Type 1 diabetes mellitus (T1D) is one of the most prevalent chronic conditions in adolescents. Adolescents with T1D have higher rates of stress and anxiety than the general adolescent population. Mindfulness techniques, such as guided meditation, yoga, and body scan, are an evidence-based method of reducing stress and anxiety symptoms. However, these techniques have not been operationalized in adolescents with T1D. The purpose of this qualitative descriptive study was to provide an in-depth description of the perception and current use of mindfulness techniques to manage stress and anxiety in adolescents with T1D.
We used a qualitative descriptive approach, consisting of an in-depth, semi-structured interview comprised of 10 open-ended questions with follow-up probes. The analysis was guided by the principles of thematic analysis. We also collected demographic data and hemoglobin A1c. IRB approval was obtained prior to data collection.
Twenty participants with T1D (ages 13 to 17, 60% identified as female, mean A1c 7.6%) engaged in an in-depth qualitative interview (mean duration 40 minutes). We identified 4 major themes: 1. Adolescents were exposed to mindfulness techniques previously, including breathing exercises and yoga, and most reported positive effects of practicing mindfulness; 2. Adolescents reported that mindfulness was a means of escape from constant cell phone and social media usage, reminders, and notifications –“you get to put your phone away for the full hour you’re doing it”; 3. Several adolescents inadvertently used music as a way of cultivating mindfulness to “get away from everything” (most participants reported that listening to music was a way of escaping the external environment and shifting their focus internally, although most did not consider this a mindfulness practice); 4. Participation in a regular mindfulness practice was cost prohibitive to the majority of adolescents (most used a commercially available mobile health [mHealth] application and were not able to subscribe to access the full content). All adolescents endorsed an interest in an mHealth application that delivered mindfulness practices designed for teens, especially with customizable options (asynchronous, a variety of durations, multiple types of mindfulness practices to try).
Adolescents living with T1D experience high rates of stress and anxiety, impacting their chronic disease management and quality of life. Mindfulness is an evidence-based intervention that reduces stress and anxiety that has not yet been operationalized in adolescents with T1D. We found that adolescents with T1D have commonly been exposed to mindfulness techniques and are open to trying mindfulness in their daily lives. They value mindfulness practices as a means of “escaping” technology. Several adolescents use music as a form of unintentional mindfulness practice, describing “eliminating external stimuli” and “zoning internally” while listening to music. Our results suggest that implementing a low-cost, accessible mHealth application that delivers mindfulness practices of variable durations may be an effective strategy for mitigating stress and anxiety in adolescents with T1D.
© 2022 Published by Elsevier Inc.