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: 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 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 CONTEXT Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms , including pain , fatigue , shortness of breath , and psychological distress . Caregivers and patients are adversely affected . However , previous studies of coping skills training ( CST ) interventions have not been tested in patients with lung cancer nor have systematic ally included caregivers . OBJECTIVES This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer . METHODS Two hundred thirty-three lung cancer patients and their caregivers were r and omly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver . Patients completed measures assessing pain , psychological distress , quality of life ( QOL ) , and self-efficacy for symptom management ; caregivers completed measures assessing psychological distress , caregiver strain , and self-efficacy for helping the patient manage symptoms . RESULTS Patients in both treatment conditions showed improvements in pain , depression , QOL , and self-efficacy , and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up . Results of exploratory analyses suggested that the CST intervention was more beneficial to patients /caregivers with Stage II and III cancers , whereas the education/support intervention was more beneficial to patients /caregivers with Stage I cancer . CONCLUSION Taken together with the broader literature in this area , results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients . Suggestions for future studies include the use of three-group design s ( e.g. , comparing two active interventions with a st and ard-care control ) and examining mechanisms of change In this study , we investigated whether a clinical nursing intervention focusing on teaching family caregivers and their cancer patients skills to better manage the patients ' symptoms would reduce caregiver depressive symptomatology .  Two hundred thirty-seven patient/caregiver dyads were recruited for the study . These dyads were r and omized into either the 10-contact , 20-week experimental intervention group ( n=118 ) , which focused on assisting the patient and caregiver in managing patient symptoms and reducing emotional distress , or to a conventional care control group ( n=119 ) . A longitudinal r and om effects regression analysis did not indicate that the clinical nursing intervention was effective in decreasing caregiver depression over the 20-week course of the study . The relationship of the intervention to caregiver depressive symptomatology seems to be a complex one . We recommend further research to explore whether a lengthened intervention and /or delayed follow-up might reveal delayed positive effects of such interventions After treatment for prostate cancer , multidisciplinary sexual rehabilitation involving couples appears more promising than traditional urologic treatment for erectile dysfunction ( ED ) . The authors of this report conducted a r and omized trial comparing traditional or internet‐based sexual counseling with waitlist ( WL ) control OBJECTIVE The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention ( CG ) for women diagnosed with early stage breast cancer . DESIGN Participants ( N = 238 ) were r and omly assigned to 6 sessions of a couple-focused group versus usual care . Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression . MAIN OUTCOME MEASURES The primary outcome measures for this study were psychological distress and psychological well-being . RESULTS Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression , emotional processing , and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being . CONCLUSION The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer BACKGROUND The purpose of this study was to determine if patients with advanced breast cancer and their family caregivers , who participated in a family based intervention , report better quality of life and other psychosocial outcomes than dyads who received st and ard care alone . METHODS Using a r and omized clinical trial , 134 patients and their family caregivers were assigned to usual care ( control ) or to usual care plus the family intervention ( experimental condition ) . Dyads were assessed at baseline , three- and six-months later . The intervention consisted of five sessions and addressed  family involvement , optimistic attitude , coping effectiveness , uncertainty reduction , and symptom management . RESULTS Patients in the family intervention reported significantly less hopelessness and less negative appraisal of illness than controls ; their family caregivers reported significantly less negative appraisal of caregiving . Intervention effects were evident at three-months , but were not sustained at six-months . No difference was found in the quality of life of dyads in experimental or control conditions . CONCLUSIONS Although the family intervention had positive effects initially , these effects were not sustained over time . Future studies need to consider program dose and duration of effect , outcome measures that are more sensitive to change , and realistic end-points for patients with advanced cancer 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 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 The efficacy of problem-solving therapy ( PST ) to reduce psychological distress was assessed among a sample of 132 adult cancer patients . A second condition provided PST for both the patient and a significant other . At posttreatment , all participants receiving PST fared significantly better than waiting list control patients . Further , improvements in problem solving were found to correlate significantly with improvements in psychological distress and overall quality of life . No differences in symptom reduction were identified between the 2 treatment protocol s. At a 6-month follow-up , however , patients who received PST along with their significant other reported lower levels of psychological distress as compared with members of the PST-alone condition on approximately half of the outcome measures . These effects were further maintained 1-year posttreatment This research evaluates the impact of a r and omized clinical trial for lowering family members ' reactions and increasing their involvement in assisting cancer patients undergoing chemotherapy to better manage their symptoms . The cognitive behavioral intervention was directed toward both the patient and family caregivers . At 10 weeks , caregivers who received the experimental intervention had significantly lower total reactions to assisting with symptoms and assisted with significantly fewer symptoms ( linked to patient improvement in symptom severity ) than caregivers receiving conventional care alone .  