Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Symptoms and General Pathology

Respiratory Tract (Lung and Bronchial) Diseases

Rare Diseases

Uterine Cervical Neoplasms

Uterine Cervical Dysplasia

Pain

Cough

Uterine Neoplasms

Genital Neoplasms, Female

Urogenital Neoplasms

Uterine Cervical Diseases

Uterine Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Precancerous Conditions

Respiration Disorders

Respiratory Tract Diseases

Signs and Symptoms, Respiratory

Cervical Intraepithelial Neoplasia

Patients are asked to cough during the first biopsy. They should not cough during the second biopsy, and no additional interventions will be performed during the second biopsy.

Patients are asked to cough during the second biopsy. They should not cough during the first biopsy, and no additional interventions will be performed during the first biopsy.

Patients are asked to cough or not to cough during cervical biopsy.

Coughing at the time of biopsy

Ziad Hilal, M.D.

To investigate the effect of coughing as an intervention to reduce pain in colposcopy guided biopsy.

Colposcopy is a frequently practiced examination and Colposcopy guided biopsy causes pain. A few trials Investigated whether medical interventions such as the application of lidocaine led to reduced pain perception with inconsistent results. Only one trial compared coughing versus no coughing at the moment of biopsy. Although the results of this study did not lead to a significant difference between the two study arms, coughing seems to positively affect pain perception.

Since the patients are, in the best case, their own controls when it comes to subjective parameters such as pain perception, we prefer a cross-over rather than a parallel group design.

Based on the descriptive variables for pain during biopsy with and without cough determined in the pilot study, a case estimate for a prospective randomized cross-over study will be carried out. Since two biopsies are usually taken from the cervix in daily practice, the now planned pilot study in a cross-over design envisages the following two study arms:

1. Group I: Patients cough during the first biopsy, they do not cough during the second biopsy
2. Group II: Patients cough during the second biopsy, they do not cough during the first biopsy

The primary Outcome measure is the difference in the patients' perception of pain during the first and second biopsy on the cervix (ectocervix), measured using an 11-part numerical analogue scale (11-item NAS).

Coughing at Time of Cervical Biopsy

Pain Reduction by Forced Coughing During Colposcopy Guided Cervical Biopsies: a Randomized Controlled Pilot Study

the difference in the patients' perception of pain during the first and second biopsy on the cervix (ectocervix), measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

the patients' perception of pain before examination, measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

the patients' perception of pain at the moment of the insertion of the specula, measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

the patients' perception of pain at the moment of the application of acetic acid, measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

the patients' perception of pain during the first biopsy, measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

the patients' perception of pain during the second biopsy, measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

the patients' perception of pain just after finishing the examination, measured using an 11-part numerical analogue scale (11-item NAS). The numerical analogue scale consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' (score 0) and 'pain as bad as it could be' (score 10). Women will be asked to mark her pain level on the line between the two endpoints.

Zydolab - Institute of Cytology and Immune Cytochemistry

Principal Investigator

Biophilic Nature Scene and Sound

Noah Lechtzin, MD, MHS

Pain is a common and difficult problem for patients with cancer. It has been reported that over 80% of cancer patients suffer from pain. Much of this pain is iatrogenic and related to procedures. Dr. Grossman recently demonstrated that most patients undergoing bone marrow biopsy have poor pain control during the procedure. Treatment of pain is almost entirely with analgesic medications, principally opioids. These medications have numerous undesirable effects such as sedation, confusion, hypotension and constipation that limit their efficacy and utility. Drs. Diette, Lechtzin, Rubin and colleagues recently demonstrated that use of nature sights and sounds (NSS), a simple, safe, and inexpensive intervention, decreases pain during fiberoptic bronchoscopy, a procedure commonly performed to diagnose cancer and to detect pulmonary complications of cancer therapy. Patients were randomly assigned to either standard care with intravenous narcotics and benzodiazepines or standard care coupled with view of a nature scene and use of nature sounds before, during, and after bronchoscopy. The group assigned to the NSS reported significantly better pain control than the control group. While these findings are novel and exciting, they raised several new questions that suggest logical extensions of this work. It is not known whether this intervention can be applied to patients in other settings, nor is it known whether comparison to standard care is an appropriate control group. Further, the mechanism of action of NSS needs to be determined. NSS may simply be a form of distraction therapy but it may have other properties. The theory of biophilia proposes there are specific elements in nature imagery that exert beneficial health effects. Because NSS appears to be a promising and safe intervention for the treatment of pain, these investigators plan to perform a controlled clinical trial in cancer patients undergoing invasive procedures. Patients will be randomly assigned to one of three arms, standard care, NSS, and a non-nature based distraction technique. We will study the efficacy of NSS for the management of procedure-related pain in oncology patients. The findings will provide necessary background information to develop more definitive studies of NSS that should be competitive for external funding. This exciting study will help develop a harmless, inexpensive method to treat pain in cancer patients, that may complement or replace analgesic medications.

