human
***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: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice 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 This study evaluated a supportive intervention for fatigue in patients undergoing chemotherapy . One hundred three chemotherapy-naïve patients were recruited , stratified by treatment regimen , and r and omly allocated to intervention or usual care . The intervention was conducted over three months . Recipients were provided with an investigator- design ed information pack and Fatigue Diary that they completed during the week following each treatment . Additionally , support nurses visited them monthly at home . They assessed fatigue , provided psychological support , and coached participants in self-care . The intervention group reported significantly less fatigue ( P < 0.05 ) , lower associated distress ( P < 0.05 ) , and less impact of fatigue on valued pastimes ( P < 0.05 ) than the control group . Further , they reported significantly less anxiety ( P < 0.05 ) and depression ( P < 0.05 ) and displayed more adaptive coping ( P < 0.05 ) . The intervention enabled patients to adapt to living with fatigue and contributed to their psychological/emotional well-being and ability to cope with their illness and treatment Goals of workBased on meta-analyses regarding the preparation of patients for potentially threatening medical procedures , a DVD , incorporating behavioral role modelling , was developed to prepare patients for chemotherapy and assist them to self-manage side effects . It was hypothesized that patients who watched the DVD ( vs those who did not ) would report ( 1 ) lower anxiety ; ( 2 ) higher self-efficacy related to coping with treatment side effects ; ( 3 ) fewer supportive care needs ; and ( 4 ) higher satisfaction with information received . It was further hypothesized that these effects would be stronger in those perceiving their treatment intent to be curative rather than palliative . Material s and methods Quasi-experimental design using a historical control group was employed . Participants were scheduled to receive their first ever chemotherapy treatment . Group 1 ( usual care ; n = 50 ) was prospect ively recruited before the release of the DVD and group 2 ( DVD plus usual care ; n = 50 ) after the release . Before commencing chemotherapy , all patients completed reliable and valid measures of self-efficacy , anxiety , and supportive care needs . Data was stratified according to perceived treatment intent . Independent sample t tests were performed for each group ( curative vs palliative).Main results Significant differences were found between the usual care and intervention groups : for self-perceived curative patients in relation to self-efficacy for seeking social support ( p = 0.044 ) , with increased confidence in those watching the DVD , and for self-perceived palliative patients in relation to their satisfaction with information about side effects ( p = 0.026 ) , with increased satisfaction in those watching the DVD . Overall , significant differences were found between self-perceived curative vs palliative patients on measures of self-efficacy and supportive care needs , with self-perceived curative patients reporting more confidence and fewer needs . Conclusions The educational DVD was considered highly acceptable by patients and was found to increase self-efficacy and reduce supportive care needs . Hence , it is appropriate to give to patients before face-to-face chemotherapy education . Additional pretreatment education is recommended , particularly for self-perceived palliative patients , to reduce their pretreatment anxiety and enhance their confidence in coping with treatment PURPOSE / OBJECTIVES To determine the effectiveness of informational audiotapes on self-care behaviors , state anxiety , and use of self-care behaviors ; to describe the occurrence and intensity of common side effects in patients with breast cancer . DESIGN R and omized clinical trial . SETTING Outpatient chemotherapy clinics operated by a university center in a rural area . SAMPLE 70 women receiving their first treatment of chemotherapy .  METHODS Subjects completed demographic data and the Spielberger State-Trait Anxiety instrument ( stai ) . The experimental group received two audiotapes . At one and three months , subjects completed the modified nail self-care diary  and  stai via telephone . MAIN RESEARCH VARIABLES State anxiety , side-effect severity , and use and efficacy of self-care behaviors . FINDINGS The most frequent side effects were fatigue , nausea and vomiting , and taste change . The experimental group reported symptom improvements that were not found in the control group . The experimental group increased the use of recommended self-care behaviors , whereas the control group continued to use the same self-care behaviors without effectiveness . State anxiety for both groups diminished over time ; however , anxiety in the control group was consistently higher . CONCLUSIONS Audiotapes are effective teaching tools . Self-care behaviors can be taught and can be effective in managing side effects . Anxiety was high in both groups , but the symptom decreased in the women who received audiotapes and telephone calls . IMPLICATION S FOR NURSING Constraints on nurses decrease the length of teaching time available , but audiotapes provide effective teaching and reinforcement of education . Anxiety in clinical environments interferes with patient learning . Teaching effective self-care behaviors enhances patients ' independence , comfort , control , and quality of life Outpatient chemotherapy treatment shifts the managing of side effects from health care providers to patients and families . The primary purpose of