Female caregivers receiving the intervention reported significantly lower reaction per symptom where assistance was provided compared to female caregivers in the control group . Thus , the intervention did not increase caregiver involvement in symptom management , quite possibly due to reduced symptom severity among patients in the intervention group . This research offers a model for evaluating trials directed toward both members of a dyad A secondary analysis of a prospect i ve r and omized clinical trial with repeated measures was conducted to examine the effects of a st and ardized nursing intervention on patient and spouse depressive symptoms , sexual function , and marital interaction . Another purpose of this study was to determine if , over time , differences existed in men and their spouses ' levels of depressive symptoms , sexual function  , and marital interaction  following radical prostatectomy . Spouses reported significantly higher levels of depressive symptoms and significantly more marital interaction distress compared to patients . Patients reported significantly more distress pertaining to sexual function than their spouses PURPOSE / OBJECTIVES To test an intervention for hospice caregivers design ed to help them better manage symptoms experienced by patients with cancer . DESIGN A three-group comparative design with repeated measures . SETTING A large nonprofit hospice that primarily provides home care . SAMPLE 329 hospice homecare patients with cancer and their caregivers were r and omized into three groups : a control group  ( n = 109 ) receiving st and ard care  , a group  ( n = 109 )  receiving st and ard care plus friendly visits , and a group  ( n = 111 )  receiving st and ard care plus the COPE intervention . METHODS Caregivers received experimental training in the COPE intervention ( creativity , optimism , planning , expert information ) over nine days to assist with symptom management . MAIN RESEARCH VARIABLES Intensity of pain , dyspnea , and constipation , overall symptom distress , and quality of life ( QOL ) . Data were collected on admission and days 16 and 30 . FINDINGS Although symptom intensity for three target symptoms did not decrease , symptom distress was significantly improved ( p = 0.009 ) in the COPE intervention group . QOL was not significantly different . CONCLUSIONS Symptom distress , a measure that encompasses patient suffering along with intensity , was significantly decreased in the group in which caregivers were trained to better manage patient symptoms . IMPLICATION S FOR NURSING The COPE intervention is effective and immediately translatable to the bedside for hospice homecare patients with advanced cancer Background : Although various forms of psychoeducation and counseling interventions have been examined among patients with a variety of diagnoses , the unique contribution of phase-specific psychoeducation and telephone counseling ( TC ) to the ongoing process of adjustment has not been explored among patients with breast cancer and their partners . Objective : To conduct a r and omized controlled clinical trial of phase-specific evidence -based psychoeducation and TC interventions to enhance emotional , physical , and social adjustments in patients with breast cancer and their partners . Methods : A purpos 
    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: 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 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 CONTEXT Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms , including pain , fatigue , shortness of breath , and psychological distress . Caregivers and patients are adversely affected . However , previous studies of coping skills training ( CST ) interventions have not been tested in patients with lung cancer nor have systematic ally included caregivers . OBJECTIVES This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer . METHODS Two hundred thirty-three lung cancer patients and their caregivers were r and omly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver . Patients completed measures assessing pain , psychological distress , quality of life ( QOL ) , and self-efficacy for symptom management ; caregivers completed measures assessing psychological distress , caregiver strain , and self-efficacy for helping the patient manage symptoms . RESULTS Patients in both treatment conditions showed improvements in pain , depression , QOL , and self-efficacy , and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up . Results of exploratory analyses suggested that the CST intervention was more beneficial to patients /caregivers with Stage II and III cancers , whereas the education/support intervention was more beneficial to patients /caregivers with Stage I cancer . CONCLUSION Taken together with the broader literature in this area , results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients . Suggestions for future studies include the use of three-group design s ( e.g. , comparing two active interventions with a st and ard-care control ) and examining mechanisms of change In this study , we investigated whether a clinical nursing intervention focusing on teaching family caregivers and their cancer patients skills to better manage the patients ' symptoms would reduce caregiver depressive symptomatology .  Two hundred thirty-seven patient/caregiver dyads were recruited for the study . These dyads were r and omized into either the 10-contact , 20-week experimental intervention group ( n=118 ) , which focused on assisting the patient and caregiver in managing patient symptoms and reducing emotional distress , or to a conventional care control group ( n=119 ) . A longitudinal r and om effects regression analysis did not indicate that the clinical nursing intervention was effective in decreasing caregiver depression over the 20-week course of the study . The relationship of the intervention to caregiver depressive symptomatology seems to be a complex one . We recommend further research to explore whether a lengthened intervention and /or delayed follow-up might reveal delayed positive effects of such interventions After treatment for prostate cancer , multidisciplinary sexual rehabilitation involving couples appears more promising than traditional urologic treatment for erectile dysfunction ( ED ) . The authors of this report conducted a r and omized trial comparing traditional or internet‐based sexual counseling with waitlist ( WL ) control OBJECTIVE The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention ( CG ) for women diagnosed with early stage breast cancer . DESIGN Participants ( N = 238 ) were r and omly assigned to 6 sessions of a couple-focused group versus usual care . Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression . MAIN OUTCOME MEASURES The primary outcome measures for this study were psychological distress and psychological well-being . RESULTS Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression , emotional processing , and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being . CONCLUSION The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer BACKGROUND The purpose of this study was to determine if patients with advanced breast cancer and their family caregivers , who participated in a family based intervention , report better quality of life and other psychosocial outcomes than dyads who received st and ard care alone . METHODS Using a r and omized clinical trial , 134 patients and their family caregivers were assigned to usual care ( control ) or to usual care plus the family intervention ( experimental condition ) . Dyads were assessed at baseline , three- and six-months later . The intervention consisted of five sessions and addressed  family involvement , optimistic attitude , coping effectiveness , uncertainty reduction , and symptom management . RESULTS Patients in the family intervention reported significantly less hopelessness and less negative appraisal of illness than controls ; their family caregivers reported significantly less negative appraisal of caregiving . Intervention effects were evident at three-months , but were not sustained at six-months . No difference was found in the quality of life of dyads in experimental or control conditions . CONCLUSIONS Although the family intervention had positive effects initially , these effects were not sustained over time . Future studies need to consider program dose and duration of effect , outcome measures that are more sensitive to change , and realistic end-points for patients with advanced cancer 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 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 The efficacy of problem-solving therapy ( PST ) to reduce psychological distress was assessed among a sample of 132 adult cancer patients . A second condition provided PST for both the patient and a significant other . At posttreatment , all participants receiving PST fared significantly better than waiting list control patients . Further , improvements in problem solving were found to correlate significantly with improvements in psychological distress and overall quality of life . No differences in symptom reduction were identified between the 2 treatment protocol s. At a 6-month follow-up , however , patients who received PST along with their significant other reported lower levels of psychological distress as compared with members of the PST-alone condition on approximately half of the outcome measures . These effects were further maintained 1-year posttreatment This research evaluates the impact of a r and omized clinical trial for lowering family members ' reactions and increasing their involvement in assisting cancer patients undergoing chemotherapy to better manage their symptoms . The cognitive behavioral intervention was directed toward both the patient and family caregivers . At 10 weeks , caregivers who received the experimental intervention had significantly lower total reactions to assisting with symptoms and assisted with significantly fewer symptoms ( linked to patient improvement in symptom severity ) than caregivers receiving conventional care alone .  Female caregivers receiving the intervention reported significantly lower reaction per symptom where assistance was provided compared to female caregivers in the control group . Thus , the intervention did not increase caregiver involvement in symptom management , quite possibly due to reduced symptom severity among patients in the intervention group . This research offers a model for evaluating trials directed toward both members of a dyad A secondary analysis of a prospect i ve r and omized clinical trial with repeated measures was conducted to examine the effects of a st and ardized nursing intervention on patient and spouse depressive symptoms , sexual function , and marital interaction . Another purpose of this study was to determine if , over time , differences existed in men and their spouses ' levels of depressive symptoms , sexual function  , and marital interaction  following radical prostatectomy . Spouses reported significantly higher levels of depressive symptoms and significantly more marital interaction distress compared to patients . Patients reported significantly more distress pertaining to sexual function than their spouses PURPOSE / OBJECTIVES To test an intervention for hospice caregivers design ed to help them better manage symptoms experienced by patients with cancer . DESIGN A three-group comparative design with repeated measures . SETTING A large nonprofit hospice that primarily provides home care . SAMPLE 329 hospice homecare patients with cancer and their caregivers were r and omized into three groups : a control group  ( n = 109 ) receiving st and ard care  , a group  ( n = 109 )  receiving st and ard care plus friendly visits , and a group  ( n = 111 )  receiving st and ard care plus the COPE intervention . METHODS Caregivers received experimental training in the COPE intervention ( creativity , optimism , planning , expert information ) over nine days to assist with symptom management . MAIN RESEARCH VARIABLES Intensity of pain , dyspnea , and constipation , overall symptom distress , and quality of life ( QOL ) . Data were collected on admission and days 16 and 30 . FINDINGS Although symptom intensity for three target symptoms did not decrease , symptom distress was significantly improved ( p = 0.009 ) in the COPE intervention group . QOL was not significantly different . CONCLUSIONS Symptom distress , a measure that encompasses patient suffering along with intensity , was significantly decreased in the group in which caregivers were trained to better manage patient symptoms . IMPLICATION S FOR NURSING The COPE intervention is effective and immediately translatable to the bedside for hospice homecare patients with advanced cancer Background : Although various forms of psychoeducation and counseling interventions have been examined among patients with a variety of diagnoses , the unique contribution of phase-specific psychoeducation and telephone counseling ( TC ) to the ongoing process of adjustment has not been explored among patients with breast cancer and their partners . Objective : To conduct a r and omized controlled clinical trial of phase-specific evidence -based psychoeducation and TC interventions to enhance emotional , physical , and social adjustments in patients with breast cancer and their partners . Methods : A purpos 
    Output:
    