Study Design: This is a randomized, controlled trial assessing the impact of nature sights and sounds (NSS) on pain control in oncology outpatients undergoing bone marrow aspirate and biopsy (BMBx) in the Weinberg Cancer Center at Johns Hopkins. One hundred twenty patients will be assigned to one of three groups: 1) standard care, 2) NSS, 3) Music/Photo. The primary outcome will be pain scores during the procedures as measured by the Hopkins Pain Rating Instrument (HPRI). Patients in all groups will receive analgesic medications as dictated by the personnel performing the procedure and the physicians responsible for their clinical care. Patients in the NSS group will have Bedscapes nature scene murals placed at the bedside in a location that is visible throughout the procedure. They will also listen to a complementary audiotape during the procedure. The music/photo group will listen to city sounds during the procedure and view a poster of a city skyline.

Setting: The study will be conducted in the Weinberg Cancer Pavilion of the Kimmel Cancer Center at the Johns Hopkins Hospital.

Patient Selection: All patients 18 years and older with a diagnosis of cancer undergoing a BMBx in the Johns Hopkins Oncology Center will be screened for enrollment in the study.

Informed Consent: The study design and consent procedure will be explained to all prospective patients. If patients are interested in taking part in the study, written informed consent will be obtained. The study nurse will administer a mental status exam and assess eligibility. Consent and screening must occur within 5 days of the patient's procedure.

Randomization: Blocked randomization will be used with variable block sizes to ensure roughly equal numbers of patients in each study arm.

Study Interventions: All subjects will have pain managed by the physicians responsible for their clinical care as dictated by those physicians. Subjects assigned to NSS will have Bedscapes fabric panels depicting a scene of a mountain stream placed by the procedure table at a location where it will be visible throughout the procedure. An accompanying audiotape of complementary nature sounds will be played on portable tape players through headphones or speakers. They will be instructed to listen to the tape and look at the nature scene as frequently and for as long as they desire. The standard care group will have pain managed according to current oncology center protocols but will not be allowed to use the distraction interventions. The Music/Photo group will be played a tape of typical city sounds and will have a poster of a city skyline placed by the procedure table. The city skyline poster will be similar in size to the Bedscapes mural. The skyline image is a daytime photograph without water, trees or other nature elements. The subjects will be asked to listen to the music and view the picture during the procedure.

The HPRI will be used to measure pain. This is a plastic VAS with a sliding marker that moves within a grove. The side facing the patient appears like a traditional VAS. It has a 10cm line with the anchors "No Pain" and "Worst Pain Imaginable". The opposite side of the instrument is a 10 cm scale with markings every 0.5cm that enables the clinician to read and record numerical values (see figure in appendix). Scores will be recorded to the nearest 0.5cm. All patients will have a baseline assessment of pain immediately prior to the procedure. Subjects will be interviewed within one hour following the procedure and will be asked to quantify their pain during the procedure.Patients will also complete a questionnaire following the procedure in which they will score their level of pain control during the procedure on a 5-point Likert scale, which was used in the bronchoscopy study .

