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: CONTEXT Dignity therapy ( DT ) is a psychotherapeutic intervention with increasing evidence of acceptability and utility in palliative care setting s. OBJECTIVES The aim of this study was to evaluate the legacy creation component of DT by comparing this intervention with life review ( LR ) and waitlist control ( WC ) groups . METHODS Seventy adults with advanced terminal disease were r and omly allocated to DT , LR , or WC followed by DT , of which 56 completed the study protocol . LR followed an identical protocol to DT except that no legacy document was created in LR . Primary outcome measures were the Brief Generativity and Ego-Integrity Question naire , Patient Dignity Inventory , Functional Assessment of Cancer Therapy-General , version 4 , and treatment evaluation question naires . RESULTS Unlike LR and WC groups , DT recipients demonstrated significantly increased generativity and ego-integrity scores at study completion . There were no significant changes for dignity-related distress or physical , social , emotional , and functional well-being among the three groups . There were also no significant changes in primary outcomes after the provision of DT after the waiting period in the WC group . High acceptability and satisfaction with interventions were noted for recipients of both DT and LR and family/carers of DT participants . CONCLUSION This study provides initial evidence that the specific process of legacy creation is able to positively affect sense of generativity , meaning , and acceptance near end of life . High acceptability and satisfaction rates for both DT and LR and positive impacts on families/carers of DT participants provide additional support for clinical utility of these interventions . Further evaluation of specific mechanisms of change post-intervention is required given DT 's uncertain efficacy on other primary outcomes OBJECTIVE This pilot study aim ed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention ( MMi ) in patients newly diagnosed with Stage III or IV ovarian cancer , and to provide estimates of parameters needed to design a full-scale study . METHODS A r and omized controlled trial with 24 patients ( 12 experimental and 12 control ) was conducted . Existential well-being ( primary outcome ) , overall quality of life , distress , anxiety , depression and self-efficacy were measured . RESULTS Compared to the control group , patients in the experimental group had a better sense of meaning in life at one and three months post-intervention . CONCLUSION The MMi seems a promising intervention for advanced cancer patients , and a full r and omized controlled trial is warranted to further investigate its efficacy BACKGROUND We developed an indicated preventive life- review course , " Looking for Meaning " , based on the assumption that reminiscence styles influence coping with depressive symptoms . This study describes the impact of this course in a pragmatic r and omized controlled trial . METHODS Inclusion criteria were > 50 years , a score of 5 or higher on the Center for Epidemiological Studies Depression Scale ( CES-D ) , and no depressive disorder or psychotropic or psychological treatment . Participants were r and omized and stratified by gender : the experimental group ( N = 83 ) was offered the course and the comparison group ( N = 88 ) a movie . There were three measurements : pre-treatment , post-treatment and 6 months after post-treatment . Depressive symptoms constituted the primary outcome . Secondary outcomes were anxiety symptoms , satisfaction with life , mastery and reminiscence styles . All analyses were conducted according to the intention-to-treat principle . Missing values were replaced by regression imputation . RESULTS The course reduced depressive symptoms , a decrease that was retained during follow-up . A significant between-group effect size was found ( d = 0.58 ) . There was also a reduction in symptoms of anxiety ; however , the comparison group showed the same reduction , result ing in a small between-group effect size . Gender and level of depressive symptoms were found to be prognostic factors for the change in depressive symptoms ; age was not . Post hoc analyses showed significant between-group effect sizes for females and those with a score above the cut-off of the CES-D. CONCLUSION The course " Looking for Meaning " can be recommended for people aged over 50 years , females and older adults with a clinical ly relevant level of depressive symptoms ( above cut-off ) in particular Palliative care is now considered an essential part of end-of-life care , yet little research examines the efficacy of interventions addressing the psychological treatment of dying patients . Forgiveness therapy has been shown to be effective in improving psychological well-being and may provide a valuable addition to a terminal cancer patient 's overall treatment plan . This study experimentally tested the effectiveness of a four-week forgiveness therapy in improving the quality of life of elderly terminally ill cancer patients . Participants ( n=20 ) were r and omly assigned to a forgiveness therapy group or to a  wait-list control group , which received forgiveness therapy in the second four-week period . All participants completed instruments measuring forgiveness , hope , quality of life , and anger at pre-test , post-test 1 , and post-test 2 . The forgiveness therapy group showed greater improvement than the control group , with one-tailed t-tests , on all measures . After receiving forgiveness therapy , participants in