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: Cancer diagnosis affects the psychological well-being of both patients and their partners , and effective coping has been suggested to be a conjoint process of mutual support . Ninety-four married women with early stage cancer and their partners were r and omly assigned to couples-based coping training ( CanCOPE ) , individual coping training for the woman , or a medical education control . Couples ' observed support communication and self-reported psychological distress , coping effort , and sexual adjustment were assessed at diagnosis , after cancer surgery , and at 6- and 12-month follow-ups . CanCOPE produced significant improvements in couples ' supportive communication , reduced psychological distress and coping effort , and improved sexual adjustment . Training in couples rather than individual coping was more effective in facilitating adaptation to cancer Background There are few interventions for couples facing cancer . Purpose This study aims to investigate the utility of providing dyadic skills to these couples . Methods Woman recently diagnosed with breast or gynecological cancer and their partners were r and omly assigned to either a couple-skills intervention ( Side by Side ) or to cancer education ( Couples Control Program ) . Assessment s with self-report and behavioral observation of both partners were conducted four times over 16 months . Results Multilevel analyses of data from 72 participating couples suggest that females receiving Side by Side showed larger reductions in fear of progression , and couples reported less avoidance in dealing with the cancer , more posttraumatic growth , and better relationship skills relative to the Couples Control Program . All differences favoring Side by Side disappeared by 16 months after the diagnosis . ConclusionS hort-term changes in functioning may be improved by enhancing couples ’ dyadic skills during acute medical treatment of the disease The objective of this study was to test the efficacy of an  individualized uncertainty management intervention delivered by telephone to Caucasian and African‐American men with localized prostate carcinoma and directed at managing the uncertainties of their disease and treatment African American men experience worse prostate cancer outcomes compared with those of Caucasian men , not only in incidence and mortality rates , but also in coping with the side effects of treatment . Unfortunately , African American men have been significantly under‐represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors . This pilot study explored the feasibility and efficacy of coping skills training ( CST ) , an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners . The intervention was delivered in a telephone‐based format design ed to facilitate research participation . A total of 40 couples were r and omized to either 6 sessions of CST or usual care . Survivors completed measures of disease‐specific quality of life ( QOL ) related to urinary , sexual , bowel , and hormonal symptom domains , as well as measures of global QOL ( i.e. , physical functioning and mental health ) . Partners completed measures of caregiver strain , mood , and vigor . Analysis of data from 30 couples ( 12 couples in CST , 18 couples in usual care ) indicated that CST produced moderate to large treatment effects for QOL related to bowel , urinary , sexual , and hormonal symptoms .  Partners who underwent CST  reported less caregiver strain , depression , and fatigue , and more vigor , with moderate effect sizes observed that approached conventional levels of statistical significance . These preliminary findings suggest that telephone‐based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners . Cancer 2007 . © 2006 American Cancer Society This study evaluated a novel intervention for older osteoarthritis ( OA ) patients and their spousal caregivers that consisted of st and ard patient education supplemented by information related to effectively managing arthritis as a couple . Twenty-four female OA patients and their husb and s were r and omly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient . Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention . In addition , patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms . The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects . Two hundred thirty-eight women were r and omly assigned to receive either 6 sessions of a couple-focused group intervention or usual care . Intent-to-treat growth curve analyses indicated that participants assigned to the couples ' group reported lower depressive symptoms . Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners , and women with more physical impairment benefited more from the intervention group than did women with less impairment . Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention This study evaluated an intervention to facilitate adaptive coping by persons living with HIV ( PLWH ) , with the participation of their cohabiting partners as a dimension of the intervention . An experimental design with r and omization was used , and 84 PLWH and their partners were recruited . The intervention was based on a psychosocial educational model that incorporated four 2-hour sessions focused on communication , stress appraisal , adaptive coping strategies , and building social support . Both members of the dyad were included in each session . The comparison control included four supportive phone calls to the PLWH alone . Data were collected from both the PLWH and their partner in each of the two groups at baseline , immediately following the intervention , and 3 months and 6 months posttreatment . Data were analyzed using repeated measures analysis of variance , with change scores from the partner data being covariates . Results indicated that the design was a feasible model , which demonstrated potential for the management of stress and possibly problems such as adherence in PLWH . A manual was developed as a part of this intervention and is currently available Objective : To assess the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems . Design : A r and omized controlled trial ( SMART Couples Study ) conducted between August 2000 and January 2004 . Setting : Two HIV/AIDS outpatient clinics in New York City . Participants : Heterosexual and homosexual HIV-serodiscordant couples ( n = 215 ) in which the HIV-seropositive partner had < 80 % adherence at baseline . The sample was predominantly lower-income racial/ethnic minorities . Intervention : Participants were r and omly assigned to a four-session couple-focused adherence intervention or usual care . The intervention consisted of education about treatment and adherence , identifying adherence barriers , developing communication and problem-solving strategies , optimizing partner support , and building confidence for optimal adherence . Outcome measures : Medication adherence at week 8 ( 2 weeks after the intervention ) compared with baseline , assessed with a Medication Event Monitoring System cap . Results : Intervention participants showed higher mean medication adherence at post-intervention when compared with controls whether adherence was defined as proportion of prescribed doses taken ( 76 % versus 60 % ) or doses taken within specified time parameters ( 58 % versus 35 % ) . Also , participants in the intervention arm were significantly more likely to achieve high levels of adherence ( > 80 % , > 90 % , or > 95 % ) when compared with controls . However , in most cases , effects diminished with time , as seen at follow-up at 3 and 6 months . Conclusion : The SMART Couples program significantly improved medication adherence over usual care , although the level of improved adherence , for many participants , was still suboptimal and the effect was attenuated over time BACKGROUND Chronic heart failure ( CHF ) causes great suffering for both patients and their partners . The aim of this study was to evaluate the effects of an integrated dyad care program with education and psychosocial support to patients with CHF and their partners during a postdischarge period after acute deterioration of CHF . METHODS One hundred fifty-five patient-caregiver dyads were r and omized to usual care ( n = 71 ) or a psychoeducation intervention ( n = 84 ) delivered in 3 modules through nurse-led face-to-face counseling , computer-based education , and other written teaching material s to assist dyads to develop problem-solving skills . Follow-up assessment s were completed after 3 and 12 months to assess perceived control , perceived health , depressive symptoms , self-care , and caregiver burden . RESULTS Baseline sociodemographic and clinical characteristics of dyads in the experimental and control groups were similar at baseline . Significant differences were observed in patients ' perceived control over the cardiac condition after 3 ( P < .05 ) but not after 12 months , and no effect was seen for the caregivers . No group differences were observed over time in dyads ' health-related quality of life and depressive symptoms , patients ' self-care behaviors , and partners ' experiences of caregiver burden . CONCLUSIONS Integrated dyad care focusing on skill-building and problem-solving education and psychosocial support was effective in initially enhancing patients ' levels of perceived control . More frequent professional contact and ongoing skills training may be necessary to have a higher impact on dyad outcomes and warrants further research Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life . The objective of this study was to determine whether a family‐based intervention could improve appraisal variables ( appraisal of illness or caregiving , uncertainty , hopelessness ) , coping re sources ( coping strategies , self‐efficacy , communication ) , symptom distress , and quality of life in men with prostate cancer and their spouses & NA ; This study tested the separate and combined effects of spouse‐assisted pain coping skills training ( SA‐CST ) and exercise training ( ET ) in a sample of patients having persistent osteoarthritic knee pain . Seventy‐two married osteoarthritis ( OA ) patients with persistent knee pain and their spouses were r and omly assigned to : SA‐CST alone , SA‐CST plus ET , ET alone , or st and ard care ( SC ) . Patients in SA‐CST alone , together with their spouses , attended 12 weekly , 2‐h group sessions for training in pain coping and couples skills . Patients in SA‐CST+ET received spouse‐assisted coping skills training and attended 12‐weeks supervised ET . Patients in the ET alone condition received just an exercise program . Data analyses revealed : ( 1 ) physical fitness and strength :  the SA‐CST+ET and ET alone groups had significant improvements in physical fitness compared to SA‐CST alone and patients in SA‐CST+ET and ET alone had significant improvements in leg flexion and extension compared to SA‐CST alone and SC , ( 2 ) pain coping : patients in SA‐CST+ET and SA‐CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA‐CST+ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC , and ( 3 ) self‐efficacy : patients in SA‐CST+ET reported significant improvements in self‐efficacy and their spouses rated them as showing significant improvements in self‐efficacy compared to ET alone or SC . Patients receiving SA‐CST+ET who showed increased self‐efficacy were more likely to have improvements in psychological disability . An intervention that combines spouse‐assisted coping skills training and exercise training  can improve physical fitness , strength , pain coping , and self‐efficacy in patients suffering from pain due to osteoarthritis Background : Psychosocial interventions can improve psychological quality of life ( symptoms of depression and anxiety ) of both women with breast cancer and their partners , but are not offered routinely to women and their partners . Objective : To test the hypotheses that telephone-delivered psychosocial interventions decrease depression and anxiety in women with breast cancer and their partners . Methods : The design of the study was a three-wave repeated measures with a between-subjects factor ( treatment group ) . Ninety-six women and their 96 partners were assigned r and omly to participate in one of three different 6-week programs : ( a ) telephone interpersonal counseling ( TIP-C ) ; ( b ) self-managed exercise ; or ( c ) attention control ( AC ) . Results : The mixed-model analysis of variance for symptoms of depression among women with breast cancer revealed  women 's depressive symptom scores decreased over time in all groups . For anxiety , women 's symptoms of anxiety decreased in the TIP-C and exercise groups over time , but not in the AC group . A parallel set of analyses was conducted on  partners ' depression and anxiety data . Symptoms of depression and anxiety among the partners decreased substantially over the course of the investigation . Similar to the women , partners '  symptoms of anxiety decreased significantly in the TIP-C and exercise groups , but not in the AC group . Discussion : Findings from this study support that these telephone-delivered psychosocial interventions were effective for decreasing symptoms of depression and anxiety to improve psychological quality of life when compared to an AC group BACKGROUND We previously developed and piloted a telephone-based intimacy enhancement ( IE ) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study . The current study tested the feasibility , acceptability , and preliminary efficacy of the IE intervention in a r and omized , controlled trial . METHODS Twenty-three couples were r and omized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures . The IE intervention teaches skills for coping with sexual concerns and improving intimacy . Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations 
    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: Cancer diagnosis affects the psychological well-being of both patients and their partners , and effective coping has been suggested to be a conjoint process of mutual support . Ninety-four married women with early stage cancer and their partners were r and omly assigned to couples-based coping training ( CanCOPE ) , individual coping training for the woman , or a medical education control . Couples ' observed support communication and self-reported psychological distress , coping effort , and sexual adjustment were assessed at diagnosis , after cancer surgery , and at 6- and 12-month follow-ups . CanCOPE produced significant improvements in couples ' supportive communication , reduced psychological distress and coping effort , and improved sexual adjustment . Training in couples rather than individual coping was more effective in facilitating adaptation to cancer Background There are few interventions for couples facing cancer . Purpose This study aims to investigate the utility of providing dyadic skills to these couples . Methods Woman recently diagnosed with breast or gynecological cancer and their partners were r and omly assigned to either a couple-skills intervention ( Side by Side ) or to cancer education ( Couples Control Program ) . Assessment s with self-report and behavioral observation of both partners were conducted four times over 16 months . Results Multilevel analyses of data from 72 participating couples suggest that females receiving Side by Side showed larger reductions in fear of progression , and couples reported less avoidance in dealing with the cancer , more posttraumatic growth , and better relationship skills relative to the Couples Control Program . All differences favoring Side by Side disappeared by 16 months after the diagnosis . ConclusionS hort-term changes in functioning may be improved by enhancing couples ’ dyadic skills during acute medical treatment of the disease The objective of this study was to test the efficacy of an  individualized uncertainty management intervention delivered by telephone to Caucasian and African‐American men with localized prostate carcinoma and directed at managing the uncertainties of their disease and treatment African American men experience worse prostate cancer outcomes compared with those of Caucasian men , not only in incidence and mortality rates , but also in coping with the side effects of treatment . Unfortunately , African American men have been significantly under‐represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors . This pilot study explored the feasibility and efficacy of coping skills training ( CST ) , an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners . The intervention was delivered in a telephone‐based format design ed to facilitate research participation . A total of 40 couples were r and omized to either 6 sessions of CST or usual care . Survivors completed measures of disease‐specific quality of life ( QOL ) related to urinary , sexual , bowel , and hormonal symptom domains , as well as measures of global QOL ( i.e. , physical functioning and mental health ) . Partners completed measures of caregiver strain , mood , and vigor . Analysis of data from 30 couples ( 12 couples in CST , 18 couples in usual care ) indicated that CST produced moderate to large treatment effects for QOL related to bowel , urinary , sexual , and hormonal symptoms .  