Data Collection: Following the procedure patients will complete a set of questionnaires. Questions will inquire about attitudes, beliefs and prior use of CAM. Patients in the NSS, and Music/Photo groups will be asked whether they found the study intervention to be helpful and if so what aspects of the intervention were beneficial. They will be asked to rate their satisfaction with several aspects of the procedure including comfort, the nursing care, the physician care, and the facility. Psychological distress will be measured with the Brief Symptom Index 18 , negative mood states and anxiety will be measured with the Profile of Mood States (POMS) . The BSI provides a global symptom severity score that will be used to control for subjects' underlying psychological distress, while POMS is well suited to measuring changes in mood related to the procedure. We will specifically focus on the Tension-Anxiety, Depression-Dejection, Anger-Hostility, and Confusion-Bewilderment subscales. Differences in response to pain will be measured with the Pain Catastrophizing Scale . Salivary cortisol will be measured before and after the procedure as a neuroendocrine marker of stress. Two baseline measurements of cortisol will be taken at least 15 minutes apart prior to the procedure. Immediately following the procedure three additional salivary cortisol samples will be collected approximately 15 minutes apart. The study nurse will record heart rate, blood pressure and respiratory rate before and every 15 minutes during the procedures. The high and low systolic blood pressure, heart rate, and respiratory rate will be extracted. The study nurse will record the percentage of time the patient used the study intervention during the procedure. Patients will also be asked what percentage of the time they used the intervention.

Outcomes: The primary outcomes is to determine if NSS is effective at reducing pain in cancer patients undergoing invasive procedures, we will compare mean pain scores during the procedure from the HPRI between the NSS group and the standard care group. We will also compare the difference between ratings of baseline pain and pain during the procedure in the two groups and the rating of pain control during the procedure between the groups. We will also determine if NSS reduces pain more than non-nature based distraction therapy we will compare pain ratings, and the difference in pain ratings from baseline to that during the procedure between the NSS and the music/photo group. Lastly we will determine if NSS reduces affective distress in cancer patients undergoing painful procedures we will compare mean scores from the POMS between the three groups. Secondary outcomes that pertain to all specific aims include vital signs during procedures and salivary cortisol levels. We will also assess overall satisfaction with care, ratings of physicians, ratings of nurses, and attitudes towards CAM interventions using Likert-type scales.

Sample Size: The primary outcome is difference in maximal pain level during procedures between the NSS group and the Music/Photo group. Power estimates are based on the magnitude of effect from the bronchoscopy study and the standard deviation of pain ratings in bone marrow biopsies studied by Dr. Grossman. In order to have 80% power to detect a 2-point difference in pain rating using the HPRI with an alpha error level of 0.05 we will need 29 patients in each group (total n=87). We plan to enroll 40 patients in each group (total n=120) to compensate for study withdrawal and missing data. We will continue to enroll patients until we have met these goals.

Data Entry and Management: The Biostatistics Core of the CAM center will provide recommendations on data entry and analysis. Because this is a small, single center trial of a relatively safe intervention there will not be a formal data safety monitoring committee. However, Dr. Lechtzin will oversee data integrity.

Adverse Events Monitoring: This is a minimal risk intervention and we expect very few adverse events. During our bronchoscopy study there was only one adverse event; a patient became incontinent on the procedure table due to the sound of running water. Adverse events to the experimental intervention will be assessed at the interview following the procedure by recording all voluntary complaints of subjects and through structured interviews. Attention will be directed to clinical adverse experiences associated with the procedure and the experimental intervention. In addition, all study participants will be provided a telephone number they can contact 24 hours/day, 7 days/week in case of questions, concerns, or adverse events. Adverse events will be documented on a standardized case report form. Summary reports of adverse events will be generated every three months. Dr. Lechtzin will review these. All serious adverse events including death, hospitalization, and premature withdrawal will be reported to the principal investigator within 24 hours of their occurrence. The principal investigator will report all serious adverse events to the Johns Hopkins IRB. Unexpected adverse events will be reported within 10 days.

Statistical Analysis: Analyses will be based on intention to treat. Analyses will be performed comparing patients who used NSS to the standard care group and the Music/Photo group. Descriptive analyses will be performed to assess subject characteristics (demographics, disease characteristics, education, prior CAM use and attitudes). Procedure characteristics will be compared including duration, complications, and medication usage. Continuous variables will be represented as mean plus or minus SE, medians and interquartile ranges. Bivariate analyses of outcomes will compare pain ratings, POMS subscales, and psychological distress between the groups. Chi squared test or Fisher's Exact test will be used to compare categorical variables such as age, gender, and race between groups. Unpaired t-tests or the Kruskal Wallis test will be used to compare continuous outcomes such as Pain Inventory scores. Pain scores will be analyzed as continuous variables and will also be categorized into mild (0-2), moderate (3-6) and severe (7-10). Multivariate analyses will be performed in order to adjust for possible confounding factors such as amount of narcotic analgesics given and amount of local anesthetic used. Ordinal logistic regression models to explain pain level by study intervention will be developed to adjust for factors such as age, gender, race, procedure type, education level, local anesthetic dose, narcotic dose, benzodiazepine dose, and BSI score. Additional factors will be included in the models if they are significant in bivariate analyses. Logistic regression models will be developed to determine factors associated with favorable response to NSS. Stepwise maximum-likelihood ratio estimation with a significance level of 0.2 for removal and 0.1 for inclusion will assist in model development. For all analyses significance will be set at p\<0.05.

