***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: Abstract OBJECTIVE : Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer , with particular emphasis on assisting the underserved . DESIGN : R and omized controlled trial conducted between 1995 and 1998 . SETTING : Five sites : two teaching hospitals ( Madison , Wis , and Chicago , Ill ) , two nonteaching hospitals ( Chicago , Ill ) , and a cancer re source center ( Indianapolis , Ind ) . The latter three sites treat many underserved patients . PARTICIPANTS : Newly diagnosed breast cancer patients ( N=246 ) under age 60 . INTERVENTIONS : Experimental group received Comprehensive Health Enhancement Support System ( CHESS ) , a home-based computer system providing information , decision-making , and emotional support . MEASUREMENTS AND MAIN RESULTS : Pretest and two posttest surveys ( at two- and five-month follow-up ) measured aspects of participation in care , social/information support , and quality of life . At two-month follow-up , the CHESS group was significantly more competent at seeking information , more comfortable participating in care , and had greater confidence in doctor(s ) . At five-month follow-up , the CHESS group had significantly better social support and also greater information competence . In addition , experimental assignment interacted with several indicators of medical underservice ( race , education , and lack of insurance ) , such that CHESS benefits were greater for the disadvantaged than the advantaged group . CONCLUSIONS : Computer-based patient support systems such as CHESS may benefit patients by providing information and social support , and increasing their participation in health care . These benefits may be largest for currently underserved population PURPOSE To evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue .  PATIENTS AND METHODS This r and omized controlled trial involved 109 women commencing adjuvant chemotherapy for stage I or II breast cancer in five chemotherapy treatment centers . Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10- to 20-minute sessions 1 week apart . Instruments included a numeric rating scale assessing confidence with managing fatigue ; 11-point numeric rating scales measuring fatigue at worst , average , and best ; the Functional Assessment of Cancer Therapy-Fatigue and Piper Fatigue Scales ; the Cancer Self-Efficacy Scale ; the European Organisation for Research and Treatment of Cancer Quality of Life Question naire C30 ; and the Hospital Anxiety and Depression Scale . For each outcome , separate analyses of covariance of change scores between baseline ( T1 ) and the three follow-up time points ( T2 , T3 , and T4 ) were conducted , controlling for the variable 's corresponding baseline value . RESULTS Compared with the intervention group , mean difference scores between the baseline ( T1 ) and immediate after the test ( T2 ) assessment s increased significantly more for the control group for worst and average fatigue , Functional Assessment of Cancer Therapy-Fatigue , and Piper fatigue severity and interference measures . These differences were not observed between baseline and T3 and T4 assessment s. No significant differences were identified for any pre- or post-test change scores for confidence with managing fatigue , cancer self-efficacy , anxiety , depression , or quality of life . CONCLUSION Preparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term . However , further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue OBJECTIVE The aim is to evaluate the effectiveness of a manualized 12-week supportive-expressive group therapy program among primary breast cancer patients treated in community setting s , to determine whether highly distressed patients were most likely to benefit and whether therapist 's training or experience was related to outcome . METHOD Three hundred and fifty-three women within one year of diagnosis with primary breast cancer were r and omly assigned to receive supportive-expressive group therapy or to an education control condition . Participants were recruited from two academic centers and nine oncology practice s , which were members of NCI 's Community Clinical Oncology Program ( CCOP ) and were followed over 2 years . RESULTS A 2x2x19 analysis of variance was conducted with main effects of treatment condition , cohort , and baseline distress and their interactions . There was no main effect for treatment condition after removing one subject with an extreme score .  