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: PURPOSE The purpose of this r and omized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer ( MBSR[BC ] ) program in improving psychological and physical symptoms and quality of life among breast cancer survivors ( BCSs ) who completed treatment . Outcomes were assessed immediately after 6 weeks of MBSR(BC ) training and 6 weeks later to test efficacy over an extended timeframe . PATIENTS AND METHODS A total of 322 BCSs were r and omly assigned to either a 6-week  MBSR(BC ) program ( n = 155 ) or a usual care group ( n = 167 ) . Psychological ( depression , anxiety , stress , and fear of recurrence ) and physical symptoms ( fatigue and pain ) and quality of life ( as related to health ) were assessed at baseline and at 6 and 12 weeks . Linear mixed models were used to assess MBSR(BC ) effects over time , and participant characteristics at baseline were also tested as moderators of MBSR(BC ) effects . RESULTS Results demonstrated extended improvement for the MBSR(BC ) group compared with usual care in both psychological symptoms of anxiety , fear of recurrence overall , and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference ( P < .01 ) . Overall effect sizes were largest for fear of recurrence problems ( d = 0.35 ) and fatigue severity ( d = 0.27 ) . Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC ) . CONCLUSION The MBSR(BC ) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC ) training , with generally small to moderate overall effect sizes Background : Compelling evidence has yet to be published regarding the positive effect of psychoeducational interventions ( PEIs ) on psychological distress in patients with breast cancer . The impact of PEIs on self-efficacy , resilience , and quality of life is also unclear . Purpose : The aim of this study was to assess the effects of a PEI on anxiety , depression , disease-specific care knowledge , self-efficacy , resilience and quality of life in patients with breast cancer during and after chemotherapy . The intervention was administered before and during five rounds of chemotherapy treatment . Methods : A r and omized controlled trial was conducted . Patients with breast cancer ( N = 40 ) were r and omly assigned to either the experimental or control group . The experimental group participated in PEI , a brief and highly structured program consisting of two parts : ( a ) an educational manual that addressed depression , anxiety , disease-specific care knowledge , self-efficacy , and resilience and ( b ) a self- assessment of learning . The control group received only traditional pamphlet education . Data were collected at four time points : before the first chemotherapy session ( T1 ) , during the third chemotherapy session ( T2 ) , during the fifth chemotherapy session ( T3 ) , and at 2 weeks after the final chemotherapy session ( T4 ) . Results : Anxiety , depression , resilience , and quality of life in the experimental group showed significant differences at T4 . Significant differences became apparent at T2 for knowledge and at T3 for self-efficacy . The effects of knowledge , resilience , and quality of life remained significant when group and time interactions were included in the model , showing a positive relationship between PEI and the variables of knowledge , resilience , and quality of life . Conclusions / Implication s for Practice : Face-to-face PEI for patients with breast cancer is potentially effective in improving knowledge , resilience , and quality of life during and after chemotherapy . In the current study , PEI significantly improved disease care techniques , reduced chemotherapy-related discomfort , and improved quality of life for participants in the experimental group OBJECTIVE The aim is to evaluate the effectiveness of a manualized 12-week supportive-expressive group therapy program among primary breast cancer patients treated in community setting s , to determine whether highly distressed patients were most likely to benefit and whether therapist 's training or experience was related to outcome . METHOD Three hundred and fifty-three women within one year of diagnosis with primary breast cancer were r and omly assigned to receive supportive-expressive group therapy or to an education control condition . Participants were recruited from two academic centers and nine oncology practice s , which were members of NCI 's Community Clinical Oncology Program ( CCOP ) and were followed over 2 years . RESULTS A 2x2x19 analysis of variance was conducted with main effects of treatment condition , cohort , and baseline distress and their interactions . There was no main effect for treatment condition after removing one subject with an extreme score .  