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: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice Abstract A r and omized clinical trial with 152 patients was conducted to examine the effects of an informational intervention on the severity of side effects result ing from  radiation therapy for prostate cancer . We also examined negative affect both as a predictor and as an outcome variable . The informational intervention , given to patients at the first and fifth treatments , was based upon self-regulation theory and provided patients with specific , objective information about what to expect during their radiation treatments . Patients in the comparison group received general information at the same point in time .  Negative affect was measured using the Profile of Mood States ( POMS ) prior to the intervention and at the last treatment . The severity of side effects for each individual was assessed at their last treatment . The results showed that patients in the informational intervention group reported significantly fewer problems with sleep and less fatigue ( marginally significant ) than those in the comparison group . Negative affect was not influenced by group assignment . Baseline negative affect was not related to symptom development , although the development of side effects was associated with an increase in negative mood . The results suggest that patients could benefit from increased knowledge about what to expect during their radiation treatments Background Diagnosis and treatment of cancer can contribute to psychological distress and anxiety  amongst patients . Evidence indicates that information giving can be beneficial in reducing patient anxiety , so oncology specific information may have a major impact on this patient group . This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and /or radiation therapy in the cancer care centre of a large tertiary Australian hospital . Methods The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system . Historically , most orientation programs at this cancer centre were conducted by one nurse . A r and omised controlled trial has been design ed to test the effectiveness of an  orientation program  with bundled interventions ; a face-to-face program which includes introduction to the hospital facilities , introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies . The aim is to orientate patients to the cancer centre and to meet the health care team . We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress , and a higher level of self-efficacy . Discussion An orientation program is a common health care service provided by cancer care centres for new cancer patients . Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre . It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes . Yet , evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce , particularly with respect to the use of multidisciplinary team members . This paper presents the design of a r and omised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients .Trial registration Current Controlled Trials In order to test the efficacy of various information inputs , 210 consecutive cancer patients were r and omized to one of three information conditions before the start of curative radiation treatment  : ( 1 ) st and ard information plus group and repeated individual information ( n=70 ) , ( 2 ) st and ard information plus brochure ( n=70 ) , and ( 3 ) st and ard information only ( n=70 ) . Patients completed questions regarding satisfaction with information , anxiety , depression , subjective distress and quality of life at inclusion , and 1h before the start of the radiation therapy treatment ( approximately 4 weeks later ) . Patients receiving st and ard information plus group and repeated individual information were significantly more satisfied with the information than were patients in the remaining two groups . There were no differences with respect to any of the other outcome measures . This study has shown that the nurses group and individual information was of significant importance in preparing the patients for the procedure of receiving radiation therapy To test the hypotheses that pessimists might benefit from concrete objective information based on self-regulation theory and that optimists might benefit from instruction in self-care and coping based on self-care theory , 62 patients receiving radiation therapy ( RT ) for prostate cancer were studied . The two experimental and control intervention messages were given three times during RT .  Mood and disruption of activities were assessed three times during and three times after RT . The self-care instruction had no effects on either outcome . The prediction from self-regulation theory was supported , in part , with concrete objective information having a positive effect on mood among pessimistic patients . Concrete objective information result ed in less recreation and pastime disruption in both optimistic and pessimistic patients at the times they experienced the most RT side effects PURPOSE To determine the prevalence of psychosocial distress among patients undergoing radiotherapy ( RT ) for head and neck cancer and to examine the association between depression and anxiety and demographic and medical variables . METHODS AND MATERIAL S A total of 40 patients ( 25 men and 15 women ) with nonmetastatic head and neck cancer were enrolled in this prospect i ve study and underwent RT administered with definitive ( 24 patients ) or postoperative ( 16 patients ) intent . Twenty patients ( 50 % ) received concurrent chemotherapy . All patients