Table 1.
Literature Summary
| Study | Participants | Design | Intervention | Measurement of Home-Practice | Distress-Related Outcome Measure | Results | Average Home Practice (% Adherence)a | |
|---|---|---|---|---|---|---|---|---|
| Speca et al 200021 Canada | 90 patients with various cancer types [average age=51 years; 78% females; 38% breast cancer; mean of 15 years of formal education] | Waitlist RCT | MBCR [7 weekly 90-min sessions, home practice 45min/day was encouraged using a booklet and audiotape] | Home practice log | POMS and SOSI, administered at baseline and postintervention | After the intervention, patients in the treatment group had significantly lower scores on POMS-TMD (−65% vs −12%) and subscales of depression and anxiety, and stress (−30.7% vs −11.1%) than control subjects. | 32 min/day (71%adherence) | |
| Carlson et al 200723 Canada | 59 patients with early stage 0-II breast (n=49) or localized prostate (n=10) cancer [average age=54 years; 85% females; 64% married; average time since cancer diagnosis= 1.1 years; average of 14.7 years of formal education] | Single-group | MBCR [8 weekly 90 mins sessions, 3-h retreat, home practice 45 min/day] | Daily log collected each week during class | POMS, SOSI, and salivary cortisol, assessed pre- and post-intervention, and at 6- and 12-month follow-up. | Changes in POMS scores over the course of the intervention and follow-up were not significant. Stress scores showed a significant reduction (−19.3%) over the course of the intervention, which were maintained over the follow-up period. The average daily mean of cortisol values and overall slope of the diurnal rate did not change from pre- to post-intervention, but cortisol levels decreased significantly over the course of the follow-up. | 37 min/day (82% adherence) | |
| Lengacher et al 200927 USA | 85 breast cancer survivors [average ag= 57 years; 72% White; 56% employed; 78% some college education or more; 70% stage 0–I cancer, 30% stage II–III; average time since treatment completion=5 months) | Waitlist RCT | MBSR [6 weekly 2-h sessions, home practice 15–45 min/day using a manual and CD] | Daily diary | CARS, STAI, PSS, and CESD, assessed at baseline and postintervention. | MBSR participants exhibited greater improvements in fear of recurrence, anxiety and depression scores, relative to controls. | 25.6 min/day (57% adherence) | |
| Foley et al 201032 Australia | 115 participants with various cancer types [average age= 55.1 years; 77% females; 42% breast cancer; 44% employed] | Waitlist RCT | MBCT [8 weekly 2-h sessions, 5-hr retreat day, home practice up to 1-h/day using mindfulness recordings] | Daily diary collected at intervention end | HAM-D, HAM-S, and DASS, assessed at baseline, postintervention, and 3 months postintervention. | There were significant improvements in depression (d= 0.83), anxiety (d= 0.59), and stress (d=0.53) scores for MBCT participants compared with controls. Benefits were maintained at 3-month postintervention. | 30 min/day (50% adherence) | |
| Lengacher et al 201228 USA | 26 patients with advanced stage cancer [average age= 53 years; 69% female; 73% White; 69% married; 30% breast cancer; 63% some college education or more] | Single-group | MBSR [6 weekly 2-h sessions, home practice 15–45 min/day using a manual and CD] | Daily diary | CARS, STAI, and CESD, assessed at baseline and postintervention. Salivary cortisol and interleukin-6 were assessed pre- and post-MBSR session at 1, 3, and 6 weeks. | Following the 6-week MBSR program, patients showed improvements in stress and anxiety. Patients also had significant decreases in cortisol at Weeks 1 and 3 but not at Week 6. Salivary cortisol and interleukin-6 levels at Week 6 were lower overall (before/after an MBSR session), compared with Week 1. | 14.3 min/day (31% adherence) | |
| Hoffman et al 201234 United Kingdom | 114 females with stage 0-III breast cancer [average age=49 years; average time since treatment completion=9.2 months; average time since diagnosis= 17.4 months] | Waitlist RCT | MBSR [8 weekly 2–2.5 classes, 6-h retreat, 45 min/day home practice using a CD and manual] | Weekly record sheets | POMS, assessed at baseline, 8 and 12 weeks | There were statistically significant lower POMS-TMD scores in the experimental group than in the control group at postintervention (d= −0.5) and follow-up (d=−0.4). Similarly, there were lower POMS-anxiety subscale scores in the experimental group at postintervention (d= −0.4) and follow-up (d= −0.5). | 21 min/day (46% adherence) | |
| Campbell et al 201225 Canada | 70 female cancer survivors [average age= 53 years; 74% breast cancer; 87% White; average time since diagnosis=24 months, average time since treatment completion=13 months; average years of education= 14.6 years; 75% married or living with a partner; 10% metastatic disease] | Non-randomized waitlist trial | MBCR [8 weekly 90 min classes, 6-h retreat, home practice 45 min/day] | Daily log collected each week during class | RRQ-Rumination subscale, assessed at weeks 1 and 8 | MBCR group participants had significantly lower rumination scores than controls pre-post intervention. | 33 min/day (73% adherence) | |
