Forewarned is forearmed--benefits of preparatory information on video cassette for patients receiving chemotherapy or radiotherapy--a randomised controlled trial. The effects of information and negative affect on severity of side effects from radiation therapy for prostate cancer Effects and feasibility of a multi-disciplinary orientation program for newly registered cancer patients: design of a randomised controlled trial Effects of information supply on satisfaction with information and quality of life in cancer patients receiving curative radiation therapy. Coping with radiation therapy: optimism and the effect of preparatory interventions. Prospective study of psychosocial distress among patients undergoing radiotherapy for head and neck cancer. Supportive intervention for fatigue in patients undergoing chemotherapy: a randomized controlled trial. Improving information to Italian cancer patients: results of a randomized study. Randomised trial of personalised computer based information for cancer patients Education for cancer-related fatigue: could talking about it make people more likely to report it? Optimizing expectations to prevent side effects and enhance quality of life in breast cancer patients undergoing endocrine therapy: study protocol of a randomized controlled trial Impact of providing booklets about chemotherapy to newly presenting patients with cancer: a randomized controlled trial. Managing symptoms in patients with advanced lung cancer during radiotherapy: results of a psychoeducational randomized controlled trial. Randomized controlled trial to assess the effectiveness of a videotape about radiotherapy Audiotaped social comparison information for cancer patients undergoing radiotherapy: differential effects of procedural, emotional and coping information. Preparing patients for threatening medical treatments: effects of a chemotherapy educational DVD on anxiety, unmet needs, and self-efficacy Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. Pilot randomised controlled trial of a radiation therapist-led educational intervention for breast cancer patients prior to commencing radiotherapy Behavioral and psychological predictors of chemotherapy adherence in patients with advanced non-small cell lung cancer. Effect of different forms of information produced for cancer patients on their use of the information, social support, and anxiety: randomised trial Development and pilot testing of a radiation therapist‐led educational intervention for breast cancer patients prior to commencing radiotherapy The effect of timing of the provision of information on anxiety and satisfaction of cancer patients receiving radiotherapy. Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs: results from a randomised, controlled trial. The effect of preparatory patient education on the anxiety and satisfaction of cancer patients receiving radiation therapy The effectiveness of a self-care management interactive multimedia module. Evaluation of the addition of video-based education for patients receiving standard pre-chemotherapy education. First year after head and neck cancer: quality of life. Impact of more intensive written information in patients having radical radiation therapy: results of a prospective randomized phase III trial.
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 sessions of cognitive-behavioral training including psychoeducation to provide a realistic view of endocrine therapy , imagination-training to integrate positive aspects of medication into daily life , and side-effect management to enhance expectations about coping ability . Side effects three months after the start of endocrine therapy serve as primary outcomes . Secondary outcomes include quality of life , coping ability and patients ’ medication adherence . Patients ’ expectations ( i.e. , expectations about side effects , coping ability , treatment and illness ) are analyzed as mediators . Discussion The optimization of expectations might be a potential pathway in health care to improve patients ’ quality of life during long-term medication intake . The results will provide implication s for a possible integration of evidence -based prevention training into clinical practice .Trial registration Clinical Trials.gov , ( NCT01741883 ) BACKGROUND There has been limited research examining the efficacy of providing written information to cancer patients in southern and eastern European countries . This study investigated the impact of a booklet about chemotherapy on patient satisfaction , quality of life ( QoL ) and emotional distress , and assessed booklet use . PATIENTS AND METHODS A total of 145 Greek cancer out patients prior to commencing chemotherapy completed a question naire and were r and omized to receive ( n = 72 ) or not receive ( n = 73 ) the booklet . All patients completed the second question naire before the following cycle of chemotherapy . RESULTS Baseline characteristics were well balanced between the two groups . Experimental group patients reported being significantly more satisfied with the information received and care overall than those in the control