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: OBJECTIVES Early psychosocial screening may guide interventions and ameliorate the adverse psychosocial effects of childhood cancer . The revised psychosocial assessment tool provides risk information - Universal ( typical distress ) , Targeted ( additional specific distress ) , and Clinical ( severe distress ) - about the child with cancer and his or her family . This pilot study investigated the benefits of providing a summary of family psychosocial risk information to the medical team treating the newly diagnosed child ( Experimental Group , EG ) . METHOD We conducted a pilot r and omized control trial with a sample of 67 parents , comparing the EG to the control group ( CG )  on parental perception of family psychosocial difficulties (  revised psychosocial assessment tool risk levels ) , child behavior ( behavior assessment scale for children-2 ) , pediatric quality of life ( PedsQL ) , and parental anxiety ( state-anxiety scale of the state-trait anxiety inventory ) , 2 - 4 weeks after diagnosis ( Time 1 ) and 6 months later ( Time 2 ) . RESULTS Compared to the CG , participants in the EG had significantly reduced targeted and clinical risk ( p < 0.001 ) , and improved pain related PedsQL at Time 2 ( p < 0.05 ) . Scores for PedsQL total and nearly all subscales improved over time in both groups ( p < 0.05 to p < 0.001 ) . No changes in behavior scores were noted . CONCLUSION Preliminary findings suggest that providing a summary of the Psychosocial Assessment Tool to the treating team shortly after diagnosis may help reduce family wide psychosocial risk 6 months later and improve quality of life related to pain for children who are undergoing treatment for cancer BACKGROUND Carers of patients with advanced cancer often have health and psychosocial needs , which are frequently overlooked . AIM To meet the needs of carers through a GP consultation directed by a self-completed carer needs checklist . DESIGN AND SETTING R and omised controlled trial in general practice with recruitment through specialist oncology clinics , in Brisbane , Australia . METHOD Intervention was ( a )  carer-GP consultations directed by a self-completed checklist of needs at baseline and 3 months ; and ( b ) a GP-Toolkit to assist GPs to address carer-identified needs . Control group received usual care . Outcome measures were intensity of needs , anxiety and depression , and quality of life . RESULTS Total recruitment 392 . Overall , no significant differences were detected in the number or intensity of need between groups . Compared to controls , intervention participants with baseline clinical anxiety showed improvements in mental wellbeing ( P = 0.027 ) , and those with baseline clinical depression had slower development of anxiety ( P = 0.044 ) at 6 months . For those not anxious , physical wellbeing improved at 1 month ( P = 0.040 ) . Carers looking after patients with poor functional status had more physical needs ( P = 0.037 ) at 1 month and more psychological and emotional needs at 3 months ( P = 0.034 ) . Those caring for less unwell patients showed improved mental wellbeing at 3 months ( P = 0.022 ) . CONCLUSION The intervention did not influence the number or intensity of needs reported by carers of people with advanced cancer . There was limited impact in people with pre-existing clinical anxiety and depression . For the carer of those most severely affected by advanced cancer , it drew attention to the needs arising from the caregiving role Purpose A r and omized controlled trial was conducted to evaluate outcomes of a multimedia instructional program for family caregivers in simple touch-based techniques to provide comfort to cancer patients at home . Methods A multilingual 78-min DVD and 66-page manual were produced for homebased instruction . Content addresses attitudes and communication about touch in cancer , psychological preparation for giving and receiving touch , safety pre caution s , massage techniques for comfort and relaxation , acupressure for specific cancer-related symptoms , and practice in the home setting . Material s were produced in English , Spanish , and Chinese versions . A community-based multiethnic sample of 97 adult patient/caregiver dyads was r and omized to experimental ( massage ) or attention control ( reading ) groups for 4 weeks .  