Yun, M.R., Song, M., Jung, K.H., Yu, B.J., & Lee, K.J. (2017). The effects of mind subtraction meditation on breast cancer survivors' psychological and spiritual well-being and sleep quality: A randomized controlled trial in South Korea. Cancer Nursing, 40, 377–385.

The purpose was to examine effects of mind subtraction meditation on depression and other aspects of well-being.

Patients were randomized to groups receiving meditation or an active control of self-management education. The meditation group participated in sessions twice weekly for two hours over eight weeks. The first four sessions included self-management education, and full meditation began during the fifth session. Group members were sent texts and emails to encourage home meditation twice per week. The education group had two-hour sessions weekly for four weeks, including information on relationships, communication, managing stress, and comfort. Study assessments were done at baseline and weeks 4 and 8.

• N = 52; 48 assessed at week 8   
• AGE: Mean 48.44 years
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Breast cancer
• OTHER KEY SAMPLE CHARACTERISTICS: Mean time since surgery was 9 months; most had chemotherapy and endocrine therapy.

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: South Korea

RCT with active control

• CES-D for depression
• Beck Anxiety Inventory
• FACT-Breast – quality of life
• Satisfaction With Life Scale
• Pittsburgh Sleep Quality Index – Korean version
• Posttraumatic Growth Index

There were no differences between groups at week 4. At week 8, there were significant group differences in depression (p = 0.034), perceived stress (p = 0.009), anxiety (p = 0.036), as well as other measures. Before meditation, 90% of those in the meditation group reported sleep problems, and after the intervention, 9.1% reported problems. Evaluation of change in sleep quality showed more in the meditation group reported improvement and none reported worsening sleep quality over the eight-week study period (p = 0.010). Attendance in both groups ranged from 75% to 100% of the sessions.

Participation in meditation resulted in improved symptoms of depression and anxiety and improvement in sleep quality.

• Small sample (< 100)
• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Other limitations/explanation: It is not stated whether sessions were done in a group setting, in which case, group interaction and support could have affected results. The education group received much less attention.

Meditation may be beneficial for patients to improve sleep and reduce symptoms of anxiety and depression. Additional evidence beyond this study is needed to evaluate these effects.