both forgiveness treatment conditions demonstrated significant improvements on all measures . The aggregated effect size was large . The four-week forgiveness therapy demonstrated psychological benefits for elderly terminally ill cancer patients and thus may be an appropriate addition to the treatment plan for terminal cancer patients BACKGROUND Significant palliative care intervention has focused on physical pain and symptom control ; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience . OBJECTIVE To evaluate the impact of an intervention ( Outlook ) that promotes discussion s of end-of-life preparation and completion on health outcomes in dying persons , including pain and symptoms , physical function , emotional function ( anxiety and depression ) , spiritual well-being , and quality of life at the end of life . DESIGN A three-arm pilot r and omized control trial . Subjects were recruited from inpatient and outpatient hospital , palliative care , and hospice setting s. Intervention subjects met with a facilitator three times and discussed issues related to life review , forgiveness , and heritage and legacy . Attention control subjects met with a facilitator three times and listened to a nonguided relaxation CD . True control subjects received no intervention . MEASUREMENTS Pre outcomes and post outcomes included the Memorial Symptom Assessment Scale , QUAL-E , Rosow-Breslau ADL Scale , Profile of Mood States anxiety sub-scale , the CESD short version , and the Daily Spiritual Experience Scale . RESULTS Eighty-two hospice eligible patients enrolled in the study ; 38 were women , 35 were African American . Participants ' primary diagnoses included cancer ( 48 ) , heart disease ( 5 ) lung disease ( 10 ) , and other ( 19 ) Ages ranged from 28 - 96 . Participants in the active discussion intervention showed improvements in functional status , anxiety , depression , and preparation for end of life . CONCLUSIONS The Outlook intervention was acceptable to patients from a variety of educational and ethnic background s and offers a brief , manualized , intervention for emotional and spiritual concerns PURPOSE Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer . We developed Individual Meaning-Centered Psychotherapy ( IMCP ) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer . PATIENTS AND METHODS Patients with stage III or IV cancer ( N = 120 ) were r and omly assigned to seven sessions of either IMCP or therapeutic massage ( TM ) . Patients were assessed before and after completing the intervention and 2 months postintervention . Primary outcome measures assessed spiritual well-being and quality of life ; secondary outcomes included anxiety , depression , hopelessness , symptom burden , and symptom-related distress . RESULTS Of the 120 participants r and omly assigned , 78 ( 65 % ) completed the post-treatment assessment and 67 ( 56 % ) completed the 2-month follow-up . At the post-treatment assessment , IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being ( b = 0.39 ; P < .001 , including both components of spiritual well-being ( sense of meaning : b = 0.34 ; P = .003 and faith : b = 0.42 ; P = .03 ) , and quality of life ( b = 0.76 ; P = .013 ) . Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden ( b = -6.56 ; P < .001 ) and symptom-related distress ( b = -0.47 ; P < .001 ) but not for anxiety , depression , or hopelessness . At the 2-month follow-up assessment , the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group . CONCLUSION IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer . Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being OBJECTIVE This study was aim ed at evaluating whether a Life Review Group Program ( LRGP ) improved the self-esteem and life satisfaction in the elderly . METHODS This r and omized , controlled trial consisted of 75 elderly males from a Veterans ' Home in Northern Taiwan , 36 of whom were in the experimental group and 39 of whom were in the control group . The subjects in the experimental group participated in an 8-week LRGP . Data were collected before and after the LRGP and again 1 month after the end of the program . RESULTS The study subjects had a mean age of 78.13 years . The generalized estimating equation was used to compare alterations in the self-esteem and life satisfaction of the elderly before and after the intervention . The alterations in self-esteem and life satisfaction in the experimental group after the LRGP were significantly improved compared to the control group . One month after the LRGP was completed , the self-esteem and life satisfaction of the experimental group continued to improve when compared with pre-intervention levels . CONCLUSIONS Based on these results , the LRGP can potentially improve the self-affirmation , confidence , and self-esteem of the elderly and promote short-term life satisfaction . The results of this study provide a model for clinical evidence -based therapy , serving as a reference for related studies and evaluation of health-promoting programs , as well as improving the health and quality of care of the elderly CONTEXT There is a little information about effective psychotherapies to enhance the spiritual well-being of terminally ill cancer patients . OBJECTIVES The primary aim of the study was to examine the efficacy of a one-week Short-Term Life Review for the enhancement of spiritual well-being , using a r and omized controlled trial . The secondary aim was to assess the effect of this therapy on anxiety and depression , suffering , and elements of a good death . METHODS The subjects were 68 terminally