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: In a r and omized controlled design , this study tested the efficacy of a theoretically based uncertainty management intervention delivered to older long-term breast cancer survivors . The sample included 509 recurrence-free women ( 360 Caucasian , 149 African-American women ) with a mean age of 64 years ( S.D.=8.9 years ) who were 5 - 9 years post-treated for breast cancer . Women were r and omly assigned to either the intervention or usual care control condition . The intervention was delivered during four weekly telephone sessions , in which study nurses guided cancer survivors in the use of audiotaped cognitive-behavioral strategies to manage uncertainty about recurrence , and a self-help manual design ed to help women underst and and manage long-term treatment side effects and other symptoms . Treatment outcome data on uncertainty management were gathered at pre-intervention and 10-months afterward . Repeated measures MANOVA evaluating treatment group , ethnic group , and treatment by ethnic interaction effects indicated that training in uncertainty management result ed in improvements in cognitive reframing , cancer knowledge , patient-health care provider communication , and a variety of coping skills . Results are discussed in terms of the importance of theory-based interventions for cancer survivors that target triggers of uncertainty about recurrence and in terms of ethnic differences in response to the intervention 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 Introduction Self-management has been identified as an important opportunity to improve health outcomes among cancer survivors . However , few evidence -based interventions are available to meet this need . Methods The effectiveness of an adapted version of the Chronic Disease Self-Management Program for cancer survivors called Cancer Thriving and Surviving was evaluated in a r and omized trial . Outcomes were assessed at baseline and 6-months post program via written survey among 244 participants in Colorado . Repeated measures analysis was used to analyze pre/post program change . Results Statistically significant improvement was observed among those in the intervention in the following outcomes : Provider communication ( + 16.7 % change ) ; depression ( −19.1 % ) ; energy ( + 13.8 % ) ; sleep ( −24.9 % ) and stress-related problems ( −19.2 % ) ; change over time was also observed in the controls for energy , sleep , and stress-related outcomes though to a lesser degree . Effect sizes of the difference in change over time observed indicate a net beneficial effect for provider communication ( 0.23 ) ; and decreases in depression ( −0.18 ) ; pain ( −0.19 ) ; problems related to stress ( −0.17 ) ; and sleep ( −0.20 ) . Conclusion Study data suggest that the self-management support from adaptation of the CDSMP can reach and appeal to cancer survivors , improves common concerns in this population , and can fill an important gap in meeting the ongoing need for management of post-diagnosis issues in this growing segment of the U.S. population Until now , little research has been conducted examining the reactive dimension , or the degree to which a symptom limits an individual 's life , in a multiplicity of symptoms . This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations . The purpose was threefold : to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer , who are receiving chemotherapy ; to determine , after adjusting for covariates , how symptom limitations change over time ; and to describe which symptoms are most limiting . This r and omized control trial was conducted in two comprehensive and four community cancer centers . Two hundred thirty-seven individuals , aged 31 - 87 , newly diagnosed with solid tumor cancers , participated . The experimental group ( 118 individuals ) received a 10-contact , 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms . The control group ( 119 individuals ) received conventional care . Interviews occurred at baseline , 10 , 20 , and 32 weeks . Data analysis used a two-level hierarchical linear model . Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group . At the onset of the study , younger patients reported more symptom limitations than their older counterparts ; however , this was reversed by the end of the study . The cognitive behavioral intervention was key to decreasing symptom limitations . Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations Background : Recent literature has indicated that a significant percentage of oncology patients describe finding some benefit ( e.g. , improved personal growth , sense of meaning , and enhanced interpersonal relationships ) in the cancer experience . However , few studies have investigated the role of group-based psychosocial interventions in improving benefit finding ( BF ) , and virtually none have investigated these constructs in men . Purpose : This study examined whether a cognitive-behavioral stress management ( CBSM ) intervention improves BF and quality of life ( QoL ) in men recovering from treatment for localized prostate cancer . Methods : Participants in this study were 191 men ( M age = 65.1 ) treated with radiation or radical prostatectomy for clinical ly localized ( i.e. , Stage I or II ) prostate cancer . Participants were primarily non-Hispanic White ( 40 % ) or Hispanic ( 41 % ) , followed by Black ( 18 % ) and other ethnicity ( 1 % ) , were an average of 65.1 years old ( SD = 7.7 ) , and earned an average of $ 47,800 annually ( SD = $ 41,000 ) . Participants were r and omized to either a 10-week group-based cognitive-behavioral stress management intervention or a