group , felt significantly more and better informed , and perceived the information received as being clearer and detailed . The intervention produced no benefits in terms of anxiety , depression or QoL. The booklet was read by almost all patients and to a great extent by significant others . The majority considered the booklet useful to read and helpful in recalling chemotherapy-related information . CONCLUSIONS The current results provide further evidence on the efficacy of information-giving interventions in societies where disclosure of information to cancer patients still remains controversial CONTEXT Breathlessness , fatigue , and anxiety are distressing symptoms for patients with advanced lung cancer . Usually managed as isolated symptoms , they often can occur simultaneously . Previous research often has addressed management of discrete symptoms rather than considering them as a cluster , which , in reality , is the situation faced by patients . OBJECTIVES This study aim ed to examine the effectiveness of a psychoeducational intervention ( PEI ) on the symptom cluster of anxiety , breathlessness , and fatigue , compared with usual care . METHODS A pretest/post-test , two-group , r and omized , controlled trial was conducted . Education on symptom management and coaching in the use of progressive muscle relaxation were delivered to patients one week prior to commencing radiotherapy ( RT ) , and repeated three weeks after beginning RT . Symptom data were collected at four time points : prior to the intervention , three weeks , six weeks , and 12 weeks postintervention . RESULTS One hundred forty lung cancer patients receiving palliative RT were recruited from a publicly funded hospital in Hong Kong . Doubly multivariate analysis of variance revealed a significant difference ( time × group interaction effect , P=0.003 ) over time between the PEI and usual care control group on the pattern of change of the symptom cluster . Significant effects on the patterns of changes in breathlessness ( P=0.002 ) , fatigue ( P=0.011 ) , anxiety ( P=0.001 ) , and functional ability ( P=0.000 ) also were found . CONCLUSION PEI is a promising treatment for relieving the symptom cluster and each of the individually assessed symptoms . More effort needs to be directed at study ing impact of interventions on common symptom clusters In a r and omized controlled trial , the additional provision of information on videotape was no more effective than written information alone in reducing pre-treatment worry about radiotherapy . Images of surviving cancer patients , however , may provide further reassurance to patients once therapy is completed . © 2001 Cancer Research The present study focused on the effects of social comparison information on subjective underst and ing of radiation therapy , validation of emotions , and self-efficacy of cancer patients undergoing radiation therapy .  The effects of three different audiotapes , containing different kinds of social comparison information , were examined . On the procedural tape a man and woman discussed their illness and radiation treatment , on the emotion tape they focused on the emotional aspects of these issues , and on the coping tape they focused on the way they had been coping . The effects of these tapes were measured on subjective underst and ing about radiation therapy , validation and recognition of emotions , self-efficacy , and mood . The results indicate positive effects of the tapes , especially of the procedural and the coping tape . These audiotapes increased underst and ing of radiation therapy , self-efficacy and the feeling of validation of emotions . Therefore , these tapes may be an important supplement to existing patient education information . Possible explanations and practical implication s are discussed Goals of workBased on meta-analyses regarding the preparation of patients for potentially threatening medical procedures , a DVD , incorporating behavioral role modelling , was developed to prepare patients for chemotherapy and assist them to self-manage side effects . It was hypothesized that patients who watched the DVD ( vs those who did not ) would report ( 1 ) lower anxiety ; ( 2 ) higher self-efficacy related to coping with treatment side effects ; ( 3 ) fewer supportive care needs ; and ( 4 ) higher satisfaction with information received . It was further hypothesized that these effects would be stronger in those perceiving their treatment intent to be curative rather than palliative . Material s and methods Quasi-experimental design using a historical control group was employed . Participants were scheduled to receive their first ever chemotherapy treatment . Group 1 ( usual care ; n = 50 ) was prospect ively recruited before the release of the DVD and group 2 ( DVD plus usual care ; n = 50 ) after the release . Before commencing chemotherapy , all patients completed reliable and valid measures of self-efficacy , anxiety , and supportive care needs . Data was stratified according to perceived treatment intent . Independent sample t tests were performed for each group ( curative vs palliative).Main