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: PURPOSE : Rectal cancer is the most common reason for a person to undergo  ostomy surgery .  The aim of this study was to assess concerns and health-related quality of life ( HRQOL ) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer . SUBJECTS AND SETTING S : The sample comprised 57 patients at a university hospital in Gothenburg , Sweden . Their median age was 66 years ( range , 30–87 ) ; 35 men and 22 women participated in the study . METHODS : Participants prospect ively answered question naires preoperatively , and at 1 , 3 , and 6 months postoperatively . Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns , and HRQOL was evaluated using the 36-Item Short Form Health Survey . Results were compared with population norms . RESULTS : Participants expressed concerns associated with developing cancer , being a burden on others , and related to the uncertain nature of disease . Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively , but scores improved at 6 months . There were significant differences between preoperative study group scores and population norms on physical and emotional role function , social function , and for mental health domains . Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health . Participants identified good relations with significant others , social and leisure activities , psychological issues , and health as important for maintaining QOL . Obstacles to maintaining QOL included fatigue , pain , illness-induced limitations in life , and worries over what their new life would entail . CONCLUSION : Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months PURPOSE Little is known about factors associated with unmet needs for symptom management in patients with cancer . METHODS Patients with a new diagnosis of lung and colorectal cancer from the diverse nationally representative Cancer Care Outcomes Research and Surveillance cohort completed a survey approximately 5 months after diagnosis ( N = 5,422 ) . We estimated the prevalence of unmet need for symptom management , defined as patients who report that they wanted help for at least one common symptom ( pain , fatigue , depression , nausea/vomiting , cough , dyspnea , diarrhea ) during the 4 weeks before the survey but did not receive it . We identified patient factors associated with unmet need by using logistic regression with r and om effects to account for clustering within study sites . RESULTS Overall , 15 % ( 791 of 5,422 ) of patients had at least one unmet need for symptom management . Adjusting for sociodemographic and clinical factors , African American race , being uninsured or poor , having early-stage lung cancer , and the presence of moderate to severe symptoms were associated with unmet need ( all P < .05 ) . Furthermore , patients who rated their physician 's communication score < 80 ( on a 0 to 100 scale ) had adjusted rates of an unmet need for symptom management that were more than twice as high as patients who rated their physicians with a perfect communication score ( 23.1 % v 10.0 % ; P < .001 ) . CONCLUSION A significant minority of patients with newly diagnosed lung and colorectal cancer report unmet needs for symptom management . Interventions to improve symptom management should consider the importance of physician communication to the patient 's experience of disease Goals of workThis study aims to describe a pilot study of the feasibility , acceptability and likely impact of a nurse-delivered , telephone intervention to reduce unmet need and improve quality of life for surgical patients with colorectal cancer . Material s and methods The CONNECT intervention comprises five st and ardised calls over 6 months commencing on day 3 post-discharge . A prospect i ve non-r and omised control trial with patients who had surgery for colorectal cancer at Royal Prince Alfred Hospital , Sydney between July and December 2006 was conducted . Patients completed a telephone interview with an independent research er at 1 , 3 and 6 months to assess study outcomes , including unmet need ( Supportive Care Needs Survey ) , psychological distress and quality of life ( FACT-C ) . Patients ’ views of the intervention were ascertained . Main results Forty-one patients participated , 20 in the intervention period . Intervention calls were successfully completed with 85 % or more of patients at each of the five time points . Mean call duration ranged from 14–19 min with the highest number of needs ( 27 for 20 patients ) identified on day 3 . Patients indicated that the timing of the calls was appropriate and the majority ( 85 % ) felt the number of calls was sufficient . There were promising trends in outcomes . For both patient