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Original Paper
Measuring Self-Reported Well-Being of Physicians Using the
Well-Being Thermometer: CohortStudy
Marios Adamou1, MD, PhD; Sarah L Jones2, PhD; Niki Kyriakidou3, PhD; Andrew Mooney4, PhD; Shriti Pattani5;
Matthew Roycroft6, MEd
1University of Huddersfield, Huddersfield, United Kingdom
2South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
3Leeds Beckett University, Leeds, United Kingdom
4Renal Unit, St James's Hospital, Leeds, United Kingdom
5London North West University Healthcare NHS Trust, London, United Kingdom
6Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
Corresponding Author:
Sarah L Jones, PhD
South West Yorkshire Partnership NHS Foundation Trust
Belle Isle Health Park
Wakefield, WF1 5PN
United Kingdom
Phone: 44 1924 316492
Email: sarah.jones1@swyt.nhs.uk
Abstract
Background: Advancements in medical science have focused largely on patient care, often overlooking the well-being of
health care professionals (HCPs). This oversight has consequences; not only are HCPs prone to mental and physical health
challenges, but the quality of patient care may also endure as a result. Such concerns are also exacerbated by unprecedented
crises like the COVID-19 pandemic. Compared to other sectors, HCPs report high incidence of stress, depression, and suicide,
among other challenging factors that have a significant negative impact on their well-being.
Objective: Given these substantial concerns, the development of a tool specifically designed to be used in clinical settings to
measure the well-being of HCPs is essential.
Methods: A United Kingdom–based cross-sectional pilot study was carried out to measure self-reported well-being in a
cohort of 148 physicians, using the newly developed well-being thermometer. The aim of the tool is to allow respondents to
develop an individual sense of “well-being intelligence” thus supporting HCPs to have better insight and control over their
well-being and allow insights into how to manage it. The tool consists of 5 well-being domains—health, thoughts, emotions,
spiritual, and social. Each domain can be measured individually or combined to produce an overall well-being score.
Results: The tool demonstrated good internal consistency; the Cronbach α in this study was 0.84 for the total scale.
Conclusions: Results from this cohort demonstrated that the well-being thermometer can be used to gather intelligence of
staff well-being. This is a promising new tool that will assist HCPs to recognize their own well-being needs and allow health
care organizations to facilitate change in policies and practices to reflect a better understanding of staff well-being.
JMIR Form Res 2025;9:e54158; doi: 10.2196/54158
Keywords: well-being; health care professionals; mental health; well-being thermometer; health care
Introduction
Medicine has developed greatly in relation to disease control
and health interventions, yet it is questioned if health care
professionals (HCPs) are fully aware of their own well-being,
and the toll poor levels of well-being may have on their lives
[1]. HCPs face unique challenges that could be damaging to
their mental and physical health [2-5], and given the recent
challenges of the COVID-19 pandemic [6,7], plus the current
public health crisis, monitoring the well-being of our HCPs is
vital for the mental health of the workforce.
Poor well-being is often reported in HCP cohorts [8-11],
leading to serious health consequences and reduced quality
of life for those affected [12]. In economic terms, higher
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staff turnover and sickness absence are the consequence [13],
potentially resulting in poor quality of care for patients [14].
HCPs consistently report higher levels of sickness absence,
job dissatisfaction, and stress compared to other work sectors
[15-20]. A recent systematic review found moderate to
high levels of stress, anxiety, depression, sleep disturbance,
and burnout reported by frontline health care employees
compared to workers in other sectors [21]. Moreover, a
survey conducted in the United Kingdom (pre–COVID-19
pandemic) reported that, of public sector workers, those who
work for the NHS recorded the most stress [22]. There is
also increasing morbidity in HCPs compared to the general
population [23]. Reasons for these higher levels of stress are
multifactorial, including lack of staff, increasing workload,
patient expectation [23], emotional demands of the role [24],
as well as others [25]. Research is supported by latest figures
showing anxiety, stress, and depression are among the most
reported reason for sickness absence in the NHS, account-
ing for 24.9% of absence in the year preceding September
2022 [26]. The issues pertaining to employee well-being
have been acknowledged by the development of the “NHS
workforce health and wellbeing framework” [27], although
the outcomes of this are unclear at present. While there is
extensive research around employee well-being [28], there
are calls for deeper consideration of psychological needs of
HCPs specifically [21,23,29]. The benefits of considering this
not only help on an individual level, but also aid health care
organizations with the economic cost of staff burnout [13].