Partners who underwent CST  reported less caregiver strain , depression , and fatigue , and more vigor , with moderate effect sizes observed that approached conventional levels of statistical significance . These preliminary findings suggest that telephone‐based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners . Cancer 2007 . © 2006 American Cancer Society This study evaluated a novel intervention for older osteoarthritis ( OA ) patients and their spousal caregivers that consisted of st and ard patient education supplemented by information related to effectively managing arthritis as a couple . Twenty-four female OA patients and their husb and s were r and omly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient . Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention . In addition , patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms . The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects . Two hundred thirty-eight women were r and omly assigned to receive either 6 sessions of a couple-focused group intervention or usual care . Intent-to-treat growth curve analyses indicated that participants assigned to the couples ' group reported lower depressive symptoms . Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners , and women with more physical impairment benefited more from the intervention group than did women with less impairment . Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention This study evaluated an intervention to facilitate adaptive coping by persons living with HIV ( PLWH ) , with the participation of their cohabiting partners as a dimension of the intervention . An experimental design with r and omization was used , and 84 PLWH and their partners were recruited . The intervention was based on a psychosocial educational model that incorporated four 2-hour sessions focused on communication , stress appraisal , adaptive coping strategies , and building social support . Both members of the dyad were included in each session . The comparison control included four supportive phone calls to the PLWH alone . Data were collected from both the PLWH and their partner in each of the two groups at baseline , immediately following the intervention , and 3 months and 6 months posttreatment . Data were analyzed using repeated measures analysis of variance , with change scores from the partner data being covariates . Results indicated that the design was a feasible model , which demonstrated potential for the management of stress and possibly problems such as adherence in PLWH . A manual was developed as a part of this intervention and is currently available Objective : To assess the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems . Design : A r and omized controlled trial ( SMART Couples Study ) conducted between August 2000 and January 2004 . Setting : Two HIV/AIDS outpatient clinics in New York City . Participants : Heterosexual and homosexual HIV-serodiscordant couples ( n = 215 ) in which the HIV-seropositive partner had < 80 % adherence at baseline . The sample was predominantly lower-income racial/ethnic minorities . Intervention : Participants were r and omly assigned to a four-session couple-focused adherence intervention or usual care . The intervention consisted of education about treatment and adherence , identifying adherence barriers , developing communication and problem-solving strategies , optimizing partner support , and building confidence for optimal adherence . Outcome measures : Medication adherence at week 8 ( 2 weeks after the intervention ) compared with baseline , assessed with a Medication Event Monitoring System cap . Results : Intervention participants showed higher mean medication adherence at post-intervention when compared with controls whether adherence was defined as proportion of prescribed doses taken ( 76 % versus 60 % ) or doses taken within specified time parameters ( 58 % versus 35 % ) . Also , participants in the intervention arm were significantly more likely to achieve high levels of adherence ( > 80 % , > 90 % , or > 95 % ) when compared with controls . However , in most cases , effects diminished with time , as seen at follow-up at 3 and 6 months . Conclusion : The SMART Couples program significantly improved medication adherence over usual care , although the level of improved adherence , for many participants , was still suboptimal and the effect was attenuated over time BACKGROUND Chronic heart failure ( CHF ) causes great suffering for both patients and their partners . The aim of this study was to evaluate the effects of an integrated dyad care program with education and psychosocial support to patients with CHF and their partners during a postdischarge period after acute deterioration of CHF . METHODS One hundred fifty-five patient-caregiver dyads were r and omized to usual care ( n = 71 ) or a psychoeducation intervention ( n = 84 ) delivered in 3 