Highly distressed women did not derive a greater benefit from treatment . Therapist training and psychotherapy experience were not associated with a treatment effect . CONCLUSIONS This study provides no evidence of reduction in distress as the result of a brief supportive-expressive intervention for women with primary breast cancer . Future studies might productively focus on women with higher initial levels of distress Objective : Mindfulness meditation reduces psychological distress among individuals with cancer . However , mechanisms for intervention effects have not been fully determined . This study tested emotion regulation strategies as mediators of intervention effects in a sample of younger women treated for breast cancer , a group at risk for psychological distress . We focused on two distinct strategies targeted by the intervention — rumination and self-kindness— and further examined the broader construct of mindfulness as a potential mediator . Method : Women ( n = 71 ) with Stage 0-III breast cancer diagnosed at or before age 50 who had completed cancer treatment were r and omly assigned to a 6-week mindfulness intervention or wait-list control group . Assessment s occurred at study entry , postintervention , and a 3-month follow-up . Results : In single mediator analyses , increases in self-kindness ( CIB [ −7.83 , −1.93 ] ) , decreases in rumination ( CIB [ −5.05 , −.31 ] ) , and increases in mindfulness ( CIB [ −6.58 , −.82 ] ) each mediated reductions in depressive symptoms from pre- to postintervention . Increases in self-kindness also mediated reductions in perceived stress ( CIB [ −5.37 , −.62 ] ) from pre- to postintervention , and increases in self-kindness ( CIB [ −5.67 , −.22 ] ) and in mindfulness ( CIB [ −5.51 , −.16 ] ) each mediated intervention effects on perceived stress from preintervention to 3-month follow-up . In multiple mediator analysis , only self-kindness mediated intervention effects on depressive symptoms from pre- to postintervention ( CIB [ −6.41 , −.61 ] ) , and self-kindness and mindfulness together mediated intervention effects on perceived stress from preintervention to follow-up ( CIB [ −6.77 , −.35 ] ) . Conclusions : Self-kindness played a consistent role in reducing distress in younger women with breast cancer . The efficacy of this understudied emotion regulation strategy should be evaluated in other clinical population Abstract Breast cancer ( BC ) patients in China suffered from a variety of psychology stress such as perceived stress and anxiety , posttraumatic growth ( PTG ) as a positive factor could promote their psychology health and quality of life . This study aim ed to investigate the efficacy of mindfulness-based stress reduction ( MBSR ) on promoting PTG , decreasing perceived stress and anxiety of Chinese BC patients . A r and omized controlled trial of 60 BC patients ( Stages I – III ) was conducted . They were r and omly divided to the 8-week MBSR group or usual care ( UC ) group . PTG inventory , Perceived Stress Scale of Chinese version ( CPSS ) and State Trait Anxiety Inventory ( STAI ) evaluated the PTG level , perceived stress and anxiety at three times(before intervention-T1 , after intervention-T2 and follow up at 3 months-T3 ) . A repeated- measures analysis of variance model was used to compare each outcome measure of two groups at the three times . There was one patient discontinued the intervention and one lose to follow up in MBSR group , finally 58 BC patients completed the research . There was no difference between two groups before the intervention . The results showed significant improvements in MBSR group comparing with the UC group that PTG level was much higher after the 8-week intervention and the follow up ( F = 34.73 , p < .00 ) . At the same time , CPSS ( F = 14.41 , p < .00 ) and STAI ( F = 15.24 , p < .00 ) scores were significant decreased at T2 and T3 . The results showed that MBSR promoted the level of PTG and decreased perceived stress and anxiety state of Chinese BC patients , and the results persisted at three months after intervention . The research preliminary proved that MBSR was suitable to Chinese BC patients .  