groups , there were clinical ly meaningful improvements in FACT-C scores over time , with a larger improvement in the intervention group ( 20.4 points ) than the control group ( 11.7 ) . Conclusions The CONNECT intervention was found to be feasible and acceptable to patients . A larger r and omised trial is underway to establish its effectiveness to improve patient outcomes Goals of the workMany cancer patients experience unmet needs and elevated levels of anxiety and depression . This paper describes a volunteer-delivered intervention to reduce the psychosocial needs of cancer patients and presents findings from a feasibility study of this intervention . Material s and methods The telephone-based intervention , called the Pathfinder Program , involves the assignment of volunteers to patients  to assist them in addressing their needs as identified in question naires . Fifty-two patients with colorectal cancer were involved in the feasibility study , with 18 in the intervention . Sixty-two percent of the sample was male and the mean age was 64 years . Patients ’ needs were assessed using The Supportive Care Needs Survey , a colorectal cancer symptom checklist , and the Hospital Anxiety and Depression Scale . All patients completed baseline question naires ( Time 1 ) and 47 completed Time 2 question naires 3 months later . Main results The most common needs were fear of the cancer spreading and returning , concerns about the worries of others , gas or wind , changes in weight , and bowel problems such as diarrhea , constipation , and pain . A statistically significant Time 1 to Time 2 decrease in supportive care needs and depression was found for the intervention group . Conclusions The Pathfinder Program has been found to be feasible , acceptable for patients , and has the potential to reduce needs and depression . A larger , r and omized controlled trial is needed to determine the impact of this program on colorectal symptoms and anxiety Background . Previous integrative literature review s and meta-analyses have yielded conflicting results regarding the effectiveness of  psychosocial interventions for cancer patients . Methods . An integrative review of the literature focused on 19 r and omized , controlled trials ( 2006–2011 ) was completed to examine the effectiveness of psychosocial interventions for cancer patients . Eligibility criteria : Inclusion criteria were the study was an English language r and omized controlled clinical trial . Results . Seven studies involved nurses . Eleven studies result ed in positive outcomes . Overall , study quality was limited . In eight studies the intervention was not adequately described , 7 studies did not contain a hypothesis , 4 did not include clear eligibility criteria , 10 studies did not r and omize appropriately , 9 did not list recruitment date s , 11 did not include a power analysis , 14 did not include blinded patients or data collectors , 11 did not use an intent-to-treat analysis , 10 did not clarify reasons for drop outs , and 11 did not discuss treatment fidelity . Conclusions . Future studies should build on previous findings , use comparable outcome measures , and adhere to st and ards of quality research . Qualitative studies are needed to determine what cancer patients of varied ages , cancer stages , and racial/ethnic background s believe would be an effective intervention to manage their psychosocial needs Purpose Cancer is primarily a disease of ageing , yet the unmet supportive care needs of older cancer patients are not well understood . This study aims to explore how unmet needs differ by age over the 3 months following colorectal cancer surgery . Methods Control groups from pilot phases of an ongoing r and omised trial completed the Supportive Care Needs Survey-Short Form 34 ( SCNS-SF34 ) at 1 and 3 months following hospital discharge  ( n = 57 ) . Multiple regression was used to investigate whether age was an independent predictor of unmet needs in each of the five SCNS-SF34 domains . The proportion of patients with unmet needs and the pattern of item responses were compared between patients aged < 65 and ≥65 years at both time points . Results Older age independently predicted significantly lower levels of unmet need than younger age in nearly all SCNS-SF34 domains . However , more than half of all older patients had unmet needs at both time points ( 56 % and 65 % ) , and age differences in unmet needs were less apparent by 3 months . Older patients were less likely than younger patients to report ‘ satisfied ’ needs , as older patients were significantly more likely to report items were ‘ not applicable ’ at both 1 month ( mean difference 29 % , p < 0.001 ) and 3 months ( mean difference 23 % , p = 0.01 ) . Conclusions While older patients reported lower levels of unmet need than younger patients , the high prevalence of unmet needs and age differences in item response patterns indicate that further research is needed to determine whether older patients ' needs are being accurately captured Purpose This study investigated psychological morbidity , quality of life ( QoL ) , colorectal cancer (CRC)-specific symptoms and supportive care needs in a CRC population at the end of treatment ( EOT ) . Methods CRC survivors ( n = 152 ) completed a post-treatment baseline question naire as part of a multisite supportive care r and omised controlled trial ( SurvivorCare ) . CRC survivors had completed treatment with curative intent within 0 to 6 months . Measures are as follows : Brief Symptom Inventory 18 ( BSI-18 ) ( psychological morbidity ) , EORTC QLQ-C30 and QLQ-CR29 ( QoL and CRC-specific symptoms and problems ) and Cancer Survivors ’ Unmet Needs ( CaSUN ) measure with a simplified response format ( unmet needs ) . Linear regression models were used to compare participants ’ QoL with a general population sample . Correlation analysis examined associations between psychological morbidity , QoL and CRC-specific symptoms and problems . Results Average participant age was 64 years , and 51 % were male . The majority ( 68 % ) had stage 3 disease . In comparison to population norms , CRC survivors had lower depression and anxiety scores ( 47.4 and 45.6 , respectively ) but higher somatisation , and lower role , cognitive and social functioning ( p < 0.001 ) . CRC survivors had higher fatigue , nausea/vomiting , appetite loss , diarrhoea and financial problems ( all p < 0.001 ) , as well as pain ( p = 0.002 ) and constipation ( p = 0.019 ) . CRC-specific psychological scores were positively correlated with all three BSI domain scores , and pain and fatigue symptom scores on the QLQ-C30 while negatively correlated with all five functional scales of the QLQ-C30 . Conclusions CRC survivors reported good mental health at EOT . Role and social functioning were impaired compared to population norms , possibly related to physical symptoms . Implication s for Cancer Survivors Findings may help guide consultations with patients and inform the design of more tailored supportive care interventions .Trial registration : PURPOSE OF THE RESEARCH To investigate the prevalence and nature of unmet needs among colorectal cancer ( CRC ) survivors and the relationship between needs and quality of life ( QoL ) . METHODS AND SAMPLE Using the Northern Irel and Cancer Registry ( NICR ) as a sampling frame and working in collaboration with primary care physicians or GPs , the Cancer Survivors Unmet Needs ( CaSUN ) question naire and the Quality of Life in Adult Cancer Survivors Scale ( QLACS ) were posted to a r and omly selected sample of 600 CRC survivors . KEY RESULTS Approximately 69 % ( 413/600 ) met eligibility criteria for participating in the study ; and 30 % ( 124/413 ) responded to the survey . A comparative analysis of NICR data between respondents and non-respondents did not indicate any systematic bias except that respondents appeared to be younger ( 65 years vs. 67 years ) . Approximately 60 % of respondents reported having no unmet needs , with 40 % reporting one or more unmet health and social care needs such as fear of recurrence , information needs , difficulty obtaining travel insurance and car parking problems . QoL was significantly lower for CRC survivors who reported an unmet need . Highest scores ( poorer QoL ) were reported for fatigue , welfare benefits and distress recurrence . CONCLUSIONS Overall , the majority of CRC survivors who had care needs appeared to have needs that were mainly psychosocial in nature and these unmet needs were related to poorer Background : Colorectal cancer ( CRC ) is the most common cancer affecting both men and women in Australia . The illness and related treatments can cause distressing adverse effects , impact on emotional and psychological well-being , and adversely affect social , occupational , and relationship functioning . Current models of follow-up fail to address the complex needs arising after treatment completion . Strategies to better prepare and support survivors are urgently required . Objectives : This study aim ed to develop and pilot test an innovative supportive care program for people with potentially curative CRC . Methods : The SurvivorCare intervention was developed by a multidisciplinary team using 3 key principles : ( 1 ) promote patient involvement and engagement ; ( 2 ) address the specific needs of individual patients , and ( 3 ) use evidence -based strategies to promote well-being and reduce treatment sequelae . It also 
