***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: 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 OBJECTIVE Psychosocial interventions are historically underutilized by cancer caregivers , but support programs delivered flexibly over the Internet address multiple barriers to care . We adapted Meaning-Centered Psychotherapy for  cancer caregivers , an in-person psychotherapeutic intervention intended to augment caregivers ' sense of meaning and purpose and ameliorate burden , for delivery in a self-administered web-based program , the Care for the Cancer Caregiver ( CCC ) Workshop . The present study evaluated the feasibility , acceptability , and preliminary effects of this program . METHODS Eighty-four caregivers were r and omized to the CCC Workshop or waitlist control arm .  Quantitative assessment s of meaning , burden , anxiety , depression , benefit finding , and spiritual well-being were conducted preintervention ( T1 ) , within 2-weeks postintervention ( T2 ) , and 2- to 3-month follow-up ( T3 ) . In-depth semistructured interviews were conducted with a subset of participants . RESULTS Forty-two caregivers were r and omized to the CCC Workshop .  Attrition was moderate at T2 and T3 , with caregiver burden and bereavement as key causes of drop-out . At T2 and T3 , some observed mean change scores and effect sizes were consistent with hypothesized trends ( eg , meaning in caregiving , benefit finding , and depressive symptomatology ) , though no pre-post significant differences emerged between groups . However , a longitudinal mixed-effects model found significant differential increases in benefit finding in favor of the CCC arm . CONCLUSIONS The CCC Workshop was feasible and acceptable . Based on effect sizes reported here , a larger study will likely establish the efficacy of the CCC Workshop , which has the potential to address unmet needs of caregivers who underutilize in-person supportive care services CONTEXT Dignity therapy ( DT ) is a psychotherapeutic intervention with increasing evidence of acceptability and utility in palliative care setting s. OBJECTIVES The aim of this study was to evaluate the legacy creation component of DT by comparing this intervention with life review ( LR ) and waitlist control ( WC ) groups . METHODS Seventy adults with advanced terminal disease were r and omly allocated to DT , LR , or WC followed by DT , of which 56 completed the study protocol . LR followed an identical protocol to DT except that no legacy document was created in LR . Primary outcome measures were the Brief Generativity and Ego-Integrity Question naire , Patient Dignity Inventory , Functional Assessment of Cancer Therapy-General , version 4 , and treatment evaluation question naires . RESULTS Unlike LR and WC groups , DT recipients demonstrated significantly increased generativity and ego-integrity scores at study completion . There were no significant changes for dignity-related distress or physical , social , emotional , and functional well-being among the three groups . There were also no significant changes in primary outcomes after the provision of DT after the waiting period in the WC group . High acceptability and satisfaction with interventions were noted for recipients of both DT and LR and family/carers of DT participants . CONCLUSION This study provides initial evidence that the specific process of legacy creation is able to positively affect sense of generativity , meaning , and acceptance near end of life . High acceptability and satisfaction rates for both DT and LR and positive impacts on families/carers of DT participants provide additional support for clinical utility of these interventions . Further evaluation of specific mechanisms of change post-intervention is required given DT 's uncertain efficacy on other primary outcomes BACKGROUND The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors ( MCGP-CS ) to improve personal meaning , compared with supportive group psychotherapy ( SGP ) and care as usual ( CAU ) . METHOD A total of 170 cancer survivors were r and omly assigned to one of the three study arms : MCGP-CS ( n = 57 ) ; SGP ( n = 56 ) ; CAU ( n = 57 ) . The primary outcome measure was the Personal Meaning Profile ( PMP ; total score ) . Secondary outcome measures were subscales of the PMP , psychological well-being ( Scales of Psychological Well-being ; SPWB ) , post-traumatic growth ( Posttraumatic Growth Inventory ) , Mental Adjustment to Cancer ( MAC ) , optimism ( Life Orientation Test-Revised ) , hopelessness ( Beck 's Hopelessness Scale ) , psychological distress ( anxiety and depression , Hospital Anxiety and Depression Scale ; HADS ) and quality of life ( European Organization for Research and Treatment of Cancer Quality of Life Question naire ; EORTC QLQ-C30 ) . Outcome measures were assessed before r and omization , post-intervention , and after 3 and 6 months of follow-up ( FU ) . RESULTS Linear mixed model analyses ( intention-to-treat ) showed significant differences between MCGP-CS , SGP and CAU on the total PMP score , and on (sub)scales of the PMP , SPWB , MAC and HADS . Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning ( d = 0.81 ) , goal -orientedness ( d = 1.07 ) , positive relations ( d = 0.59 ) , purpose in life ( d = 0.69 ) ; fighting spirit ( d = 0.61 ) ( post-intervention ) and helpless/hopeless ( d = -0.87 ) ( 3 months FU ) ; and distress ( d = -0.6 ) and depression ( d = -0.38 ) ( 6 months FU ) . Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth ( d = 0.57 ) ( 3 months FU ) and environmental mastery ( d = 0.66 ) ( 6 months FU ) . CONCLUSIONS MCGP-CS is an effective intervention for cancer survivors to improve personal meaning , psychological well-being and mental adjustment to cancer in the short term , and to reduce psychological distress in the long run OBJECTIVE This pilot study aim ed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention ( MMi ) in patients newly diagnosed with Stage III or IV ovarian cancer , and to provide estimates of parameters needed to design a full-scale study . METHODS A r and omized controlled trial with 24 patients ( 12 experimental and 12 control ) was conducted . Existential well-being ( primary outcome ) , overall quality of life , distress , anxiety , depression and self-efficacy were measured . RESULTS Compared to the control group , patients in the experimental group had a better sense of meaning in life at one and three months post-intervention . CONCLUSION The MMi seems a promising intervention for advanced cancer patients , and a full r and omized controlled trial is warranted to further investigate its efficacy PURPOSE To compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope : mindfulness-based cancer recovery ( MBCR ) and supportive-expressive group therapy ( SET ) . PATIENTS AND METHODS This multisite , r and omized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR , SET , or a 1-day stress management control condition . MBCR focused on training in mindfulness meditation and gentle yoga , whereas SET focused on emotional expression and group support . Both intervention groups included 18 hours of professional contact . Measures were collected at baseline and after intervention by assessors blind to study condition . Primary outcome measures were mood and diurnal salivary cortisol slopes . Secondary outcomes were stress symptoms , quality of life , and social support . RESULTS Using linear mixed-effects models , in intent-to-treat analyses , cortisol slopes were maintained over time in both SET ( P = .002 ) and MBCR ( P = .011 ) groups relative to the control group , whose cortisol slopes became flatter . Women in MBCR improved more over time on stress symptoms compared with women in both the SET ( P = .009 ) and control ( P = .024 ) groups . Per- protocol analyses showed greater improvements in the MBCR group in quality of life compared with the control group ( P = .005 ) and in social support compared with the SET group ( P = .012 ) . CONCLUSION In the largest trial to date , MBCR was superior for improving stress levels , quality of life and social support [ CORRECTED ] for distressed survivors of breast cancer . Both SET and MBCR also result ed in more normative diurnal cortisol profiles than the control condition . The clinical implication s of this finding require further investigation OBJECTIVE We developed a specific cognitive-existential intervention to improve existential distress in nonmetastatic cancer patients . The present study reports the feasibility of implementing and evaluating this intervention , which involved 12 weekly sessions in both individual and group formats , and explores the efficacy of the intervention on existential and global quality of life ( QoL ) measures . METHOD Some 33 nonmetastatic cancer patients were r and omized between the  group intervention , the individual intervention , and the usual condition of care .  Evaluation of the intervention on the existential and global QoL of patients was performed using the existential well-being subscale and the global scale of the McGill Quality of Life ( MQoL ) Question naire . RESULTS All participants agreed that their participation in the program helped them deal with their illness and their personal life . Some 88.9 % of participants agreed that this program should be proposed for all cancer patients , and 94.5 % agreed that this intervention helped them to reflect on the meaning of their life . At post-intervention , both existential and psychological QoL improved in the group intervention versus usual care ( p = 0.086 and 0.077 , respectively ) . At the three-month follow-up , global and psychological QoL improved in the individual intervention versus usual care ( p = 0.056 and 0.047 , respectively ) . SIGNIFICANCE OF RESULTS This pilot study confirms the relevance of the intervention and the feasibility of the recruitment and r and omization processes . The data strongly suggest a potential efficacy of the intervention for existential and global quality of life , which will have to be confirmed in a larger study Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more CONTEXT There is a little information about effective psychotherapies to enhance the spiritual well-being of terminally ill cancer patients . OBJECTIVES The primary aim of the study was to examine the efficacy of a one-week Short-Term Life Review for the enhancement of spiritual well-being , using a r and omized controlled trial . The secondary aim was to assess the effect of this therapy on anxiety and depression , suffering , and elements of a good death . METHODS The subjects were 68 terminally ill cancer patients r and omly allocated to a Short-Term Life- Review interview group or a control group . The patients completed question naires pre- and post-treatment , including the meaning of life domain from the Functional Assessment of Chronic Illness Therapy-Spiritual ( FACIT-Sp ) scale , the Hospital Anxiety and Depression Scale ( HADS ) , a numeric scale for psychological suffering , and items from the Good Death Inventory ( Hope , Burden , Life Completion , and Preparation ) . RESULTS The FACIT-Sp , Hope , Life Completion , and Preparation scores in the intervention group showed significantly greater improvement compared with those of the control group ( FACIT-Sp , P<0.001 ; Hope , P<0.001 ; Life Completion , P<0.001 ; and Preparation , P<0.001 ) . HADS , Burden , and Suffering scores in the intervention group also had suggested greater alleviation of suffering compared with the control group ( HADS , P<0.001 ; Burden , P<0.007 ; Suffering , P<0.001 ) . CONCLUSION We conclude that the Short-Term Life Review is effective in improving the spiritual well-being of terminally ill cancer patients , and alleviating psychosocial distress and promoting a good death Main objective To assess the ability of dignity therapy to reduce distress in advanced cancer patients . Design A phase II open-label trial . Setting Two UK National Health Service trusts . Participants 45 adults with advanced cancer . Intervention Dignity therapy : a brief palliative care psychotherapy . Methods Participants were r and omly allocated to receive the intervention plus st and ard care or st and ard care only ( control group ) . Outcomes were collected at baseline and at 1- and 4-week follow-up . 
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No significant effects were found on the remaining outcomes and time points .
Significant moderator effects were found for professional background of therapists , intervention concept , number of sessions , and setting .
This systematic review and meta- analysis provides evidence that adult patients with cancer across all stages and types benefit from existential interventions .