MBSR should be recommending to BC survivors in China OBJECTIVE Women with breast cancer ( BCa ) report elevated distress postsurgery . Group-based cognitive-behavioral stress management ( CBSM ) following surgery improves psychological adaptation , though its key mechanisms remain speculative . This r and omized controlled dismantling trial compared 2 interventions featuring elements thought to drive CBSM effects : a 5-week cognitive-behavioral training ( CBT ) and 5-week relaxation training ( RT ) versus a 5-week health education ( HE ) control group . METHOD Women with stage 0-III BCa ( N = 183 ) were r and omized to CBT , RT , or HE condition 2 - 10 weeks postsurgery . Psychosocial measures were collected at baseline ( T1 ) and postintervention ( T2 ) . Repeated- measures analyses of variance ( ANOVAs ) tested whether CBT and RT treatments improved primary measures of psychological adaptation and secondary measures of stress management re source perceptions from pre- to postintervention relative to HE . RESULTS Both CBT and RT groups reported reduced depressive affect . The CBT group reported improved emotional well-being/ quality of life and less cancer-specific thought intrusions . The RT group reported improvements on illness-related social disruption . Regarding stress management re sources , the CBT group reported increased reliability of social support networks , while the RT group reported increased confidence in relaxation skills . Psychological adaptation and stress management re source constructs were unchanged in the HE control group . CONCLUSIONS Nonmetastatic breast cancer patients participating in 2 forms of brief , 5-week group-based stress management intervention after surgery showed improvements in psychological adaptation and stress management re sources compared with an attention-matched control group . Findings provide preliminary support suggesting that using brief group-based stress management interventions may promote adaptation among nonmetastatic breast cancer patients Context . Breast cancer ( BC ) requires a significant psychological adaptation once treatment is finished . There is growing evidence of how compassion training enhances psychological and physical well-being , however , there are very few studies analyzing the efficacy of compassion-based Interventions on BC survivors . Objective . To study the efficacy of the Cognitively-Based Compassion Training ( CBCT ) protocol in a BC survivor sample on quality of life , psychological well-being , fear of cancer recurrence , self-compassion , and compassion domains and mindfulness facets . Furthermore , enrollment , adherence , and satisfaction with the intervention were also analyzed . Methods . A r and omized clinical trial was design ed . Participants ( n = 56 ) were r and omly assigned to CBCT ( n = 28 ) or a treatment-as-usual control group ( TAU  ; n = 28 ) . Pre-post intervention and 6-month follow-up measures took place to evaluate health-related quality of life , psychological well-being ; psychological stress , coping strategies , and triggering cognitions ; self-compassion and compassion ; and mindfulness in both intervention and wait-list groups . Results . Accrual of eligible participants was high ( 77 % ) , and the drop-out rate was 16 % .  Attendance to  CBCT sessions was high and practice off sessions exceeded expectations ) . CBCT was effective in diminishing stress caused by FCR , fostering self-kindness and common humanity , and increasing overall self-compassion scores , mindful observation , and acting with awareness skillsets . Conclusion . CBCT could be considered a promising and potentially useful intervention to diminish stress caused by FCR and enhance self-kindness , common humanity , overall self-compassion , mindful observation , and acting with awareness skillsets . Nevertheless , future r and omized trials are needed and a process of deeper cultural adaptation required Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses . The primary purpose of this r and omized controlled trial was to determine the efficacy of a mindfulness‐based stress reduction ( MBSR ) intervention for mood disorders in women with breast cancer . Secondary outcomes were symptom experience , health status , coping capacity , mindfulness , posttraumatic growth , and immune status . This RTC assigned 166 women with breast cancer to one of three groups :  MBSR ( 8 weekly group sessions of MBSR ) , active controls ( self‐instructing MBSR ) and non‐MBSR . The primary outcome measure was the Hospital Anxiety and Depression Scale . Secondary outcome measures were : Memorial Symptom Assessment Scale , SF‐36 , Sense of Coherence , Five Facets of Mindfulness Question naire , and Posttraumatic Growth Index . Blood sample s were analyzed using flow cytometry for NK‐cell activity ( FANKIA ) and lymphocyte phenotyping ; concentrations of cytokines were determined in sera using commercial high sensitivity IL‐6 and IL‐8 ELISA ( enzyme‐linked immunosorbent assay ) kits . Results provide evidence for beneficial effects of MBSR on psychological and biological responses . Women in the MBSR group experienced significant improvements in depression scores , with a mean pre‐MBSR HAD‐score of 4.3 and post‐MBSR score of 3 