Conceptualizing well-being is not straightforward. It is
a complex construct, subject to much academic debate
[30]. Current models of well-being tend to be grounded
on concepts of mental illness or psychological functioning
[31]. However, well-being is best described as multifaceted;
measured by a range of subjective and objective concepts
rather than one single notion [32]. Well-being is often used
interchangeably with the term “mental health.” For instance,
according to the World Health Organization (WHO), “mental
health” is “a state of well-being in which every individual
realizes his or her own potential, can cope with the normal
stresses of life, can work productively and fruitfully, and is
able to make a contribution to her or his community” [33].
It is important to note that well-being is different from the
terms “quality of life” or “health-related quality of life,” terms
that are primarily used to measure a person’s perspective of
their own life within a cultural context [34]. Furthermore
“happiness” is not conducive to well-being. Happiness is
often tied to external factors such as pursuit and fulfillment
of life goals or life events, rather than a holistic concept
such as well-being [35,36]. In terms of how we define
well-being here, there is no commonly accepted definition.
Subsequently there is no universally accepted approach to
measure it. Instead, studies of well-being are often ambig-
uous in their approach and theoretical underpinnings [37].
A systematic review of self-report measures for assessing
well-being found that while the 2 main theories referred to
were Diener’s model of subjective well-being and the WHO
definition of health, authors were very rarely obvious about
how theory had influenced the development of their tool or
study. Further, argument suggests that the 2 most popular
scales, The Warwick-Edinburgh Mental Wellbeing Scale and
the WHO Five well-being index fail to capture the holistic
nature of well-being [37].
Conceptualizing well-being is complex and often grounded
in various subjective and objective factors. Despite vari-
ous studies and tools aiming to measure well-being, none
specifically target HCPs in a comprehensive manner. Adamou
et al [31] developed a new theoretical framework of well-
being specifically with HCPs in mind. The development
of the well-being thermometer consisted of a three-step
formation: (1) understanding the concept of well-being from
existing literature and tools, (2) constructing a new frame-
work of well-being, and (3) devising a tool to measure it.
See Adamou et al [31] for further discussion of the concep-
tual development of the well-being thermometer. This study
aims to pilot a new instrument, the well-being thermometer,
specifically designed for HCPs. This tool aims to enhance
individual “well-being intelligence,” helping HCPs better
manage their mental and physical health.
Methods
The Well-Being Thermometer
Developed by Adamou et al [31], this tool incorporates 5
well-being domains—health, thoughts, emotions, spiritual,
and social. It aims to provide a comprehensive yet individu-
alized snapshot of well-being, thereby allowing for targeted
interventions.
Each of the domains comprises 5 items related to that
domain. Each domain can be reviewed individually or
collectively providing the individual with a score, allowing
reflection of overall and domain-specific well-being. The
health domain includes items which relate to the physical and
eating health. The thoughts domain relates to mental health.
Emotions domain measures the experience of emotions such
as joy, satisfaction, and frustration. Spiritual health aligns
with the connection with oneself and the meaning of life. The
social domain relates to the experience of positive relation-
ships and social networks. Total score can range from 0 to
25, with a score of 25 being the highest level of well-being.
Example statements include “I tend to dwell on things more
than I should” or “I feel there is a lot to enjoy in life.” See
Adamou et al [31] for further details.
Participants and Procedure
Doctors were recruited to participate in the well-being
survey through verbal advertisements at 2 separate events—a
diploma course in occupational medicine organized by the
Royal Society of Public Health and a Regional (Yorkshire)
Conference for Physicians organized by the Royal College of
Physicians. At each event, information was provided about
the survey’s purpose and the automatic feedback participants
would receive upon completion. The survey was administered
using an online platform, and opportunity sampling was used
to gather the cohort. Participants received an email contain-
ing a link to complete the survey online. By completing the
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survey, respondents were informed that they were consenting
to have their data included in the research.