results Significant differences were found between the usual care and intervention groups : for self-perceived curative patients in relation to self-efficacy for seeking social support ( p = 0.044 ) , with increased confidence in those watching the DVD , and for self-perceived palliative patients in relation to their satisfaction with information about side effects ( p = 0.026 ) , with increased satisfaction in those watching the DVD . Overall , significant differences were found between self-perceived curative vs palliative patients on measures of self-efficacy and supportive care needs , with self-perceived curative patients reporting more confidence and fewer needs . Conclusions The educational DVD was considered highly acceptable by patients and was found to increase self-efficacy and reduce supportive care needs . Hence , it is appropriate to give to patients before face-to-face chemotherapy education . Additional pretreatment education is recommended , particularly for self-perceived palliative patients , to reduce their pretreatment anxiety and enhance their confidence in coping with treatment PURPOSE Professionally administered psychosocial interventions have been shown to improve the quality of life of cancer patients undergoing chemotherapy . The present study sought to improve access to psychosocial interventions during chemotherapy treatment by evaluating the efficacy and costs of a patient self-administered form of stress management training that requires limited professional time or experience to deliver . PATIENTS AND METHODS Four hundred eleven patients about to start chemotherapy were r and omly assigned to receive usual psychosocial care only , a professionally administered form of stress management training , or a patient self-administered form of stress management training .  Quality -of-life assessment s were conducted before r and omization and before the second , third , and fourth treatment cycles . Intervention costs were estimated from both payer and societal perspectives . RESULTS Compared with patients who received usual care only , patients receiving the self-administered intervention reported significantly ( P < or = .05 ) better physical functioning , greater vitality , fewer role limitations because of emotional problems , and better mental health . In contrast , patients who received the professionally administered intervention fared no better in terms of quality of life than patients receiving usual care only . Costs of the self-administered intervention were estimated to be 66 % ( from a payer perspective ) to 68 % ( from a societal perspective ) less than the average costs of professionally administered psychosocial interventions for patients starting chemotherapy . CONCLUSION Evidence regarding the efficacy and favorable costs of self-administered stress management training suggests that this intervention has the potential to greatly improve patient access to psychosocial intervention during chemotherapy treatment Purpose Although patients receive information prior to commencing radiotherapy , they often experience anxiety and distress . We conducted a pilot r and omised controlled trial to determine whether a radiation therapist led psycho-educational intervention for breast cancer patients prior to radiotherapy is likely to be effective in reducing radiotherapy-related concerns , patient anxiety and depression . Methods The intervention comprised two face-to-face consultations with a radiation therapist ( one prior to radiation planning and the other prior to treatment ) . Patients completed surveys at baseline , prior to treatment planning and on the first day of treatment . Outcome measures included the Hospital Anxiety and Depression Scale , Radiation Therapy Related Patient Concerns and Radiation Therapy Knowledge Scales . Results One hundred and twenty two patients completed baseline measures . Fifty-eight patients received usual care , and 64 received the intervention .  After the first consultation , patient anxiety was significantly lower in the intervention group ( p = 0.048 ) , as were concerns about radiotherapy ( p = 0.001 ) . There were no differences between groups for depression . Patient knowledge for the intervention group was higher after the first consultation ( p < 0.001 ) . Conclusion This intervention is likely to be effective in reducing patient anxiety and concerns and increasing knowledge . Future research is required to test this intervention with a larger population OBJECTIVE Dose delays and reductions in chemotherapy due to hematologic toxicities are common among patients with advanced non-small cell lung cancer ( NSCLC ) . However , limited data on behavioral or psychological predictors of chemotherapy adherence exist . The goal of this study was to explore the frequency and clinical predictors of infusion dose delays and reductions in this patient population . METHODS Fifty patients newly diagnosed with advanced NSCLC of high performance status ( Eastern Cooperative Oncology Group Performance Status=0 - 1 ) completed baseline assessment s on quality of life ( Functional Assessment of