***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: There is today a wide consensus regarding the need to improve communication skills ( CS ) of health-care professionals ( HCPs ) dealing with cancer patients .  Psychological training programs ( PTPs ) may be useful to acquire the needed CS . Testing the efficacy of PTP will allow to define their optimal content . The present study was design ed to assess the impact of a PTP on HCP stress , attitudes and CS , and on HCP and patients ' satisfaction with HCP communication skills in a r and omised study . A total of 115 oncology nurses were r and omly assigned to a 105-h PTP or to a waiting list .  Stress was assessed with the Nursing Stress Scale , attitudes with a Semantic Differential Question naire , CS used during one simulated and one actual patient interview with the Cancer Research Campaign Workshop Evaluation Manual , and satisfaction with the nurses ' CS with a question naire completed by the patients and the nurses . Trained ( TG ) and control ( CG ) groups were compared at baseline , after 3 months ( just following training for TG ) and after 6 months ( 3 months after the end of training for TG ) . Compared to controls , trained nurses reported positive changes on their stress levels ( P⩽0.05 ) and on their attitudes ( P⩽0.05 ) . Positive training effects were found on CS used during the simulated interview : a significant increase in facilitative behaviours ( open questions : P⩽0.001 ; evaluative functions : P⩽0.05 ) and a significant decrease in inhibitory behaviours ( inappropriate information : P⩽0.01 ; false reassurance : P⩽0.05 ) . Less positive training effects were found regarding interviews with a cancer patient : a significant increase in educated guesses ( P⩽0.001 ) was noticed . No training effect was observed on nurses ' satisfaction levels , but a positive training effect was found on patients ' satisfaction levels ( P⩽0.01 ) . Although results outline PTP efficacy , they indicate the need to design PTP , amplifying the transfer of learned CS to clinical practice Background Physicians often experience work-related stress that may lead to personal harm and impaired professional performance . Biofeedback has been used to manage stress in various population s. Objective To determine whether a biofeedback-based stress management tool , consisting of rhythmic breathing , actively self-generated positive emotions and a portable biofeedback device , reduces physician stress . Design R and omized controlled trial measuring efficacy of a stress-reduction intervention over 28 days , with a 28-day open-label trial extension to assess effectiveness . Setting Urban tertiary care hospital . Participants Forty staff physicians ( 23 men and 17 women ) from various medical practice s ( 1 from primary care , 30 from a medical specialty and 9 from a surgical specialty ) were recruited by means of electronic mail , regular mail and posters placed in the physicians ’ lounge and throughout the hospital . Intervention Physicians in the intervention group were instructed to use a biofeedback-based stress management tool three times daily . Participants in both the control and intervention groups received twice-weekly support visits from the research team over 28 days , with the intervention group also receiving re-inforcement in the use of the stress management tool during these support visits . During the 28-day extension period , both the control and the intervention groups received the intervention , but without intensive support from the research team . Main outcome measure Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians ( maximum score 200 ) . Results During the r and omized controlled trial ( days 0 to 28 ) , the mean stress score declined significantly for the intervention group ( change –14.7 , st and ard deviation [ SD ] 23.8 ; p = 0.013 ) but not for the control group ( change –2.2 , SD 8.4 ; p = 0.30 ) . The difference in mean score change between the groups was 12.5 ( p = 0.048 ) . The lower mean stress scores in the intervention group were maintained during the trial extension to day 56 . The mean stress score for the control group changed significantly during the 28-day extension period ( change –8.5 , SD 7.6 ; p < 0.001 ) . Conclusion A biofeedback-based stress management tool may be a simple and effective stress-reduction strategy for physicians Background Caring for a person with dementia can be physically and emotionally dem and ing , with many long-term care facility staff experiencing increased levels of stress and burnout . Massage has been shown to be one way in which nurses ’ stress can be reduced . However , no research has been conducted to explore its effectiveness for care staff working with older people with dementia in long-term care facilities . Methods This was a pilot , parallel group , r and omized controlled trial aim ed at exploring feasibility for a larger r and omized controlled trial . Nineteen staff , providing direct care to residents with dementia and regularly working ≥ two