mHealth: providing a mindfulness app for women with chronic pelvic pain in gynaecology outpatient clinics: qualitative data analysis of user experience and lessons learnt
Julie Dodds, Liz Steed, Stephanie Taylor, Sian Newton, Clara Cantalapiedra Calvete, Judy Birch, Carol Rivas, Frank Röhricht, Elizabeth F. Ball
BMJ Open June 2, 2021 DOI: 10.1136/bmjopen-2019-030711 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Three-arm randomised feasibility trial with embedded qualitative interviews and focus groups Randomized Peer reviewed |
|---|---|
| Sample size | 21 |
| Population | Women with chronic pelvic pain lasting at least 6 months, recruited from two NHS gynaecology clinics, plus staff members |
| Topics | Meditation |
| Key findings | App use was low in both active groups. Prestudy patient volunteers were enthusiastic about the app, but women recruited from a routine clinic were less positive, citing lack of opportunities and motivation to use it and unfamiliarity with technology; staff cited needs for extra support, organisational backing, and peer acceptance. The authors suggest prestudy volunteers may not represent routine clinic patients and that codesigning with typical users may be more successful than adapting existing apps. |
Abstract
Objectives To determine whether a pre-existing smartphone app to teach mindfulness meditation is acceptable to women with chronic pelvic pain (CPP) and can be integrated into clinical practice within the National Health Service (NHS) CPP pathways, and to inform the design of a potential randomised clinical trial.Design A prestudy patient and public involvement (PPI) group to collect feedback on the acceptability of the existing app and study design was followed by a three-arm randomised feasibility trial. In addition, we undertook interviews and focus groups with patients and staff to explore app usability and acceptability. We also obtained participant comments on the research process, such as acceptability of the study questionnaires.Setting Two gynaecology clinics within Barts Health NHS, London, UK.Participants Patients with CPP lasting ≥6 months with access to smartphone or personal computer and understanding of basic English.Intervention The intervention was mindfulness meditation content plus additional pain module delivered by a smartphone app. Active controls received muscle relaxation content from the same app. Passive (waiting list) controls received usual care.Main outcome measures Themes on user feedback, app usability and integration, and reasons for using/not using the app.Results The use of the app was low in both active groups. Patients in the prestudy PPI group, all volunteers, were enthusiastic about the app (convenience, content, portability, flexibility, ease of use). Women contributing to the interview or focus group data (n=14), from a ‘real world’ clinic (some not regular app users), were less positive, citing as barriers lack of opportunities/motivation to use the app and lack of familiarity and capabilities with technology. Staff (n=7) were concerned about the potential need for extra support for them and for the patients, and considered the app needed organisational backing and peer acceptance.Conclusion The opinions of prestudy PPI volunteers meeting in their private time may not represent those of patients recruited at a routine clinic appointment. It may be more successful to codesign/codevelop an app with typical users than to adapt existing apps for use in real-world clinical populations.Trial registration number ISRCTN10925965.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 5
- Patients with Chronic Pain: Are Mindfulness Traits Protective Against Distress, Anxiety and Depression? Clinical neuropsychiatry October 1, 2023
- Attrition Rates in Mindfulness-Based Interventions for Chronic Pain: A Meta-Analysis bioRxiv (Cold Spring Harbor Laboratory) May 30, 2025
- Using Artificial Intelligence-informed Experience-Based Co-Design (AI-EBCD) to create a virtual reality-based mindfulness application to reduce diabetes distress: protocol for a mixed-methods feasibility study BMJ Open December 15, 2024
- Online Mindfulness Intervention for Inflammatory Bowel Disease: Adherence and Efficacy Frontiers in Psychology March 29, 2022
- MEMPHIS: a smartphone app using psychological approaches for women with chronic pelvic pain presenting to gynaecology clinics: a randomised feasibility trial. BMJ Open March 12, 2020
Cites 11
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Mindfulness and Compassion: An Examination of Mechanism and Scalability PLoS One February 17, 2015
- MEMPHIS: a smartphone app using psychological approaches for women with chronic pelvic pain presenting to gynaecology clinics: a randomised feasibility trial. BMJ Open March 12, 2020
- A randomised active-controlled trial to examine the effects of an online mindfulness intervention on executive control, critical thinking and key thinking dispositions in a university student sample. BMC Psychology April 5, 2018
- Smartphone App Using Mindfulness Meditation for Women With Chronic Pelvic Pain (MEMPHIS): Protocol for a Randomized Feasibility Trial JMIR Research Protocols 2018
and 6 more in the library