this quasi-experimental study was to determine whether women who receive an intervention of three telephone calls and oral and written self-care measures for specific side effects  will use more self-care measures and have higher effectiveness scores as measured by the  Exercise of Self-Care Question naire ( ESCQ ) after treatment 4 than women who receive st and ard care . A second purpose was to determine if women scoring higher on the  Exercise of Self-Care Agency ( ESCA ) Scale before chemotherapy used more and effective self-care measures during chemotherapy than women scoring lower on this scale . Forty-eight women beginning chemotherapy for breast cancer completed the ESCA pretreatment and were interviewed using the  ESCQ  during a sequence of therapy . The experimental group ( n = 26 ) received additional self-care measures . Subjects with higher ESCA scores before chemotherapy treatment used more  self-care measures  to alleviate chemotherapy side effects . A telephone call and written self-care measures after the second , third , and fourth chemotherapy treatments did not increase use or effectiveness of self-care measures . The implication s of assessing patients ' self-care agency before chemotherapy are discussed and a nursing intervention recommended OBJECTIVE This r and omized controlled trial aim ed to determine whether an interactive CD-ROM improved cancer patients ' recall of chemotherapy treatment information over st and ard written information , and whether demographic , cognitive , and psychological factors better predicted recall than this format of delivery . METHODS One-hundred- and -one new patients about to commence chemotherapy were r and omized to receive written information or a CD-ROM containing treatment information before giving informed consent . Patients ' recall , concentration , short-term memory , reading comprehension , anxiety , depression , and coping styles were assessed with st and ardized measures pre-treatment . Seventy-seven patients completed tests for recall of treatment information before their second chemotherapy session . RESULTS Intention-to-treat analyses indicated no significant differences between the written information and CD-ROM groups across recall questions about number of drugs received ( p=.43 ) , treatment length ( p=.23 ) , and treatment goal ( p=.69 ) . Binary logistic regressions indicated that for groups combined different variables predicted each of the recall questions . CONCLUSION An interactive CD-ROM did not improve cancer patients '  recall of treatment information enough to warrant changes in consent procedures . PRACTICE IMPLICATION S Different variables predicted recall of different treatment aspects highlighting the complex nature of attempting to improve patient recall . Attending to the effect of depression on patient knowledge and underst and ing appears paramount PURPOSE / OBJECTIVES To develop and test an interactive multimedia module prototype design ed to accommo date adults with limited literacy and without computer skills . DESIGN Experimental , r and omized , controlled , pretest , post-test . SETTING Cancer treatment centers in California , Louisiana ( pilot ) . New Hampshire , Pennsylvania , and Texas . SAMPLE Out patients who were at least 18 years old with a minimum fifth- grade reading level ; 86 experimental treatment , 88 control . METHODS Experimental treatment involved use of the interactive multimedia module ; the control group received customary Instruction . FINDINGS As compared to the control group , subjects in the experimental group had significant improvement ( p = 0.0001 ; 257 % gain ) in self-care ability regardless of age , sex race , education , geographic location , reading ability , computer experience , or preferred learning style ; a 6.515 % increase in fatigue content covered and 16.775 % Increase in instructional duration ; and significantly greater benefit from sleep-related activities and a consistent , positive pattern of self-care behavior . CONCLUSIONS The program is instructionally effective , appropriate for a wide and geographically diverse audience , and feasible for use in the ambulatory setting . IMPLICATION S FOR NURSING PRACTICE The interactive multimedia module is an effective , self-directed re source for individualized patient fatigue education Preparing cancer patients and their families for chemotherapy treatment is difficult . The challenge lies in finding ways to promote self-care and improve their ability to recall instructions . The aim of this study was to evaluate the usefulness of an educational video with regard to patients ' ability to recall and report side effects of treatment .  Patients referred for adjuvant chemotherapy for breast and colorectal cancer were r and omized to receive st and ard pre-chemotherapy education or st and ard education plus addition of a video .  Patients completed a base line question naire assessing existing knowledge and another question naire prior to the second chemotherapy cycle evaluating recall of information . Patients who watched the video were asked to assess the video after six cycles of chemotherapy .  Telephone calls to the department reporting symptoms were monitored for both groups . The video group demonstrated trends towards higher recall in information concerning fever , mouth problems , low red cell count and prevention of constipation . They more commonly telephoned reporting medical problems of nausea , vomiting and signs of infection compared with the st and ard group . In summary , our study demonstrated inclusion of video to st and ard chemotherapy education improves retention of information regarding management of predictable chemotherapy side effects and reporting of treatment-related symptoms 
    Output:
    
