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 suggest that mindfulness meditation-based interventions benefit people with long-term conditions, particularly in terms of psychological well-being. 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 - 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 conceptualized 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.