journal of Management Reviews, 12,
    384-412.
  • Grouzet, F., Kasser, T., Ahuvia, A., Dols, J.,
    Kim, Y., Ryan, R.M., Kennon M. S. (2005). The
    structure of goal contents across 15 cultures.
    Journal of Personality and Social
    Psychology,89(5), 800816
  • Nemcek, M.A. (2007). Registered nurses
    self-nurturance and life and career satisfaction.
    AAOHN Journal, 55(8), 305-320.
  • OBrien, C. (May, 2010) Sustainability, happiness
    and education. Journal of Sustainability
    Education. 1.

40
References
  • Ryan, R.M., Huta, V. Deci, E.L. (2008). Living
    well a self-determination theory perspective on
    eudaimonia. Journal of Happiness Studies, 9,
    139-170.
  • Schimmack, U. (2008). The structure of subjective
    well-being. In Eid, M. Larsen, R.J. (eds.) The
    Science of Subjective Well-being. New York The
    Guilford Press.
  • Scott, D.E. (2009). Happiness at work. The
    Alabama Nurse, 36 (1) p.9.
  • Seligman, M. (2002). Authentic happiness.
    Toronto Free Press. 
  • Steptoe, A., Wardle, J., Marmot, M. (2005).
    Positive affect and health-related
    neuroendrocrine, cardiovascular, and inflammatory
    process. Proceedings of the National Academy of
    Science,102 (18), 6508-6512.
  • Tomlin-Murphy, G., Birch, S., Alder, R.,
    MacKenzie, A., Lethbridge, L., Little, L. Cook,
    A. (2009). Tested solutions for eliminating
    Canadas registered nurse shortage (Canadian
    Nurses Association Rep.)
  • Veenhoven, R. (2006). Healthy happiness Effects
    of happiness on physical health and the
    consequences for preventive health care, Journal
    of Happiness Studies, 15-11.

41
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