ill cancer patients r and omly allocated to a Short-Term Life- Review interview group or a control group . The patients completed question naires pre- and post-treatment , including the meaning of life domain from the Functional Assessment of Chronic Illness Therapy-Spiritual ( FACIT-Sp ) scale , the Hospital Anxiety and Depression Scale ( HADS ) , a numeric scale for psychological suffering , and items from the Good Death Inventory ( Hope , Burden , Life Completion , and Preparation ) . RESULTS The FACIT-Sp , Hope , Life Completion , and Preparation scores in the intervention group showed significantly greater improvement compared with those of the control group ( FACIT-Sp , P<0.001 ; Hope , P<0.001 ; Life Completion , P<0.001 ; and Preparation , P<0.001 ) . HADS , Burden , and Suffering scores in the intervention group also had suggested greater alleviation of suffering compared with the control group ( HADS , P<0.001 ; Burden , P<0.007 ; Suffering , P<0.001 ) . CONCLUSION We conclude that the Short-Term Life Review is effective in improving the spiritual well-being of terminally ill cancer patients , and alleviating psychosocial distress and promoting a good death Main objective To assess the ability of dignity therapy to reduce distress in advanced cancer patients . Design A phase II open-label trial . Setting Two UK National Health Service trusts . Participants 45 adults with advanced cancer . Intervention Dignity therapy : a brief palliative care psychotherapy . Methods Participants were r and omly allocated to receive the intervention plus st and ard care or st and ard care only ( control group ) . Outcomes were collected at baseline and at 1- and 4-week follow-up . Main outcome measures The primary outcome was dignity-related distress ( Palliative Dignity Inventory ) . Secondary outcomes were hope , anxiety and depression , quality of life , palliative-related outcomes , and self-reported study benefits . Results 45/188 ( 24 % ) patients responded . 27/45 ( 60 % ) participants remained at 1-week and 20/45 ( 44 % ) at 4-week follow-up . Baseline levels of distress were low . Groups did not differ in dignity-related distress at any time . An effect on only one secondary outcome was found : the intervention group reported more hope than the control group at both follow-ups . Effect sizes were medium ( partial η2=0.20 and 0.15 ) and the difference was statistically significant at 1-week follow-up ( difference in adjusted means 2.55 ; 95 % CI −4.73 to 0.36 ; p=0.02 ) . The intervention group was more positive than the control group on all the self-reported benefits ratings . Effect sizes ( Cohen 's d ) ranged from 1.34 for feeling that dignity therapy had helped to 0.31 for increasing will to live . Conclusions The effects of dignity therapy on people 
    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: CONTEXT Dignity therapy ( DT ) is a psychotherapeutic intervention with increasing evidence of acceptability and utility in palliative care setting s. OBJECTIVES The aim of this study was to evaluate the legacy creation component of DT by comparing this intervention with life review ( LR ) and waitlist control ( WC ) groups . METHODS Seventy adults with advanced terminal disease were r and omly allocated to DT , LR , or WC followed by DT , of which 56 completed the study protocol . LR followed an identical protocol to DT except that no legacy document was created in LR . Primary outcome measures were the Brief Generativity and Ego-Integrity Question naire , Patient Dignity Inventory , Functional Assessment of Cancer Therapy-General , version 4 , and treatment evaluation question naires . RESULTS Unlike LR and WC groups , DT recipients demonstrated significantly increased generativity and ego-integrity scores at study completion . There were no significant changes for dignity-related distress or physical , social , emotional , and functional well-being among the three groups . There were also no significant changes in primary outcomes after the provision of DT after the waiting period in the WC group . High acceptability and satisfaction with interventions were noted for recipients of both DT and LR and family/carers of DT participants . CONCLUSION This study provides initial evidence that the specific process of legacy creation is able to positively affect sense of generativity , meaning , and acceptance near end of life . High acceptability and satisfaction rates for both DT and LR and positive impacts on families/carers of DT participants provide additional support for clinical utility of these interventions . Further evaluation of specific mechanisms of change post-intervention is required given DT 's uncertain efficacy on other primary outcomes OBJECTIVE This pilot study aim ed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention ( MMi ) in patients newly diagnosed with Stage III or IV ovarian cancer , and to provide estimates of parameters needed to design a full-scale study . METHODS A r and omized controlled trial with 24 patients ( 12 experimental and 12 control ) was conducted . Existential well-being ( primary outcome ) , overall quality of life , distress , anxiety , depression and self-efficacy were measured . RESULTS Compared to the control group , patients in the experimental group had a better sense of meaning in life at one and three months post-intervention . CONCLUSION The MMi seems a promising intervention for advanced cancer patients , and a full r and omized controlled trial is warranted to further investigate its efficacy BACKGROUND We developed an indicated preventive life- review course , " Looking for Meaning " , based on the assumption that reminiscence styles influence coping with depressive symptoms . This study describes the impact of this course in a pragmatic r and omized controlled trial . METHODS Inclusion criteria were > 50 years , a score of 5 or higher on the Center for Epidemiological Studies Depression Scale ( CES-D ) , and no depressive disorder or psychotropic or psychological treatment . Participants were r and omized and stratified by gender : the experimental group ( N = 83 ) was offered the course and the comparison group ( N = 88 ) a movie . There were three measurements : pre-treatment , post-treatment and 6 months after post-treatment . Depressive symptoms constituted the primary outcome . Secondary outcomes were anxiety symptoms , satisfaction with life , mastery and reminiscence styles . All analyses were conducted according to the intention-to-treat principle . Missing values were replaced by regression imputation . RESULTS The course reduced depressive symptoms , a decrease that was retained during follow-up . A significant between-group effect size was found ( d = 0.58 ) . There was also a reduction in symptoms of anxiety ; however , the comparison group showed the same reduction , result ing in a small between-group effect size . Gender and level of depressive symptoms were found to be prognostic factors for the change in depressive symptoms ; age was not . Post hoc analyses showed significant between-group effect sizes for females and those with a score above the cut-off of the CES-D. CONCLUSION The course " Looking for Meaning " can be recommended for people aged over 50 years , females and older adults with a clinical ly relevant level of depressive symptoms ( above cut-off ) in particular Palliative care is now considered an essential part of end-of-life care , yet little research examines the efficacy of interventions addressing the psychological treatment of dying patients . Forgiveness therapy has been shown to be effective in improving psychological well-being and may provide a valuable addition to a terminal cancer patient 's overall treatment plan . This study experimentally tested the effectiveness of a four-week forgiveness therapy in improving the quality of life of elderly terminally ill cancer patients . Participants ( n=20 ) were r and omly assigned to a forgiveness therapy group or to a  wait-list control group , which received forgiveness therapy in the second four-week period . All participants completed instruments measuring forgiveness , hope , quality of life , and anger at pre-test , post-test 1 , and post-test 2 . The forgiveness therapy group showed greater improvement than the control group , with one-tailed t-tests , on all measures . After receiving forgiveness therapy , participants in both forgiveness treatment conditions demonstrated significant improvements on all measures . The aggregated effect size was large . The four-week forgiveness therapy demonstrated psychological benefits for elderly terminally ill cancer patients and thus may be an appropriate addition to the treatment plan for terminal cancer patients BACKGROUND Significant palliative care intervention has focused on physical pain and symptom control ; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience . OBJECTIVE To evaluate the impact of an intervention ( Outlook ) that promotes discussion s of end-of-life preparation and completion on health outcomes in dying persons , including pain and symptoms , physical function , emotional function ( anxiety and depression ) , spiritual well-being , and quality of life at the end of life . DESIGN A three-arm pilot r and omized control trial . Subjects were recruited from inpatient and outpatient hospital , palliative care , and hospice setting s. Intervention subjects met with a facilitator three times and discussed issues related to life review , forgiveness , and heritage and legacy . Attention control subjects met with a facilitator three times and listened to a nonguided relaxation CD . True control subjects received no intervention . MEASUREMENTS Pre outcomes and post outcomes included the Memorial Symptom Assessment Scale , QUAL-E , Rosow-Breslau ADL Scale , Profile of Mood States anxiety sub-scale , the CESD short version , and the Daily Spiritual Experience Scale . RESULTS Eighty-two hospice eligible patients enrolled in the study ; 38 were women , 35 were African American . Participants ' primary diagnoses included cancer ( 48 ) , heart disease ( 5 ) lung disease ( 10 ) , and other ( 19 ) Ages ranged from 28 - 96 . Participants in the active discussion intervention showed improvements in functional status , anxiety , depression , and preparation for end of life . CONCLUSIONS The Outlook intervention was acceptable to patients from a variety of educational and ethnic background s and offers a brief , manualized , intervention for emotional and spiritual concerns PURPOSE Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer . We developed Individual Meaning-Centered Psychotherapy ( IMCP ) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer . PATIENTS AND METHODS Patients with stage III or IV cancer ( N = 120 ) were r and omly assigned to seven sessions of either IMCP or therapeutic massage ( TM ) . Patients were assessed before and after completing the intervention and 2 months postintervention . Primary outcome measures assessed spiritual well-being and quality of life ; secondary outcomes included anxiety , depression , hopelessness , symptom burden , and symptom-related distress . RESULTS Of the 120 participants r and omly assigned , 78 ( 65 % ) completed the post-treatment assessment and 67 ( 56 % ) completed the 2-month follow-up . At the post-treatment assessment , IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being ( b = 0.39 ; P < .001 , including both components of spiritual well-being ( sense of meaning : b = 0.34 ; P = .003 and faith : b = 0.42 ; P = .03 ) , and quality of life ( b = 0.76 ; P = .013 ) . Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden ( b = -6.56 ; P < .001 ) and symptom-related distress ( b = -0.47 ; P < .001 ) but not for anxiety , depression , or hopelessness . At the 2-month follow-up assessment , the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group . CONCLUSION IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer . Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being OBJECTIVE This study was aim ed at evaluating whether a Life Review Group Program ( LRGP ) improved the self-esteem and life satisfaction in the elderly . METHODS This r and omized , controlled trial consisted of 75 elderly males from a Veterans ' Home in Northern Taiwan , 36 of whom were in the experimental group and 39 of whom were in the control group . The subjects in the experimental group participated in an 8-week LRGP . Data were collected before and after the LRGP and again 1 month after the end of the program . RESULTS The study subjects had a mean age of 78.13 years . The generalized estimating equation was used to compare alterations in the self-esteem and life satisfaction of the elderly before and after the intervention . The alterations in self-esteem and life satisfaction in the experimental group after the LRGP were significantly improved compared to the control group . One month after the LRGP was completed , the self-esteem and life satisfaction of the experimental group continued to improve when compared with pre-intervention levels . CONCLUSIONS Based on these results , the LRGP can potentially improve the self-affirmation , confidence , and self-esteem of the elderly and promote short-term life satisfaction . The results of this study provide a model for clinical evidence -based therapy , serving as a reference for related studies and evaluation of health-promoting programs , as well as improving the health and quality of care of the elderly CONTEXT There is a little information about effective psychotherapies to enhance the spiritual well-being of terminally ill cancer patients . OBJECTIVES The primary aim of the study was to examine the efficacy of a one-week Short-Term Life Review for the enhancement of spiritual well-being , using a r and omized controlled trial . The secondary aim was to assess the effect of this therapy on anxiety and depression , suffering , and elements of a good death . METHODS The subjects were 68 terminally ill cancer patients r and omly allocated to a Short-Term Life- Review interview group or a control group . The patients completed question naires pre- and post-treatment , including the meaning of life domain from the Functional Assessment of Chronic Illness Therapy-Spiritual ( FACIT-Sp ) scale , the Hospital Anxiety and Depression Scale ( HADS ) , a numeric scale for psychological suffering , and items from the Good Death Inventory ( Hope , Burden , Life Completion , and Preparation ) . RESULTS The FACIT-Sp , Hope , Life Completion , and Preparation scores in the intervention group showed significantly greater improvement compared with those of the control group ( FACIT-Sp , P<0.001 ; Hope , P<0.001 ; Life Completion , P<0.001 ; and Preparation , P<0.001 ) . HADS , Burden , and Suffering scores in the intervention group also had suggested greater alleviation of suffering compared with the control group ( HADS , P<0.001 ; Burden , P<0.007 ; Suffering , P<0.001 ) . CONCLUSION We conclude that the Short-Term Life Review is effective in improving the spiritual well-being of terminally ill cancer patients , and alleviating psychosocial distress and promoting a good death Main objective To assess the ability of dignity therapy to reduce distress in advanced cancer patients . Design A phase II open-label trial . Setting Two UK National Health Service trusts . Participants 45 adults with advanced cancer . Intervention Dignity therapy : a brief palliative care psychotherapy . Methods Participants were r and omly allocated to receive the intervention plus st and ard care or st and ard care only ( control group ) . Outcomes were collected at baseline and at 1- and 4-week follow-up . Main outcome measures The primary outcome was dignity-related distress ( Palliative Dignity Inventory ) . Secondary outcomes were hope , anxiety and depression , quality of life , palliative-related outcomes , and self-reported study benefits . Results 45/188 ( 24 % ) patients responded . 27/45 ( 60 % ) participants remained at 1-week and 20/45 ( 44 % ) at 4-week follow-up . Baseline levels of distress were low . Groups did not differ in dignity-related distress at any time . An effect on only one secondary outcome was found : the intervention group reported more hope than the control group at both follow-ups . Effect sizes were medium ( partial η2=0.20 and 0.15 ) and the difference was statistically significant at 1-week follow-up ( difference in adjusted means 2.55 ; 95 % CI −4.73 to 0.36 ; p=0.02 ) . The intervention group was more positive than the control group on all the self-reported benefits ratings . Effect sizes ( Cohen 's d ) ranged from 1.34 for feeling that dignity therapy had helped to 0.31 for increasing will to live . Conclusions The effects of dignity therapy on people 
    Output:
    