Mindfulness-What Works for Whom? Referral, Feasibility, and User Perspectives Regarding Patients with Mixed Chronic Pain

Objective: The purpose of this study was to describe and predict the patients who would benefit from a mindfulness-based stress reduction (MBSR) course and those for whom the conditions or timing are not optimal. The hypothesis was that patients' sociodemographic status would affect the effectiveness of MBSR. Methods: Data were collected by using mixed methods. Quantitative data were collected from a group of 58 patients who completed health-related questionnaires and from an evaluation 6 months after completion of a mindfulness course. Qualitative data were collected from three focus group interviews and seven case stories. Results: There were no significant differences in positive or negative outcomes after MBSR regarding any sociodemographic variables, and no clear predictors to identify patients best suited for participating in mindfulness were found. Techniques used by most patients (with or without positive outcome) were meditation and focus on breathing. Patients expressed positive feedback and reported positive changes they felt would last for the rest of their lives. Focusing on the issue of what works, four categories of interest were identified from the transcribed interviews: lessons learned, being oneself, permanence, and continuity as a condition for success. Conclusions: Mindfulness meditation makes a difference for patients. Patients felt rested and in better control of their pain and its role in their life. Only older age predicted better outcome, but patients who recognized that pain is part of their life and were living under stable conditions may have been more likely to learn and put forth personal effort, which may have made change possible. More specific variables have to be developed to study good match between the specific intervention and the specific patient.