Treatment of diseased quality of life in specific dimensions: Effectiveness of quality-of-life diagnosis and treatment in a community-based RCT in women with breast cancer.

e16520 Background: Many studies described deficits in quality of life (QoL) in cancer patients. We developed a new pathway with QoL diagnosis and treatment which was implemented as complex intervention with theory building, modeling, exploratory trial and RCT, integrated in a population based (2.1 mio) Tumorcenter. Methods: We conducted a two-armed, randomized clinical trial with 200 breast cancer patients.QoL was measured prospectively in 10 specific dimensions in first year after surgery. Along new QoL pathway patients in intervention group (IG) received QoL diagnosis and treatment consisting of 5 therapeutic options (eg physiotherapy, psychotherapy, social counseling). Members of control group (CG) received standard postoperative care. Primary endpoint was rate of patients with diseased QoL (<50 points on at least one scale with 0=bad, 100=good QoL). χ2-tests were performed to compare rates of diseased QoL (Klinkhammer-Schalke et al, BrJCancer, 2012). Results: At begin of study there were no significant differences in both groups considering QoL. 6 months after surgery rate of patients with diseased QoL was significantly lower for emotion in IG (19.8%) vs CG (38.4%, p=.007), and for global QoL almost reached significance in IG (17.6%) vs CG (29.8%, p=.064). For other dimensions (except family life) there was a trend showing better QoL in IG, but results were not significant. Rates of patients with diseased QoL in 10 dimensions 6 months after surgery in intervention group [%] vs control [%]: Global QoL 17.6% vs 29.8%!, Physical functioning 4.7% vs 5.7%, Role functioning 26.4% vs 29.9%, Arm symptoms 13.8% vs 23.3%, Body image 13.8% vs 22.1%, Pain 19.5% vs 24.4%, Emotion 19.8 %vs 38.4%xx, Concentration, remembering 10.5% vs 17.4%, Fatigue 37.9 %vs 46.5%, Family life, social encounters 17.4% vs 16.3% (χ2-test: p<.10!, p<.01xx). Conclusions: Results confirm effectiveness of QoL pathway: 6 months after surgery IG showed better QoL in 2 important dimensions. Lower rates of diseased QoL in other dimensions support the result. Cancer patients will benefit from the QoL system implemented in clinical routine (long term implementation).

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Randomized Controlled Trial of Yoga Among a Multiethnic Sample of Breast Cancer Patients: Effects on Quality of Life

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.6027 ◽

2007 ◽

Vol 25 (28) ◽

pp. 4387-4395 ◽

Cited By ~ 218

Author(s):

Alyson B. Moadel ◽

Chirag Shah ◽

Judith Wylie-Rosett ◽

Melanie S. Harris ◽

Sapana R. Patel ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Patients ◽

Intervention Group ◽

Well Being ◽

Control Group ◽

Breast Cancer Patients ◽

Spiritual Well Being ◽

Multiethnic Sample

Purpose This study examines the impact of yoga, including physical poses, breathing, and meditation exercises, on quality of life (QOL), fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients. Patients and Methods One hundred twenty-eight patients (42% African American, 31% Hispanic) recruited from an urban cancer center were randomly assigned (2:1 ratio) to a 12-week yoga intervention (n = 84) or a 12-week waitlist control group (n = 44). Changes in QOL (eg, Functional Assessment of Cancer Therapy) from before random assignment (T1) to the 3-month follow-up (T3) were examined; predictors of adherence were also assessed. Nearly half of all patients were receiving medical treatment. Results Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates (P < .0001). Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL (P < .008), emotional well-being (P < .015), social well-being (P < .004), spiritual well-being (P < .009), and distressed mood (P < .031). Sixty-nine percent of intervention participants attended classes (mean number of classes attended by active class participants = 7.00 ± 3.80), with lower adherence associated with increased fatigue (P < .001), radiotherapy (P < .0001), younger age (P < .008), and no antiestrogen therapy (P < .02). Conclusion Despite limited adherence, this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors. Among patients not receiving chemotherapy, yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL.