| Zernicke et al 201424 Canada | 62 underserved cancer survivors [73% females; 82% in a relationship; 92% White; 34% breast cancer; average age= 58 years; 34% retired or employed full time; 77% completed some type of postsecondary education] | Waitlist RCT | Online MBCR [8 weekly 2-hour synchronous group sessions, 6-h retreat, home practice 45 min/day using recordings and videos] | Daily log | POMS and C-SOSI, administered at baseline and postintervention. | MBCR participants exhibited significant improvements in POMS-TMD (d= 0.44) and stress (d=0.49) scores compared to waitlist controls. | 21.4 min/day (47% adherence) | |
| Labelle et al 201522 Canada | 211 patients with various cancer types [58% breast cancer; average age=52 years; 80% female; 92% White; 71% married; average years of education=15 years; 70% completed treatment; average time since diagnosis= 23 months] | Non-randomized waitlist trial | MBCR [8 weekly 90 min classes, 6-h retreat, home practice 45 min/day] | Daily log collected each week during class | POMS, RRQ, and PSWQ, assessed at baseline, weeks 4 and 8. | Relative to controls, MBCR participants demonstrated greater decreases in POMS (d= 0.52), rumination (d=0.68), and worry (d= 0.57) scores. | 27.3 min/day (60% adherence) | |
| Tamagawa et al 201526 Canada | 38 females with stage I (40%) or II [45%) breast cancer [average age=55 years; average time since diagnosis= 20 months; 61% employed; 63% married or cohabitating; average years of education= 15 years] | Single-group | MBCR [8 weekly 90 min classes, 6-h retreat, home practice 45 min/day using a program manual and two compact discs] | Daily log collected each week during class | POMS and PTGI, assessed at baseline and postintervention | Not reported (results published separately as part of a larger study) | 20.6 min/day (45% adherence) | |
| Johns et al 201530 USA | 35 patients with various cancer types [average age=58 years; 85% breast cancer; 94% females; 80% White; 71% college educated; 49% employed; 60% married, 60% had a comfortable income; average time since treatment completion= 51.3 months] |
Waitlist RCT | MBSR [7 weekly 2-h classes, no retreat, and home practice 20 min/day] | Weekly log | GAD-7 and PHQ-8, assessed at baseline, postintervention, and 1-month follow-up | Compared to controls, MBSR participants reported significant reductions in depression at postintervention (d= −1.30) and follow-up (d=−1.71). Anxiety scores were lower for MBSR participants than controls at follow-up (d = −0.98) but not at postintervention. | 35 min/day (>100% adherence) |
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| Johannsen et al 201635 Denmark | 129 females with breast cancer [average age= 56.8 years; on average 40 months post- mastectomy or lumpectomy; 70% married; 43% employed; 69% more than 2 years of post-high school education] | Waitlist RCT | MBCT [8 weekly 90 min classes, no retreat, home practice 45 min/day using a CD] | Weekly homework records | HADS, assessed at baseline, 8 weeks, 3 and 6 months | Interactions between group and time were not significant, indicating no difference between groups. | 24 min/day (53% adherence) | |
| Johns et al 201631 USA | 71 patients with stage 0-III breast (n=60) or colorectal (n=11) cancer [average age= 56 years; 90% females; 70% White; 52.1% had a comfortable income; 54.9% married; average time since treatment completion= 2.4 years] | RCT with an active control group [psycho-educational support (PES)] | MBSR [8 weekly 2-h classes, no retreat, home practice 20 mins/day] vs a structurally equivalent PES program | Weekly log | GAD-7 and PHQ-8, assessed at baseline, postintervention, and 6 months later | Both groups exhibited significant improvements in anxiety (MBSR: postintervention d =−0.89, 6-month d =−0.74) and depression (MBSR: postintervention d=−1.05, 6-month d= −0.98) scores. Differences between groups were not significant. | MBSR: 16.8 min/day (84% adherence) PES: 13.2 min/day (66% adherence) |
|
| Lengacher et al 201829 USA | 15 stage 0‐III breast cancer survivors [average age= 57 years; 80% married; 93% White; average time since treatment completion= 10 months] | Single-group | Online asynchronous MBSR [6 weekly 2-h sessions, home practice 15–45 min/day using audio and video files] | Electronic practice diary | STAI, CESD, PSS, and CARS, assessed at baseline and postintervention | Following the program, participants reported significant improvements in anxiety (d=1.48), depression (d=1.62), stress (d=1.62), fear of recurrence overall (d=1.51), and fear of recurrence problems (d=1.31). | 36 min/day (80% adherence) | |
| Compen et al 201833 Netherlands | 245 patients with various cancer types [86% females; average age= 51.7 years; 62% breast cancer; 82% married; 68% high education] | Three-arm RCT (in-person MBCT vs online MBCT vs treatment as usual) | In-person MBCT [8 weekly 2.5-h group sessions, 6-h retreat, daily home practice using audio files] Online asynchronous MBCT [delivered individually and offered online material for 8 weeks, 6-h retreat, daily home practice] | Daily diary | HADS, FCRI, and RRQ-rumination subscale, assessed at baseline and postintervention | Compared with treatment as usual, both in-person and online MBCT groups exhibited significant improvements in HADS (d=0.45 and 0.71, respectively), fear of recurrence (d= 0.27 and 0.53, respectively), and ruminative thinking (d= 0.42 and 0.51, respectively) from baseline to postintervention. | All MBCT participants: 29.6 min/day bAdherence rate could not be calculated. In-person MBCT: 30.6 min/day Online MBCT: 28.7 min/day |