    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: PURPOSE The purpose of this r and omized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer ( MBSR[BC ] ) program in improving psychological and physical symptoms and quality of life among breast cancer survivors ( BCSs ) who completed treatment . Outcomes were assessed immediately after 6 weeks of MBSR(BC ) training and 6 weeks later to test efficacy over an extended timeframe . PATIENTS AND METHODS A total of 322 BCSs were r and omly assigned to either a 6-week  MBSR(BC ) program ( n = 155 ) or a usual care group ( n = 167 ) . Psychological ( depression , anxiety , stress , and fear of recurrence ) and physical symptoms ( fatigue and pain ) and quality of life ( as related to health ) were assessed at baseline and at 6 and 12 weeks . Linear mixed models were used to assess MBSR(BC ) effects over time , and participant characteristics at baseline were also tested as moderators of MBSR(BC ) effects . RESULTS Results demonstrated extended improvement for the MBSR(BC ) group compared with usual care in both psychological symptoms of anxiety , fear of recurrence overall , and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference ( P < .01 ) . Overall effect sizes were largest for fear of recurrence problems ( d = 0.35 ) and fatigue severity ( d = 0.27 ) . Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC ) . CONCLUSION The MBSR(BC ) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC ) training , with generally small to moderate overall effect sizes Background : Compelling evidence has yet to be published regarding the positive effect of psychoeducational interventions ( PEIs ) on psychological distress in patients with breast cancer . The impact of PEIs on self-efficacy , resilience , and quality of life is also unclear . Purpose : The aim of this study was to assess the effects of a PEI on anxiety , depression , disease-specific care knowledge , self-efficacy , resilience and quality of life in patients with breast cancer during and after chemotherapy . The intervention was administered before and during five rounds of chemotherapy treatment . Methods : A r and omized controlled trial was conducted . Patients with breast cancer ( N = 40 ) were r and omly assigned to either the experimental or control group . The experimental group participated in PEI , a brief and highly structured program consisting of two parts : ( a ) an educational manual that addressed depression , anxiety , disease-specific care knowledge , self-efficacy , and resilience and ( b ) a self- assessment of learning . The control group received only traditional pamphlet education . Data were collected at four time points : before the first chemotherapy session ( T1 ) , during the third chemotherapy session ( T2 ) , during the fifth chemotherapy session ( T3 ) , and at 2 weeks after the final chemotherapy session ( T4 ) . Results : Anxiety , depression , resilience , and quality of life in the experimental group showed significant differences at T4 . Significant differences became apparent at T2 for knowledge and at T3 for self-efficacy . The effects of knowledge , resilience , and quality of life remained significant when group and time interactions were included in the model , showing a positive relationship between PEI and the variables of knowledge , resilience , and quality of life . Conclusions / Implication s for Practice : Face-to-face PEI for patients with breast cancer is potentially effective in improving knowledge , resilience , and quality of life during and after chemotherapy . In the current study , PEI significantly improved disease care techniques , reduced chemotherapy-related discomfort , and improved quality of life for participants in the experimental group OBJECTIVE The aim is to evaluate the effectiveness of a manualized 12-week supportive-expressive group therapy program among primary breast cancer patients treated in community setting s , to determine whether highly distressed patients were most likely to benefit and whether therapist 's training or experience was related to outcome . METHOD Three hundred and fifty-three women within one year of diagnosis with primary breast cancer were r and omly assigned to receive supportive-expressive group therapy or to an education control condition . Participants were recruited from two academic centers and nine oncology practice s , which were members of NCI 's Community Clinical Oncology Program ( CCOP ) and were followed over 2 years . RESULTS A 2x2x19 analysis of variance was conducted with main effects of treatment condition , cohort , and baseline distress and their interactions . There was no main effect for treatment condition after removing one subject with an extreme score .  