Starting where I am: a grounded theory exploration of mindfulness as a facilitator of transition in living with a long-term condition

Aim: To explore how practising mindfulness affects people’s experiences of living with a long-term condition. Background: Increasing evidence suggests that mindfulness meditation-based interventions benefit people with long-term conditions, particularly in terms of psychological wellbeing. Most evidence however relates to short-term outcomes, and limited information exists about how people use mindfulness in the longer-term, and how this affects their experience of living with their condition. Design: A qualitative study using constructivist-informed grounded theory. Methods: Using interviews, diaries and focus groups, data were collected between 2011 and 2012 from participants and/or trainers of Breathworks’ mindfulness intervention. Phased recruitment enabled theoretical sampling, with data analysed concurrently using Charmaz’s two-stage coding strategy. Findings: The final sample comprised 41 adults with diverse physical and/or mental health conditions. Participants reported predominantly positive experiences, almost all identifying significant changes in thinking and behaviour. A core process of ‘Starting where I am’ was formulated, highlighting how people became more aware and accepting of their condition and thus able to self-care more effectively. The process was encapsulated in five themes: Getting a new perspective; Feeling equipped to cope; Doing life differently; Seeing a change; and Finding mindfulness difficult. Strong resonances were identified between participants’ experiences and the process of transition through which people come to terms with challenging life events. Conclusion: Mindfulness can be conceptualised as a facilitator of transition, enabling people to adapt to living with a long-term condition. Transition is associated with improved, self- directed self-management, which is significant to both people with long-term conditions and healthcare providers.

http://dx.doi.org/10.1111/jan.12998