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The Effects of Individual Diet Therapy on Food Intake, Quality of Life, and Related Serum Proteins in Patients with Breast Cancer: A Randomized Clinical Trial

Basic & Clinical Cancer Research ◽

10.18502/bccr.v12i3.5768 ◽

2021 ◽

Author(s):

Azadeh Fallah ◽

Kiana Parnian ◽

Hamid Abdolazimi ◽

Sajjad Tezerji ◽

Zohreh Mazloom

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Side Effects ◽

Cancer Patients ◽

Serum Proteins ◽

Intervention Group ◽

Diet Therapy ◽

Control Group ◽

Nutritional Needs

Background: In cancer patients, weight loss due to malnutrition has a significant impact on the patients’ treatment and quality of life. This study aimed to determine the appropriate therapeutic strategy to control the side effects of chemotherapy in patients with breast cancer to improve their health, quality of life, and nutritional status. Methods: In our prospective study, we examined gastric cancer patients who were Seventy patients undergoing chemotherapy were included and randomly divided into intervention (n=35) and control groups (n=35). The intervention group received an individualized diet according to their nutritional needs for eight weeks, and the control group received dietary advice on the side effects of chemotherapy. Malnutrition, nutritional barriers, and patients’ quality of life were evaluated by PG-SGA, nutritional barriers, and QLQ-C30 questionnaires. Serum proteins were also assessed at the beginning and the end of the study. Results: The patients’ mean age was 50.91±1.72 years in the intervention group and 51±1.35 in the control group. According to the PG-SGA questionnaire classification, 68.5% of patients had malnutrition at baseline. In the intervention group, the mean score of PG-SGA decreased, which indicated an improvement in patients’ nutritional status. Increased scores in the functional section of QLQC30 and a decrease in the symptom section of this questionnaire indicated the improved quality of life in patients undergoing treatment at the end of the intervention. Albumin (P<0.001) and hemoglobin (P<0.001) levels increased in the intervention group, while there were no significant changes in these variables of the control group. Serum levels of ferritin did not show significant changes in either the intervention or the control group. Conclusion: Identifying nutritional barriers in breast cancer patients and individual diet therapy based on these barriers and nutritional needs reduces nutritional barriers. Consequently, malnutrition would decline, and the quality of life may enhance in these patients.

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Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of Stage IIA-IIB Breast Cancer Survivors

Integrative Cancer Therapies ◽

10.1177/1534735420924757 ◽

2020 ◽

Vol 19 ◽

pp. 153473542092475

Author(s):

Julia Ruiz-Vozmediano ◽

Sarah Löhnchen ◽

Lucas Jurado ◽

Rosario Recio ◽

Andrea Rodríguez-Carrillo ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Mediterranean Diet ◽

Breast Cancer Survivors ◽

Intervention Program ◽

Intervention Group ◽

Control Group ◽

Cancer Symptoms

Background: Integrative oncology has proven to be a useful approach to control cancer symptoms and improve the quality of life (QoL) and overall health of patients, delivering integrated patient care at both physical and emotional levels. The objective of this randomized trial was to evaluate the effects of a triple intervention program on the QoL and lifestyle of women with breast cancer. Methods: Seventy-five survivors of stage IIA-IIB breast cancer were randomized into 2 groups. The intervention group (IG) received a 6-month dietary, exercise, and mindfulness program that was not offered to the control group (CG). Data were gathered at baseline and at 6 months postintervention on QoL and adherence to Mediterranean diet using clinical markers and validated questionnaires. Between-group differences at baseline and 3 months postintervention were analyzed using Student’s t test for related samples and the Wilcoxon and Mann-Whitney U tests. Results: At 6 months postintervention, the IG showed significant improvements versus CG in physical functioning ( p = .027), role functioning ( p = .028), and Mediterranean diet adherence ( p = .02) and a significant reduction in body mass index ( p = .04) and weight ( p = .05), with a mean weight loss of 0.7 kg versus a gain of 0.55 kg by the CG ( p = .05). Dyspnea symptoms were also increased in the CG versus IG ( p = .066). Conclusions: These results demonstrate that an integrative dietary, physical activity, and mindfulness program enhances the QoL and healthy lifestyle of stage IIA-IIB breast cancer survivors. Cancer symptoms may be better managed by the implementation of multimodal rather than isolated interventions.