Massage dyads received the program and instructions to practice at least three times per week , while control caregivers read to their patients for the same frequency . Self-report instruments assessed change in symptom severity , quality of life , perceived stress , and caregiver attitudes . Results Significant reductions in all symptoms occurred for patients after both activities : 12–28 % reductions after reading vs. 29–44 % after massage . Massage caregivers showed significant gains in confidence , comfort , and self-efficacy using touch and massage as forms of caregiving . Conclusions Multimedia instruction in touch and massage methods may offer family members a viable means of enhancing self-efficacy and satisfaction in caregiving while decreasing patient pain , depression , and other symptoms . Family members may be able to learn and apply safe and simple methods that increase patient comfort and reduce distress High- grade gliomas ( HGG ) are serious primary brain tumors that may prevent the patient from functioning normally in social , emotional and cognitive respect . Often the partner ’s role will convert to that of informal caregiver . Consequently , they may experience significant stress and reductions in caregiver mastery , negatively affecting their health-related quality of life ( HRQOL ) . We aim ed at ( 1 ) determining factors that impact HRQOL and mastery of caregivers of HGG patients , and ( 2 ) investigate if a structured intervention consisting of psychoeducation and cognitive behavioral therapy leads to improvements in the mental component of HRQOL and mastery of caregivers . Fifty-six patient-caregiver dyads were r and omly assigned to the intervention group or the care as usual group .  The intervention program consisted of six one-hour sessions with a psychologist . Participants completed question naires concerning their perceptions of the patients ’ HRQOL ( SF-36 ) , neurological functioning ( BN20 ) , and cognitive functioning ( MOS ) , and concerning their own HRQOL ( SF-36 ) and feelings of caregiver mastery ( CMS ) both at baseline ( i.e. before r and omization ) and every 2 months thereafter until 8 months later , five times in total . Patients ’ HRQOL and neurological functioning were found to be related to HRQOL and feelings of mastery of the informal caregiver at baseline . The intervention helped caregivers in maintaining a stable level of HRQOL and improved feelings of mastery over an 8 month period . Our findings suggest that informal caregivers can benefit from a psychological intervention as it is a helpful tool in maintaining a stable level of mental functioning and caregiver mastery Background Cancer often affects the quality of life and well-being of patients as well as their relatives . Previous studies have suggested that relatives should be involved in psychosocial rehabilitation to address the needs for an interpersonal relationship with others in the disease trajectory . We developed an innovative rehabilitation program to be offered to the patient and a relative as a pair . Objective The aim of the present pilot study was to examine the feasibility of the intervention in a r and omized controlled trial ( RCT ) and to evaluate the impact on quality of life . Methods The study was design ed as an RCT comparing the new multimodal psychosocial rehabilitation with the usual services . The intervention comprised three ‘ supportive talks ’ and a residential rehabilitation course . From March 2010 to March 2011 , participation was offered at the time of diagnosis to patients with lung or gynecological cancer from two departments at Odense University Hospital in Denmark . Question naires were used to estimate changes in quality of life ( EORTC-QLQ-C30 on global health status ) and well-being ( WHO-Five Well-Being Index ) at baseline and after 2 and 12 months . Information on the participants ’ views about the rehabilitation intervention was obtained from assessment charts and qualitative interviews . Results A total of 209 patients were assessed for eligibility , but only 42 pairs were r and omized to the study . The 2-month follow-up was completed by 34 patients and 32 relatives , and 19 patients and 21 relatives completed the 12-month follow-up . A higher dropout rate at the 12-month follow-up was reported in the intervention group compared with controls . Quality of life and well-being increased for patients and relatives in both the intervention and the control group , and no clinical ly significant difference was observed between the intervention and the control group . Pairs reported that the time of inclusion was inconvenient and that rehabilitation ought to meet their changing needs . Conclusions The pilot study showed that it may be difficult to conduct an RCT of a psychosocial rehabilitation intervention for pairs , and difficulties with inclusion and drop out have to be addressed . Interventions need to be carefully developed and tested before evaluating an effect in a large-scale study 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 Purpose We examined the effects of an enhanced informal caregiver training ( Enhanced-CT ) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients . Methods We recruited adult patients in oncology units and their informal caregivers . We utilized a two-armed , r and omized controlled trial design with data collected at baseline , post-training , and at 2 and 4 weeks after hospital discharge . Primary outcomes were self-efficacy for managing patients ’ cancer symptoms and caregiver stress and preparedness for caregiving . Secondary outcomes were caregiver depression , anxiety , and burden . The education