J Nurs Manag. 2018;1–15. wileyonlinelibrary.com/journal/jonm | 1 © 2018 John Wiley & Sons Ltd 1 | BACKGROUND Gratitude has received considerable attention over the past two decades because of its association with subjective well‐being (McCullough, Emmons, & Tsang, 2002; Wood, Froh, & Geraghty, 2010; Wood, Joseph, & Linley, 2007). A large body of evidence now indicates that gratitude is strongly related to multiple aspects of well‐being and can be positively influenced. On that basis, promis‐ ing brief clinical interventions have been developed (Bono, Emmons, & McCullough, 2012; Emmons & McCullough, 2003). However, despite burgeoning research, the phenomenon of gratitude re‐ mains conceptually confusing since it is variously characterized as a transient emotional state, a stable personality trait, and a moral vir‐ tue, as well as a habit, a coping response, an attitude and a life orien‐ tation (Emmons, 2008; Emmons & McCullough, 2003; McCullough, Kilpatrick, Emmons, & Larson, 2001; Wood et al., 2010). The most common approaches to studying gratitude involve investigating it as either a trait or as an emotion. As a trait or dis‐ position, gratitude reflects individuals’ generalized tendencies to notice and experience appreciation for the good in their daily lives (Emmons & McCullough, 2003). This trait is stable over time within individuals but varies among individuals (Roberts, 2004). As an emotion, gratitude has been conceptualized as a pleas‐ ant state; a feeling of thankfulness that arises when one recognizes Received: 11 August 2017 | Revised: 25 April 2018 | Accepted: 16 May 2018 DOI: 10.1111/jonm.12670 REVIEW ARTICLE Gratitude between patients and their families and health professionals: A scoping review Maria Aparicio 1,2 | Carlos Centeno 1,3 | Carole Robinson 4 | María Arantzamendi 1,3 1 ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain 2 St John's Hospice, London, UK 3 IdiSNA, Área Onco‐Hematología: Medicina Paliativa, Pamplona, España 4 School of Nursing, Faculty of Health and Social Development, University of British, Vancouver, British Columbia, Canada Correspondence Maria Aparicio, ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona (Navarra), Spain. Email: maria.aparicio.email@gmail.com Abstract Aim: To synthesize existing evidence regarding gratitude in health care relationships, with a specific focus on expressions of gratitude from patients and their families to health professionals, including their meaning and impact. Background: Studying expressions of gratitude by patients and their families within the scope of health care is an innovative way of identifying the most valuable ele‐ ments of care. Evaluation: A scoping review of three data bases was conducted using the terms gratitude and health professionals (1984–2016). Data were extracted, analysed the‐ matically and synthesized. Key Issues: A total of 32 publications were identified, around half being opinions or reflections. Thematic analysis resulted in the identification of three themes: the char‐ acteristics of expressions of gratitude, the focus of expressions of gratitude and the effect of gratitude on health professionals. Conclusions: Expressions of gratitude by patients and their families may have an im‐ portant personal and professional effect on health professionals that is long lasting. A systematic study of its effect is needed. Implications for Nursing Management: Gratitude from patients and their families may contribute to motivation and retention among health professionals. Gratitude can be nurtured and is associated with a healthy work environment. KEYWORDS gratitude, health care relationships, health professionals, patient/family, scoping review