***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: Uncertainty is a central feature of long-term childhood cancer survivorship during which time it principally has to do with late effects . Therefore , the purpose s of this article are ( a ) to assess feasibility of a r and omized clinical trial of a telephone-delivered coping skills training ( CST ) intervention in terms of recruitment , retention , and timeline , as well as the performance of the study measures ; and ( b ) to demonstrate trends in change on outcomes within the context of a small pilot study . The results of this pilot study suggest that HEROS PLUS CST has clinical relevance and that in-person long-term follow-up plus telephone-delivered psychosocial care is a practical way to deliver integrated care to adolescent — young adult childhood cancer survivors and their parents Background Since siblings of pediatric cancer patients are at risk for emotional , behavioral , and social problems , there is considerable interest in development of early psychological interventions . This paper aim ed at evaluating the effectiveness of a two-session psychological intervention for siblings of newly diagnosed pediatric cancer patients . Methods Thirty siblings age 6 - 17 years were r and omly assigned to an intervention group or an active control group with st and ard psychosocial care . The manualized intervention provided to siblings in the first 2 months after the cancer diagnosis of the ill child included medical information , promotion of coping skills , and a psychoeducational booklet for parents . At 4 to 6 weeks , 4 months , and 7 months after the diagnosis , all siblings and their parents completed measures ( from st and ardized instruments ) of social support , quality of life , medical knowledge , posttraumatic stress symptoms , and anxiety . Results At follow-up siblings in the intervention group showed better psychological well-being , had better medical knowledge , and reported receiving social support from more people . However , the intervention had no effects on posttraumatic stress symptoms and anxiety . Conclusions The results of this pilot trial suggest that a two-session sibling intervention can improve siblings ' adjustment , particularly psychological well-being , in the early stage after a cancer diagnosis . Trial Registration Clinical Trials.gov Abstract Objective The aim of the study was to investigate the feasibility and preliminary efficacy of an Internet‐based guided self‐help intervention for posttraumatic stress symptoms ( PTSS ) and related symptoms in parents of children on cancer treatment . Methods Parents of children on cancer treatment , who fulfilled the modified symptom criteria on the PTSD Checklist , were r and omly allocated to the intervention  or to a  wait‐list control condition . The intervention group accessed a 10‐week guided self‐help program via the Internet based on principles from cognitve behavior therapy . The primary outcome PTSS and the secondary outcomes depression and anxiety were assessed by self‐report preintervention and postintervention . Results Seven hundred forty‐seven parents were approached and informed about the study , 92 were assessed for eligibility , and 58 were included and r and omized to the intervention ( n = 31 ) or wait list ( n = 27 ) . Eightteen participants completed the intervention . Intention‐to‐treat analyses indicated a significant effect of the intervention on PTSS with a large between‐group effect size at post assessment ( Cohen 's d = 0.88 ) . The intervention group reported reductions in PTSS with a large within‐group effect size ( d = 1.62 ) compared with a minimal reduction in the wait‐list group ( d = 0.09 ) . There was a significant intervention effect on depression and anxiety and reductions in the intervention group with large within‐group effect sizes ( d = 0.85–1.09 ) . Conclusions Findings indicate a low enrollment rate and considerable attrition but also that Internet‐based guided self‐help shows promise for parents of children on cancer treatment who report a high level of PTSS and would like to take part in an Internet‐based intervention . © 2015 The Authors . Psycho‐Oncology published by John Wiley & Sons , BACKGROUND We conducted a prospect i ve two-group evaluation of pediatric cancer patients and their siblings regarding experiences and affective changes result ing from a 1-week summer camp experience . METHODS The patients and siblings were assessed prior to camp ( Baseline ) , at the end of camp ( Follow-up 1 ) , and again 4 - 6 months later ( Follow-up 2 ) . Assessment s included st and ardized tests for depressive affects , social competency , and a measure of pleasure and participation in camp activities . RESULTS Sixty-six children were assessed , including 31 ( 47 % ) patients and 35 ( 53 % ) siblings . Ages ranged from 7 to 17 years . Of the patient campers 19 ( 61 % ) had leukemia or lymphoma and 12 ( 39 % ) had solid tumors . Results showed marked changes in affective symptoms for patient campers over time ( improvements ) , not shown by sibling campers . For patient campers these affective changes were not present immediately after camp , but were quite