Nature Sights and Sounds to Reduce Pain in Cancer Patients Undergoing Bone Marrow Aspiration and Biopsy

National Center for Complementary and Integrative Health (NCCIH)

Johns Hopkins University

Behaviors and Mental Disorders

Skin and Connective Tissue Diseases

Anxiety Disorders

Breast Neoplasms

Fatigue

Breast Diseases

Skin Diseases

Mental Disorders

Psychotic Disorders

It is planned to pre-test, wear virtual reality glasses and post-test before chemotherapy for breast cancer women who will receive adjuvant treatment for the first time, who agree to participate in the study. This follow-up will be done 3 more times, and each cure will be followed for 4 cures. It will be ensured that the patients fill out the State Anxiety Scale and Cancer Fatigue Scale as a pre-test and post-test. After the chemotherapy infusion starts, the patient will listen and watch the relaxing beach and nature content with 360 degrees for 30 minutes with virtual reality glasses attached to the patient.

Women with breast cancer who will receive adjuvant treatment for the first time, who agree to participate in the study, will be pre-tested before chemotherapy and a post-test will be performed 30 minutes after the start of chemotherapy treatment by the nurse. This follow-up will be done 3 more times, and each cure will be followed for 4 cures. It will be ensured that the patients fill out the State Anxiety Scale and Cancer Fatigue Scale as a pre-test and post-test.

Virtual Reality Glasses

Arzu USLU, RN, MS, PhD(c), Instructor

Selda ARSLAN, Assoc. Prof.

It was aimed to determine the effect of virtual reality glasses application on anxiety and fatigue in women with breast cancer receiving adjuvant chemotherapy.

The number of women with breast cancer worldwide is increasing day by day. Uncertainty of the efficacy of treatment, difficulty in accepting the disease, financial difficulties, insomnia, fear and anxiety about the future, concentration disorder, feeling angry, focusing on thoughts of illness and death, irregularities in work and family life, emergence of treatment Their quality of life is adversely affected due to many conditions such as worrying about side effects and loss of appetite. The disease process should be managed correctly before these symptoms related to treatment occur in patients. Anxiety and fatigue are the leading symptoms that limit the activities of daily living and significantly affect the social lives of patients receiving chemotherapy for the first time after the diagnosis of breast cancer. 46%-71% of patients diagnosed with cancer experience anxiety and 80%-90% fatigue during chemotherapy. Nurses, who are health professionals, use non-pharmacological methods as well as pharmacological methods in the prevention and management of symptoms during the chemotherapy treatment process. Non-pharmacological methods include practices such as meditation, yoga, hypnosis, prayer, relaxation techniques, daydreaming, and cognitive behavioral therapies that involve distraction. With these cognitive behavioral therapies, nurses aim to strengthen the self-care of cancer patients, increase adherence to the disease, develop effective coping methods, manage chemotherapy-related side effects, and increase hope and belief. With the method of distraction, which is frequently used from cognitive behavioral therapies, it is aimed to focus on another stimulus and to get away from negative feelings and thoughts. Recently, virtual reality application has been used frequently in the field of health for the method of distraction. Virtual reality is defined as the human computer interface that makes it feel as if it is in another universe with tools. The three-dimensional screen provides the attention of the person with the virtual reality stimuli with the motion detection system. The virtual reality application that attracts attention is preferred because it is a non-invasive intervention, has an affordable cost, and is effective in the motivation and well-being of the individual. In the meta-analysis of cancer-related symptom management, virtual reality applications, which do not require any special training, were found to increase tolerance to chemotherapy, to be effective in symptom management, to increase quality of life, and to enable acceptance of chronic disease. In the study, it was also stated that virtual reality applications were effective in reducing anxiety, depression, pain and cognitive function symptoms, although not effective in reducing fatigue, it was beneficial, and no serious side effects were reported. It is seen that the studies were designed as a single-time measurement, non-randomized research design, and a single-group pre-test-post-test. In this study, which aims to evaluate the effect of virtual reality glasses application on anxiety and fatigue in women with breast cancer receiving adjuvant chemotherapy, it is planned to increase the level of evidence of virtual reality glasses application by making multiple measurements and to evaluate fatigue with physical, emotional and cognitive sub-dimensions. In addition, this study is important in terms of increasing the awareness of oncology nurses who care for breast cancer patients about virtual reality application and integrating the method of distraction with virtual reality application into standard care. It is thought that it is useful and appropriate for the nurse to manage the distraction method with the virtual reality application, which is a non-invasive intervention, does not require specific skills, and has no serious side effects. For this purpose, it was planned to determine the effect of virtual reality glasses application on anxiety and fatigue in women with breast cancer receiving adjuvant chemotherapy.

