***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: CONTEXT Few studies consider patient 's and caregiver 's preferences when developing nonpharmacological interventions . This is important to develop acceptable and accessible nonpharmacological interventions for patients with cancer . OBJECTIVES The objective of this study was to identify the views of patients with lung cancer and their informal caregivers on the desirable components of a novel nonpharmacological intervention for the management of the symptom cluster of cough , breathlessness , and fatigue , and their needs and preferences regarding uptake and delivery of the intervention . METHODS This study was qualitative in orientation , using semistructured interviews and framework analysis to elicit the views of 37 patients with lung cancer and 23 caregivers regarding the issues that were perceived to be important regarding the development and delivery of a nonpharmacological intervention . RESULTS A number of key issues were identified that carried important implication s for patient participation and adherence to the intervention , including the perceived relevance of potential techniques ; appreciable benefits in the short term ; convenience ; variation in patient preferences ; timing of the intervention ; venue ; caregiver involvement ; the provider of the intervention , and contact with other patients . CONCLUSION The data from this study have provided insight into the key issues that are likely to influence the development , uptake , and delivery of a nonpharmacological intervention to help manage the respiratory symptom cluster of cough , breathlessness , and fatigue . It is crucial that these findings are considered when developing and modeling a nonpharmacological symptom management intervention BACKGROUND Lung cancer has high mortality rates , with up to 90 % of patients dying within one to two years of its onset . It is essential to carry out research to attempt to solve the problems . Most patients suffer serious fatigue result ing from various symptoms and its long-term treatment . Furthermore , the other related complications such as underlying disease , anemia , malnutrition , nausea , and vomiting can reduced tolerance of chemotherapy . Study showed that nurses are the only hospital staff involved in managing fatigue . As it remains unclear to how fatigue should be managed , it is important to devise a strategy for providing a better service to help these patients survive longer . OBJECTIVE To examine fatigue scores in patients with lung cancer after chemotherapy treatment  , and to compare the scores of the group receiving the multidisciplinary education program in self-care group with those of the control group . MATERIAL AND METHOD A r and omized controlled trial was conducted in two groups . The control group and the trial group were 30 patients in each . Studied aged from 45 to 65 years old who were receiving chemotherapy at the Chemotherapy Unit in the Out- Patients Department , Rajavithi Hospital . For a nine-week period , the control group received the hospital 's normal care program while the trial group received the multidisciplinary education program in self-care on fatigue . Scores were allocated to each individual to reflect their levels of fatigue , nutrition , physical fitness , and depression , compared using Independent t-test , Fisher exact test , and Mann-Whitney U-test . RESULTS Sixty patients were enrolled into the study ( mean age = 56.10 ( 45 - 65 ) , male = 68.33 % ) . The basic characteristics of each individual were not significantly different between the two groups . The mean ( + /- SD ) fatigue scores were 2.98 + /- 1.96 and 3.99 + /- 1.64 for the control and the trial group respectively , and these figures were statistically significant ( p = 0.036 ) . Nutrition scores were significantly higher in the trial group than in the control group ( p = 0.002 ) , but the other scores weight , albumin , physical fitness , and depression were not significantly different between the two groups . CONCLUSION The multidisciplinary education program in self-care results in decreased fatigue in patients with lung cancer who are receiving chemotherapy . Therefore , it is recommended that more health professionals and specialists participate actively inpatient care to respond directly to patients ' needs . This strategy should be adopted as the st and ard guideline for caring for patients with cancer who are receiving chemotherapy , and for patients with other conditions Purpose Patients with advanced cancer frequently experience anxiety , depression and poor quality of life ( QOL ) , as well as physical symptoms such as fatigue and weakness .  