significant when measured 4 - 6 months later . Both patient and sibling campers reflected the same positive memories and pleasure in camp activities over time . For neither group did memories or pleasure fade over time . The camping experience did not have differential impacts on first time versus returning campers . Twelve campers ( 18 % of sample ) indicated suicidal ideation on the measure of depressive affects . They did well at camp and presented no special management issues . CONCLUSION Expectations appear substantially different for patient versus sibling campers . The camping experience appeared to impact these groups differently , with patient campers impacted in ways not experienced by sibling campers OBJECTIVES ( 1 ) To examine the acceptability and feasibility of a stress management intervention for caregivers of children recently diagnosed with cancer . ( 2 ) To explore whether caregivers with lower baseline perceived social support derive greater benefit from the intervention than those with higher perceived support . METHODS 45 primary caregivers were r and omly assigned to intervention or st and ard care . Of these , 37 completed measures of social support , depression , anxiety , and perceived stress at both pre-intervention ( T1 ; mean = 24 days post-diagnosis ) and post-intervention time points ( T2 ; mean = 165 days post-diagnosis ) . RESULTS Enrollment , retention , and satisfaction data support feasibility and acceptability of the intervention . There was no overall significant impact of participation in the intervention on levels of distress at T2 . However , T1 social support moderated intervention response , with caregivers who perceived lower T1 support showing greater psychological benefit from the intervention . CONCLUSIONS Primary caregivers with lower levels of perceived social support may benefit from preemptive stress management intervention This study investigated a behavioral intervention incorporating parent coaching , attentional distraction , and positive reinforcement to control child distress during invasive cancer treatment . Children ( N = 23 ) requiring physical restraint to complete venipuncture were alternately assigned to either a behavioral intervention or an attention control condition .  Child distress behaviors were recorded , and self-reports of parent , child , and nurse distress were obtained . Parent and nurse also rated child distress . Results of planned comparisons indicate that observed child distress , parent-rated child distress , and parent ratings of his/her own distress were significantly reduced by behavioral intervention and were maintained across the course of three intervention trials . The use of physical restraint to manage child behavior was also significantly reduced . Child self-reported pain and nurse ratings of child distress were not significantly affected Posttraumatic stress symptoms ( PTSS ) , particularly intrusive thoughts , avoidance , and arousal , are among the most common psychological aftereffects of childhood cancer for survivors and their mothers and fathers . We conducted a r and omized wait-list control trial of a newly developed 4-session , 1-day intervention aim ed at reducing PTSS that integrates cognitive-behavioral and family therapy approaches -- the Surviving Cancer Competently Intervention Program ( SCCIP ) . Participants were 150 adolescent survivors and their mothers , fathers , and adolescent siblings . Significant reductions in intrusive thoughts among fathers and in arousal among survivors were found in the treatment group . A multiple imputations approach was used to address nonr and om missing data and indicated that treatment effects would likely have been stronger had more distressed families been retained . The data are supportive of brief interventions to reduce PTSS in this population and provide additional support for the importance of intervention for multiple members of the family OBJECTIVE To report acceptability , feasibility , and outcome data from a r and omized clinical trial ( RCT ) of a brief intervention for caregivers of children newly diagnosed with cancer . METHOD Eighty-one families were r and omly assigned following collection of baseline data to Intervention or Treatment as Usual ( TAU ) . Recruitment and retention rates and progression through the protocol were tracked . Measures of state anxiety and posttraumatic stress symptoms served as outcomes . RESULTS Difficulties enrolling participants included a high percentage of newly diagnosed families failing to meet inclusion criteria ( 40 % ) and an unexpectedly low participation rate ( 23 % ) . However , movement through the protocol was generally completed in a timely manner and those completing the intervention provided positive feedback . Outcome data showed no significant differences between the arms of the RCT . CONCLUSIONS There are many challenges inherent in conducting a RCT shortly after cancer diagnosis . Consideration of alternative research design s and optimal timing for interventions are essential next steps OBJECTIVE To document levels of stress in parents of children undergoing bone marrow transplantation ( BMT ) over the course of hospitalization and to pilot a psychological intervention program design ed to teach parents techniques for managing stress associated with their child 's illness and hospitalization . METHODS Twenty-two mothers of children ( ages 2 - 16 ) undergoing BMT  were followed prospect ively from preadmission to three weeks posttransplant . Eleven mothers , r and omly assigned to participate in a pilot intervention program , were compared with 11 control mothers receiving st and ard care preparation of their child 's BMT .  