***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: The mental health challenges of some vocations present a challenge for current intervention models . Bibliotherapy focused on transdiagnostic processes that might both prevent and alleviate a range of mental health distress could be an effective and practical approach . K-12 school personnel ( N = 236 ; 91 % female ; 30 - 60 years old ) responding to a wellness-oriented program announcement  were r and omized to receive an Acceptance and Commitment Therapy ( ACT ) self-help volume or to a waitlist . Three-fourths were above clinical cutoffs in general mental health , depression , anxiety , or stress . Participants read the book for two months , completed exercises and quizzes , and after post assessment were followed for 10 weeks ; waitlist participants were then also given the book with two months to complete it . Overall , participants showed significant improvement in psychological health . Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression , anxiety and stress . Follow up general mental health , depression , and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility Background Physicians , particularly in hospitals , suffer from adverse working conditions . There is a close link between physicians ’ psychosocial work environment and the quality of the work they deliver . Our study aim ed to explore whether a participatory work- design intervention involving hospital physicians is effective in improving working conditions and quality of patient care . Methods A prospect i ve , controlled intervention study was conducted in two surgical and two internal departments . Participants were 57 hospital physicians and 1581 in patients . The intervention was a structured , participatory intervention based on continuous group meetings . Physicians actively analyzed problematic working conditions , developed solutions , and initiated their implementation . Physicians ’ working conditions and patients ’ perceived quality of care were outcome criteria . These variables were assessed by st and ardized question naires . Additional data on implementation status were gathered through interviews . Results Over the course of ten months , several work-related problems were identified , categorized , and ten solutions were implemented . Post-intervention , physicians in the intervention departments reported substantially less conflicting dem and s and enhanced quality of cooperation with patients ’ relatives , compared to control group physicians . Moreover , positive changes in enhanced colleague support could be attributed to the intervention . Regarding patient reports of care quality of care , patient ratings of physicians organization of care improved for physicians in the intervention group . Five interviews with involved physicians confirm the plausibility of obtained results , provide information on implementation status and sustainability of the solutions , and highlight process-related factors for re- design interventions to improve hospital physicians work . Conclusions This study demonstrates that participatory work design for hospital physicians is a promising intervention for improving working conditions and promoting patient quality of care There have been few prospect i ve studies of the impact of workplace interventions on employee and organizational well-being within health care setting s. This study was conducted at a large regional hospital in Sweden in 1994 with a follow-up in 1995 . Effects of a structured organizational and staff intervention program on perceived psychosocial work quality , supporting re sources and self-reported health and well-being were evaluated . Based on department-specific results from the baseline assessment in 1994 , each department formulated their own improvement goals . They also made their own decisions on relevant improvement activities . Since there was no formal reference group in this study , departments with high and low rating levels , respectively , with regard to intervention activities were compared . Despite an overall worsening in most of the measures most likely due to a notice of 20 % staff reduction prior to the follow-up assessment , the intervention appeared to have attenuated negative changes in the high as compared with the low activity group . Manager-rated impact of the program as well as positive staff attitudes and staff involvement in the enhancement process were identified as important determinants for more favourable changes . The study points out the relevance of structured workplace interventions for organizational and employee well-being especially in times of cut-backs and organizational turmoil . Department-specific factors will determine the impact of such programs . The study indicates that the psychosocial impact of personnel cut-backs in health care may be attenuated through management initiatives Part III of the study on mindfulness-based stress reduction ( MBSR ) describes qualitative data and discusses the implication s of the findings . Study analysis revealed that nurses found MBSR helpful . Greater relaxation and self-care and improvement in work and family relationships were among reported benefits . Challenges included restlessness , physical pain , and dealing with difficult emotions Aims : To investigate if workplace interventions result ed in changes in the psychosocial work environment . Process evaluation was conducted to study the implementation process and to use this knowledge to underst and the results . Methods : Seven intervention units ( n = 128 ) and seven non-r and omized reference units ( n = 103 ) of a large hospital in Denmark participated in an intervention project with the goal of improving the psychosocial working conditions . The intervention consisted of discussion days for all staff , employee working groups , leader coaching , and activities to improve communication and cooperation . Measures of the psychosocial work environment were conducted before the start of the intervention and again after 16 months using 13 scales from the Copenhagen Psychosocial Question naire , version I ( COPSOQ I ) . Results : In the intervention units there was a statistically significant worsening in six out of 13 work environment scales . The decrease was most pronounced for three scales that measure aspects of interpersonal relations and leadership . In addition , all three scales that measure aspects of work organization and job content decreased . In comparison , the reference group showed statistically significant changes in only two scales . Process evaluation revealed that a large part of the implementation failed and that different implicit theories were at play . Conclusions : Without the insights gained from process data the negative effects of this intervention could not be understood . Sometimes — as it seems happened in this study — more harm can be done by disappointing expectations than by not conducting an intervention A pilot study was conducted to assess the feasibility and efficacy of massage therapy for cardiac catheterization laboratory staff . Staff members ( N = 50 ) were r and omly assigned to 5 or 10 weekly 30-min massages , followed by outcomes assessment . A control group ( n = 10 ) receiving no massage therapy  underwent comparable assessment . Visual analog scales , the t test , and the repeated measures model evaluated fatigue , pain , relaxation , stress/anxiety , tension/discomfort , and scheduling ease at baseline , 5 weeks , and 10 weeks . The Aickin separation test was used to assess feasibility of further research . Overall , 90 % ( 337/375 ) of massage appointments were used . No significant effects were observed , but the Aickin separation test supported further research on massage therapy for fatigue , pain , relaxation , and tension/discomfort . Conducting massage therapy in the workplace is logistically feasible . Larger , longitudinal trials are warranted to better evaluate its effects on staff A means- goals analysis requires a plan with some degree of distinctness , which is worked out beforeh and and specifies reasonably clear goals and intended means . This article draws its material from a broadly design ed strategy for organizational change that meets these criteria . A service division of Swedish Telecom underwent a program of comprehensive organizational change ; major efforts were made to improve the occupational health of 300 telephone operators in manual service operations . Over a full three-year period , a number of specific problems were to be resolved . An independent research team evaluated the implementation of the program prospect ively . The team followed an evaluation model in which stringent distinction was made between : ( 1 ) action areas , ( 2 ) intended specific means , ( 3 ) intended immediate goals , and ( 4 ) the longer-term favorable effects of achieving these immediate goals . In addition , an attempt was made to interpret and underst and the findings of the means- goals evaluation by paying systematic attention to the implementation process and factors that might permit an underst and ing of the final outcomes of the program . Compared with other efforts to improve telephone operators ' work conditions as reported in the research literature , this strategy for the promotion of change is broad and ambitious 
    Output:
    
The findings suggest that there is great heterogeneity in methods and process variables used in process evaluations of SMI .