Ethical Considerations
This project was granted ethics approval in line with the
Research Ethics Policy and Procedures at Leeds Beckett
University (138110). Consent for participation was implic-
itly granted by the subjects through their active engagement
with the survey, after being fully informed about the study’s
methodology and purpose via the online platform. Moreover,
the study ensured the privacy and confidentiality of the
participants by anonymizing or deidentifying all data used in
the research. No compensation was provided to participants,
aligning with the study’s observational and noninterventional
design.
Statistical Analysis
SPSS (version 29; IBM Corp) was used for statistical
analyses. The Kolmogorov-Smirnov Test for Goodness of Fit
determined data deviated significantly from normal distribu-
tion P<.05; therefore, nonparametric analysis was reported.
Results
Demographics
The cohort consisted of 148 physicians (without missing
data), 68 (46%) recorded female sex, 78 (53%) reported male
sex, and 2 (1%) respondents did not want to disclose gender.
Age was recorded in category format, with age range of
40‐44 years recorded most frequently. Ages ranged from 20
to 69 years. Two respondents chose not to disclose age (see
Table 1). Respondents recorded level and speciality pertain-
ing to their profession. See Table 1 for full demographic
details.
Table 1 shows the demographic information of the 148
participants who participated in this cross-sectional United
Kingdom–based study exploring the validity of the well-being
thermometer using survey data. Details include self-reported
gender, age, profession level, and speciality pertaining to their
medical career.
Table 1. Respondent demographics (N=148).
Values, n (%)
Sex
Female 68 (45.9)
Male 78 (52.7)
Prefer not to say 2 (1.4)
Missing 0 (0)
Age (years)
20‐24 2 (1.4)
25‐29 4 (2.7)
30‐34 23 (15.5)
35‐39 16 (10.8)
40‐44 33 (22.3)
45‐49 21 (14.2)
50‐54 22 (14.9)
55‐59 13 (8.8)
60‐64 7 (4.7)
65‐69 5 (3.4)
Prefer not to say 2 (1.4)
Missing 0 (0)
Level
Foundation doctor 3 (2)
Core trainee 5 (3.4)
Higher specialty trainee 20 (13.5)
SASb or nontraining grade doctors 15 (10.1)
Consultant or GPa91 (61.5)
Prefer not to say 5 (3.4)
Other 9 (6.1)
Missing 0 (0)
Specialty
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Values, n (%)
Foundation programme 1 (7)
Core medical training or internal medicine stage 1 3 (2)
Acute internal medicine 12 (8.1)
Cardiology 8 (5.4)
Endocrinology and diabetes 4 (2.7)
Gastroenterology 5 (3.4)
General internal medicine 1 (0.7)
Genitourinary medicine 11 (7.4)
Geriatric medicine 33 (22.3)
GP 22 (14.9)
Infectious diseases 3 (2)
Medical oncology 1 (0.7)
Palliative medicine 5 (3.4)
Rehabilitation medicine 1 (0.7)
Renal medicine 2 (1.4)
Respiratory medicine 14 (9.5)
Rheumatology 3 (2)
Sport and exercise medicine 1 (0.7)
Stroke medicine 4 (2.7)
Not applicable 3 (2)
Prefer not to say 6 (4.1)
Other 5 (3.4)
Missing 0 (0)
aGP: general practitioner.
bSAS: specialty and specialist.
Well-Being Scores
A total of 148 participants in this cross-sectional United
Kingdom–based study recorded an overall median score of
18 (IQR 14-22) on the well-being thermometer.
Table 2 shows the cross-sectional median and IQR
score recorded by the 148 participants of the United
Kingdom–based study of the well-being thermometer. Scores
for individual well-being domains ranged between 3 and 4.
Table 2. Scores by domain.
Domain Median (IQR)
Health 3 (2-4)
Social 3.5 (3-5)
Thoughts 4 (2-5)
Emotions 4 (3-5)
Spiritual 4 (3-5)
All domains 18 (14-22)
There was no significant effect of age, profession level, or
speciality on well-being scores, both overall and domain
specific.