completed the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument before RT , on the last day of RT , and at the first follow-up visit . The effect of patient- , tumor- , and treatment-related factors on psychosocial distress was analyzed . RESULTS The prevalence of mild to severe pre-RT depression was 58 % and 45 % using the Hospital Anxiety and Depression Scale-D and Beck Depression Inventory-II scale , respectively . The prevalence of severe pre-RT anxiety was 7 % . The depression levels , as determined by the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument increased significantly during RT and remained elevated at the first follow-up visit ( p < 0.001 for both ) . The variables that were significantly associated with post-RT depression included a greater pre-RT depression level , employment status ( working at enrollment ) , younger age ( < 55 years ) , single marital status , and living alone ( p < 0.05 , for all ) . CONCLUSION The results of our study have shown that an alarming number of patients undergoing RT for head and neck cancer have symptoms suggestive of psychosocial distress even before beginning treatment . This proportion increases significantly during RT . Studies investigating the role of antidepressants and /or psychiatric counseling might be warranted in the future This study evaluated a supportive intervention for fatigue in patients undergoing chemotherapy . One hundred three chemotherapy-naïve patients were recruited , stratified by treatment regimen , and r and omly allocated to intervention or usual care . The intervention was conducted over three months . Recipients were provided with an investigator- design ed information pack and Fatigue Diary that they completed during the week following each treatment . Additionally , support nurses visited them monthly at home . They assessed fatigue , provided psychological support , and coached participants in self-care . The intervention group reported significantly less fatigue ( P < 0.05 ) , lower associated distress ( P < 0.05 ) , and less impact of fatigue on valued pastimes ( P < 0.05 ) than the control group . Further , they reported significantly less anxiety ( P < 0.05 ) and depression ( P < 0.05 ) and displayed more adaptive coping ( P < 0.05 ) . The intervention enabled patients to adapt to living with fatigue and contributed to their psychological/emotional well-being and ability to cope with their illness and treatment BACKGROUND It has been widely shown that the provision of adequate levels of information to patients does have a positive effect on quality of life by reducing anxiety and depression levels . The aim of this study was to show how Italian cancer patients rate the information they are given and whether the use of booklets and videotapes can improve their quality of life . PATIENTS AND METHODS Cancer patients aged between 18 and 80 years who were about to receive their first chemotherapy course were r and omized to fill in question naires on perceived quality of information , level of psychological distress , perceived severity and curability of the disease , and quality of life . The results were evaluated by means of statistical analyses . RESULTS Out of 328 consecutive patients enrolled in 21 cancer centers , 86 - 93 % considered the booklets either " very useful " or " useful " . The videotape was regarded as " quite " or " much " more complete than the booklets ( 87 % ) . According to 81%/87 % of patients , the information that had been given had improved their knowledge of the disease/chemotherapy either " a lot " or " enough " . CONCLUSIONS The information patients receive from the oncologist was rated the highest , as long as they were devoted enough time . Booklets and videotapes can partially overcome the lack of oral information given by medical doctors . A better informed patient does help the oncologist save time Abstract Objective : To compare the use and effect of a  computer based information system  for cancer patients that is personalised using each patient 's medical record with a system providing only general information and with information provided in booklets . Design : R and omised trial with three groups . Data collected at start of radiotherapy , one week later ( when information provided ) , three weeks later , and three months later . Participants : 525 patients started radical radiotherapy ; 438 completed follow up . Interventions : Two groups were offered information via computer ( personalised or general information , or both ) with open access to computer thereafter ; the third group was offered a selection of information booklets . Outcomes : Patients ' views and preferences , use of computer and information , and psychological status ; doctors ' perceptions ; cost of interventions . Results : More patients offered the personalised information said that they had learnt something new , thought the information was relevant , used the computer again , and showed their computer printouts to others . There were no major differences in doctors ' perceptions of patients . More of the general computer group were anxious at three months . With an electronic patient record system , in the long run the personalised information system would cost no more than the general system . Full access to booklets cost twice as much as the general system . Conclusions : Patients preferred computer systems that provided information from their medical records to systems that just provided general information . This has implication s for the design and implementation of electronic patient record systems and reliance on general