comparison ( EDUC ) group received information about community re sources . We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group . Results We consented and r and omized 138 dyads : Enhanced-CT = 68 and EDUC = 70 . The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessment s. There were no intervention group differences in depression , anxiety , and burden . Conclusion An Enhanced-CT protocol result ed in short-term improvements in self-efficacy for managing patients ’ cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers ’ psychological well-being . The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge PURPOSE / OBJECTIVES To evaluate the effectiveness of a psychoeducational intervention , the Caring for the Caregiver Programme ( CCP ) . DESIGN A pilot r and omized , controlled trial , two-group pretest , and repeated post-tests . SETTING Four home hospice organizations and an outpatient clinic in Singapore . SAMPLE 80 caregivers were r and omized into experimental and st and ard care groups . METHODS Outcomes were measured at baseline , week 4 , and week 8 after the intervention . The st and ard care group received routine home hospice care , and the intervention group received the CCP in addition to routine care . MAIN RESEARCH VARIABLES Quality of life ( QOL ) , social support , stress and depression , self-efficacy in self-care , closeness with the patient , rewards , and knowledge . FINDINGS Compared to the st and ard care group , the intervention group reported significantly higher QOL , social support satisfaction and number of supported people , closeness with the patient , self-efficacy in self-care , rewards of caregiving , and knowledge , and lower stress and depression . CONCLUSIONS The CCP had positive effects on family caregivers of patients with advanced cancer . IMPLICATION S FOR NURSING A psychoeducational intervention potentially could help caregivers cope with the dem and s of caregiving Purpose There is a paucity of research evaluating the impact of symptom management interventions on increasing  family caregiver involvement in symptom management and on caregivers ' emotional health . In addition , most caregiver interventions are delivered by a health care professional , which can be costly to implement in clinical practice . The purpose of this study was to determine whether , in patients with solid tumors , a nurse-delivered symptom management intervention was more effective than a coach-led intervention in increasing caregiver 
    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: OBJECTIVES Early psychosocial screening may guide interventions and ameliorate the adverse psychosocial effects of childhood cancer . The revised psychosocial assessment tool provides risk information - Universal ( typical distress ) , Targeted ( additional specific distress ) , and Clinical ( severe distress ) - about the child with cancer and his or her family . This pilot study investigated the benefits of providing a summary of family psychosocial risk information to the medical team treating the newly diagnosed child ( Experimental Group , EG ) . METHOD We conducted a pilot r and omized control trial with a sample of 67 parents , comparing the EG to the control group ( CG )  on parental perception of family psychosocial difficulties (  revised psychosocial assessment tool risk levels ) , child behavior ( behavior assessment scale for children-2 ) , pediatric quality of life ( PedsQL ) , and parental anxiety ( state-anxiety scale of the state-trait anxiety inventory ) , 2 - 4 weeks after diagnosis ( Time 1 ) and 6 months later ( Time 2 ) . RESULTS Compared to the CG , participants in the EG had significantly reduced targeted and clinical risk ( p < 0.001 ) , and improved pain related PedsQL at Time 2 ( p < 0.05 ) . Scores for PedsQL total and nearly all subscales improved over time in both groups ( p < 0.05 to p < 0.001 ) . No changes in behavior scores were noted . CONCLUSION Preliminary findings suggest that providing a summary of the Psychosocial Assessment Tool to the treating team shortly after diagnosis may help reduce family wide psychosocial risk 6 months later and improve quality of life related to pain for children who are undergoing treatment for cancer BACKGROUND Carers of patients with advanced cancer often have health and psychosocial needs , which are frequently overlooked . AIM To meet the needs of carers through a GP consultation directed by a self-completed carer needs checklist . DESIGN AND SETTING R and omised controlled trial in general practice with recruitment through specialist oncology clinics , in Brisbane , Australia . METHOD Intervention was ( a )  carer-GP consultations directed by a self-completed checklist of needs at baseline and 3 months ; and ( b ) a GP-Toolkit to assist GPs to address carer-identified needs . Control group received usual care . Outcome measures were intensity of needs , anxiety and depression , and quality of life . RESULTS Total recruitment 392 . Overall , no significant