Gender-Based Analysis
For the United Kingdom–based cross-sectional study
exploring the well-being thermometer, organized by gender
(N=148), the median score for men (n=78) was 20 (IQR
16-23) compared to 16 (IQR 12-20.5) for women (n=68).
Table 3 shows the median and IQR scores recorded by
the sample (N=148) on individual domains (health, social,
thoughts, emotions, and spiritual) of the well-being ther-
mometer, organized by gender. The data are derived from
a cross-sectional United Kingdom–based study exploring
the validity of the well-being thermometer. Scores ranged
between 4 and 5 for men and 3 to 4 for women.
Men reported significantly higher levels of well-being
than women overall (U=1593; P=.002). In terms of specific
well-being domains, men reported higher levels of well-being
on health (U=1979.5; P=.015), thoughts (U=1948.5; P=.019),
emotions (U=1971; P=.013), and spiritual (U=1914; P=.014)
domains, compared to women. There was also a trend for
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men to score higher on levels of social well-being (U=2109.5;
P=.05).
Table 3. Domain scores by gender.
Male (n=78) Female (n=68)
Domain Median (IQR) Median (IQR)
Health 4 (3-5) 3 (1.5-4)
Social 4 (3-5) 3 (3-4)
Thoughts 4 (2-5) 3 (2-5)
Emotions 4 (3-5) 3 (2-4)
Spiritual 5 (4-5) 4 (3-5)
All domains 20 (7) 16 (8.5)
Correlation
Table 4 demonstrates that Spearman rho identified posi-
tive relationships between scores on individual domains on
the well-being thermometer in this cross-sectional United
Kingdom–based study of HCPs (N=148). Suggesting that
higher scores on 1 domain of well-being was reflected in
other domains of well-being.
Table 4. Spearman rho.
Total for health
domain, n
Total for social
domain, n
Total for thoughts
domain, n
Total for emotions
domain, n
Total for
spiritual
domain, n
Total for health domain
Correlation coefficient —a0.399b0.376b0.468b0.400b
Significance (2-tailed) — .00 .00 .00 .00
n — 144 143 144 142
Total for social domain
Correlation coefficient 0.399b— 0.492b0.453b0.453b
Significance (2-tailed) .000 — .000 .195 .000
n 144 — 142 144 141
Total for thoughts domain
Correlation coefficient 0.376b0.492b— 0.640b0.537b
Significance (2-tailed) .000 .000 — .000 .000
n 143 142 — 143 142
Total for emotions domain
Correlation coefficient 0.468b0.453b0.640b— 0.534b
Significance (2-tailed) .000 .000 .000 — .000
n 144 144 143 — 143
Total for spiritual domain
Correlation coefficient 0.400b0.453b0.537b0.534b—
Significance (2-tailed) .000 .000 .000 .000 —
n 142 141 142 143 —
aNot applicable.
bCorrelation is significant at the .01 level (2-tailed).
Cronbach α Analysis
Cronbach α values of 0.7 are considered high levels of
internal consistency (DeVillis [38]; Kline [39]). Values above
0.5 are acceptable (Bowling [40]; Schmitt [41]). The scale
had a high level of internal consistency, as determined by a
Cronbach α of 0.872. Value would improve to α=0.878 if
question 7 (I drink more alcohol than would be considered
healthy) was removed.
Discussion
Principal Results
The aim of this study was to pilot a new instrument, the
well-being thermometer. The tool was specifically designed
for use with HCPs and was piloted here with a sam-
ple of physicians. In this cross-sectional study the well-
being thermometer demonstrated a good level of internal
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consistency. It was evident that higher scores in 1 well-being
domain correlated with higher scores on other well-being
domains. The factors of age, speciality, and professional level
had no significant effect on well-being. Results suggest that
the well-being thermometer has the potential to be a useful
and informative tool, both within clinical settings and on an
individual level.