    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: PURPOSE : Rectal cancer is the most common reason for a person to undergo  ostomy surgery .  The aim of this study was to assess concerns and health-related quality of life ( HRQOL ) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer . SUBJECTS AND SETTING S : The sample comprised 57 patients at a university hospital in Gothenburg , Sweden . Their median age was 66 years ( range , 30–87 ) ; 35 men and 22 women participated in the study . METHODS : Participants prospect ively answered question naires preoperatively , and at 1 , 3 , and 6 months postoperatively . Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns , and HRQOL was evaluated using the 36-Item Short Form Health Survey . Results were compared with population norms . RESULTS : Participants expressed concerns associated with developing cancer , being a burden on others , and related to the uncertain nature of disease . Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively , but scores improved at 6 months . There were significant differences between preoperative study group scores and population norms on physical and emotional role function , social function , and for mental health domains . Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health . Participants identified good relations with significant others , social and leisure activities , psychological issues , and health as important for maintaining QOL . Obstacles to maintaining QOL included fatigue , pain , illness-induced limitations in life , and worries over what their new life would entail . CONCLUSION : Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months PURPOSE Little is known about factors associated with unmet needs for symptom management in patients with cancer . METHODS Patients with a new diagnosis of lung and colorectal cancer from the diverse nationally representative Cancer Care Outcomes Research and Surveillance cohort completed a survey approximately 5 months after diagnosis ( N = 5,422 ) . We estimated the prevalence of unmet need for symptom management , defined as patients who report that they wanted help for at least one common symptom ( pain , fatigue , depression , nausea/vomiting , cough , dyspnea , diarrhea ) during the 4 weeks before the survey but did not receive it . We identified patient factors associated with unmet need by using logistic regression with r and om effects to account for clustering within study sites . RESULTS Overall , 15 % ( 791 of 5,422 ) of patients had at least one unmet need for symptom management . Adjusting for sociodemographic and clinical factors , African American race , being uninsured or poor , having early-stage lung cancer , and the presence of moderate to severe symptoms were associated with unmet need ( all P < .05 ) . Furthermore , patients who rated their physician 's communication score < 80 ( on a 0 to 100 scale ) had adjusted rates of an unmet need for symptom management that were more than twice as high as patients who rated their physicians with a perfect communication score ( 23.1 % v 10.0 % ; P < .001 ) . CONCLUSION A significant minority of patients with newly diagnosed lung and colorectal cancer report unmet needs for symptom management . Interventions to improve symptom management should consider the importance of physician communication to the patient 's experience of disease Goals of workThis study aims to describe a pilot study of the feasibility , acceptability and likely impact of a nurse-delivered , telephone intervention to reduce unmet need and improve quality of life for surgical patients with colorectal cancer . Material s and methods The CONNECT intervention comprises five st and ardised calls over 6 months commencing on day 3 post-discharge . A prospect i ve non-r and omised control trial with patients who had surgery for colorectal cancer at Royal Prince Alfred Hospital , Sydney between July and December 2006 was conducted . Patients completed a telephone interview with an independent research er at 1 , 3 and 6 months to assess study outcomes , including unmet need ( Supportive Care Needs Survey ) , psychological distress and quality of life ( FACT-C ) . Patients ’ views of the intervention were ascertained . Main results Forty-one patients participated , 20 in the intervention period . Intervention calls were successfully completed with 85 % or more of patients at each of the five time points . Mean call duration ranged from 14–19 min with the highest number of needs ( 27 for 20 patients ) identified on day 3 . Patients indicated that the timing of the calls was appropriate and the majority ( 85 % ) felt the number of calls was sufficient . There were promising trends in outcomes . For both patient groups , there were clinical ly meaningful improvements in FACT-C scores over time , with a larger improvement in the intervention group ( 20.4 points ) than the control group ( 11.7 ) . Conclusions The CONNECT intervention was found to be feasible and acceptable to patients . A larger r and omised trial is underway to establish its effectiveness to improve patient outcomes Goals of the workMany cancer patients experience unmet needs and elevated levels of anxiety and depression . This paper describes a volunteer-delivered intervention to reduce the psychosocial needs of cancer patients and presents findings from a feasibility study of this intervention . Material s and methods The telephone-based intervention , called the Pathfinder Program , involves the assignment of volunteers to patients  to assist them in addressing their needs as identified in question naires . Fifty-two patients with colorectal cancer were involved in the feasibility study , with 18 in the intervention . Sixty-two percent of the sample was male and the mean age was 64 years . Patients ’ needs were assessed using The Supportive Care Needs Survey , a colorectal cancer symptom checklist , and the Hospital Anxiety and Depression Scale . All patients completed baseline question naires ( Time 1 ) and 47 completed Time 2 question naires 3 months later . Main results The most common needs were fear of the cancer spreading and returning , concerns about the worries of others , gas or wind , changes in weight , and bowel problems such as diarrhea , constipation , and pain . A statistically significant Time 1 to Time 2 decrease in supportive care needs and depression was found for the intervention group . Conclusions The Pathfinder Program has been found to be feasible , acceptable for patients , and has the potential to reduce needs and depression . A larger , r and omized controlled trial is needed to determine the impact of this program on colorectal symptoms and anxiety Background . Previous integrative literature review s and meta-analyses have yielded conflicting results regarding the effectiveness of  psychosocial interventions for cancer patients . Methods . An integrative review of the literature focused on 19 r and omized , controlled trials ( 2006–2011 ) was completed to examine the effectiveness of psychosocial interventions for cancer patients . Eligibility criteria : Inclusion criteria were the study was an English language r and omized controlled clinical trial . Results . Seven studies involved nurses . Eleven studies result ed in positive outcomes . Overall , study quality was limited . In eight studies the intervention was not adequately described , 7 studies did not contain a hypothesis , 4 did not include clear eligibility criteria , 10 studies did not r and omize appropriately , 9 did not list recruitment date s , 11 did not include a power analysis , 14 did not include blinded patients or data collectors , 11 did not use an intent-to-treat analysis , 10 did not clarify reasons for drop outs , and 11 did not discuss treatment fidelity . Conclusions . Future studies should build on previous findings , use comparable outcome measures , and adhere to st and ards of quality research . Qualitative studies are needed to determine what cancer patients of varied ages , cancer stages , and racial/ethnic background s believe would be an effective intervention to manage their psychosocial needs Purpose Cancer is primarily a disease of ageing , yet the unmet supportive care needs of older cancer patients are not well understood . This study aims to explore how unmet needs differ by age over the 3 months following colorectal cancer surgery . Methods Control groups from pilot phases of an ongoing r and omised trial completed the Supportive Care Needs Survey-Short Form 34 ( SCNS-SF34 ) at 1 and 3 months following hospital discharge  ( n = 57 ) . Multiple regression was used to investigate whether age was an independent predictor of unmet needs in each of the five SCNS-SF34 domains . The proportion of patients with unmet needs and the pattern of item responses were compared between patients aged < 65 and ≥65 years at both time points . Results Older age independently predicted significantly lower levels of unmet need than younger age in nearly all SCNS-SF34 domains . However , more than half of all older patients had unmet needs at both time points ( 56 % and 65 % ) , and age differences in unmet needs were less apparent by 3 months . Older patients were less likely than younger patients to report ‘ satisfied ’ needs , as older patients were significantly more likely to report items were ‘ not applicable ’ at both 1 month ( mean difference 29 % , p < 0.001 ) and 3 months ( mean difference 23 % , p = 0.01 ) . Conclusions