Prospective randomized controlled clinical trial

The Effect of Virtual Reality on Anxiety and Fatigue in Women With Breast Cancer Receiving Adjuvant Chemotherapy

The Effect of Virtual Reality Glasses Application on Anxiety and Fatigue in Women With Breast Cancer Receiving Adjuvant Chemotherapy: Pretest-Posttest Randomized Controlled Study

The mean anxiety scores of virtual reality glasses application in women with breast cancer receiving adjuvant chemotherapy are different from the control group. A minimum of 20 points and a maximum of 80 points are taken from the scale. The higher the score, the higher the anxiety.

The mean fatigue scores of virtual reality glasses application in women with breast cancer receiving adjuvant chemotherapy are different from the control group. A minimum of 15 points and a maximum of 60 points are taken from the scale. The higher the score, the higher the fatigue.

The physical function sub-dimension mean scores of fatigue of virtual reality glasses application in women with breast cancer receiving adjuvant chemotherapy are different from the control group. A minimum of 7 points and a maximum of 28 points are taken from the scale. As the score increases, physical fatigue increases.

The emotional function sub-dimension mean scores of fatigue of virtual reality glasses application in women with breast cancer receiving adjuvant chemotherapy are different from the control group. A minimum of 4 points and a maximum of 16 points are taken from the scale. Emotional fatigue increases as the score increases.

The cognitive function sub-dimension mean scores of fatigue of virtual reality glasses application in women with breast cancer receiving adjuvant chemotherapy are different from the control group. A minimum of 4 points and a maximum of 16 points are taken from the scale. As the score increases, cognitive fatigue increases.

Necmettin Erbakan University

RN, MS, PhD(c), Instructor

Nervous System Diseases

Syndrome

Dyssomnias

Parasomnias

Standard care + cancer education

Participants receive a single session with a research nurse to discuss the importance of understanding cancer and cancer treatment strategies, and to introduce educational recordings available on an MP3 player. The educational recordings provide a selection of publicly available American Cancer Society patient information materials addressing topics related to cancer and cancer treatment strategies. Participants are asked to listen to at least one recording per day, or more frequently as desired.

Standard care + Patient-Controlled Cognitive Behavioral Intervention

Participants will receive a single training session with a research nurse including: 1) Information about the causes of cancer-related pain, fatigue, and sleep disturbance. 2) An explanation of how cognitive-behavioral interventions may affect symptoms. 3) Review of the specific cognitive-behavioral strategies provided on the MP3 player. 4) Individualized recommendations for using the cognitive-behavioral strategies. The nurse interventionist and patient will develop a written plan for practicing the strategies with recommendations to use a strategy at least once a day, or more frequently as needed.

Standard care + Selection of 12 recorded imagery- and non imagery-based cognitive-behavioral coping strategies provided on an MP3 player.

Cognitive-Behavioral Intervention

Attention Control

Kristine Kwekkeboom, PhD., RN

The purpose of the research is to test the efficacy of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance during cancer treatment, and to evaluate moderators and mediators of intervention effects. The intervention uses guided imagery, relaxation exercises, and nature sound recordings, self-administered via an MP3 player. The study will determine (1) if the intervention helps to control symptoms during chemotherapy, (2) if personal and clinical characteristics influence how well the intervention works, and (3) if the cognitive-behavioral strategies reduce markers of stress and inflammation found in blood and saliva.

