Evidence map›Paper›PMID 30189462›Full record

Trial reportPsycho-oncology2018

Randomized controlled trial of a brief cognitive-behavioral strategies intervention for the pain, fatigue, and sleep disturbance symptom cluster in advanced cancer.

Kristine Kwekkeboom, Yingzi Zhang, Toby Campbell, Christopher L Coe, Erin Costanzo, Ronald C Serlin, Sandra Ward

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psycho-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  13. Identification of symptom clusters and sentinel symptoms in preoperative patients with oral and maxillofacial cancers: A cross-sectional study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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  18. Non-pharmacological interventions for sleep disturbance ("insomnia") in patients with advanced cancer: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kristine KwekkeboomSchool of Nursing, University of Wisconsin-Madison, Madison, WI, USA.ORCID 0000-0003-2459-0896
Yingzi ZhangSchool of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
Toby CampbellSchool of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
Christopher L CoeDepartment of Psychology, College of Letters and Science, University of Wisconsin-Madison, Madison, WI, USA.
Erin CostanzoDepartment of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Ronald C SerlinDepartment of Educational Psychology, School of Education, University of Wisconsin-Madison, Madison, WI, USA.
Sandra WardSchool of Nursing, University of Wisconsin-Madison, Madison, WI, USA.

Funding

A Brief Patient-Controlled Intervention for a Symptom Cluster in Advanced CancerR01NR013468 · NINR · UNIVERSITY OF WISCONSIN-MADISON · PI KWEKKEBOOM, KRISTINE L · 2013 to 2016
$2.0M
NINR NIH HHS R01 NR013468NINR NIH HHS R01NR013468
6 · The paper itself

Abstract

objectivePatients receiving treatment for advanced cancer suffer significant symptom burden, including co-occurring pain, fatigue, and sleep disturbance. There is limited evidence for effective interventions targeting this common symptom cluster.

methodsA randomized controlled trial of a brief cognitive-behavioral strategies (CBS) intervention was conducted. A sample of 164 patients with advanced cancer receiving chemotherapy practiced imagery, relaxation, and distraction exercises or listened to cancer education recordings (attention-control) to manage co-occurring pain, fatigue, and sleep disturbance over a 9-week period. Symptom cluster severity, distress, and interference with daily life were measured at baseline and 3, 6, and 9 weeks. We also evaluated the moderating influence of imaging ability and number of concurrent symptoms, and mediating effects of changes in stress, anxiety, outcome expectancy, and perceived control over symptoms.

resultsCompared with the cancer education condition, participants receiving the CBS intervention reported less symptom cluster distress at week 6 (M = 1.82 vs 2.15 on a 0-4 scale, P < .05). No other group differences were statistically significant. The number of concurrent symptoms moderated the intervention effect on symptom cluster interference. Changes in stress, outcome expectancy, and perceived control mediated the extent of intervention effects on symptom outcomes, primarily at weeks 6 and 9.

conclusionsThe brief CBS intervention had limited effects in this trial. However, findings regarding potential mediators affirm hypothesized mechanisms and provide insight into ways to strengthen future interventions to reduce the suffering associated with co-occurring pain, fatigue, and sleep disturbance.

Indexed as

AdultAgedAnxietyCancer PainCognitive Behavioral TherapyDepressionExercise TherapyFatigueFemaleHumansMaleMiddle AgedNeoplasmsSleep Wake DisordersStress, Psychologicalcancerfatigueimageryoncologypainrelaxationsleepsymptom cluster

Identifiers

PMID30189462
PMCPMC6279506

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.