differences were detected in the number or intensity of need between groups . Compared to controls , intervention participants with baseline clinical anxiety showed improvements in mental wellbeing ( P = 0.027 ) , and those with baseline clinical depression had slower development of anxiety ( P = 0.044 ) at 6 months . For those not anxious , physical wellbeing improved at 1 month ( P = 0.040 ) . Carers looking after patients with poor functional status had more physical needs ( P = 0.037 ) at 1 month and more psychological and emotional needs at 3 months ( P = 0.034 ) . Those caring for less unwell patients showed improved mental wellbeing at 3 months ( P = 0.022 ) . CONCLUSION The intervention did not influence the number or intensity of needs reported by carers of people with advanced cancer . There was limited impact in people with pre-existing clinical anxiety and depression . For the carer of those most severely affected by advanced cancer , it drew attention to the needs arising from the caregiving role Purpose A r and omized controlled trial was conducted to evaluate outcomes of a multimedia instructional program for family caregivers in simple touch-based techniques to provide comfort to cancer patients at home . Methods A multilingual 78-min DVD and 66-page manual were produced for homebased instruction . Content addresses attitudes and communication about touch in cancer , psychological preparation for giving and receiving touch , safety pre caution s , massage techniques for comfort and relaxation , acupressure for specific cancer-related symptoms , and practice in the home setting . Material s were produced in English , Spanish , and Chinese versions . A community-based multiethnic sample of 97 adult patient/caregiver dyads was r and omized to experimental ( massage ) or attention control ( reading ) groups for 4 weeks .  Massage dyads received the program and instructions to practice at least three times per week , while control caregivers read to their patients for the same frequency . Self-report instruments assessed change in symptom severity , quality of life , perceived stress , and caregiver attitudes . Results Significant reductions in all symptoms occurred for patients after both activities : 12–28 % reductions after reading vs. 29–44 % after massage . Massage caregivers showed significant gains in confidence , comfort , and self-efficacy using touch and massage as forms of caregiving . Conclusions Multimedia instruction in touch and massage methods may offer family members a viable means of enhancing self-efficacy and satisfaction in caregiving while decreasing patient pain , depression , and other symptoms . Family members may be able to learn and apply safe and simple methods that increase patient comfort and reduce distress High- grade gliomas ( HGG ) are serious primary brain tumors that may prevent the patient from functioning normally in social , emotional and cognitive respect . Often the partner ’s role will convert to that of informal caregiver . Consequently , they may experience significant stress and reductions in caregiver mastery , negatively affecting their health-related quality of life ( HRQOL ) . We aim ed at ( 1 ) determining factors that impact HRQOL and mastery of caregivers of HGG patients , and ( 2 ) investigate if a structured intervention consisting of psychoeducation and cognitive behavioral therapy leads to improvements in the mental component of HRQOL and mastery of caregivers . Fifty-six patient-caregiver dyads were r and omly assigned to the intervention group or the care as usual group .  The intervention program consisted of six one-hour sessions with a psychologist . Participants completed question naires concerning their perceptions of the patients ’ HRQOL ( SF-36 ) , neurological functioning ( BN20 ) , and cognitive functioning ( MOS ) , and concerning their own HRQOL ( SF-36 ) and feelings of caregiver mastery ( CMS ) both at baseline ( i.e. before r and omization ) and every 2 months thereafter until 8 months later , five times in total . Patients ’ HRQOL and neurological functioning were found to be related to HRQOL and feelings of mastery of the informal caregiver at baseline . The intervention helped caregivers in maintaining a stable level of HRQOL and improved feelings of mastery over an 8 month period . Our findings suggest that informal caregivers can benefit from a psychological intervention as it is a helpful tool in maintaining a stable level of mental functioning and caregiver mastery Background Cancer often affects the quality of life and well-being of patients as well as their relatives . Previous studies have suggested that relatives should be involved in psychosocial rehabilitation to address the needs for an interpersonal relationship with others in the disease trajectory . We developed an innovative rehabilitation program to be offered to the patient and a relative as a pair . Objective The aim of the present pilot study was to examine the feasibility of the intervention in a r and