Highly distressed women did not derive a greater benefit from treatment . Therapist training and psychotherapy experience were not associated with a treatment effect . CONCLUSIONS This study provides no evidence of reduction in distress as the result of a brief supportive-expressive intervention for women with primary breast cancer . Future studies might productively focus on women with higher initial levels of distress Background : Internet-based methods for provision of psychological support and intervention to cancer survivors hold promise for increasing the public impact of such treatments . Purpose : The goal of this controlled pilot study was to examine the effect and potential mechanisms of action of a self-guided , Internet-based coping-skills training group on quality of life outcomes in women with early-stage breast cancer . Methods : Sixty-two women completed baseline evaluations and were r and omized into either a small online coping group or a waiting-list control condition . Results : No main effects for treatment were observed at the 12-week follow up . However , there was a significant interaction between baseline self-reported health status and treatment , such that women with poorer self-perceived health status showed greater improvement in perceived health over time when assigned to the treatment condition . Linguistic analyses revealed that positive changes across quality of life variables were associated with greater expression of negative emotions such as sadness and anxiety , greater cognitive processing , and lower expression of health-related concerns . Conclusions : These results demonstrate the potential efficacy of self-guided Internet coping groups while highlighting the limitations of such groups PURPOSE Evidence suggests that the re-entry phase ( ie , early period after medical treatment completion ) presents distinct challenges for cancer patients . To facilitate the transition to recovery , we conducted the Moving Beyond Cancer ( MBC ) trial , a multisite , r and omized , controlled trial of psychoeducational interventions for breast cancer patients . METHODS Breast cancer patients were registered within 6 weeks after surgery . After medical treatment , they completed baseline measures and were r and omly assigned to st and ard National Cancer Institute print material ( CTL ) ; st and ard print material and peer-modeling videotape ( VID ) ; or st and ard print material , videotape , two sessions with a trained cancer educator , and informational workbook ( EDU ) . Two primary end points were examined : energy/fatigue and cancer-specific distress . Secondary end points were depressive symptoms and post-traumatic growth . Perceived preparedness for re-entry was analyzed as a moderator of effects . RESULTS Of 558 women r and omly assigned to treatment , 418 completed the 6-month assessment and 399 completed the 12-month assessment . In analyses controlling for study site and baseline depressive symptoms , VID produced significant improvement in energy/fatigue at 6 months relative to CTL , particularly among women who felt less prepared for re-entry at baseline . No significant main effect of the interventions emerged on cancer-specific distress , but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry . Between-group differences in the primary outcomes were not significant at 12 months , and no significant effects emerged on the secondary end points . CONCLUSION A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer , particularly among those who feel less prepared for re-entry In a prospect i ve , r and omized study , an individual psychosocial support intervention performed by specially trained oncology nurses , or psychologists , were compared with st and ard care .  Consecutive primary breast cancer patients about to start adjuvant therapy ( n = 179 ) were included . Data were supplied by the question naires European Organisation for Research and Treatment of Cancer Quality of Life Study Group Core Quality of life question naire with 30 questions ( EORTC QLQ-C30 ) and Breast Cancer Module with 23 questions ( BR23 ) , the Hospital Anxiety and Depression Scale , Spielberger 's State-Trait Anxiety Inventory , and the Impact of Event Scale before r and omization and 1 , 3 , and 6 months later . Patient files provided data on utilization of psychosocial support offered in routine care . Global quality of life/health status , nausea and vomiting , and systemic therapy side effects were the subscales showing significant Group by Time interactions , favoring the interventions . Intervention groups improved statistically significantly more than the st and ard care group regarding insomnia , dyspnea , and financial difficulties . Nurse patients experienced less intrusion compared with the st and ard care group . All groups showed statistically and clinical ly significant improvements with time on several subscales . The intervention groups , however , improved to a greater extent . Fewer patients in the intervention groups used psychosocial hospital support compared with the st and ard care group . In conclusion , psychosocial support by specially trained nurses using techniques derived from cognitive behavioral therapy is beneficial for breast cancer patients and may be a realistic alternative in routine cancer care PURPOSE / OBJECTIVES To find the most effective methods of providing social support for women diagnosed with breast cancer by testing the effectiveness of a telephone social support and education intervention to promote emotional and interpersonal adaptation to breast cancer . DESIGN Multisite , two-group