half-day educational seminar as a control condition . All participants provided demographic information and completed the Positive Contributions Scale-Cancer to assess BF , the Functional Assessment of Cancer Therapy to measure quality of life , and a measure of perceived stress management skills . Structural equation modeling was utilized for all analyses . Results : Results indicated that the CBSM condition led to increases in BF and QoL and that these changes were mediated by the development of stress management skills . Conclusions : Results support the use of group-based cognitive-behavioral interventions in promoting QoL and BF in this population OBJECTIVE Women with gynecological cancers have reported poor health-related quality of life ( QOL ) , with complex physical and psychological needs post-surgery and during chemotherapy treatment . There are no studies reporting interventions addressing these needs post-hospital discharge in this population . METHODS Patients were r and omized into two groups . The intervention group received 6 months of specialized care by an Advanced Practice Nurse ( APN ) ; in addition , women with high distress were evaluated and monitored by a psychiatric consultation-liaison nurse ( PCLN ) . The attention control group was assisted with symptom management by a research assistant . The effects of the 6-month intervention were evaluated using self-report question naires at baseline ( 24 - 48 h after surgery ) , 1 , 3 , and 6 months post- surgery . QOL assessment s included the Center for Epidemiological Studies -Depression Scale , the ambiguity subscale of the Mishel Uncertainty in Illness Scale , the Symptom Distress Scale , and the Short-Form Health Survey ( SF-12 ) . The sample for the longitudinal analysis included 123 who completed QOL outcome measures  across three occasions post-surgery . RESULTS The APN intervention result ed in significantly less uncertainty than the attention control intervention 6 months after surgery . When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group , the sub-group had significantly less uncertainty , less symptom distress , and better SF-12 mental and physical QOL over time . CONCLUSION Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect PURPOSE Evidence suggests that the re-entry phase ( ie , early period after medical treatment completion ) presents distinct challenges for cancer patients . To facilitate the transition to recovery , we conducted the Moving Beyond Cancer ( MBC ) trial , a multisite , r and omized , controlled trial of psychoeducational interventions for breast cancer patients . METHODS Breast cancer patients were registered within 6 weeks after surgery . After medical treatment , they completed baseline measures and were r and omly assigned to st and ard National Cancer Institute print material ( CTL ) ; st and ard print material and peer-modeling videotape ( VID ) ; or st and ard print material , videotape , two sessions with a trained cancer educator , and informational workbook ( EDU ) . Two primary end points were examined : energy/fatigue and cancer-specific distress . Secondary end points were depressive symptoms and post-traumatic growth . Perceived preparedness for re-entry was analyzed as a moderator of effects . RESULTS Of 558 women r and omly assigned to treatment , 418 completed the 6-month assessment and 399 completed the 12-month assessment . In analyses controlling for study site and baseline depressive symptoms , VID produced significant improvement in energy/fatigue at 6 months relative to CTL , particularly among women who felt less prepared for re-entry at baseline . No significant main effect of the interventions emerged on cancer-specific distress , but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry . Between-group differences in the primary outcomes were not significant at 12 months , and no significant effects emerged on the secondary end points . CONCLUSION A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer , particularly among those who feel less prepared for re-entry OBJECTIVE The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment . Patient 's age , education , and depressive symptomatology were considered as potential moderators . METHODS A secondary analysis of data of 782 patients from two r and omized clinical trials was performed . Both trials enrolled patients with solid tumors undergoing chemotherapy . After completing baseline interviews , patients were r and omized to a nurse-delivered intervention versus intervention delivered by a ' coach ' in trial I and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II . In each of the two trials , following a six-contact 8-week intervention , patients were interviewed at week 10 to assess the primary outcome of symptom severity . RESULTS Although nurse-delivered intervention proved no better than the coach or automated system in lowering symptom severity , important differences in the intervention by age were found in both trials . Patients aged ≤45 years responded better to the coach or automated system , whereas those aged ≥75 years favored the nurse . Education and depressive symptomatology did not modify the intervention effects in either of the two trials . Depressive symptomatology had a significant main effect on symptom severity at week 10 in both trials ( p = 0.03 and p < 0.01 , respectively ) . Education was not associated with symptom severity over and above age and depressive symptomatology . CONCLUSIONS Clinicians need to carefully consider the age of the population when using or testing interventions to manage symptoms among cancer patients 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 
