title: Randomized controlled pilot study of mindfulness-based stress reduction for persistently fatigued cancer survivors.
abstract: OBJECTIVE
  Cancer-related fatigue (CRF) is one of the most common, persistent, and disabling symptoms associated with cancer and its treatment. Evidence-based treatments that are acceptable to patients are critically needed. This study examined the efficacy of mindfulness-based stress reduction (MBSR) for CRF and related symptoms.
  
  
  METHODS
  A sample of 35 cancer survivors with clinically significant CRF was randomly assigned to a 7-week MBSR-based intervention or wait-list control group. The intervention group received training in mindfulness meditation, yoga, and self-regulatory responses to stress. Fatigue interference (primary outcome) and a variety of secondary outcomes (e.g., fatigue severity, vitality, disability, depression, anxiety, and sleep disturbance) were assessed at baseline, post-intervention, and 1-month follow-up. Bonferroni correction was employed to account for multiple comparisons. Controls received the intervention after the 1-month follow-up. Participants in both groups were followed for 6 months after completing their respective MBSR courses to assess maintenance of effects.
  
  
  RESULTS
  Compared to controls, the MBSR group reported large post-intervention reductions as assessed by effect sizes (d) in the primary outcome, fatigue interference (d = -1.43, p < 0.001), along with fatigue severity (d = -1.55, p < 0.001), vitality (d = 1.29, p < 0.001), depression (d = -1.30, p < 0.001), and sleep disturbance (d = -0.74, p = 0.001). Results were maintained or strengthened at 1-month follow-up, the point at which significant improvements in disability (d = -1.22, p < 0.002) and anxiety (d = -0.98, p = 0.002) occurred. Improvements in all outcomes were maintained 6 months after completing the course. MBSR adherence was high, with 90% attendance across groups and high rates of participant-reported home practice of mindfulness.
  
  
  CONCLUSIONS
  Mindfulness-based stress reduction is a promising treatment for CRF and associated symptoms.
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.|Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Shelley A
authors.identifier: http://orcid.org/0000-0001-5730-1822
authors.initials: SA
authors.lastname: Johns
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Linda F
authors.initials: LF
authors.lastname: Brown
authors.affiliation: Indiana University School of Nursing, Indianapolis, IN, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Beck-Coon
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Monahan
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.|Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D006233:Persons with Disabilities; D005221:Fatigue / Q000209:etiology* / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation; D008875:Middle Aged; D064866:Mindfulness; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D010865:Pilot Projects; D018401:Sample Size; D015983:Selection Bias; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000628:therapy; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D014850:Waiting Lists; D015013:Yoga
keywords: MBSR; cancer; cancer-related fatigue; meditation; mindfulness; oncology