Cancer Therapy - Lung ) and  mood ( Hospital Anxiety and Depression Scale ) within 8 weeks of diagnosis . Participants were followed prospect ively for 6 months . Chemotherapy dosing data came from medical chart review . RESULTS All patients received chemotherapy during the course of the study , beginning with a platinum-based doublet ( 74 % ) , an oral epidermal growth factor receptor-tyrosine kinase inhibitor ( 14 % ) , or a parenteral single agent ( 12 % ) . Forty percent ( n=20 ) of patients had a dose delay ( 38 % ) and /or reduction ( 16 % ) in their scheduled infusions . Fisher 's Exact Tests and regression analyses showed that patients who experienced neutropenia , smoked at the time of diagnosis , or reported heightened baseline anxiety were significantly more likely to experience dose delays or reductions . There were no associations between  chemotherapy adherence and patient demographics , performance status , or quality of life . CONCLUSION In this sample , more than one third of patients with advanced NSCLC experienced either a dose delay or reduction in prescribed chemotherapy regimens . Behavioral and psychological factors , such as tobacco use and anxiety symptoms , appear to play an important role in chemotherapy adherence , though further study is required to confirm these findings Abstract Objective To explore the hypothesis that different methods of selecting and printing information for cancer patients could improve emotional support by affecting interaction with others , and so lead to improved psychological wellbeing . Design R and omised trial with eight groups ( three factors , 2′2′2 ) . Data collected at recruitment and three month follow-up . Participants 400 patients starting radiotherapy , of whom 325 with breast or prostate cancer and complete anxiety and depression data were included in the analysis . Interventions Printed booklets : half had only general information from CancerBACUP about each patient 's cancer and half had personalised information from the patient 's medical record plus selected general information ; half were composed of information chosen interactively by the patient and half were produced automatically with a larger volume of material ; and half had additional advice on anxiety management and half did not . Main outcome measures Patients ' views of the information , use of their booklets with others ; change in reported social support ; change in anxiety and depression . Results The larger booklets produced automatically were more likely to be found useful and to tell patients something new and less likely to be seen as too limited than the booklets produced interactively , but they were also more likely to overwhelm some patients . Personalised booklets were more likely than general booklets to tell patients something new . There was no difference in patients ' perceived underst and ing of their cancer by any of the intervention factors . Patients with personalised information were more likely to show their booklets to others and to think it helped in discussing their cancer or its treatment . There were no major differences in social support , anxiety , or depression by any intervention factors . Conclusions Patients were more likely to show personalised information to their confidants than general information . Further research is needed into the effects of sharing information on patients ' social support and anxiety . Trial registration US Government Clinical Trials Data base Aim : To describe the development of the content and pilot testing of a radiation therapist‐led educational intervention for breast cancer patients about to commence radiotherapy .  Pilot testing consisted of testing the intervention for appropriateness , feasibility and acceptance BACKGROUND To improve the provision of information to their radiotherapy patients , the authors examined whether the timing of given written information has an effect on anxiety and satisfaction . METHODS Two sources of information were used : 1 ) a booklet with a description of radiotherapy procedures and the sensations patients can experience ; 2 ) teaching sheets with treatment-site-related information .  68 patients were r and omized to a simultaneous-information group ( n = 31 ) and a stepwise-information group ( n = 37 ) . The patients were being treated for cancers of the breast , lung , head , and neck or the pelvic region . The authors analyzed the impacts of several variables on patient learning , including anxiety , age , gender , support , referral , stage of illness , and diagnosis . Assessment s were recorded before the simulation procedure and during the second and last weeks of treatment . RESULTS The stepwise-information group was significantly less anxious before simulation ( p = 0.02 ) and more satisfied ( p = 0.001 ) . Of the variables studied , only the support variable was associated with high state anxiety ( p < 0.0001 ) . CONCLUSIONS Provision of patient information in a stepwise format leads to less treatment-related anxiety and greater patient satisfaction  among radiation therapy patient undergoing simulation BACKGROUND High