day-shifts a week , from one long-term care facility in Queensl and ( Australia ) , were r and omized into either a foot massage intervention ( n=9 ) or a silent resting control ( n=10 ) . Each respective session lasted for 10-min , and participants could receive up to three sessions a week , during their allocated shift , over four-weeks . At pre- and post-intervention , participants were assessed on self-report outcome measures that rated mood state and experiences of working with people with dementia . Immediately before and after each intervention/control session , participants had their blood pressure and anxiety measured . An Intention To Treat framework was applied to the analyses . Individual qualitative interviews were also undertaken to explore participants ’ perceptions of the intervention . Results The results indicate the feasibility of undertaking such a study in terms of : recruitment ; the intervention ; timing of intervention ; and completion rates . A change in the intervention indicated the importance of a quiet , restful environment when undertaking a relaxation intervention . For the psychological measures , although there were trends indicating improvement in mood there was no significant difference between groups when comparing their pre- and post- scores . There were significant differences between groups for diastolic blood pressure ( p= 0.04 , partial η2=0.22 ) and anxiety ( p= 0.02 , partial η2=0.31 ) , with the foot massage group experiencing greatest decreases immediately after the session . The qualitative interviews suggest the foot massage was well tolerated and although taking staff away from their work result ed in some participants feeling guilty about taking time out , a 10-min foot massage was feasible during a working shift . Conclusions This pilot trial provides data to support the feasibility of the study in terms of recruitment and consent , the intervention and completion rates . Although the outcome data should be treated with caution , the pilot demonstrated the foot massage intervention showed trends in improved mood , reduced anxiety and lower blood pressure in long-term care staff working with older people with dementia . A larger study is needed to build on these promising , but preliminary , findings .Trial registration ACTRN : ACTRN12612000659808 The study used a mixed methodology to investigate the effects of HealingTouch ( HT )  on the coping ability , self esteem and general health of undergraduate nursing students to : check the veracity of cl aims made by HT practitioners that the therapy is effective in reducing stress ; monitor the effects of HTon  participants ' scores using instruments which measure coping , self esteem and general health ; and compare objective data with subjective accounts relating to coping , self esteem and general health . Quantitative findings showed no effects of HT on the coping ability , self esteem and general health of first year students , but there were some slight effects for the third year students who were in the experimental group . Qualitative findings showed that all participants in the experimental group found the experience positive . However , conclusions may be drawn tentatively that HT is effective while acknowledging that this project 's design may have been ineffective in measuring the effects of HT , as the question naire may not have tested the actual effects of the therapy , and objective measures may be inadequate for exploring subjective experiences such as HT This clinical r and omized trial was performed with the objective to evaluate the  stress levels of the nursing staff of a hospital and analyze the effectiveness of auriculotherapy with needles and seeds . The 75 participants with mean ( 44/58.7 % ) and high ( 31/41.3 % ) scores according to the Stress Symptoms List were divided into groups ( control , needles , and seeds ) , who received eight sessions on the Shenmen , Kidney and Brainstem points and were evaluated at the baseline , fourth and eighth sessions and on the 15-day follow-up session . The analysis of variance ( ANOVA ) showed significant differences among the groups at the third assessment ( F=3.963/P=0.023 ) and follow-up ( F=6.136/P=0.003 ) . These differences occurred between the control and needle groups . The ' seeds ' and needles groups both showed differences ( p<0.05 ) at the second assessment when compared within the same group . In conclusion , auriculotherapy reduced the stress in the nursing staff  , with needles showing better results than seeds for high scores , maintaining the effects for 15 days BACKGROUND To assess possible psychophysiological changes in personnel being exposed to organizational change and to assess the effects of a structured empowerment programme . METHODS A r and omized , prospect i ve , controlled , and non-blinded intervention was carried out in two wards within a geriatric hospital . The I-ward ( intervention ) was offered a structured intervention programme with a trained , registered psychologist during 20 weekly 1-hour sessions before and after the organizational change . The C-ward ( control ) was passively attended by the same psychologist during equal time conditions .  