Hou 2014.

Methods	Study design: randomised controlled trial Study grouping: parallel group
Participants	Inclusion criteria: Adults aged 18 or above Cantonese speaker Long‐term caregiving responsibility for first‐degree relatives with chronic illness conditions Score of 7 or above in the Caregiver Strain Index No self reported doctor's diagnosis of psychiatric illnesses and impaired cognitive status Exclusion criteria: Serious diseases or disorders that could potentially affect participation Care recipients had passed away before the study Previous participation in a mindfulness‐based, meditation, or similar programme within the preceding year Characteristics of carers of people with dementia N = 41 Mean age: 59.8 (SD 9.29) years Percentage of females: 78% Relationship to individuals with dementia: 51.2% spouses, 31.7% children, 12.2% parents, 4.9% relatives Average levels of carers' depressive symptoms at baseline (measured by CESD): 16.91 (SD 8.91) for participants in intervention group, 17.55 (SD 8.92) for participants in control group Average levels of carer burden (measured by Caregiver Strain Index) at baseline: 9.32 (SD 1.70) Notes: We included only carers of individuals with dementia in this review
Interventions	MBSR Duration: 8 weeks No. of sessions: 8 sessions, 2 hours per session Frequency: weekly Delivery: face‐to‐face, group Content of intervention: class activities of MBSR 1‐day retreat home practice: "participants were instructed to do CD‐guided home practice for 30‐45 minutes per day" Self help control Content of intervention: "The control group received self‐help health education booklets."
Outcomes	Carers' depressive symptoms Outcome type: continuous outcome Reporting: fully reported Scale: CESD Direction: lower is better Data value: endpoint Notes: "Mean refers to estimated marginal mean adjusted by the baseline measure." Carers' anxiety Outcome type: continuous outcome Scale: STAI‐state anxiety Direction: lower is better Data value: endpoint Notes: "Mean refers to estimated marginal mean adjusted by the baseline measure."
Identification	Sponsorship source: research grant from the Food and Health Bureau Country: Hong Kong, China
Notes	Adherence to intervention: "83% participants attended at least 6 sessions in MBSR and 43% attended all 8 sessions" Adverse events: "Only 1 male aged 80 strained his neck when practicing yoga at home, which did not inhibit him from participating in the weekly MBSR course."
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Randomization was conducted independently by a research assistant using the random numbers generated in Microsoft Excel 2003 and was not disclosed until the eligible participants completed baseline assessment and signed the informed consent form." Comment: Adequate sequence generation
Allocation concealment (selection bias)	Low risk	Quote: "the random numbers generated in Microsoft Excel 2002 and was not disclosed until the eligible participants completed baseline assessment and signed the informed consent form Comment: Adequate allocation concealment
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "The intervention group received MBSR, while the control group received self‐help health education booklets"; "The first and most important limitation is that we did not employ an active control group. The effects of MBSR can be overestimated because of the potential beneficial effects of social interaction and extra attention given to them by the intervention." Comment: Inactive control used in this study, plus the challenge of blinding participants or personnel or both for psychosocial interventions of this nature
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "participants were asked to self‐administer the questionnaires." Comment: Results from self reported scales may lead to a risk of detection bias.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote: "The total attrition rate of this study was 19.9%; the MBSR group had a significantly lower attrition rate than the control group (12.9% vs. 26.8%; P < 0.05)." "The attritions were significantly younger (P < 0.05) and had a lower level of physical activity (P < 0.05)." Comment: The study used intention‐to‐treat analyses, however the imputation method for missing data was not described.
Selective reporting (reporting bias)	Unclear risk	Comment: We did not find a published protocol.
Other risks of bias	Low risk	Not identified