modules through nurse-led face-to-face counseling , computer-based education , and other written teaching material s to assist dyads to develop problem-solving skills . Follow-up assessment s were completed after 3 and 12 months to assess perceived control , perceived health , depressive symptoms , self-care , and caregiver burden . RESULTS Baseline sociodemographic and clinical characteristics of dyads in the experimental and control groups were similar at baseline . Significant differences were observed in patients ' perceived control over the cardiac condition after 3 ( P < .05 ) but not after 12 months , and no effect was seen for the caregivers . No group differences were observed over time in dyads ' health-related quality of life and depressive symptoms , patients ' self-care behaviors , and partners ' experiences of caregiver burden . CONCLUSIONS Integrated dyad care focusing on skill-building and problem-solving education and psychosocial support was effective in initially enhancing patients ' levels of perceived control . More frequent professional contact and ongoing skills training may be necessary to have a higher impact on dyad outcomes and warrants further research Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life . The objective of this study was to determine whether a family‐based intervention could improve appraisal variables ( appraisal of illness or caregiving , uncertainty , hopelessness ) , coping re sources ( coping strategies , self‐efficacy , communication ) , symptom distress , and quality of life in men with prostate cancer and their spouses & NA ; This study tested the separate and combined effects of spouse‐assisted pain coping skills training ( SA‐CST ) and exercise training ( ET ) in a sample of patients having persistent osteoarthritic knee pain . Seventy‐two married osteoarthritis ( OA ) patients with persistent knee pain and their spouses were r and omly assigned to : SA‐CST alone , SA‐CST plus ET , ET alone , or st and ard care ( SC ) . Patients in SA‐CST alone , together with their spouses , attended 12 weekly , 2‐h group sessions for training in pain coping and couples skills . Patients in SA‐CST+ET received spouse‐assisted coping skills training and attended 12‐weeks supervised ET . Patients in the ET alone condition received just an exercise program . Data analyses revealed : ( 1 ) physical fitness and strength :  the SA‐CST+ET and ET alone groups had significant improvements in physical fitness compared to SA‐CST alone and patients in SA‐CST+ET and ET alone had significant improvements in leg flexion and extension compared to SA‐CST alone and SC , ( 2 ) pain coping : patients in SA‐CST+ET and SA‐CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA‐CST+ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC , and ( 3 ) self‐efficacy : patients in SA‐CST+ET reported significant improvements in self‐efficacy and their spouses rated them as showing significant improvements in self‐efficacy compared to ET alone or SC . Patients receiving SA‐CST+ET who showed increased self‐efficacy were more likely to have improvements in psychological disability . An intervention that combines spouse‐assisted coping skills training and exercise training  can improve physical fitness , strength , pain coping , and self‐efficacy in patients suffering from pain due to osteoarthritis Background : Psychosocial interventions can improve psychological quality of life ( symptoms of depression and anxiety ) of both women with breast cancer and their partners , but are not offered routinely to women and their partners . Objective : To test the hypotheses that telephone-delivered psychosocial interventions decrease depression and anxiety in women with breast cancer and their partners . Methods : The design of the study was a three-wave repeated measures with a between-subjects factor ( treatment group ) . Ninety-six women and their 96 partners were assigned r and omly to participate in one of three different 6-week programs : ( a ) telephone interpersonal counseling ( TIP-C ) ; ( b ) self-managed exercise ; or ( c ) attention control ( AC ) . Results : The mixed-model analysis of variance for symptoms of depression among women with breast cancer revealed  women 's depressive symptom scores decreased over time in all groups . For anxiety , women 's symptoms of anxiety decreased in the TIP-C and exercise groups over time , but not in the AC group . A parallel set of analyses was conducted on  partners ' depression and anxiety data . Symptoms of depression and anxiety among the partners decreased substantially over the course of the investigation . Similar to the women , partners '  symptoms of anxiety decreased significantly in the TIP-C and exercise groups , but not in the AC group . Discussion : Findings from this study support that these telephone-delivered psychosocial interventions were effective for decreasing symptoms of depression and anxiety to improve psychological quality of life when compared to an AC group BACKGROUND We previously developed and piloted a telephone-based intimacy enhancement ( IE ) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study . The current study tested the feasibility , acceptability , and preliminary efficacy of the IE intervention in a r and omized , controlled trial . METHODS Twenty-three couples were r and omized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures . The IE intervention teaches skills for coping with sexual concerns and improving intimacy . Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations 
    Output:
    