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| Russell et al 201941 Australia | 69 patients with melanoma [54% females; average age= 54 years; 76% married; 39% university degree] | RCT (usual care control group) | 6-week web-based asynchronous MBI program. Participants were asked to practice daily. | Weekly online home practice questionnaire | FCRI, administered at baseline and postintervention | Compared with controls, MBI participants exhibited significant improvements in FCR severity (d=1.01) from baseline to postintervention. | 13.7 min/day bAdherence rate could not be calculated. | |
| Huberty et al 201939 USA | 128 patients with myeloproliferative neoplasm [average age=58 years; 81% females; 96% white; 61% well-educated with a bachelor’s education or higher; 74% married] | 4-group cross-over design RCT with a and an educational control group | 8-week app-based MBI program of two meditation apps (10% Happier and Calm). Participants were asked to practice 10 min/day. | Smartphone app developers reported weekly practice data to the research team. | PROMISSF-anxiety and PROMISSF-depression, assessed at baseline, week 5, and week 9. | 10% Happier app participants reported significant improvements in anxiety (d=−0.43) and depression (d=−0.38). No significant differences were found between baseline and postintervention scores for anxiety (d=−0.22) and depression (d=−0.29) among Calm app participants. | All study participants: 7.2 min/day (72% adherence) 10% Happier app: 4.4 min/day (44% adherence) Calm app: 10.1 min/day (100% adherence) |
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| Donovan et al 201940 USA | 20 adolescents or young adults with sarcoma [57% females; average age=19 years; 65% white] | Single-group | 4-week app-based MBI program. Participants were encouraged to practice daily. | Not specified | PCQL-32- Psychological Functioning subscale, administered at baseline and postintervention | Changes in psychological functioning were not statistically significant. | 4 min/day bAdherence rate could not be calculated. | |
| Poletti et al 201936 Italy | 20 patients with metastatic cancer [average age= 54 years; 85% females; 60% undergoing treatment] | Single-group | MBSR [8 weekly 2.5-h classes, 4.5-h retreat, home practice 30 min/day using a CD] | Home practice diary collected at intervention end | POMS, assessed at baseline, postintervention, and 2 and 4 months postintervention | POMST-TMD and POMS-depression subscale scores significantly improved postintervention. Benefits were maintained at 2- and 4-month follow-up. | 19 min/day (63% adherence) | |
| Park et al 202037 Japan | 74 females with stage I–III breast cancer [average age=53.7 years; 60% married; 46% employed] | Waitlist RCT | MBCT [8 weekly 2-h classes, no retreat, home practice 20–45 min/day using a compact disc] | Not specified | HADS and CARS, assessed at baseline, 8 and 12 weeks | MBCT participants reported significant improvements in HADS (d=1.17) and fear of recurrence (d: 0.43), compared with controls. Benefits were maintained at follow-up (4 weeks postintervention). | 24 min/day (53% adherence) | |
| Zhao et al 202038 China | 135 breast cancer survivors [average age= 53 years; 50% diploma or university degree; 93% married; average time since treatment completion= 2.3 years] | Waitlist RCT | MBCT [6 weekly 90-min classes, home practice 20–40 min/day using an audio tape and handouts] | Daily log | No distress measure was included in this study. | No distress measure was included in this study. | 23.7 min/day (59% adherence) | |
Notes: aAdherence rate was calculated using the following formula: average number of minutes of actual home practice per day/prescribed number of minutes of home practice per day x 100. bStudies did not specify the length of assigned home practice, which precluded adherence rate calculation.
Abbreviations: POMS-TMD, Profile of Mood States – Total Mood Disturbance; HADS, Hospital Anxiety and Depression Scale; RRQ, Rumination–Reflection Questionnaire; GAD-7, Generalized Anxiety Disorder Scale; PHQ-8, Patient Health Questionnaire Depression Scale; CARS, Concerns About Recurrence Scale; FCRI, Fear of Cancer Recurrence Inventory; C-SOSI, Calgary Symptoms of Stress Inventory; SOSI, Symptoms of Stress Inventory; PSWQ, Penn State Worry Questionnaire; STAI, State-Trait Anxiety Inventory; CESD, Center for Epidemiological Studies Depression Scale; PSS, Perceived Stress Scale; HAM-D, Hamilton Depression Rating Scale; HAM-A, Hamilton Anxiety Rating Scale; DASS, Depression, Anxiety and Stress Scale; PTGI, Post-Traumatic Growth Inventory; PROMISSF, Patient Reported Outcomes Measurement Information System Short Form (8-item); PCQL-32, Pediatric Cancer Quality of Life Inventory.