Interpretations
The purpose of the well-being thermometer is to enhance
individual “well-being intelligence.” To aid HCPs to better
manage their mental and physical health, and to measure
well-being in a more holistic framework than popular scales
have allowed [31]. The well-being thermometer has shown to
be a valid tool for measuring well-being in HCPs. Subse-
quently, with better understanding of well-being, services
can offer better interventions, protection, and help to their
workforce, and use this information to influence policy.
The well-being thermometer also allows HCPs to identify
elements of their individual well-being which may need
attention.
Interestingly, results from this study demonstrated that
there was a difference in well-being levels between the
sexes, with men reporting higher levels of well-being than
women overall, but also on the health, thoughts, emotions,
and spiritual domains. This variable was considered impor-
tant to explore here, as men have often reported higher
levels of subjective well-being than women in numerous
previous studies [21,29,42-44]. With best evidence derived
from a large-scale study of 6397 HCPs, where men reported
significantly greater level of overall well-being than women
[45]. The findings from this study follow this trend.
Importantly, the well-being thermometer can be used to
gather intelligence of staff well-being to facilitate change
in policies and practices across health care organizations
[31]. While better well-being is a valuable goal in its own
right, HCPs should be a priority target because their roles
require frontline responsibilities toward the general public
and vulnerable populations. We have seen advancements
in medical science largely focused on patient care, often
overlooking the well-being of HCPs. This oversight has
consequences—not only are HCPs prone to mental and
physical health challenges, but the quality of patient care
also endures as a result. Such concerns are exacerbated by
unprecedented crises like the COVID-19 pandemic. HCPs
are pressured with dealing with public health crisis in real
time, in which difficult moral decision-making is associated
with significant stress, lack of control, and feelings of fear
[46]. Troublingly, the prevalence of burnout, depression, and
suicide is high for this group [47-49]. Compromised well-
being among HCPs leads to medical errors, reduced patient
safety, high rates of staff turnover, increased absence due
to sickness, and diminished patient care [12,14,50,51]. Thus,
health care organizations have a responsibility to support and
protect staff well-being for both patient and staff safety [52]
and the well-being thermometer has shown it can be a useful
tool in supporting this objective.
Limitations
Further work pertaining to the well-being thermometer should
be conducted with additional demographic information such
as race and ethnicity, as this information was not captured
here, and is a limitation of the study. A focus on threshold
analysis is also necessary to gain further insight. Also, future
work with larger samples is recommended.
Conclusions
Conceptualizing well-being remains complex and often
grounded in various subjective and objective factors, and
despite various studies and tools aiming to measure well-
being, none specifically target HCPs in a comprehensive
manner. The aim of this study was to pilot a new instru-
ment, the well-being thermometer, specifically designed for
HCPs. This study demonstrated that the well-being thermom-
eter can be used to gather intelligence of staff well-being.
This information is required to facilitate much needed change
in policies and practices across health care organizations. A
specific focus on staff well-being will benefit not only HCPs,
but also those who trust in our organizations to provide safe
and efficient health care services.
Data Availability
The datasets generated and analyzed during this study are available from the corresponding author on reasonable request.
Conflicts of Interest
None declared.
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Abbreviations
HCP: health care professional
NHS: National Health Service
WHO: World Health Organization
Edited by Amaryllis Mavragani; peer-reviewed by Konstantinos Kamposioras, Tehmina Gladman; submitted 31.10.2023;
final revised version received 04.11.2024; accepted 06.11.2024; published 09.01.2025
Please cite as:
Adamou M, Jones SL, Kyriakidou N, Mooney A, Pattani S, Roycroft M
Measuring Self-Reported Well-Being of Physicians Using the Well-Being Thermometer: Cohort Study
JMIR Form Res 2025;9:e54158
URL: https://formative.jmir.org/2025/1/e54158
doi: 10.2196/54158
© Marios Adamou, Sarah L Jones, Niki Kyriakidou, Andrew Mooney, Shriti Pattani, Matthew Roycroft. Originally published
in JMIR Formative Research (https://formative.jmir.org), 09.01.2025. This is an open-access article distributed under the terms
of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is
properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well
as this copyright and license information must be included.
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