levels of distress and need for self-care information by patients commencing chemotherapy  suggest that current prechemotherapy education is suboptimal . We conducted a r and omised , controlled trial of a prechemotherapy education intervention ( ChemoEd ) to assess impact on  patient distress , treatment-related concerns , and the prevalence and severity of and bother caused by six chemotherapy side-effects . PATIENTS AND METHODS One hundred and ninety-two breast , gastrointestinal , and haematologic cancer patients were recruited before the trial closing prematurely ( original target 352 ) . ChemoEd  patients received a DVD , question -prompt list , self-care information , an education consultation≥24 h before first treatment ( intervention 1 ) , telephone follow-up 48 h after first treatment ( intervention 2 ) , and a face-to-face review immediately before second treatment ( intervention 3 ) . Patient outcomes were measured at baseline ( T1 : pre-education ) and immediately preceding treatment cycles 1 ( T2 ) and 3 ( T3 ) . RESULTS ChemoEd did not significantly reduce patient distress . However , a significant decrease in sensory/psychological ( P=0.027 ) and procedural ( P=0.03 ) concerns , as well as prevalence and severity of and bother due to vomiting ( all P=0.001 ) , were observed at T3 . In addition , subgroup analysis of patients with elevated distress at T1 indicated a significant decrease ( P=0.035 ) at T2 but not at T3 ( P=0.055 ) in ChemoEd patients . CONCLUSIONS ChemoEd holds promise to improve patient treatment-related concerns and some physical/psychological outcomes ; however , further research is required on more diverse patient population s to ensure generalisability Facing treatment of cancer with radiation therapy  causes anxiety for most prospect i ve patients . The purpose of this study was to test the effectiveness of preparatory patient education in reducing anxiety and improving satisfaction during the course of treatment . A quasiexperimental time series design was used to compare two groups of 25 patients , matched according to treatment type and gender , who were commencing radiation therapy for the first time . The experimental group received two structured teaching interventions incorporating sensory and procedural information design ed to familiarize the patient with the forthcoming experience . The theoretical basis for the intervention arose from Johnson 's work ( 1973 ) on preparing patients for threatening events . The control group received the st and ard information that was current in the Radiation Therapy Department where the study was conducted . The results indicated that the experimental group was significantly less anxious and significantly more satisfied during radiation therapy than their counterparts in the control group , and the effects were maintained throughout the treatment period of up to 7 weeks PURPOSE / OBJECTIVES To develop and test an interactive multimedia module prototype design ed to accommo date adults with limited literacy and without computer skills . DESIGN Experimental , r and omized , controlled , pretest , post-test . SETTING Cancer treatment centers in California , Louisiana ( pilot ) . New Hampshire , Pennsylvania , and Texas . SAMPLE Out patients who were at least 18 years old with a minimum fifth- grade reading level ; 86 experimental treatment , 88 control . METHODS Experimental treatment involved use of the interactive multimedia module ; the control group received customary Instruction . FINDINGS As compared to the control group , subjects in the experimental group had significant improvement ( p = 0.0001 ; 257 % gain ) in self-care ability regardless of age , sex race , education , geographic location , reading ability , computer experience , or preferred learning style ; a 6.515 % increase in fatigue content covered and 16.775 % Increase in instructional duration ; and significantly greater benefit from sleep-related activities and a consistent , positive pattern of self-care behavior . CONCLUSIONS The program is instructionally effective , appropriate for a wide and geographically diverse audience , and feasible for use in the ambulatory setting . IMPLICATION S FOR NURSING PRACTICE The interactive multimedia module is an effective , self-directed re source for individualized patient fatigue education Preparing cancer patients and their families for chemotherapy treatment is difficult . The challenge lies in finding ways to promote self-care and improve their ability to recall instructions . The aim of this study was to evaluate the usefulness of an educational video with regard to patients ' ability to recall and report side effects of treatment .  Patients referred for adjuvant chemotherapy for breast and colorectal cancer were r and omized to receive st and ard pre-chemotherapy education or st and ard education plus addition of a video .  Patients completed a base line question naire assessing existing knowledge and another question naire prior to the second chemotherapy cycle evaluating recall of information . Patients who watched the video were asked to assess the video after six cycles of chemotherapy .  