    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: In a r and omized controlled design , this study tested the efficacy of a theoretically based uncertainty management intervention delivered to older long-term breast cancer survivors . The sample included 509 recurrence-free women ( 360 Caucasian , 149 African-American women ) with a mean age of 64 years ( S.D.=8.9 years ) who were 5 - 9 years post-treated for breast cancer . Women were r and omly assigned to either the intervention or usual care control condition . The intervention was delivered during four weekly telephone sessions , in which study nurses guided cancer survivors in the use of audiotaped cognitive-behavioral strategies to manage uncertainty about recurrence , and a self-help manual design ed to help women underst and and manage long-term treatment side effects and other symptoms . Treatment outcome data on uncertainty management were gathered at pre-intervention and 10-months afterward . Repeated measures MANOVA evaluating treatment group , ethnic group , and treatment by ethnic interaction effects indicated that training in uncertainty management result ed in improvements in cognitive reframing , cancer knowledge , patient-health care provider communication , and a variety of coping skills . Results are discussed in terms of the importance of theory-based interventions for cancer survivors that target triggers of uncertainty about recurrence and in terms of ethnic differences in response to the intervention 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 Introduction Self-management has been identified as an important opportunity to improve health outcomes among cancer survivors . However , few evidence -based interventions are available to meet this need . Methods The effectiveness of an adapted version of the Chronic Disease Self-Management Program for cancer survivors called Cancer Thriving and Surviving was evaluated in a r and omized trial . Outcomes were assessed at baseline and 6-months post program via written survey among 244 participants in Colorado . Repeated measures analysis was used to analyze pre/post program change . Results Statistically significant improvement was observed among those in the intervention in the following outcomes : Provider communication ( + 16.7 % change ) ; depression ( −19.1 % ) ; energy ( + 13.8 % ) ; sleep ( −24.9 % ) and stress-related problems ( −19.2 % ) ; change over time was also observed in the controls for energy , sleep , and stress-related outcomes though to a lesser degree . Effect sizes of the difference in change over time observed indicate a net beneficial effect for provider communication ( 0.23 ) ; and decreases in depression ( −0.18 ) ; pain ( −0.19 ) ; problems related to stress ( −0.17 ) ; and sleep ( −0.20 ) . Conclusion Study data suggest that the self-management support from adaptation of the CDSMP can reach and appeal to cancer survivors , improves common concerns in this population , and can fill an important gap in meeting the ongoing need for management of post-diagnosis issues in this growing segment of the U.S. population Until now , little research has been conducted examining the reactive dimension , or the degree to which a symptom limits an individual 's life , in a multiplicity of symptoms . This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations . The purpose was threefold : to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer , who are receiving chemotherapy ; to determine , after adjusting for covariates , how symptom limitations change over time ; and to describe which symptoms are most limiting . This r and omized control trial was conducted in two comprehensive and four community cancer centers . Two hundred thirty-seven individuals , aged 31 - 87 , newly diagnosed with solid tumor cancers , participated . The experimental group ( 118 individuals ) received a 10-contact , 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms . The control group ( 119 individuals ) received conventional care . Interviews occurred at baseline , 10 , 20 , and 32 weeks . Data analysis used a two-level hierarchical linear model . Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group . At the onset of the study , younger patients reported more symptom limitations than their older counterparts ; however , this was reversed by the end of the study . The cognitive behavioral intervention was key to decreasing symptom limitations . Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations Background : Recent literature has indicated that a significant percentage of oncology patients describe finding some benefit ( e.g. , improved personal growth , sense of meaning , and enhanced interpersonal relationships ) in the cancer experience . However , few studies have investigated the role of group-based psychosocial interventions in improving benefit finding ( BF ) , and virtually none have investigated these constructs in men . Purpose : This study examined whether a cognitive-behavioral stress management ( CBSM ) intervention improves BF and quality of life ( QoL ) in men recovering from treatment for localized prostate cancer . Methods : Participants in this study were 191 men ( M age = 65.1 ) treated with radiation or radical prostatectomy for clinical ly localized ( i.e. , Stage I or II ) prostate cancer . Participants were primarily non-Hispanic White ( 40 % ) or Hispanic ( 41 % ) , followed by Black ( 18 % ) and other ethnicity ( 1 % ) , were an average of 65.1 years old ( SD = 7.7 ) , and earned an average of $ 47,800 annually ( SD = $ 41,000 ) . Participants were r and omized to either a 10-week group-based cognitive-behavioral stress management intervention or a half-day