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Automatic inpatient palliative care consultation (PCC): Too little, too late to impact quality of life for advanced cancer patients?

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e20565 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e20565-e20565

Author(s):

Gabrielle Betty Rocque ◽

Toby Christopher Campbell ◽

Anne Elizabeth Barnett ◽

Renae M Quale ◽

Jens C. Eickhoff ◽

...

Keyword(s):

Quality Of Life ◽

Health Services ◽

Cancer Patients ◽

Advanced Cancer ◽

Primary Outcome ◽

Intervention Group ◽

Control Group ◽

Patient Reported ◽

Small Patient Population

e20565 Background: Patients with advanced cancer who are hospitalized have high symptom burden and a short life expectancy, which may warrant PCC. Methods: Using sequential cohorts, we prospectively assessed implementation of automatic PCC for hospitalized cancer patients. The primary outcome was hospice utilization. Secondary outcomes included evaluation of changes in quality of life (FACIT-PAL), symptoms (ESAS), satisfaction (FAMCARE), and anxiety and depression (HADS). Surveys were administered at baseline, 2 weeks and 3 months post-hospitalization. Chart abstraction was utilized to assess demographics, resource use, and survival information. Results: Patients were evaluated consecutively (65 in the control group, 70 in the intervention). At admission, 91% reported uncontrolled symptoms: 52% pain; 15% dyspnea. 60% of intervention patients received PCC during their first admission. 54 patients completed surveys (29 control group, 25 PCC group), 64 patients declined or were unable to complete surveys, 16 patients were excluded due to language barriers, physician preference, or not receiving surveys. Using an intent-to-treat analysis, there was no difference between patients in the control and the intervention group in FACIT-PAL (119 ± 29 vs 123 ± 30, p = 0.68 ), ESAS (28 ± 14 vs 26 ± 15, p = 0.74) HADS (13 ± 6.6 vs. 12.± 4.7, p = 0.58), or FAMCARE (58 ± 9.1 vs 59 ± 8.6, p = 0.61). In both groups, patients had modest worsening of symptoms and quality of life over the course of the study. Survival and Health Services data analysis, including hospice referral, is proceeding. Conclusions: Automatic PPC had little impact on patient-reported symptoms and quality of life. Limitations included: small patient population; high rate of incomplete surveys, likely due to illness burden; penetration of the PCC was limited to 60% by patient or provider preference and consultant availability. Our primary outcome analysis (hospice utilization) is forthcoming, as are data on survival and Health Services outcomes.

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Effects of Out-of-Hospital Continuous Nursing on Postoperative Breast Cancer Patients by Medical Big Data

Journal of Healthcare Engineering ◽

10.1155/2022/9506915 ◽

2022 ◽

Vol 2022 ◽

pp. 1-14

Author(s):