omized controlled trial ( RCT ) and to evaluate the impact on quality of life . Methods The study was design ed as an RCT comparing the new multimodal psychosocial rehabilitation with the usual services . The intervention comprised three ‘ supportive talks ’ and a residential rehabilitation course . From March 2010 to March 2011 , participation was offered at the time of diagnosis to patients with lung or gynecological cancer from two departments at Odense University Hospital in Denmark . Question naires were used to estimate changes in quality of life ( EORTC-QLQ-C30 on global health status ) and well-being ( WHO-Five Well-Being Index ) at baseline and after 2 and 12 months . Information on the participants ’ views about the rehabilitation intervention was obtained from assessment charts and qualitative interviews . Results A total of 209 patients were assessed for eligibility , but only 42 pairs were r and omized to the study . The 2-month follow-up was completed by 34 patients and 32 relatives , and 19 patients and 21 relatives completed the 12-month follow-up . A higher dropout rate at the 12-month follow-up was reported in the intervention group compared with controls . Quality of life and well-being increased for patients and relatives in both the intervention and the control group , and no clinical ly significant difference was observed between the intervention and the control group . Pairs reported that the time of inclusion was inconvenient and that rehabilitation ought to meet their changing needs . Conclusions The pilot study showed that it may be difficult to conduct an RCT of a psychosocial rehabilitation intervention for pairs , and difficulties with inclusion and drop out have to be addressed . Interventions need to be carefully developed and tested before evaluating an effect in a large-scale study 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 Purpose We examined the effects of an enhanced informal caregiver training ( Enhanced-CT ) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients . Methods We recruited adult patients in oncology units and their informal caregivers . We utilized a two-armed , r and omized controlled trial design with data collected at baseline , post-training , and at 2 and 4 weeks after hospital discharge . Primary outcomes were self-efficacy for managing patients ’ cancer symptoms and caregiver stress and preparedness for caregiving . Secondary outcomes were caregiver depression , anxiety , and burden . The education comparison ( EDUC ) group received information about community re sources . We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group . Results We consented and r and omized 138 dyads : Enhanced-CT = 68 and EDUC = 70 . The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessment s. There were no intervention group differences in depression , anxiety , and burden . Conclusion An Enhanced-CT protocol result ed in short-term improvements in self-efficacy for managing patients ’ cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers ’ psychological well-being . The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge PURPOSE / OBJECTIVES To evaluate the effectiveness of a psychoeducational intervention , the Caring for the Caregiver Programme ( CCP ) . DESIGN A pilot r and omized , controlled trial , two-group pretest , and repeated post-tests . SETTING Four home hospice organizations and an outpatient clinic in Singapore . SAMPLE 80 caregivers were r and omized into experimental and st and ard care groups . METHODS Outcomes were measured at baseline , week 4 , and week 8 after the intervention . The st and ard care group received routine home hospice care , and the intervention group received the CCP in addition to routine care . MAIN RESEARCH VARIABLES Quality of life ( QOL ) , social support , stress and depression , self-efficacy in self-care , closeness with the patient , rewards , and knowledge . FINDINGS Compared to the st and ard care group , the intervention group reported significantly higher QOL , social support satisfaction and number of supported people , closeness with the patient , self-efficacy in self-care , rewards of caregiving , and knowledge , and lower stress and depression . CONCLUSIONS The CCP had positive effects on family caregivers of patients with advanced cancer . IMPLICATION S FOR NURSING A psychoeducational intervention potentially could help caregivers cope with the dem and s of caregiving Purpose There is a paucity of research evaluating the impact of symptom management interventions on increasing  family caregiver involvement in symptom management and on caregivers ' emotional health . In addition , most caregiver interventions are delivered by a health care professional , which can be costly to implement in clinical practice . The purpose of this study was to determine whether , in patients with solid tumors , a nurse-delivered symptom management intervention was more effective than a coach-led intervention in increasing caregiver 
    Output:
    