RESULTS Repeated measures ANOVAs detected significant changes in stress over time , with most stress reported preadmission . Mothers in the intervention condition reported using more stress management techniques than mothers in the st and ard care condition , though the majority of analyses revealed no significant differences in stress between groups . CONCLUSIONS Increased levels of parenting distress may occur pretransplant , suggesting the need for additional psychological intervention at that time IMPORTANCE Parent psychological distress can impact the well-being of childhood cancer patients and other children in the home . Recognizing and alleviating factors of parent distress may improve overall family survivorship experiences following childhood cancer . OBJECTIVES To describe the prevalence and factors of  psychological distress ( PD ) among parents of children with advanced cancer . DESIGN Cohort study embedded within a r and omized clinical trial ( Pediatric Quality of Life and Evaluation of Symptoms Technology [ PediQUEST ] study ) . SETTING Multicenter study conducted at 3 children 's hospitals ( Boston Children 's Hospital , Children 's Hospital of Philadelphia , and Seattle Children 's Hospital ) . PARTICIPANTS Parents of children with advanced ( progressive , recurrent , or refractory ) cancer . MAIN OUTCOME MEASURE Parental PD , as measured by the Kessler-6 Psychological Distress Scale . RESULTS Eighty-six of 104 parents completed the Survey About Caring for Children With Cancer ( 83 % participation ) ; 81 parents had complete Kessler-6 Psychological Distress Scale data . More than 50 % of parents reported high PD and 16 % met criteria for serious PD ( compared with US prevalence of 2%-3 % ) . Parent perceptions of prognosis , goals of therapy , child symptoms/suffering , and financial hardship were associated with PD . In multivariate analyses , average parent Kessler-6 Psychological Distress Scale scores were higher among parents who believed their child was suffering highly and who reported great economic hardship . Conversely , PD was significantly lower among parents whose prognostic underst and ing was aligned with concrete goals of care . CONCLUSIONS AND RELEVANCE Parenting a child with advanced cancer is strongly associated with high to severe levels of PD . Interventions aim ed at aligning prognostic underst and ing with concrete care goals and easing child suffering and financial hardship may mitigate parental PD OBJECTIVE To investigate whether adolescent siblings of childhood cancer survivors experience posttraumatic stress ( PTS ) . METHODS Participants included 78 adolescent siblings of adolescent cancer survivors who completed self-report measures of anxiety , PTS , and perceptions of the cancer experience .  RESULTS Nearly half ( 49 % ) of our sample reported mild PTS and 32 % indicated moderate to severe levels . One fourth of siblings thought their brother/sister would die during treatment ; over half found the cancer experience scary and difficult . These perceptions were related to PTS . Siblings reported more PTS symptoms than a reference group of nonaffected teens but had similar levels of general anxiety . CONCLUSIONS Levels of PTS are elevated for siblings of childhood cancer survivors . Thus , PTS may be a useful model for underst and ing siblings ' long-term reactions to cancer . Future research and clinical efforts should consider the needs of siblings of childhood cancer survivors in a family context OBJECTIVE To report initial feasibility and outcome from a pilot study of a new three-session intervention for caregivers of children newly diagnosed with cancer , Surviving Cancer Competently Intervention Program-Newly Diagnosed ( SCCIP-ND ) . METHOD Nineteen families ( 38 caregivers ) were r and omly assigned to  SCCIP-ND  or treatment as usual subsequent to learning of their child 's illness . The study design included pre- and 2-month postintervention assessment s , with state anxiety and posttraumatic stress symptoms as outcomes . Feasibility was based on therapist feedback and supervision , program evaluations , and data from study -tracking procedures . RESULTS SCCIP-ND appears to be an acceptable intervention that can be used successfully with careg 
    Output:
    
Positive effects of mild to moderate magnitude were found in the posttests for some outcome measures .
Behavioral interventions seem to be the most promising .
Interventions achieved the best results when they were long in duration and low in intensity and when they were applied to family members with young children who were undergoing medical treatment .
At follow-up , the intervention benefits were diminished .