Peijuan He ◽

Bing Zhang ◽

Songna Shen

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Communication System ◽

Intervention Group ◽

Control Group ◽

Apriori Algorithm ◽

Breast Cancer Patients ◽

Medical Communication

This study aimed to explore the application value of the intelligent medical communication system based on the Apriori algorithm and cloud follow-up platform in out-of-hospital continuous nursing of breast cancer patients. In this study, the Apriori algorithm is optimized by Amazon Web Services (AWS) and graphics processing unit (GPU) to improve its data mining speed. At the same time, a cloud follow-up platform-based intelligent mobile medical communication system is established, which includes the log-in, my workstation, patient records, follow-up center, satisfaction management, propaganda and education center, SMS platform, and appointment management module. The subjects are divided into the control group (routine telephone follow-up, 163) and the intervention group (continuous nursing intervention, 216) according to different nursing methods. The cloud follow-up platform-based intelligent medical communication system is used to analyze patients’ compliance, quality of life before and after nursing, function limitation of affected limb, and nursing satisfaction under different nursing methods. The running time of Apriori algorithm is proportional to the data amount and inversely proportional to the number of nodes in the cluster. Compared with the control group, there are statistical differences in the proportion of complete compliance data, the proportion of poor compliance data, and the proportion of total compliance in the intervention group ( P < 0.05 ). After the intervention, the scores of the quality of life in the two groups are statistically different from those before treatment ( P < 0.05 ), and the scores of the quality of life in the intervention group were higher than those in the control group ( P < 0.05 ). The proportion of patients with limited and severely limited functional activity of the affected limb in the intervention group is significantly lower than that in the control group ( P < 0.05 ). The satisfaction rate of postoperative nursing in the intervention group is significantly higher than that in the control group ( P < 0.001 ), and the proportion of basically satisfied and dissatisfied patients in the control group was higher than that in the intervention group ( P < 0.05 ).

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The Effect of Art Therapy and Music Therapy on Breast Cancer Patients: What We Know and What We Need to Find Out—A Systematic Review

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/7390321 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Justina Kievisiene ◽

Rasa Jautakyte ◽

Alona Rauckiene-Michaelsson ◽

Natalja Fatkulina ◽

Cesar Agostinis-Sobrinho

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Systematic Review ◽

Music Therapy ◽

Cancer Patients ◽

Art Therapy ◽

Anxiety Reduction ◽

Control Group ◽

Breast Cancer Patients

Objective. To systematically review the evidence available on the effects of art therapy and music therapy interventions in patients with breast cancer. Design. Systematic search was conducted in PubMed, EBSCO, and Cochrane Central databases. Articles were scanned using the following keywords: “art therapy” or “music therapy” and “breast cancer” or “breast neoplasms,” “breast carcinoma,” “breast tumor,” and “mammary cancer.” Only RCTs published in English, with a control group and experimental group, and presenting pre-/post-therapy results were included. PRISMA guidelines for this systematic review were followed. Results. Twenty randomized controlled trials matched the eligibility criteria. Nine studies evaluated the effect of art therapy, and eleven evaluated the effect of music therapy. Improvements were measured in stress, anxiety, depression reduction, pain, fatigue, or other cancer-related somatic symptoms’ management. Overall, the results show that art therapy was oriented towards the effects on quality of life and emotional symptoms while music therapy is the most often applied for anxiety reduction purposes during or before surgeries or chemotherapy sessions. Conclusion. Art and music therapies show effective opportunities for breast cancer patients to reduce negative emotional state and improve the quality of life and seem to be promising nonmedicated treatment options in breast oncology. However, more detailed and highly descriptive single therapy and primary mental health outcome measuring RCTs are necessary to draw an evidence-based advise for the use of art and music therapies.

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Effects of Behavioral Activation on the Quality of Life and Emotional State of Lung Cancer and Breast Cancer Patients During Chemotherapy Treatment

Behavior Modification ◽

10.1177/0145445517746915 ◽

2017 ◽

Vol 43 (2) ◽

pp. 151-180 ◽

Cited By ~ 5

Author(s):

Concepción Fernández-Rodríguez ◽

Erica Villoria-Fernández ◽

Paula Fernández-García ◽

Sonia González-Fernández ◽

Marino Pérez-Álvarez

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Lung Cancer ◽

Cancer Patients ◽

Behavioral Activation ◽

Emotional State ◽

Control Group ◽

Breast Cancer Patients ◽

Chemotherapy Treatment

Research suggests that the progressive abandonment of activities in cancer patients are related to depression and worse quality of life. Behavioral activation (BA) encourages subjects to activate their sources of reinforcement and modify the avoidance responses. This study assesses the effectiveness of BA in improving quality of life and preventing emotional disorders during chemotherapy treatment. One sample of lung cancer patients and another of breast cancer patients were randomized into a BA experimental group (E.G.lung/4sess. n = 50; E.G.breast/6sess. n = 33) and a control group (C.G.lung/4sess. n = 40; C.G.breast/6sess. n = 35), respectively. In each session and in follow-ups (3/6/9 months), all participants completed different assessment scales. The results converge to show the effectiveness of BA, encouraging cancer patients to maintain rewarding activities which can activate their sources of day-to-day reinforcement and modify their experience avoidance patterns. BA appears to be a practical intervention which may improve social and role functioning and the emotional state of cancer patients during chemotherapy treatment.

