Exploring how practising mindfulness affects people's experiences of living with a long-term condition

There is increasing evidence that mindfulness meditation-based interventions (MMBIs) benefit people with many long-term conditions (LTCs), particularly in terms of psychological wellbeing. Most evidence however relates to short-term outcomes, and limited information exists about how people integrate mindfulness into life over the longer-term, and how this affects their experience. This PhD aimed to address these limitations through the research question: How does practising mindfulness affect people’s experiences of living with a LTC? A qualitative approach was adopted, using grounded theory to explore the processes of change. Using two-stage interviews, diaries and focus groups, data were gathered from 34 participants and seven trainers of Breathworks’ mindfulness course. Almost all study participants reported a diversity of physical and/or mental health problems, many with multi-morbidity. Fieldwork was supplemented by a subsequent Cochrane-informed overview of systematic reviews and a critical review of qualitative studies of MMBIs. Participants’ experiences were predominantly strongly positive, identifying significant changes in thinking and behaviour. They described in detail how mindfulness had become part of their lives, enabling them to be more effective and responsive in their self-care. Analysis identified a core process and metaphor of ‘Starting where I am’ on an unwanted journey to an unfamiliar place. This highlighted how people become more aware and accepting of their condition and its impact, but able to see it in a wider context, and thus to take appropriate action. The process was represented in five interrelated themes: Getting a new perspective; Feeling equipped to cope; Doing life differently; Seeing a change; and Finding it difficult. Through exploration of existing chronic illness literature, the study suggests that mindfulness is a powerful facilitator of transition, through which people come to terms with challenging life events. Transition is associated with improved, self-directed self-management, which is significant to both people with LTC and healthcare providers.