experimental study with repeated measures . SETTING Arkansas and New Jersey . SAMPLE The Arkansas sample consisted of 106 women who entered the study two to four weeks postsurgery for nonmetastatic breast cancer and were r and omly assigned to an experimental or control group . The comparison group consisted of 91 women from New Jersey who had participated in a previously completed study that used the same interventions and found that telephone support result ed in more positive , statistically significant adaptation to the disease . METHODS The experimental group received 13 months of telephone social support and education . Both groups received educational material s via a mailed re source kit . The Profile of Mood States ; Visual Analogue Scale-Worry ; Relationship Change Scale ; University of California , Los Angeles , Loneliness Scale-Version 3 ; and the modified Symptom Distress Scale provided data regarding the variables of interest . Data analysis included descriptive statistics , t tests , and multivariate analysis of variance with repeated measures . MAIN RESEARCH VARIABLES Mood , worry , relationships with significant others , loneliness , and symptoms . FINDINGS Data analysis showed no significant differences between groups , and both improved on some of the outcomes . Significant time-by-location interaction effects were found when comparing the Arkansas and New Jersey sample s , thereby supporting the need to consider regional differences when developing interventions . CONCLUSIONS The mailed educational re source kit alone appeared to be as effective as the telephone social support provided by oncology nurses in conjunction with the mailed re source kit . IMPLICATION S FOR NURSING Mailed educational re source kits may be the most efficient and cost-effective way to provide educational support to newly diagnosed patients with breast cancer , but their effect may differ according to region AIM This paper is a report of a study to describe the efficacy of cognitive behavioural therapy for insomnia on fatigue , mood and quality of life in breast cancer survivors . BACKGROUND Women who receive primary treatment for breast cancer often complain of insomnia . Rarely evaluated in insomnia intervention studies is the effect of cognitive behavioural treatment on the psychosocial outcomes of fatigue , mood and quality of life . METHOD Data were collected between December 2002 and March 2004 with 72 women who were at least 3 months post-completion of primary treatment without current evidence of disease . Women were r and omly assigned to either the cognitive behavioural therapy for insomnia group , which received stimulus control instructions , sleep restriction therapy and sleep education and hygiene , or the component control group which received sleep education and hygiene only . The 10-week study consisted of 2 weeks of pre-treatment , 6 weeks of treatment and 2 weeks of post-treatment . Fatigue , mood and quality of life were measured at pre- and post-treatment . FINDINGS Women receiving cognitive behavioural therapy for insomnia had significant improvements in fatigue , trait anxiety , depression and quality of life . The component control group also had statistically significant increases in quality of life , with a trend suggestive of lower depression at post-treatment . CONCLUSION Globally , as the number of survivors in this population continues to grow , it is imperative that nurses continue testing interventions that may positively affect quality of life and the commonly experienced symptoms of fatigue , anxiety and depression BACKGROUND Increasing use of anticoagulant medications , particularly antiplatelet therapies , can increase the difficulty in obtaining adequate suture line hemostasis . Multiple vascular sealants have been used as adjuncts to surgical procedures , but none of them have been universally successful . The aim of this study was to evaluate the safety and effectiveness of a new prophylactic vascular sealant in arterial surgery . METHODS A r and omized prospect i ve multi-institutional trial was undertaken comparing ArterX Vascular Sealant ( AVS ) with Gelfoam Plus during open arterial reconstruction .  RESULTS Three hundred thirty-one anastomotic sites in 217 patients were r and omized . One hundred one of 167 ( 60.5 % ) anastomotic sites in the AVS group achieved immediate hemostasis compared with 65 of 164 ( 39.6 % ) in the control group ( P = 0.001 ) . In anastomoses with polytetrafluoroethylene grafts , 105 of 167 ( 62.5 % ) in the AVS group achieved immediate hemostasis compared with 56 of 164 ( 34.0 % ) in the control group ( P < 0.001 ) . No significant differences were noted in morbidity or mortality . Operative time was significantly less in the AVS group compared with the control group ( 
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Limited documentation exists on the efficacy of psychosocial rehabilitation interventions among BC patients .
However , we found that patients might have QoL benefits from CBT given after primary BC treatment .