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Randomized clinical trial of medical qigong on quality of life, fatigue, side effects, mood, status, and inflammation of cancer patients

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.9617 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 9617-9617

Author(s):

B. Oh ◽

P. Butow ◽

B. Mullan ◽

S. Clarke ◽

P. Beale ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Side Effects ◽

Sleep Disturbance ◽

Usual Care ◽

Cancer Patients ◽

Intervention Group ◽

Control Group ◽

Usual Care Control Group

9617 Background: The quality of life (QOL) of cancer patients is often diminished due to the side effects of treatment and symptoms of the disease itself. This study examines the impact of Medical Qigong (MQ), including gentle exercise and relaxation through meditation and breathing exercise based on the Chinese Medicine theory of energy channels, on quality of life (QOL), fatigue, side effects, mood status and inflammation. Methods: One hundred sixty two patients diagnosed with a range of cancers recruited from three university teaching hospitals were randomly assigned to two groups: a control group (n=83) that received usual health care and an intervention group (n=79) who participated in a MQ program for 10 weeks in addition to receiving usual health care at the hospital. Quality of life and symptoms were measured by the FACT-G, cancer related fatigue by FACT-F and mood status by POMS. The inflammatory marker serum C-reactive protein (CRP) was also monitored serially. Results: Regression analysis indicated that the MQ intervention group significantly improved on measures of overall QOL (t144= -5.761, p<0.001), fatigue (t153= -5.621, p<0.001), mood disturbance (t122=2.346, p=0.021) and inflammation (CRP) (t99=2.042, p<0.044) compared to the usual care control group after controlling for baseline variables. Analysis of the FACT-G subscales revealed that the MQ intervention group also significantly improved in satisfaction with sex life (t92=-3.783, p<0.001) and reduced side effects of nausea (t152=-2.071, p=0.040) and sleep disturbance (t150=-2.603, p=0.010) compared to the usual care control group. Pain was improved in both intervention and control groups. Conclusions: This study suggests that MQ with usual health care can improve overall QOL, fatigue, positive mood status and reduce the side effects of nausea, sleep disturbance and inflammation of cancer patients. This study supports the use of MQ as an intervention for cancer care. No significant financial relationships to disclose.

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The effects of mindfulness meditation and progressive muscle relaxation on fatigue and quality of life in breast cancer patients receiving adjuvant paclitaxel: A three-arm randomized trial.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e12051 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e12051-e12051

Author(s):