educational seminar as a control condition . All participants provided demographic information and completed the Positive Contributions Scale-Cancer to assess BF , the Functional Assessment of Cancer Therapy to measure quality of life , and a measure of perceived stress management skills . Structural equation modeling was utilized for all analyses . Results : Results indicated that the CBSM condition led to increases in BF and QoL and that these changes were mediated by the development of stress management skills . Conclusions : Results support the use of group-based cognitive-behavioral interventions in promoting QoL and BF in this population OBJECTIVE Women with gynecological cancers have reported poor health-related quality of life ( QOL ) , with complex physical and psychological needs post-surgery and during chemotherapy treatment . There are no studies reporting interventions addressing these needs post-hospital discharge in this population . METHODS Patients were r and omized into two groups . The intervention group received 6 months of specialized care by an Advanced Practice Nurse ( APN ) ; in addition , women with high distress were evaluated and monitored by a psychiatric consultation-liaison nurse ( PCLN ) . The attention control group was assisted with symptom management by a research assistant . The effects of the 6-month intervention were evaluated using self-report question naires at baseline ( 24 - 48 h after surgery ) , 1 , 3 , and 6 months post- surgery . QOL assessment s included the Center for Epidemiological Studies -Depression Scale , the ambiguity subscale of the Mishel Uncertainty in Illness Scale , the Symptom Distress Scale , and the Short-Form Health Survey ( SF-12 ) . The sample for the longitudinal analysis included 123 who completed QOL outcome measures  across three occasions post-surgery . RESULTS The APN intervention result ed in significantly less uncertainty than the attention control intervention 6 months after surgery . When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group , the sub-group had significantly less uncertainty , less symptom distress , and better SF-12 mental and physical QOL over time . CONCLUSION Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect PURPOSE Evidence suggests that the re-entry phase ( ie , early period after medical treatment completion ) presents distinct challenges for cancer patients . To facilitate the transition to recovery , we conducted the Moving Beyond Cancer ( MBC ) trial , a multisite , r and omized , controlled trial of psychoeducational interventions for breast cancer patients . METHODS Breast cancer patients were registered within 6 weeks after surgery . After medical treatment , they completed baseline measures and were r and omly assigned to st and ard National Cancer Institute print material ( CTL ) ; st and ard print material and peer-modeling videotape ( VID ) ; or st and ard print material , videotape , two sessions with a trained cancer educator , and informational workbook ( EDU ) . Two primary end points were examined : energy/fatigue and cancer-specific distress . Secondary end points were depressive symptoms and post-traumatic growth . Perceived preparedness for re-entry was analyzed as a moderator of effects . RESULTS Of 558 women r and omly assigned to treatment , 418 completed the 6-month assessment and 399 completed the 12-month assessment . In analyses controlling for study site and baseline depressive symptoms , VID produced significant improvement in energy/fatigue at 6 months relative to CTL , particularly among women who felt less prepared for re-entry at baseline . No significant main effect of the interventions emerged on cancer-specific distress , but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry . Between-group differences in the primary outcomes were not significant at 12 months , and no significant effects emerged on the secondary end points . CONCLUSION A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer , particularly among those who feel less prepared for re-entry OBJECTIVE The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment . Patient 's age , education , and depressive symptomatology were considered as potential moderators . METHODS A secondary analysis of data of 782 patients from two r and omized clinical trials was performed . Both trials enrolled patients with solid tumors undergoing chemotherapy . After completing baseline interviews , patients were r and omized to a nurse-delivered intervention versus intervention delivered by a ' coach ' in trial I and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II . In each of the two trials , following a six-contact 8-week intervention , patients were interviewed at week 10 to assess the primary outcome of symptom severity . RESULTS Although nurse-delivered intervention proved no better than the coach or automated system in lowering symptom severity , important differences in the intervention by age were found in both trials . Patients aged ≤45 years responded better to the coach or automated system , whereas those aged ≥75 years favored the nurse . Education and depressive symptomatology did not modify the intervention effects in either of the two trials . Depressive symptomatology had a significant main effect on symptom severity at week 10 in both trials ( p = 0.03 and p < 0.01 , respectively ) . Education was not associated with symptom severity over and above age and depressive symptomatology . CONCLUSIONS Clinicians need to carefully consider the age of the population when using or testing interventions to manage symptoms among cancer patients 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 
    Output:
    