sources of patient information Purpose Education-based interventions for cancer-related fatigue have shown promise in adults undergoing radiotherapy . Research on the cancer-related fatigue intervention trial ( CAN-FIT ) programme found that pre-radiotherapy fatigue information and support ( pre-RFES ) did not improve levels of fatigue , but was associated with improvements in activity-based outcomes . We aim ed to measure whether pre-RFES result ed in greater participant self-ratings of their performance of daily living activities , fatigue , quality of life and distress . Methods Thirty people undergoing radiotherapy and /or chemotherapy  were r and omly allocated to either a 1-h RFES session from the CAN-FIT programme ( delivered individually to participants and modified where necessary for patients undergoing chemotherapy ) or st and ard care . Measures were taken pre- and post-treatment and 6 weeks after completing treatment . Results There was no significant difference between groups on performance of daily living activities or ratings of distress . Further analysis found a significant difference between the control and treatment groups for EQ-5D health state visual analogue scale ( −9.05 [ −18.09 ; −0.018 ] ; p < 0.05 ) and physical fatigue ( 2.86 [ 0.58 ; 5.14 ] ; p < 0.02 ) with the treatment group rating their overall health state worse and their physical fatigue higher than the controls . Conclusions Pre-RFES delivered individually did not significantly improve participants ’ ratings of their performance of daily occupations and was unexpectedly associated with worse overall health state and higher physical fatigue . Future trials , ideally comparing individual and group education to exercise programmes or cognitive – behavioural approaches , are recommended to examine the broader question of whether discussing fatigue might actually make participants feel worse Background Adjuvant endocrine therapy can improve disease-free survival and time before recurrence in breast cancer patients . However , it is associated with considerable side effects that negatively affect patients ’ quality of life and cause non-adherence . The recently demonstrated effect of individual expectations on side-effect development ( nocebo effect ) suggests that psychological factors play a role in the prevention of side effects . The aim of this study is to evaluate cognitive-behavioral side-effect prevention training ( SEPT ) for breast cancer patients . This article describes the study protocol and applied research methods . Methods / Design In a r and omized controlled trial , 184 female breast cancer patients are assigned to receive either SEPT , st and ard medical care or a manualized supportive therapy at the start of adjuvant endocrine treatment . SEPT consists of three 
    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: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice Abstract A r and omized clinical trial with 152 patients was conducted to examine the effects of an informational intervention on the severity of side effects result ing from  radiation therapy for prostate cancer . We also examined negative affect both as a predictor and as an outcome variable . The informational intervention , given to patients at the first and fifth treatments , was based upon self-regulation theory and provided patients with specific , objective information about what to expect during their radiation treatments . Patients in the comparison group received general information at the same point in time .  Negative affect was measured using the Profile of Mood States ( POMS ) prior to the intervention and at the last treatment . The severity of side effects for each individual was assessed at their last treatment . The results showed that patients in the informational intervention group reported significantly fewer problems with sleep and less fatigue ( marginally significant ) than those in the comparison group . Negative affect was not influenced by group assignment . Baseline negative affect was not related to symptom development , although the development of side effects was associated with an increase in negative mood . The results suggest that patients could benefit from increased knowledge about what to expect during their radiation treatments Background Diagnosis and treatment of cancer can contribute to psychological distress and anxiety  amongst patients . Evidence indicates that information giving can be beneficial in reducing patient anxiety , so oncology specific information may have a major impact on this patient group . This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and /or radiation therapy in the cancer care centre of a large tertiary Australian hospital . Methods The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system . Historically , most orientation programs at this cancer centre were conducted by one nurse . A r and omised controlled trial has been design ed to test the effectiveness of an  orientation program  with bundled interventions ; a face-to-face program which includes introduction to the hospital facilities , introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies . The aim is to orientate patients to the cancer centre and to meet the health care team . We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress , and a higher level of self-efficacy . Discussion An orientation program is a common health care service provided by cancer care centres for new cancer patients . Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre . It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes . Yet , evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce , particularly with respect to the use of multidisciplinary team members . This paper presents the design of a r and omised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients .Trial registration Current Controlled Trials In order to test the efficacy of various information inputs , 210 consecutive cancer patients were r and omized to one of three information conditions before the start of curative radiation treatment  : ( 1 ) st and ard information plus group and repeated individual information ( n=70 ) , ( 2 ) st and ard information plus brochure ( n=70 ) , and ( 3 ) st and ard information only ( n=70 ) . Patients completed questions regarding satisfaction with information , anxiety , depression , subjective distress and quality of life at inclusion , and 1h before the start of the radiation therapy treatment ( approximately 4 weeks later ) . Patients receiving st and ard information plus group and repeated individual information were significantly more satisfied with the information than were patients in the remaining two groups . There were no differences with respect to any of the other outcome measures . This study has shown that the nurses group and individual information was of significant importance in preparing the patients for the procedure of receiving radiation therapy To test the hypotheses that pessimists might benefit from concrete objective information based on self-regulation theory and that optimists might benefit from instruction in self-care and coping based on self-care theory , 62 patients receiving radiation therapy ( RT ) for prostate cancer were studied . The two experimental and control intervention messages were given three times during RT .  Mood and disruption of activities were assessed three times during and three times after RT . The self-care instruction had no effects on either outcome . The prediction from self-regulation theory was supported , in part , with concrete objective information having a positive effect on mood among pessimistic patients . Concrete objective information result ed in less recreation and pastime disruption in both optimistic and pessimistic patients at the times they experienced the most RT side effects PURPOSE To determine the prevalence of psychosocial distress among patients undergoing radiotherapy ( RT ) for head and neck cancer and to examine the association between depression and anxiety and demographic and medical variables . METHODS AND MATERIAL S A total of 40 patients ( 25 men and 15 women ) with nonmetastatic head and neck cancer were enrolled in this prospect i ve study and underwent RT administered with definitive ( 24 patients ) or postoperative ( 16 patients ) intent . Twenty patients ( 50 % ) received concurrent chemotherapy . All patients completed the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument before RT , on the last day of RT , and at the first follow-up visit . The effect of patient- , tumor- , and treatment-related factors on psychosocial distress was analyzed . RESULTS The prevalence of mild to severe pre-RT depression was 58 % and 45 % using the Hospital Anxiety and Depression Scale-D and Beck Depression Inventory-II scale , respectively . The prevalence of severe pre-RT anxiety was 7 % . The depression levels , as determined by the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument increased significantly during RT and remained elevated at the first follow-up visit ( p < 0.001 for both ) . The variables that were significantly associated with post-RT depression included a greater pre-RT depression level , employment status ( working at enrollment ) , younger age ( < 55 years ) , single marital status , and living alone ( p < 0.05 , for all ) . CONCLUSION The results of our study have shown that an alarming number of patients undergoing RT for head and neck cancer have symptoms suggestive of psychosocial distress even before beginning treatment . This proportion increases significantly during RT . Studies investigating the role of antidepressants and /or psychiatric counseling might be warranted in the future This study evaluated a supportive intervention for fatigue in patients undergoing chemotherapy . One hundred three chemotherapy-naïve patients were recruited , stratified by treatment regimen , and r and omly allocated to intervention or usual care . The intervention was conducted over three months . Recipients were provided with an investigator- design ed information pack and Fatigue Diary that they completed during the week following each treatment . Additionally , support nurses visited them monthly at home . They assessed fatigue , provided psychological support , and coached participants in self-care . The intervention group reported significantly less fatigue ( P < 0.05 ) , lower associated distress ( P < 0.05 ) , and less impact of fatigue on valued pastimes ( P < 0.05 ) than the control group . Further , they reported significantly less anxiety ( P < 0.05 ) and depression ( P < 0.05 ) and displayed more adaptive coping ( P < 0.05 ) . The intervention enabled patients to adapt to living with fatigue and contributed to their psychological/emotional well-being and ability to cope with their illness and treatment BACKGROUND It has been widely shown that the provision of adequate levels of information to patients does have a positive effect on quality of life by reducing anxiety and depression levels . The aim of this study was to show how Italian cancer patients rate the information they are given and whether the use of booklets and videotapes can improve their quality of