agent
***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: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice 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 This study evaluated a supportive intervention for fatigue in patients undergoing chemotherapy . One hundred three chemotherapy-naïve patients were recruited , stratified by treatment regimen , and r and omly allocated to intervention or usual care . The intervention was conducted over three months . Recipients were provided with an investigator- design ed information pack and Fatigue Diary that they completed during the week following each treatment . Additionally , support nurses visited them monthly at home . They assessed fatigue , provided psychological support , and coached participants in self-care . The intervention group reported significantly less fatigue ( P < 0.05 ) , lower associated distress ( P < 0.05 ) , and less impact of fatigue on valued pastimes ( P < 0.05 ) than the control group . Further , they reported significantly less anxiety ( P < 0.05 ) and depression ( P < 0.05 ) and displayed more adaptive coping ( P < 0.05 ) . The intervention enabled patients to adapt to living with fatigue and contributed to their psychological/emotional well-being and ability to cope with their illness and treatment Goals of workBased on meta-analyses regarding the preparation of patients for potentially threatening medical procedures , a DVD , incorporating behavioral role modelling , was developed to prepare patients for chemotherapy and assist them to self-manage side effects . It was hypothesized that patients who watched the DVD ( vs those who did not ) would report ( 1 ) lower anxiety ; ( 2 ) higher self-efficacy related to coping with treatment side effects ; ( 3 ) fewer supportive care needs ; and ( 4 ) higher satisfaction with information received . It was further hypothesized that these effects would be stronger in those perceiving their treatment intent to be curative rather than palliative . Material s and methods Quasi-experimental design using a historical control group was employed . Participants were scheduled to receive their first ever chemotherapy treatment . Group 1 ( usual care ; n = 50 ) was prospect ively recruited before the release of the DVD and group 2 ( DVD plus usual care ; n = 50 ) after the release . Before commencing chemotherapy , all patients completed reliable and valid measures of self-efficacy , anxiety , and supportive care needs . Data was stratified according to perceived treatment intent . Independent sample t tests were performed for each group ( curative vs palliative).Main results Significant differences were found between the usual care and intervention groups : for self-perceived curative patients in relation to self-efficacy for seeking social support ( p = 0.044 ) , with increased confidence in those watching the DVD , and for self-perceived palliative patients in relation to their satisfaction with information about side effects ( p = 0.026 ) , with increased satisfaction in those watching the DVD . Overall , significant differences were found between self-perceived curative vs palliative patients on measures of self-efficacy and supportive care needs , with self-perceived curative patients reporting more confidence and fewer needs . Conclusions The educational DVD was considered highly acceptable by patients and was found to increase self-efficacy and reduce supportive care needs . Hence , it is appropriate to give to patients before face-to-face chemotherapy education . Additional pretreatment education is recommended , particularly for self-perceived palliative patients , to reduce their pretreatment anxiety and enhance their confidence in coping with treatment PURPOSE / OBJECTIVES To determine the effectiveness of informational audiotapes on self-care behaviors , state anxiety , and use of self-care behaviors ; to describe the occurrence and intensity of common side effects in patients with breast cancer . DESIGN R and omized clinical trial . SETTING Outpatient chemotherapy clinics operated by a university center in a rural area . SAMPLE 70 women receiving their first treatment of chemotherapy .  METHODS Subjects completed demographic data and the Spielberger State-Trait Anxiety instrument ( stai ) . The experimental group received two audiotapes . At one and three months , subjects completed the modified nail self-care diary  and  stai via telephone . MAIN RESEARCH VARIABLES State anxiety , side-effect severity , and use and efficacy of self-care behaviors . FINDINGS The most frequent side effects were fatigue , nausea and vomiting , and taste change . The experimental group reported symptom improvements that were not found in the control group . The experimental group increased the use of recommended self-care behaviors , whereas the control group continued to use the same self-care behaviors without effectiveness . State anxiety for both groups diminished over time ; however , anxiety in the control group was consistently higher . CONCLUSIONS Audiotapes are effective teaching tools . Self-care behaviors can be taught and can be effective in managing side effects . Anxiety was high in both groups , but the symptom decreased in the women who received audiotapes and telephone calls . IMPLICATION S FOR NURSING Constraints on nurses decrease the length of teaching time available , but audiotapes provide effective teaching and reinforcement of education . Anxiety in clinical environments interferes with patient learning . Teaching effective self-care behaviors enhances patients ' independence , comfort , control , and quality of life Outpatient chemotherapy treatment shifts the managing of side effects from health care providers to patients and families . The primary purpose of