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Shannon, David (2020) "Eternity in an hour ...": exploring the role of mindfulness with patients receiving palliative care : an interpretative phenomenological analysis. Doctoral thesis, London Metropolitan University.
Background:
Rates of psychological distress in patients facing end-of-life and receiving palliative care are significant. The prevalence rate for all mood disorders in one meta-analytic study was 29% (Mitchell et al., 2011). Interest in mindfulness meditation has increased exponentially over the past decade (AMRA, 2020). Meta-analyses in healthcare have consistently demonstrated increases in positive mood states and quality of life (Gotink et al., 2015). Few studies have explored the role of mindfulness with patients receiving palliative care. When they have, the mindfulness training component has usually been brief. Due to the growing popularity of mindfulness, patients who require palliative care will increasingly have had some exposure to mindfulness before becoming seriously ill. This study sought to pre-empt this societal shift.
Aim:
To explore the role of mindfulness, especially in relation to symptom burden, with patients who had been practicing mindfulness for a minimum of six months prior to recruitment.
Method:
Four participants met the inclusion criteria, and each engaged in a semi-structured interview. Interviews were analysed using Interpretative Phenomenological Analysis (IPA; Smith et al., 2009) to understand the psychological essence of their experiences.
Findings:
Four superordinate themes were identified: i). An altered relationship to pain; ii). Regulating thoughts and emotions; iii). A paradigm shift; and iv). Cultivating and sustaining mindfulness. These themes reflect previously proposed ‘mechanisms of mindfulness’ (Hölzel et al., 2011; Vago and Silbersweig, 2012) but also represent some novel findings within a palliative care context. For example, mindfulness appeared to inform a more appropriate use of medication and also impacted patients’ relationships in positive ways. These themes are discussed in relation to the existing literature. Finally, the limitations of this study along with implications for future clinical practice and research are outlined.
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