While older patients reported lower levels of unmet need than younger patients , the high prevalence of unmet needs and age differences in item response patterns indicate that further research is needed to determine whether older patients ' needs are being accurately captured Purpose This study investigated psychological morbidity , quality of life ( QoL ) , colorectal cancer (CRC)-specific symptoms and supportive care needs in a CRC population at the end of treatment ( EOT ) . Methods CRC survivors ( n = 152 ) completed a post-treatment baseline question naire as part of a multisite supportive care r and omised controlled trial ( SurvivorCare ) . CRC survivors had completed treatment with curative intent within 0 to 6 months . Measures are as follows : Brief Symptom Inventory 18 ( BSI-18 ) ( psychological morbidity ) , EORTC QLQ-C30 and QLQ-CR29 ( QoL and CRC-specific symptoms and problems ) and Cancer Survivors ’ Unmet Needs ( CaSUN ) measure with a simplified response format ( unmet needs ) . Linear regression models were used to compare participants ’ QoL with a general population sample . Correlation analysis examined associations between psychological morbidity , QoL and CRC-specific symptoms and problems . Results Average participant age was 64 years , and 51 % were male . The majority ( 68 % ) had stage 3 disease . In comparison to population norms , CRC survivors had lower depression and anxiety scores ( 47.4 and 45.6 , respectively ) but higher somatisation , and lower role , cognitive and social functioning ( p < 0.001 ) . CRC survivors had higher fatigue , nausea/vomiting , appetite loss , diarrhoea and financial problems ( all p < 0.001 ) , as well as pain ( p = 0.002 ) and constipation ( p = 0.019 ) . CRC-specific psychological scores were positively correlated with all three BSI domain scores , and pain and fatigue symptom scores on the QLQ-C30 while negatively correlated with all five functional scales of the QLQ-C30 . Conclusions CRC survivors reported good mental health at EOT . Role and social functioning were impaired compared to population norms , possibly related to physical symptoms . Implication s for Cancer Survivors Findings may help guide consultations with patients and inform the design of more tailored supportive care interventions .Trial registration : PURPOSE OF THE RESEARCH To investigate the prevalence and nature of unmet needs among colorectal cancer ( CRC ) survivors and the relationship between needs and quality of life ( QoL ) . METHODS AND SAMPLE Using the Northern Irel and Cancer Registry ( NICR ) as a sampling frame and working in collaboration with primary care physicians or GPs , the Cancer Survivors Unmet Needs ( CaSUN ) question naire and the Quality of Life in Adult Cancer Survivors Scale ( QLACS ) were posted to a r and omly selected sample of 600 CRC survivors . KEY RESULTS Approximately 69 % ( 413/600 ) met eligibility criteria for participating in the study ; and 30 % ( 124/413 ) responded to the survey . A comparative analysis of NICR data between respondents and non-respondents did not indicate any systematic bias except that respondents appeared to be younger ( 65 years vs. 67 years ) . Approximately 60 % of respondents reported having no unmet needs , with 40 % reporting one or more unmet health and social care needs such as fear of recurrence , information needs , difficulty obtaining travel insurance and car parking problems . QoL was significantly lower for CRC survivors who reported an unmet need . Highest scores ( poorer QoL ) were reported for fatigue , welfare benefits and distress recurrence . CONCLUSIONS Overall , the majority of CRC survivors who had care needs appeared to have needs that were mainly psychosocial in nature and these unmet needs were related to poorer Background : Colorectal cancer ( CRC ) is the most common cancer affecting both men and women in Australia . The illness and related treatments can cause distressing adverse effects , impact on emotional and psychological well-being , and adversely affect social , occupational , and relationship functioning . Current models of follow-up fail to address the complex needs arising after treatment completion . Strategies to better prepare and support survivors are urgently required . Objectives : This study aim ed to develop and pilot test an innovative supportive care program for people with potentially curative CRC . Methods : The SurvivorCare intervention was developed by a multidisciplinary team using 3 key principles : ( 1 ) promote patient involvement and engagement ; ( 2 ) address the specific needs of individual patients , and ( 3 ) use evidence -based strategies to promote well-being and reduce treatment sequelae . It also 
    Output:
    