Physical exercise has potential to help control these symptoms but the optimal training prescription is still not clear . We performed a study comparing medical Qigong ( QG ) and st and ard endurance and strength training ( SET ) in patients with advanced stage non-small cell lung ( NSCLC ) and gastrointestinal ( GI ) cancers . Methods A r and omized , cross-over study was performed in patients with advanced NSCLC and GI cancers receiving or eligible for chemotherapy . Patients received supervised QG or SET twice-weekly for 6 weeks . Psychological functioning , QOL , symptoms and physical functioning were assessed before and after each intervention period . Results Nineteen patients completed both interventions . Comparing interventions revealed no difference between QG and SET on change in anxiety or depression scores or QOL . However , SET treatment was better at improving perceived strength ( P = 0.05 ) and walking distance ( P = 0.02 ) . The order in which interventions were performed had a significant impact on the improvement in certain symptoms ( sleep quality , breathlessness , P < 0.05 ) , QOL ( P = 0.01 ) and walking distance ( P = 0.008 ) . In all cases , the beneficial effects of the exercise interventions were markedly reduced during the second interval . Conclusions QG and SET are equivalent in their impact on many aspects of psychological function in cancer patients . However , SET leads to greater improvements in exercise capacity and helps reduce some symptoms . The reduction in beneficial effect of SET on exercise function when offered as the second intervention is a new finding that warrants further study CONTEXT Physical exercise can alleviate cancer-related fatigue . R and omized controlled trials in patients with advanced cancer are scarce . OBJECTIVES We test the impact of a structured , individual sports program on fatigue in patients with advanced cancer . METHODS Seventy-seven patients were invited to participate in this r and omized controlled trial exploring the effects of physical exercises on fatigue 12 and 24 weeks after baseline . Patients were r and omized into three groups . Group A received treatment as usual , Group B was taught a structured , individual sports program , and Group C received additional ambulatory physiotherapeutical supervision . Primary outcome was general fatigue , secondary outcomes included rate of severe general fatigue , further dimensions of the Multidimensional Fatigue Inventory ( MFI ) , as well as walking distance . RESULTS Mean score of general fatigue as well as other MFI subdimensions differed nonsignificantly between all groups at 12 weeks . However , the mental fatigue score demonstrated a statistically significant difference between the three groups . The rate of severe general fatigue was significantly reduced within Intervention Group C. Significant longitudinal change of MFI-dimension mental fatigue was found and reached the threshold for minimal clinical ly important difference , while all MFI-dimensions increased in Group A. CONCLUSION Our results imply that tumor- patients ' severe general fatigue can be reduced when patients conduct appropriate physical exercise . This study amends previous knowledge , as it describes the impact of outpatient physical exercise on fatigue in a heterogeneous patient cohort with various advanced cancer entities . Furthermore , this trial differentiates between patients with only a self-directed exercise program versus those receiving additional partially professional supervision Background : Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment . Objective : The purpose of this study was to evaluate the effectiveness of a home-based exercise training intervention , the Pro-self Fatigue Control Program on the management of cancer-related fatigue . Interventions / Methods : Participants ( N = 119 ) were r and omized into 1 of 3 groups : group 1 received the exercise prescription throughout the study ; group 2 received their exercise prescription after completing cancer treatment ; and group 3 received usual care . Patients completed the Piper Fatigue Scale , General Sleep Disturbance Scale , Center for Epidemiological Studies -Depression Scale , and Worst Pain Intensity Scale . Results : All groups reported mild fatigue levels , sleep disturbance , and mild pain , but not depression . Using multilevel regression analysis , significant linear and quadratic trends were found for change in fatigue and pain ( ie , scores increased , then decreased over time ) . No group differences were found in the changing scores over time . A significant quadratic effect for the trajectory of sleep disturbance was found , but no group differences were detected over time . No significant time or group effects were found for depression . Conclusions : Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment . The optimal timing of exercise remains to be determined . Implication s for Practice : Clinicians need to be aware that some physical activity is better than none , and there is no harm in exercise as tolerated during cancer treatment . Further analysis is needed to examine the adherence to exercise . More frequent assessment s of fatigue , sleep disturbance , depression , and pain may capture the effect of exercise The authors conducted a r and omized controlled trial to evaluate a nurse practitioner (NP)‐delivered symptom management intervention for patients initiating chemotherapy for nonmetastatic cancer . The aim was to reduce patient‐reported symptom burden by facilitating patient‐NP collaboration and the early management of symptoms Abstract Background . Patients with lung cancer are often burdened by dyspnoea , fatigue , decreased physical ability and loss of weight . Earlier studies of physical exercise of patients with COPD have shown promising results . The aim of this study was to investigate , if a well-documented COPD rehabilitation protocol can improve physical fitness and quality of life ( QoL ) in patients with lung cancer . Material and methods . Forty-five patients , with a minimum walking distance of 50 meters , absence of cognitive deficits or severe heart disease and motivated for physical training were invited to an exercise intervention .  