King's College London

My research, which explores the expression and reception of gratitude in healthcare, aims to generate advice and guidance for healthcare institutions who wish to better recognise and facilitate gratitude for the morale and subjective well-being of their staff and patients. 

The objectives are:

• To describe the ways in which gratitude is expressed and received, in (1) an archival study of almoners’ correspondence with former patients at the Frimley Sanatorium and (2) through sampling contemporary expressions of gratitude at the Royal Brompton Hospital, London.
• To record how healthcare professionals respond to different forms of expressed gratitude, and to explore the contextual factors that shape these responses. 
• To illuminate the role that gratitude has in shaping human relationships in institutional environments.

Gratitude was described in 2004, as ‘one of the most neglected emotions and one of the most underestimated of the virtues’ (Solomon 2004, p. v). Since then, gratitude has become the subject of a great deal of research especially in the field of positive psychology (see, for example, Davis et al., 2016; Armenta, Fritz and Lyubomirsky, 2017; Morgan, Gulliford and Kristjánsson, 2017). Along with ‘kindness’ and ‘compassion’, gratitude forms part of a constellation of emotions and actions that consciously counter the hostility and cynicism characterising much of public discourse especially on social media. It is well established that grateful people report improved subject wellbeing (e.g. Emmons and McCullough, 2004; Sansone and Sansone, 2010). However, most published research is based on a concept of gratitude as concerned with a general state of ‘thankfulness’ in which gratitude can be felt forsomething without necessarily being expressed tosomeone (Manela, 2015). This project will seek to understand the effects of the receipt of gratitude. When a patient or colleague expresses gratitude to a healthcare professional, how does that professional respond and what impact does gratitude have at personal, interpersonal and organisational levels? Are there institutional impediments to gratitude that could be removed so that its potential to improve workplace culture can be more fully realised?

The King’s Fund has highlighted low morale as a significant problem in the NHS, with a major contributing factor being that staff feel undervalued (The King’s Fund, 2018). Policy makers are often preoccupied with a culture of complaints in which gratitude becomes a free-floating emotion which no one seems to know how to handle. Healthcare professionals are often embarrassed by gratitude, employing ‘thanks minimisers’ (e.g. ‘I’m just doing my job’). A more positive culture around gratitude would allow professionals and patients to recognise that if gratitude is ‘seen’ and acknowledged, rather than played down or ignored, it is likely to benefit the subjective wellbeing of everyone involved in a gratitudinal encounter.

References

Armenta, C. N., Fritz, M. M. and Lyubomirsky, S. (2017) ‘Functions of Positive Emotions: Gratitude as a Motivator of Self-Improvement and Positive Change’, Emotion Review, 9(3). doi: 10.1177/1754073916669596.

Davis, D. E. et al.(2016) ‘Thankful for the Little Things: A Meta-Analysis of Gratitude Interventions’, Journal of Counseling Psychology, 63(1). doi: 10.1037/cou0000107.

Emmons, R. A. and McCullough, M. E. (eds) (2004) The Psychology of Gratitude. Oxford: Oxford University Press.

Manela, T. (2015) ‘Gratitude’, Stanford Encyclopedia of Philosophy. Spring. Stanford University. Available at: https://plato.stanford.edu/entries/gratitude/ (Accessed: 2 January 2018).

Morgan, B., Gulliford, L. and Kristjánsson, K. (2017) ‘A New Approach to Measuring Moral Virtues: The Multi-Component Gratitude Measure’,Personality and Individual Differences, 107, pp. 179–189. doi: 10.1016/j.paid.2016.11.044.

Sansone, R. A. and Sansone, L. A. (2010) ‘Gratitude and Well Being: The Benefits of Appreciation’, Psychiatry. Matrix Medical Communications, 7(11), pp. 18–22. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21191529 (Accessed: 1 March 2018).

Solomon, R. C. (2004) ‘The Psychology of Gratitude: Foreword’, in Emmons, R. A. and McCullough, M. E. (eds) The Psychology of Gratitude. Oxford: Oxford University Press, pp. 3–16.

The King’s Fund (2018) How Is the NHS Performing?,March 2018 Quarterly Monitoring Report. Available at: https://www.kingsfund.org.uk/publications/how-nhs-performing-march-2018 (Accessed: 27 March 2018).