Barriers and facilitators at attending mindfulness-based intervention programs of people with COPD. A systematic qualitative review

Introduction: A growing number of qualitative and quantitative studies have been conducted applying mindfulness-based interventions (MBIs) to treat psychological and physical manifestations in people with Chronic Obstructive Pulmonary Disease (COPD). Evidence on their effectiveness is still conflicting. Understanding the experiences of people affected by COPD attending the MBI program could help to design interventions suitable to these population and improve their effectiveness. Aim: A qualitative systematic review was conducted aimed at exploring the barriers and facilitators at the participation of MBI programs from the perspective of people with COPD. Methods: Systematic research on relevant databases was conducted including COPD individuals at any disease stage and any MBI program. Qualitative study designs were included. A meta-aggregative approach was used following the Joanna Briggs Institute approach. Results: Three qualitative and two mixed methods studies were identified and included. The participation at mindfulness-based programs was hampered by psychological barriers, such as disbelief and lack of trust, and practical barriers, such as difficulties in attending the classes. Also, cultural barriers hinder trusting the programs Having shorter sessions, distance session via skype and compassionate coaches could promote the retention and the adherence at the mindfulness practice. The absence of group physical presence could deter individuals to continuing the programs. Conclusion: Specific MBI programs considering COPD patients’ preferences should be tested to optimise the retention and adherence and to maximise their effectiveness.