The intervention consisted of seven weeks of twice weekly training , focusing on walking training , circuit training , h and ling of dyspnoea and instructions in daily diary-based training at home . Prior to , and after the intervention , Incremental- and Endurance Shuttle Walk Test ( ISWT and ESWT ) were performed , and pulmonary function as well as self-reported QoL ( EORTC-QLQ-C30 and LC13 ) were measured . Results . Fourteen subjects dropped out before commencement of the intervention . Seven were excluded after physiotherapeutic evaluation . Of the remaining 24 , three were excluded because of insufficient attendance ( < 65 % of scheduled exercise sessions ) thus 21 patients completed the intervention . For 17 patients with complete pre- and post intervention data , ISWT increased 9 % ( −77 to 39 % ) ( median and range ) ( p = 0.021 ) , while ESWT increased 109 % ( −70 to 432 % ) ( p = 0.002 ) . Twelve of 17 improved in ISWT , while 15 improved in ESWT . No changes in pulmonary function and improvements in QoL were observed . Conclusion . Patients with pulmonary cancer can achieve significant improvements in physical fitness measured with ISWT and ESWT after completion of the intervention program . No changes in pulmonary function and QoL were observed . In addition , we found that a large number of patients dropped out before intervention and that the patients , who succeeded , often discontinued training at home Purpose 1 ) To determine the effect of a home-based walking exercise program on the sleep quality and quality of life of cancer patients , as well as 2 ) to determine if enhanced sleep quality was associated with improvement in quality of life over time . Methods This is a prospect i ve , longitudinal , two-armed , r and omized clinical trial . Participants were recruited from oncology outpatient clinics in two university-based medical centers and were allocated to either usual care ( n = 35 ) or a home-based walking exercise intervention for 8 weeks ( n = 36 ) . Measurements included the Taiwanese version of the Pittsburgh Sleep Quality Index , the Medical Outcomes Study Short Form-36 , the Taiwanese Version Ratings of the Perceived Exertion Scale , and a walking exercise log . This study was analyzed on an intention-to-treat basis . Effects of the walking exercise program  on sleep quality and quality of life were analyzed by the generalized estimating equation method . Results Patients in the exercise group reported significant improvements in sleep quality ( β = −3.54 , p < 0.01 ) and the mental health dimension of quality of life ( β = 10.48 , p < 0.01 ) . Among patients who exercised , enhanced sleep quality also corresponded with reduced bodily pain ( β = 0.98 , p = 0.04 ) and improvements over time in the mental health dimension of quality of life ( β = −3.87 , p < 0.01 ) . Conclusions A home-based walking exercise program can be easily incorporated into care for cancer patients who are suffering from sleep disturbances Background Previous studies showed that exercise in cancer patients is feasible and may reduce fatigue and improve physical fitness and quality of life . However , many previous studies had method ological weaknesses related to trial design , sample size , comparison group , outcome measures , short follow-up duration s and programme content . Purpose This paper aims to present the rationale and design of the clinical research subprogramme of the Alpe d’HuZes Cancer Rehabilitation ( A-CaRe ) programme . Method A-CaRe Clinical Research includes four r and omized controlled trials in patients : ( a ) after chemotherapy , ( b ) during chemotherapy , ( c ) after stem cell transplantation and ( d ) during childhood cancer . These trials compare high-intensity resistance and endurance exercise interventions with usual care or a waiting list control group . In two studies , a second intervention arm consisting of low-to-moderate intensity exercise is included . All four A-CaRe trials use similar methods . Results Outcome measures are carefully chosen based on the International Classification of Functioning Disability and Health model . Measurements will be performed prior to r and omization ( T0 ) , after completion of the intervention ( T1 ) and at follow-up ( T2 ) . The primary outcome measures are cardiorespiratory fitness , muscle strength and fatigue . Secondary outcome measures include health-related quality of life and psychosocial functioning . Furthermore 
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CONCLUSION The application of behavioural change tools appears sub-optimal in this group of patients .
Explicit use of BCTs targeting behavioural components upon which outcomes depend may improve the uptake and effectiveness of rehabilitation interventions