Blood pressure as well as pulse rate were taken and blood sample s were drawn from all participants before ( 0 weeks ) , immediately after the intervention ( 20 weeks ) and after another 10 weeks ' follow-up ( 30 weeks ) . RESULTS There was a significant time x group interaction with increasing prolactin levels on the C-ward as compared to decreasing levels on the I-ward during the intervention . CONCLUSIONS Our study results suggest a picture of differentiated changes in stress hormone levels . The I-ward exhibited less psychoendocrine stress compared to the C-ward , probably due to the intervention and the possibility for personnel to influence the programme . We suggest that psychosocial empowerment programmes are beneficial when organizational changes are enacted in health care setting OBJECTIVES To estimate burnout prevalence among pediatric residents and to evaluate the impact of a brief intervention aim ed at controlling burnout . METHODS A r and omized controlled trial was conducted on 74 pediatric residents . The Maslach Burnout Inventory was administered to all subjects , and demographic information was gathered ( age , gender , children , cohabitants , and residency year ) . The experimental group ( n = 37 ) participated in self-care workshops over the course of 2 months , and the control group ( n = 37 ) did not receive any intervention . After the intervention , the  Maslach Burnout Inventory  was administered again to all participants . All potential predictors of burnout were included in a logistic regression model . The efficacy of the intervention was evaluated by the chi-square test . P values < 0.05 were considered significant . RESULTS The burnout prevalence among pediatric residents was 66 % . After controlling for age , gender , children , and cohabitants , the prevalence of burnout was significantly higher among third-year residents ( odds ratio = 11.8 ; 95 % confidence interval 2.3 - 59.3 ; p = 0.003 ) . There were no significant differences regarding burnout prevalence in the experimental group between the baseline and post-intervention periods ( p = 0.8 ) or between the two groups after intervention ( p = 0.8 ) . The only difference observed was an improvement regarding " depersonalization " in the experimental group ( p = 0.031 ) . CONCLUSIONS The burnout prevalence among pediatric residents was 66 % and was higher among third-year residents . A brief intervention was not effective in reducing burnout prevalence , despite the achievement of an improvement in " depersonalization . OBJECTIVES Improvement of psychosocial work environment has proved to be valuable for workers ' mental health . However , limited evidence is available for the effectiveness of participatory interventions . The purpose of this study was to investigate the effect on  mental health among nurses of a participatory intervention to improve the psychosocial work environment . METHODS A cluster r and omized controlled trial was conducted in hospital setting s. A total of 434 nurses in 24 units were r and omly allocated to 11 intervention units ( n=183 ) and 13 control units ( n=218 ) . A participatory program was provided to the intervention units for 6 months . Depressive symptoms as mental health status and psychosocial work environment , assessed by the Job Content Question naire , the Effort-Reward Imbalance Question naire , and the Quality Work Competence question naire , were measured before and immediately after the 6-month intervention by a self-administered question naire . RESULTS No significant intervention effect was observed for mental health status . However , significant intervention effects were observed in psychosocial work environment aspects , such as Coworker Support ( p<0.01 ) and Goals ( p<0.01 ) , and borderline significance was observed for Job Control ( p<0.10 ) . CONCLUSIONS It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment , but not mental health , among Japanese nurses Objective To evaluate an e-mental health ( EMH ) approach to workers ' health surveillance ( WHS ) targeting work functioning ( WF ) and mental health ( MH ) of healthcare professionals in a r and omised controlled trial . Methods Nurses and allied health professionals ( N = 1140 ) were cluster-r and omised at ward level to the intervention ( IG ) or control group ( CG ) . The intervention consisted of two parts : ( a ) online screening and personalised feedback on impaired WF and 
    Output:
    
Other organisational interventions were not more effective than no intervention or an alternative intervention .
There is low- quality evidence that CBT and mental and physical relaxation reduce stress more than no intervention but not more than alternative interventions .
There is also low- quality evidence that changing work schedules may lead to a reduction of stress .
Other organisational interventions have no effect on stress levels .