Co-occuring pain, fatigue, and sleep disturbance is a common symptom cluster among patients with advanced cancer, diminishing functional status and quality of life. Cognitive-behavioral (CB) strategies (e.g., relaxation, distraction, and imagery) are effective treatments for each of these symptoms, and provide a logical choice in managing all three co-occurring symptoms. CB strategies are thought to work psychologically by reducing anxiety and stress, improving expectations for symptom outcomes, and enhancing perceptions of personal control. Recent research also suggests a physiologic pathway, in which CB strategies attenuate dysregulation in stress hormones and reduce proinflammatory cytokines that contribute to symptom exacerbation. CB strategies are not equally effective for all patients, with differences based on individual preferences and skills and concurrent symptoms. Thus, training in a single strategy is not sufficient. Our previous work demonstrates feasibility and initial efficacy of a patient-controlled cognitive-behavioral (PC-CB) intervention in which patients receive information about their symptoms and rationale for CB strategies, then self-administer their selection of various relaxation, distraction, and imagery strategies via MP3 player, using the CB strategies at whatever time and place they are needed. This brief intervention was designed to be mindful of the high symptom burden, unpredictable treatment course, and often short life expectancy of persons with advanced cancer. The purpose of this study is to test efficacy of the PC-CB intervention in a randomized controlled trial and to test moderators and mediators of intervention effects. The specific aims are (1) to test efficacy of the PC-CB intervention on severity, distress, and interference with daily life from the pain, fatigue, sleep disturbance symptom cluster, (2) to test proposed moderators (imaging ability, concurrent symptoms) of PC-CB intervention effects, (3) to test psychological mediators (anxiety, stress, outcome expectancy, perceived control) of PC-CB intervention effects, and (4) to explore two types of physiological mediators (neuroendocrine stress hormones and indices of inflammation) of PC-CB intervention effects. A sample of 198 adults receiving chemotherapy for advanced breast, lung, colorectal, prostate, gynecologic or other solid tumor cancers and experiencing pain, fatigue, and sleep disturbance will be recruited. Patients randomized to the PC-CB intervention will receive a brief training session and instructions to use the recorded CB strategies during 9-weeks of cancer treatment. Patients randomized to attention control will receive instructions to use cancer educational recordings over the same period. Measures of symptom severity and distress, symptom interference with daily life, and proposed psychological and physiologic mediating variables will be completed at baseline and the 3-week (primary) time point. Symptom outcome measures will be repeated at 6- and 9-week (secondary) time points to evaluate longer term treatment effects.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Coughing at Time of Cervical Biopsy	NCT06149598	Cervical Cancer Cervical Dyspla... Colposcopy Pain Sensation Cervical Biopsy	Coughing at the...	18 Years - 80 Years	Zydolab - Institute of Cytology and Immune Cytochemistry
Nature Sights and Sounds to Reduce Pain in Cancer Patients Undergoing Bone Marrow Aspiration and Biopsy	NCT00315796	Cancer	Biophilic Natur...	18 Years -	Johns Hopkins University
Nature Sights and Sounds to Reduce Pain in Cancer Patients Undergoing Bone Marrow Aspiration and Biopsy	NCT00315796	Cancer	Biophilic Natur...	18 Years -	Johns Hopkins University
Coughing at Time of Cervical Biopsy	NCT06149598	Cervical Cancer Cervical Dyspla... Colposcopy Pain Sensation Cervical Biopsy	Coughing at the...	18 Years - 80 Years	Zydolab - Institute of Cytology and Immune Cytochemistry
The Effect of Virtual Reality on Anxiety and Fatigue in Women With Breast Cancer Receiving Adjuvant Chemotherapy	NCT05168696	Breast Cancer F... Anxiety Fatigue	Virtual Reality...	18 Years - 65 Years	Necmettin Erbakan University
A Brief Patient-Controlled Intervention for a Symptom Cluster in Advanced Cancer	NCT01954420	Pain Fatigue Sleep Disturban... Cancer	Cognitive-Behav... Attention Contr...	18 Years -	University of Wisconsin, Madison
The Effect of Virtual Reality on Anxiety and Fatigue in Women With Breast Cancer Receiving Adjuvant Chemotherapy	NCT05168696	Breast Cancer F... Anxiety Fatigue	Virtual Reality...	18 Years - 65 Years	Necmettin Erbakan University

Spots Global Cancer Trial Database for distraction

Every month we try and update this database with for distraction cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for distraction

Every month we try and update this database with for distraction cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for distraction cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.