life . PATIENTS AND METHODS Cancer patients aged between 18 and 80 years who were about to receive their first chemotherapy course were r and omized to fill in question naires on perceived quality of information , level of psychological distress , perceived severity and curability of the disease , and quality of life . The results were evaluated by means of statistical analyses . RESULTS Out of 328 consecutive patients enrolled in 21 cancer centers , 86 - 93 % considered the booklets either " very useful " or " useful " . The videotape was regarded as " quite " or " much " more complete than the booklets ( 87 % ) . According to 81%/87 % of patients , the information that had been given had improved their knowledge of the disease/chemotherapy either " a lot " or " enough " . CONCLUSIONS The information patients receive from the oncologist was rated the highest , as long as they were devoted enough time . Booklets and videotapes can partially overcome the lack of oral information given by medical doctors . A better informed patient does help the oncologist save time Abstract Objective : To compare the use and effect of a  computer based information system  for cancer patients that is personalised using each patient 's medical record with a system providing only general information and with information provided in booklets . Design : R and omised trial with three groups . Data collected at start of radiotherapy , one week later ( when information provided ) , three weeks later , and three months later . Participants : 525 patients started radical radiotherapy ; 438 completed follow up . Interventions : Two groups were offered information via computer ( personalised or general information , or both ) with open access to computer thereafter ; the third group was offered a selection of information booklets . Outcomes : Patients ' views and preferences , use of computer and information , and psychological status ; doctors ' perceptions ; cost of interventions . Results : More patients offered the personalised information said that they had learnt something new , thought the information was relevant , used the computer again , and showed their computer printouts to others . There were no major differences in doctors ' perceptions of patients . More of the general computer group were anxious at three months . With an electronic patient record system , in the long run the personalised information system would cost no more than the general system . Full access to booklets cost twice as much as the general system . Conclusions : Patients preferred computer systems that provided information from their medical records to systems that just provided general information . This has implication s for the design and implementation of electronic patient record systems and reliance on general sources of patient information Purpose Education-based interventions for cancer-related fatigue have shown promise in adults undergoing radiotherapy . Research on the cancer-related fatigue intervention trial ( CAN-FIT ) programme found that pre-radiotherapy fatigue information and support ( pre-RFES ) did not improve levels of fatigue , but was associated with improvements in activity-based outcomes . We aim ed to measure whether pre-RFES result ed in greater participant self-ratings of their performance of daily living activities , fatigue , quality of life and distress . Methods Thirty people undergoing radiotherapy and /or chemotherapy  were r and omly allocated to either a 1-h RFES session from the CAN-FIT programme ( delivered individually to participants and modified where necessary for patients undergoing chemotherapy ) or st and ard care . Measures were taken pre- and post-treatment and 6 weeks after completing treatment . Results There was no significant difference between groups on performance of daily living activities or ratings of distress . Further analysis found a significant difference between the control and treatment groups for EQ-5D health state visual analogue scale ( −9.05 [ −18.09 ; −0.018 ] ; p < 0.05 ) and physical fatigue ( 2.86 [ 0.58 ; 5.14 ] ; p < 0.02 ) with the treatment group rating their overall health state worse and their physical fatigue higher than the controls . Conclusions Pre-RFES delivered individually did not significantly improve participants ’ ratings of their performance of daily occupations and was unexpectedly associated with worse overall health state and higher physical fatigue . Future trials , ideally comparing individual and group education to exercise programmes or cognitive – behavioural approaches , are recommended to examine the broader question of whether discussing fatigue might actually make participants feel worse Background Adjuvant endocrine therapy can improve disease-free survival and time before recurrence in breast cancer patients . However , it is associated with considerable side effects that negatively affect patients ’ quality of life and cause non-adherence . The recently demonstrated effect of individual expectations on side-effect development ( nocebo effect ) suggests that psychological factors play a role in the prevention of side effects . The aim of this study is to evaluate cognitive-behavioral side-effect prevention training ( SEPT ) for breast cancer patients . This article describes the study protocol and applied research methods . Methods / Design In a r and omized controlled trial , 184 female breast cancer patients are assigned to receive either SEPT , st and ard medical care or a manualized supportive therapy at the start of adjuvant endocrine treatment . SEPT consists of three 
    Output:
    