Zehra Gok Metin ◽

Nur Izgu ◽

Canan Karadas ◽

Leyla Ozdemir ◽

Umut Demirci

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Patients ◽

Muscle Relaxation ◽

Progressive Muscle Relaxation ◽

Controlled Study ◽

Control Group ◽

Breast Cancer Patients ◽

Cancer Data

e12051 Background: Breast cancer patients often suffer from fatigue during adjuvant paclitaxel regimen which frequently impairs quality of life (QOL). Therefore, this three-arm randomized controlled study aimed to examine the effects of mindfulness-based stress reduction (MBSR) and progressive muscle relaxation (PMR) on fatigue and QOL in breast cancer patients receiving adjuvant paclitaxel. Methods: Participants were randomly assigned to either a MBSR (n = 20), (PMR) (n = 19) or control group (CG) (n = 15). Participants in the intervention groups were instructed on MBSR and PGE, the steps of interventions were recorded a voice recorder and a WhatsApp group was designed by the principal investigator. Participants were asked to listen the recorded audio files during exercises. The intervention groups continued MBSR or PMR 20 min. each day, totally 12 weeks at their home. The CG received only an attention placebo education on breast cancer. Data collection tools included Brief Fatigue Inventory (BFI) and Functional Living Index-Cancer (FLIC). Data were collected at three time points: baseline (T1), week 12 (T2), and week 14 (T3) for follow-up assessment. Kruskal Wallis tests was used for data analysis. Results: BFI scores were significantly lower in the MBSR, PMR groups compared with the CG at T2 and at T3 (p < .01). As for FLIC scores, there were no significant differences between the study groups at T2 and at T3 (p > 0.05). Conclusions: A brief, MBSR and PMR initiated concurrently with adjuvant paclitaxel regimen decreased fatigue severity. Based on the results, MBSR and PMR can be recommended as supportive therapies for breast cancer patients receiving adjuvant paclitaxel.

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Mobile App for Symptom Management and Associated Quality of Life During Systemic Treatment in Early Stage Breast Cancer: Nonrandomized Controlled Prospective Cohort Study

JMIR mhealth and uhealth ◽

10.2196/17408 ◽

2020 ◽

Vol 8 (8) ◽

pp. e17408

Author(s):

Cvetka Grašič Kuhar ◽

Tjaša Gortnar Cepeda ◽

Timotej Kovač ◽

Matjaž Kukar ◽

Nina Ružić Gorenjec

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Systemic Therapy ◽

Early Stage ◽

Intervention Group ◽

Health Resources ◽

Control Group ◽

Global Quality ◽

Global Quality Of Life

Background Providing patients with cancer who are undergoing systemic therapy with useful information about symptom management is essential to prevent unnecessary deterioration of quality of life. Objective The aim was to evaluate whether use of an app for symptom management was associated with any change in patient quality of life or use of health resources. Methods Outpatients with early stage breast cancer receiving systemic therapy were recruited at the Institute of Oncology in Ljubljana, Slovenia. Patients who received systemic therapy between December 2017 and March 2018 (control group) and between April 2018 and September 2018 (intervention group) were eligible. All patients received standard care, but only those in the intervention group were asked to use mPRO Mamma, an Android-based smartphone app, in addition. The app supported daily tracking of 50 symptoms, allowed users to grade their symptom severity (as mild, moderate, or severe), and also provided in-depth descriptions and recommendations based on reported symptom level. Patient-reported outcomes in both groups were assessed through the European Organisation for Research and Treatment of Cancer (EORTC) core (C-30) and breast cancer (BR-23) questionnaires, as well as a questionnaire about health resources use. The primary outcomes were the difference in the global quality of life between groups and the difference in summary score of the EORTC C-30 questionnaire between groups after 3 time periods (the first week of treatment, the first treatment cycle, and the entire treatment). The secondary outcome was the use of health resources (doctor visits and hospitalizations) in each time period. Other scales were used for exploratory analysis. Results The mean difference between the intervention group (n=46) and the control group (n=45) in global quality of life (adjusted for baseline and type of surgery) after the first week was 10.1 (95% CI 1.8 to 18.5, P=.02). The intervention group summary scores were significantly higher than those of the control group after the first week (adjusted mean difference: 8.9, 95% CI 3.1 to 14.7, P=.003) and at the end of treatment (adjusted mean difference: 10.6, 95% CI 3.9 to 17.3, P=.002). Use of health resources was not statistically significant between the groups in either the first week (P=.12) or the first treatment cycle (P=.13). Exploratory analysis findings demonstrated clinically important improvements (indicated by EORTC C-30 or BR-23 scale scores)—social, physical, role, and cognitive function were improved while pain, appetite loss, and systemic therapy side effects were reduced. Conclusions Use of the app enabled patients undergoing systemic therapy for early stage breast cancer to better cope with symptoms which was demonstrated by a better global quality of life and summary score after the first week and by a better summary score at the end of treatment in the intervention group compared to those of the control group, but no change in the use of health resources was demonstrated.

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