Highly distressed women did not derive a greater benefit from treatment . Therapist training and psychotherapy experience were not associated with a treatment effect . CONCLUSIONS This study provides no evidence of reduction in distress as the result of a brief supportive-expressive intervention for women with primary breast cancer . Future studies might productively focus on women with higher initial levels of distress Objective : Mindfulness meditation reduces psychological distress among individuals with cancer . However , mechanisms for intervention effects have not been fully determined . This study tested emotion regulation strategies as mediators of intervention effects in a sample of younger women treated for breast cancer , a group at risk for psychological distress . We focused on two distinct strategies targeted by the intervention — rumination and self-kindness— and further examined the broader construct of mindfulness as a potential mediator . Method : Women ( n = 71 ) with Stage 0-III breast cancer diagnosed at or before age 50 who had completed cancer treatment were r and omly assigned to a 6-week mindfulness intervention or wait-list control group . Assessment s occurred at study entry , postintervention , and a 3-month follow-up . Results : In single mediator analyses , increases in self-kindness ( CIB [ −7.83 , −1.93 ] ) , decreases in rumination ( CIB [ −5.05 , −.31 ] ) , and increases in mindfulness ( CIB [ −6.58 , −.82 ] ) each mediated reductions in depressive symptoms from pre- to postintervention . Increases in self-kindness also mediated reductions in perceived stress ( CIB [ −5.37 , −.62 ] ) from pre- to postintervention , and increases in self-kindness ( CIB [ −5.67 , −.22 ] ) and in mindfulness ( CIB [ −5.51 , −.16 ] ) each mediated intervention effects on perceived stress from preintervention to 3-month follow-up . In multiple mediator analysis , only self-kindness mediated intervention effects on depressive symptoms from pre- to postintervention ( CIB [ −6.41 , −.61 ] ) , and self-kindness and mindfulness together mediated intervention effects on perceived stress from preintervention to follow-up ( CIB [ −6.77 , −.35 ] ) . Conclusions : Self-kindness played a consistent role in reducing distress in younger women with breast cancer . The efficacy of this understudied emotion regulation strategy should be evaluated in other clinical population Abstract Breast cancer ( BC ) patients in China suffered from a variety of psychology stress such as perceived stress and anxiety , posttraumatic growth ( PTG ) as a positive factor could promote their psychology health and quality of life . This study aim ed to investigate the efficacy of mindfulness-based stress reduction ( MBSR ) on promoting PTG , decreasing perceived stress and anxiety of Chinese BC patients . A r and omized controlled trial of 60 BC patients ( Stages I – III ) was conducted . They were r and omly divided to the 8-week MBSR group or usual care ( UC ) group . PTG inventory , Perceived Stress Scale of Chinese version ( CPSS ) and State Trait Anxiety Inventory ( STAI ) evaluated the PTG level , perceived stress and anxiety at three times(before intervention-T1 , after intervention-T2 and follow up at 3 months-T3 ) . A repeated- measures analysis of variance model was used to compare each outcome measure of two groups at the three times . There was one patient discontinued the intervention and one lose to follow up in MBSR group , finally 58 BC patients completed the research . There was no difference between two groups before the intervention . The results showed significant improvements in MBSR group comparing with the UC group that PTG level was much higher after the 8-week intervention and the follow up ( F = 34.73 , p < .00 ) . At the same time , CPSS ( F = 14.41 , p < .00 ) and STAI ( F = 15.24 , p < .00 ) scores were significant decreased at T2 and T3 . The results showed that MBSR promoted the level of PTG and decreased perceived stress and anxiety state of Chinese BC patients , and the results persisted at three months after intervention . The research preliminary proved that MBSR was suitable to Chinese BC patients .  