On 2015 Jul 08, Radboudumc Psycho-Oncology Journal Club commented:

This is a very interesting and clearly reported study that identifies which patients are more or less likely to participate in mindfulness-based stress reduction (MBSR), and the relationship between presence of and search for meaning and willingness to participate in MBSR. After discussing this paper in during our journal club meeting, the following points were raised:

• 1. The results showed that being non-white is associated with higher levels of searching for meaning. As mentioned in the discussion spirituality and religious coping are important to African Americans. After reading the items of the subscale assessing search for meaning, such as ´I am seeking a purpose or mission for my life’, we wondered whether searching for meaning might be associated with spirituality or religiosity. We believe it would have been nice if a formal assessment of spirituality or religiosity had been included in this study.
• 2. Meaning making and psychological distress are closely related. As this is a cross-sectional study, we wondered about the direction of this relationship. Does higher distress lead to searching for meaning? Or does continuously searching for meaning lead to distress?
• 3. We know from practice that it is sometimes difficult to explain the rationale of MBSR to patients who might benefit from it. We read that participants in current study received a written description of MBSR, however no further elaboration of patients’ understanding of the purpose and rationale for MBSR was given. We believe it would have been helpful if a greater degree of depiction was provided to the reader about patients’ knowledge and understanding of the content and purpose of MBSR.<br>
• 4. Related to point 3, we also wondered about the order of the questionnaires. At what point patients were asked whether they were willing to participate in MBSR. At the beginning or the end of the questionnaires?
• 5. Given the findings about significant role of ethnicity, and the potential for cultural factors to influence uptake of MBSR, some members of our journal club wondered whether the research staff enrolling patients in this study were white or non-white

On 2015 Jul 08, Radboudumc Psycho-Oncology Journal Club commented:

This is a very interesting and clearly reported study that identifies which patients are more or less likely to participate in mindfulness-based stress reduction (MBSR), and the relationship between presence of and search for meaning and willingness to participate in MBSR. After discussing this paper in during our journal club meeting, the following points were raised:

• 1. The results showed that being non-white is associated with higher levels of searching for meaning. As mentioned in the discussion spirituality and religious coping are important to African Americans. After reading the items of the subscale assessing search for meaning, such as ´I am seeking a purpose or mission for my life’, we wondered whether searching for meaning might be associated with spirituality or religiosity. We believe it would have been nice if a formal assessment of spirituality or religiosity had been included in this study.
• 2. Meaning making and psychological distress are closely related. As this is a cross-sectional study, we wondered about the direction of this relationship. Does higher distress lead to searching for meaning? Or does continuously searching for meaning lead to distress?
• 3. We know from practice that it is sometimes difficult to explain the rationale of MBSR to patients who might benefit from it. We read that participants in current study received a written description of MBSR, however no further elaboration of patients’ understanding of the purpose and rationale for MBSR was given. We believe it would have been helpful if a greater degree of depiction was provided to the reader about patients’ knowledge and understanding of the content and purpose of MBSR.<br>
• 4. Related to point 3, we also wondered about the order of the questionnaires. At what point patients were asked whether they were willing to participate in MBSR. At the beginning or the end of the questionnaires?
• 5. Given the findings about significant role of ethnicity, and the potential for cultural factors to influence uptake of MBSR, some members of our journal club wondered whether the research staff enrolling patients in this study were white or non-white