***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background In the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout , aim ed at facilitating return to work ( RTW ) by job-person match through patient-supervisor communication , was evaluated . We hypothesised that the intervention group would show a more successful RTW than a control group . Methods In a prospect i ve controlled study , subjects were identified by the regional social insurance office 2 - 6 months after the first day on sick leave . The intervention group ( n = 74 ) was compared to a  control group who had declined participation , being matched by length of sick leave ( n = 74 ) . The RTW was followed up , using sick-listing register data , until 1.5 years after the time of intervention . Results There was a linear increase of RTW in the intervention group during the 1.5-year follow-up period , and 89 % of subjects had returned to work to some extent at the end of the follow-up period . The increase in RTW in the control group came to a halt after six months , and only 73 % had returned to work to some extent at the end of the 1.5-year follow-up . Conclusions We conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout . Trial registration Current Controlled Trials NCT01039168 Objective To study the implementation of multidisciplinary structured work shift evaluations at a pediatric intensive care unit ( PICU ) to enhance team communication . Design and setting Prospect i ve , repeated measurements design , comparison of pre/post measurements and process measures in a Dutch tertiary care , university-affiliated PICU . Participants All 61 PICU staff members . Interventions Implementing multidisciplinary structured work shift evaluations . Before the implementation phase the PICU team received feedback training and eight participants ( four physicians , four nurses ) were trained as “ work shift evaluation leader .  ” Measurements and results Outcome measures covered : ( a ) quality and process of the implementation through prestructured checklists during the 3 months of implementation , ( b ) a subjective evaluation of a feedback training on team communication as anticipated action and on the level of communication ( about patients and with colleagues ) , and ( c ) emotional exhaustion complaints and work-related fatigue . The interdisciplinary structured work shift evaluations were implemented successfully as planned during the work shift ; all staff were trained ahead , and the process was followed almost completely . Almost two-thirds ( 62 % ) of the staff felt a positive influence on team communication . Almost all staff members ( 92 % ) were satisfied regarding communication with their colleagues after the intervention , compared to 76 % before . Emotional exhaustion in the PICU team decreased significantly after the implementation , but no differences in work-related fatigue levels were found . Conclusions As organizational change the implementation of a multidisciplinary structured work shift evaluation at a PICU was successful and team communication improved . Emotional exhaustion decreased during the study period During the preparation of a prospect i ve study of exhaustion as a precursor of myocardial infa rct ion ( MI ) , the authors found that many coronary patients said that they had been burned out at some time in their lives . Therefore , the question , " Have you ever been burned out ? " was included in the study . The cohort was formed by 3,877 men , aged 39 to 65 , and was followed up on for 4.2 years . Among the men who were free of coronary heart disease ( CHD ) at screening , 59 subjects experienced a fatal or nonfatal myocardial infa rct ion during follow-up . Those who endorsed the above question when they entered the study were found to be at increased risk for myocardial infa rct ion when the authors controlled for age , blood pressure , smoking , and cholesterol ; RR ( relative risk ) = 2.13 ; p less than .01 . About one third of those who were exhausted before myocardial infa rct ion had been burned out at some time in their lives , chi 2 = 7.09 , p less than .01 . The data indicate that a state of exhaustion before myocardial infa rct ion is often a reactivation of earlier periods of breakdown in adaptation to stress OBJECTIVE The association between burnout and physical diseases has been studied very little . The purpose of this study was to examine the relationship between burnout and physical illness in a representative nationwide population health study . METHODS As a part of the " Health 2000 Study " in Finl and , 3368 employees aged 30 - 64 years were studied .  Burnout was assessed with the  Maslach Burnout Inventory-General Survey . Physical diseases were diagnosed in a comprehensive health examination by research physicians . RESULTS Physical illness was more common among subjects with burnout than others ( 64 % vs. 54 % , P<.0001 ) , and the prevalence of diseases increased with the severity of burnout ( P<.0001 ) . Burnout was an important correlate of cardiovascular diseases among men ( OR=1.35 ; 95 % CI , 1.13 - 1.61 ) and musculoskeletal disorders among women ( OR=1.22 , 95 % CI , 1.07 - 1.38 ) when adjusted for age , marital status , education , socioeconomic status , physical strenuousness of work , smoking , physical activity , alcohol consumption , body mass index , and depressive symptoms . The prevalence of musculoskeletal disorders and cardiovascular diseases increased with the severity of all three dimensions of burnout , that is , exhaustion ( P<.0001 and P<.001 , respectively ) , cynicism ( P=.0001 and P<.001 , respectively ) , and lack of professional efficacy ( P<.01 and P<.0001 , respectively ) . CONCLUSIONS Burnout is associated with musculoskeletal diseases among women and with cardiovascular diseases among men . These associations are not explained by sociodemographic factors , health behavior , or depression . Physical illnesses are associated with all three dimensions of burnout and not only with the exhaustion dimension . In the future , the causal relationships between burnout and physical diseases need to be investigated in prospect i ve studies In this quasi-experimental study among staff of 29 oncology wards , the authors evaluated the effects of a team-based burnout intervention program combining a staff support group with a participatory action research approach . Nine wards were r and omly selected to participate in the program . Before the program started ( Time 1 ) , directly after the program ended ( Time 2 ) , and 6 months later ( Time 3 ) , study participants filled out a question naire on their work situation and well-being . Results of multilevel analyses showed that staff in the experimental wards experienced significantly less emotional exhaustion at both Time 2 and Time 3 and less depersonalization at Time 2 , compared with the control wards . Moreover , changes in burnout levels were significantly related to changes in the perception of job characteristics over time This study was set up to test the effectiveness of primary nursing on the burnout level of psychiatric nurses .  It was expected that , under certain conditions , such as a primary nursing care delivery with an adequate feedback system , the burnout level would decrease . In a quasi-experimental research design , a cohort of 161 psychiatric nurses was followed for 2.5 years . Results showed that although the burnout level did not change as a result of primary nursing , psychiatric nurses and the practical nurses seemed able to work according to the principles of primary nursing . Strong indications were found that the job turnover decreased as a result of the introduction of primary nursing . Because two main problems were encountered in this study , a high drop-out due to job turnover among nurses and the imitation of the intervention by the control group , several additional analyses were performed 
    Output:
    
Although the risk of bias of the included studies is high , all combined interventions were effective in  facilitating rehabilitation .
Results suggest that involving employees in decision-making and enhance their job control and social support , while eliminating stressors , explain the effectiveness of the intentions .