this quasi-experimental study was to determine whether women who receive an intervention of three telephone calls and oral and written self-care measures for specific side effects  will use more self-care measures and have higher effectiveness scores as measured by the  Exercise of Self-Care Question naire ( ESCQ ) after treatment 4 than women who receive st and ard care . A second purpose was to determine if women scoring higher on the  Exercise of Self-Care Agency ( ESCA ) Scale before chemotherapy used more and effective self-care measures during chemotherapy than women scoring lower on this scale . Forty-eight women beginning chemotherapy for breast cancer completed the ESCA pretreatment and were interviewed using the  ESCQ  during a sequence of therapy . The experimental group ( n = 26 ) received additional self-care measures . Subjects with higher ESCA scores before chemotherapy treatment used more  self-care measures  to alleviate chemotherapy side effects . A telephone call and written self-care measures after the second , third , and fourth chemotherapy treatments did not increase use or effectiveness of self-care measures . The implication s of assessing patients ' self-care agency before chemotherapy are discussed and a nursing intervention recommended OBJECTIVE This r and omized controlled trial aim ed to determine whether an interactive CD-ROM improved cancer patients ' recall of chemotherapy treatment information over st and ard written information , and whether demographic , cognitive , and psychological factors better predicted recall than this format of delivery . METHODS One-hundred- and -one new patients about to commence chemotherapy were r and omized to receive written information or a CD-ROM containing treatment information before giving informed consent . Patients ' recall , concentration , short-term memory , reading comprehension , anxiety , depression , and coping styles were assessed with st and ardized measures pre-treatment . Seventy-seven patients completed tests for recall of treatment information before their second chemotherapy session . RESULTS Intention-to-treat analyses indicated no significant differences between the written information and CD-ROM groups across recall questions about number of drugs received ( p=.43 ) , treatment length ( p=.23 ) , and treatment goal ( p=.69 ) . Binary logistic regressions indicated that for groups combined different variables predicted each of the recall questions . CONCLUSION An interactive CD-ROM did not improve cancer patients '  recall of treatment information enough to warrant changes in consent procedures . PRACTICE IMPLICATION S Different variables predicted recall of different treatment aspects highlighting the complex nature of attempting to improve patient recall . Attending to the effect of depression on patient knowledge and underst and ing appears paramount PURPOSE / OBJECTIVES To develop and test an interactive multimedia module prototype design ed to accommo date adults with limited literacy and without computer skills . DESIGN Experimental , r and omized , controlled , pretest , post-test . SETTING Cancer treatment centers in California , Louisiana ( pilot ) . New Hampshire , Pennsylvania , and Texas . SAMPLE Out patients who were at least 18 years old with a minimum fifth- grade reading level ; 86 experimental treatment , 88 control . METHODS Experimental treatment involved use of the interactive multimedia module ; the control group received customary Instruction . FINDINGS As compared to the control group , subjects in the experimental group had significant improvement ( p = 0.0001 ; 257 % gain ) in self-care ability regardless of age , sex race , education , geographic location , reading ability , computer experience , or preferred learning style ; a 6.515 % increase in fatigue content covered and 16.775 % Increase in instructional duration ; and significantly greater benefit from sleep-related activities and a consistent , positive pattern of self-care behavior . CONCLUSIONS The program is instructionally effective , appropriate for a wide and geographically diverse audience , and feasible for use in the ambulatory setting . IMPLICATION S FOR NURSING PRACTICE The interactive multimedia module is an effective , self-directed re source for individualized patient fatigue education Preparing cancer patients and their families for chemotherapy treatment is difficult . The challenge lies in finding ways to promote self-care and improve their ability to recall instructions . The aim of this study was to evaluate the usefulness of an educational video with regard to patients ' ability to recall and report side effects of treatment .  Patients referred for adjuvant chemotherapy for breast and colorectal cancer were r and omized to receive st and ard pre-chemotherapy education or st and ard education plus addition of a video .  Patients completed a base line question naire assessing existing knowledge and another question naire prior to the second chemotherapy cycle evaluating recall of information . Patients who watched the video were asked to assess the video after six cycles of chemotherapy .  Telephone calls to the department reporting symptoms were monitored for both groups . The video group demonstrated trends towards higher recall in information concerning fever , mouth problems , low red cell count and prevention of constipation . They more commonly telephoned reporting medical problems of nausea , vomiting and signs of infection compared with the st and ard group . In summary , our study demonstrated inclusion of video to st and ard chemotherapy education improves retention of information regarding management of predictable chemotherapy side effects and reporting of treatment-related symptoms 
    Output:
    