Telephone calls to the department reporting symptoms were monitored for both groups . The video group demonstrated trends towards higher recall in information concerning fever , mouth problems , low red cell count and prevention of constipation . They more commonly telephoned reporting medical problems of nausea , vomiting and signs of infection compared with the st and ard group . In summary , our study demonstrated inclusion of video to st and ard chemotherapy education improves retention of information regarding management of predictable chemotherapy side effects and reporting of treatment-related symptoms PURPOSE Treatment regimens for head and neck cancer patients profoundly affect several quality -of-life domains . Rehabilitative needs have been identified through cross-sectional analyses ; however , few studies have prospect ively assessed quality of life , included assessment of psychosocial variables , and identified predictors of long-term follow-up . PARTICIPANTS AND METHODS The present study addresses these limitations through a prospect i ve assessment of 105 patients with a newly diagnosed first primary squamous cell carcinoma of the oral cavity , pharynx , or larynx . Participants were enrolled onto a larger r and omized controlled trial comparing a provider-delivered smoking cessation intervention with a usual-care-advice control condition . Participants completed a battery of self-report measures after diagnosis and before treatment and additional quality -of-life instruments  at 1 and 12 months after initial smoking cessation advice . RESULTS Participants displayed improvements at 12 months in functional status ( P = .006 ) and in the areas of eating , diet , and speech ; however , the latter three represent areas of continued dysfunction , and the changes were not statistically significant . Despite these improvements , patients reported a decline in certain quality -of-life domains , including marital ( P = .002 ) and sexual functioning ( P = .017 ) , as well as an increase in alcohol use ( P < .001 ) . Predictors of quality of life at 12 months included treatment type , the Vigor subscale of the Profile of Mood States instrument , and quality -of-life scores obtained 1 month after initial smoking cessation advice . CONCLUSION Results reinforce the need for rehabilitation management through the integration of psychologic and behavioral interventions in medical follow-up BACKGROUND AND PURPOSE A diagnosis of malignancy and its treatment is a very stressful time for patients and their families . This study was conducted to determine the impact of more intensive written information on patients ' anxiety levels . The secondary aim was to determine the impact of this information on patients ' satisfaction levels . MATERIAL S AND METHODS This prospect i ve r and omized trial consisted of patients with a pathological diagnosis of cancer having radical radiotherapy ( RT ) . Patients were r and omized to receive the more intensive information ( including written information and a telephone call from the research nurse ) or not to receive the more intensive information at the time of their initial consultation with the radiation oncologist . Study question naires measuring anxiety ( STAI form ) were completed prior to their first consultation ( baseline ) at the time of simulation ( pre-RT ) and at the completion of radiotherapy . A second question naire assessing satisfaction with the information given ( ISQ ) was completed at the time of simulation prior to commencing RT . RESULTS One hundred and ninety-four patients were enrolled in the study . The mean age of the patients was 58.5 years and 70 % of patients were female . Breast cancer ( 67 % ) was the commonest cancer . One hundred and two patients were r and omized to receive the intensive information package and 92 patients received the st and ard consultation .  There was no significant difference in mean State or Trait anxiety scores between any of the time intervals and no difference between the two information groups . There was no significant difference between the groups with regard to mean satisfaction scores with the overall information given , nor with any individual question . The satisfaction scores with lifestyle information given were lower than those for any other type of information in both r and omization arms . CONCLUSION More intensive information did not significantly change patients ' anxiety scores or satisfaction levels . The patients were generally very satisfied with the information they received but less satisfied with the information on lifestyle issues
Purpose Undergoing chemotherapy and radiotherapy can be physically and psychologically stressful for people with cancer .
Providing preparatory information to cancer patients as they face treatment and its aftermath has the potential to improve patient outcomes .
This study assessed the method ological quality and effectiveness of interventions providing preparatory information about chemotherapy and /or radiotherapy to cancer patients in improving patient outcomes and health care use .