MBSR should be recommending to BC survivors in China OBJECTIVE Women with breast cancer ( BCa ) report elevated distress postsurgery . Group-based cognitive-behavioral stress management ( CBSM ) following surgery improves psychological adaptation , though its key mechanisms remain speculative . This r and omized controlled dismantling trial compared 2 interventions featuring elements thought to drive CBSM effects : a 5-week cognitive-behavioral training ( CBT ) and 5-week relaxation training ( RT ) versus a 5-week health education ( HE ) control group . METHOD Women with stage 0-III BCa ( N = 183 ) were r and omized to CBT , RT , or HE condition 2 - 10 weeks postsurgery . Psychosocial measures were collected at baseline ( T1 ) and postintervention ( T2 ) . Repeated- measures analyses of variance ( ANOVAs ) tested whether CBT and RT treatments improved primary measures of psychological adaptation and secondary measures of stress management re source perceptions from pre- to postintervention relative to HE . RESULTS Both CBT and RT groups reported reduced depressive affect . The CBT group reported improved emotional well-being/ quality of life and less cancer-specific thought intrusions . The RT group reported improvements on illness-related social disruption . Regarding stress management re sources , the CBT group reported increased reliability of social support networks , while the RT group reported increased confidence in relaxation skills . Psychological adaptation and stress management re source constructs were unchanged in the HE control group . CONCLUSIONS Nonmetastatic breast cancer patients participating in 2 forms of brief , 5-week group-based stress management intervention after surgery showed improvements in psychological adaptation and stress management re sources compared with an attention-matched control group . Findings provide preliminary support suggesting that using brief group-based stress management interventions may promote adaptation among nonmetastatic breast cancer patients Context . Breast cancer ( BC ) requires a significant psychological adaptation once treatment is finished . There is growing evidence of how compassion training enhances psychological and physical well-being , however , there are very few studies analyzing the efficacy of compassion-based Interventions on BC survivors . Objective . To study the efficacy of the Cognitively-Based Compassion Training ( CBCT ) protocol in a BC survivor sample on quality of life , psychological well-being , fear of cancer recurrence , self-compassion , and compassion domains and mindfulness facets . Furthermore , enrollment , adherence , and satisfaction with the intervention were also analyzed . Methods . A r and omized clinical trial was design ed . Participants ( n = 56 ) were r and omly assigned to CBCT ( n = 28 ) or a treatment-as-usual control group ( TAU  ; n = 28 ) . Pre-post intervention and 6-month follow-up measures took place to evaluate health-related quality of life , psychological well-being ; psychological stress , coping strategies , and triggering cognitions ; self-compassion and compassion ; and mindfulness in both intervention and wait-list groups . Results . Accrual of eligible participants was high ( 77 % ) , and the drop-out rate was 16 % .  Attendance to  CBCT sessions was high and practice off sessions exceeded expectations ) . CBCT was effective in diminishing stress caused by FCR , fostering self-kindness and common humanity , and increasing overall self-compassion scores , mindful observation , and acting with awareness skillsets . Conclusion . CBCT could be considered a promising and potentially useful intervention to diminish stress caused by FCR and enhance self-kindness , common humanity , overall self-compassion , mindful observation , and acting with awareness skillsets . Nevertheless , future r and omized trials are needed and a process of deeper cultural adaptation required Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses . The primary purpose of this r and omized controlled trial was to determine the efficacy of a mindfulness‐based stress reduction ( MBSR ) intervention for mood disorders in women with breast cancer . Secondary outcomes were symptom experience , health status , coping capacity , mindfulness , posttraumatic growth , and immune status . This RTC assigned 166 women with breast cancer to one of three groups :  MBSR ( 8 weekly group sessions of MBSR ) , active controls ( self‐instructing MBSR ) and non‐MBSR . The primary outcome measure was the Hospital Anxiety and Depression Scale . Secondary outcome measures were : Memorial Symptom Assessment Scale , SF‐36 , Sense of Coherence , Five Facets of Mindfulness Question naire , and Posttraumatic Growth Index . Blood sample s were analyzed using flow cytometry for NK‐cell activity ( FANKIA ) and lymphocyte phenotyping ; concentrations of cytokines were determined in sera using commercial high sensitivity IL‐6 and IL‐8 ELISA ( enzyme‐linked immunosorbent assay ) kits . Results provide evidence for beneficial effects of MBSR on psychological and biological responses . Women in the MBSR group experienced significant improvements in depression scores , with a mean pre‐MBSR HAD‐score of 4.3 and post‐MBSR score of 3 
    Output:
    