Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized waitlist controlled trial

Abstract Background Irritable bowel syndrome (IBS) is a functional disorder of the lower gastrointestinal (GI) tract affected by stress, which may benefit from a biopsychosocial treatment approach such as mindfulness-based stress reduction (MBSR). Purpose A treatment as usual (TAU) wait-list controlled trial was conducted in Calgary, Canada to investigate the impact of MBSR on IBS symptoms. It was hypothesized that MBSR patients would experience greater reduction in overall IBS symptom severity and self-reported symptoms of stress relative to control patients. Method Ninety patients diagnosed with IBS using the Rome III criteria were randomized to either an immediate MBSR program (n043) or to wait for the next available program (n047). Patients completed IBS symptom severity, stress, mood, quality of life (QOL), and spirituality scales pre-and post-intervention or waiting period and at 6-month follow-up. Intent-to-treat linear mixed model analyses for repeated measures were conducted, followed by completers analyses. Results While both groups exhibited a decrease in IBS symptom severity scores over time, the improvement in the MBSR group was greater than the controls and was clinically meaningful, with symptom severity decreasing from constantly to occasionally present. Pre-to post-intervention dropout rates of 44 and 23 % for the MBSR and control groups, respectively, were observed. At 6-month follow-up, the MBSR group maintained a clinically meaningful improvement in overall IBS symptoms compared to the wait-list group, who also improved marginally, resulting in no statistically significant differences between groups at follow-up. Improvements in overall mood, QOL, and spirituality were observed for both groups over time. Conclusions The results of this trial provide preliminary evidence for the feasibility and efficacy of a mindfulness intervention for the reduction of IBS symptom severity and symptoms of stress and the maintenance of these improvements at 6 months post-intervention. Attention and selfmonitoring and/or anticipation of MBSR participation may account for smaller improvements observed in TAU patients

Online Mindfulness-Based Cancer Recovery Program for People Living with Cancer in Alberta: A Randomized Wait-List Controlled Trial

Objective Through a randomized treatment-as-usual (TAU) wait-list controlled trial, the current studies examined the feasibility and impact of an online “real-time” synchronous Mindfulness-Based Cancer Recovery (MBCR) group program for distressed people diagnosed with cancer, who did not have access to in-person MBCR. Sub-analyses combined both the immediate and TAU wait-list groups to evaluate potential medical and physical demographic effects on participant mindfulness facets and symptom subscale scores to determine which participants improved most after the online MBCR intervention. Methods Sixty-two men and women exhibiting moderate-to-high distress were randomized to either immediate online MBCR or to wait for the next available program. Intent-to-treat mixed-model analyses for repeated measures were conducted. Subsequent, pre-post linear mixed model analysis was conducted on all participants who completed MBCR, and standardized change scores were calculated for subscales of mood and stress symptom measures. Results Feasibility targets for recruitment and retention were achieved. Participants were satisfied and would recommend online MBCR to other cancer survivors. Completion rates were comparable to in-person MBCR. Improvements and moderate effect sizes were reported in the online MBCR group relative to a TAU wait-list following MBCR for total scores of mood disturbance, stress symptoms, spirituality, and mindfully acting with awareness. Significant main effects of time were observed for posttraumatic growth and remaining mindfulness facets. Sub-analyses revealed younger participants had greater reductions in stress symptoms, increases in spirituality, and non-reactivity to experience over time. Over time, men experienced significantly greater posttraumatic growth than women. Subscale analyses of mood disturbance and symptoms of stress revealed greatest relative improvements in the subscales of Vigor, Fatigue, and Sympathetic Nervous System Arousal. Conclusions Results provided evidence for the feasibility and efficacy of an online adaptation of MBCR, facilitating reduction of mood disturbance and stress symptoms, and increasing participant-reported spirituality and mindfully acting with awareness. Online MBCR also reduced the negative physical impact of distress by improving energy levels and inducing relaxation. Future study is warranted using larger active control RCT designs. Programs utilizing similar technology could potentially improve access to other specialized psychosocial programs

Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized waitlist control trial

Bibliography: p. 32-4

Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review

Mindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date

Mindfulness-based stress reduction improves distress in two different chronic illnesses

Background: Distress is well recognized as endemic in cancer populations: less is known about distress in Irritable Bowel Syndrome (IBS). Purpose: This study compared distress between individuals with IBS (n=51) and those with cancer (n=147) participating in Mindfulness-Based Stress Reduction (MBSR). Methods: Patients completed mood and symptoms of stress questionnaires pre- and post- MBSR intervention as well as at 6-month follow-up. Results: The IBS group demonstrated higher baseline total symptoms of stress and more muscle tension, sympathetic nervous system arousal, and neurological/GI symptoms. They also had higher baseline tension/anxiety scores on the mood measure. While both groups decreased significantly post-MBSR on total stress symptoms and mood disturbance scores, the IBS group showed a small increase in stress symptoms between post-program and 6-month follow-up. Conclusions: These findings highlight the high levels of distress associated with IBS, and support evidence that MBSR may be beneficial in reducing both IBS and cancer related distress

The eCALM Trial-eTherapy for cancer appLying mindfulness: online mindfulness-based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait-list controlled clinical trial

Abstract Background Elevated stress can exacerbate cancer symptom severity, and after completion of primary cancer treatments, many individuals continue to have significant distress. Mindfulness-Based Cancer Recovery (MBCR) is an 8-week group psychosocial intervention consisting of training in mindfulness meditation and yoga designed to mitigate stress, pain, and chronic illness. Efficacy research shows face-to-face (F2F) MBCR programs have positive benefits for cancer patients; however barriers exist that impede participation in F2F groups. While online MBCR groups are available to the public, none have been evaluated. Primary objective: determine whether underserved patients are willing to participate in and complete an online MBCR program. Secondary objectives: determine whether online MBCR will mirror previous efficacy findings from F2F MBCR groups on patient-reported outcomes. Method/design The study includes cancer patients in Alberta, exhibiting moderate distress, who do not have access to F2F MBCR. Participants will be randomized to either online MBCR, or waiting for the next available group. An anticipated sample size of 64 participants will complete measures online pre and post treatment or waiting period. Feasibility will be tracked through monitoring numbers eligible and participating through each stage of the protocol. Discussion 47 have completed/completing the intervention. Data suggest it is possible to conduct a randomized waitlist controlled trial of online MBCR to reach underserved cancer survivors. Trial registration Clinical Trials.gov Identifier: NCT01476891</p

The eCALM Trial-eTherapy for cancer appLying mindfulness: online mindfulness-based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait-list controlled clinical trial

Elevated stress can exacerbate cancer symptom severity, and after completion of primary cancer treatments, many individuals continue to have significant distress. Mindfulness-Based Cancer Recovery (MBCR) is an 8-week group psychosocial intervention consisting of training in mindfulness meditation and yoga designed to mitigate stress, pain, and chronic illness. Efficacy research shows face-to-face (F2F) MBCR programs have positive benefits for cancer patients; however barriers exist that impede participation in F2F groups. While online MBCR groups are available to the public, none have been evaluated