"I'm empowered to look after myself" - Mindfulness as a way to manage chronic pain: An interpretative phenomenological analysis of participant experiences in Scotland

Author: Fathima L Marikar Bawa1, Jane W Sutton2, Stewart W Mercer3, Christine M Bond4
Affiliation: <sup>1</sup> Centre of Academic Primary Care, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK. Electronic address: fathima.marikarbawa2@nhs.scot. <sup>2</sup> Department of Pharmacy and Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK. Electronic address: js293@bath.ac.uk. <sup>3</sup> Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK. Electronic address: stewart.mercer@ed.ac.uk. <sup>4</sup> Centre of Academic Primary Care, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK. Electronic address: c.m.bond@abdn.ac.uk.
Conference/Journal: Soc Sci Med
Date published: 2021 May 25
Other: Volume ID: 281 , Pages: 114073 , Special Notes: doi: 10.1016/j.socscimed.2021.114073. , Word Count: 307

Background and primary aim:
Chronic pain is a common problem that can impact on psychological and social wellbeing and activity levels. Despite pharmacological treatments, there is often a lack of improvement in physical and emotional functioning and health-related quality of life. Mindfulness meditation has become an increasingly popular self-management technique. The aim of the study was to explore the experiences of patients with chronic pain who took part in a mindfulness programme.

A mixed-methods feasibility study was carried out. Participants were aged 18 years or over with non-malignant chronic pain recruited from general medical practices in Fort William, Scotland. In 2013 participants undertook an eight-week mindfulness programme based on Mindfulness-Based Stress Reduction (MBSR) and were interviewed immediately post-programme and at eight-months' post-programme. Analysis of qualitative data involved Interpretative Phenomenological Analysis (IPA).

Thirty-four patients consented to take part in the study; twenty-four took part in the programme (14 attended four or more sessions, 10 attended one to three). Twenty-three were interviewed. Participant experiences of the programme were themed under: factors affecting experience (influence of earlier life events; the process of taking part in, and of relating to, the programme); and effects of the programme (impact on emotions, mental health, adverse events and a process of change). The process of change, resulting after better understanding the relationship between mindfulness and pain, involved learning to 'listen to the body', gaining a sense of community, learning to accept pain, and approaching life with more self-care, awareness, appreciation and empowerment.

Participants reported a variety of experiences. For some, these included undergoing a process of change which may have supported them in living with their painful condition. This contributes to our understanding of how mindfulness could benefit people with chronic pain.

Keywords: Chronic pain; Interpretative phenomenological analysis; Mindfulness; Mindfulness-based stress reduction; Pain coping; Pain management; Participant experiences; Process of change.

PMID: 34120086 DOI: 10.1016/j.socscimed.2021.114073