Sand Mandala: A Case Study in the Essence of Psychological Resilience, Growth, and Thriving in Life After Stroke.
Erin Doan, Lori Gray, Heather Noble, Julie Bertram
Healthcare May 16, 2026 DOI: 10.3390/healthcare14101370 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative instrumental case study Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | One stroke survivor with high psychological resilience and his spouse (carepartner) |
| Topics | Meditation |
| Keywords | Grounded theory Mindfulness-based stress reduction Psychological resilience Stroke |
| Key findings | The authors describe three interrelated themes in one highly resilient stroke survivor: resilience antecedents including personality traits, values, behavioral modeling, and environmental factors; the obstacle is the way to posttraumatic growth; and poststroke resilience as mindfulness embodied. They propose that prestroke strengths, responses to adversity, and mindfulness practice interacted over long-term recovery, and present these exploratory, hypothesis-generating findings as a basis for future research in larger, more diverse populations. |
Abstract
Background/Objectives: Psychological resilience is associated with improved quality of life after stroke, yet less is known about how resilience and mindfulness interact over time in long-term recovery. This qualitative instrumental case study aimed to describe how psychological resilience and mindfulness unfolded in one stroke survivor with high psychological resilience and to identify processes that may inform future research on long-term stroke rehabilitation.
Method: We conducted an instrumental qualitative case study involving a stroke survivor and his spouse (carepartner), using an in-depth interview framework for data collection and grounded theory procedures to support analysis. Data sources included interview transcripts and contextual artifacts, such as personal and professional websites, emails, and informal conversations.
Findings: Three interrelated themes described how resilience unfolded in this case: (a) antecedents to poststroke resilience: personality traits, values, behavioral modeling, and environmental factors; (b) the obstacle is the way to posttraumatic growth; and (c) poststroke resilience: mindfulness embodied. Together, these themes suggest how prestroke strengths, responses to adversity, and mindfulness practice interacted in this participant's long-term recovery.
Conclusions: This exploratory case study offers a detailed account of how resilience and mindfulness may interact after stroke in one highly resilient individual. The findings are hypothesis-generating and may help guide future research on mindfulness-based and holistic approaches to long-term stroke recovery in larger and more diverse populations.
Comparable studies
Other case reports and case series on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Brain sources of EEG gamma frequency during volitionally meditation-induced, altered states of consciousness, and experience of the self Advanced meditator | 2001 | Case study | n = 1 |
| Mindfulness Meditation for Alcohol Relapse Prevention: A Feasibility Pilot Study Adult alcohol-dependent graduates of an intensive outpatient program | 2008 | Prospective case series | n = 19 |
| How does it feel to lack a sense of boundaries? A case study of a long-term mindfulness meditator. A single long-term mindfulness practitioner (S) with 40 years of practice in... | 2015 | Qualitative case study | n = 1 |
| Loving‐kindness meditation to enhance recovery from negative symptoms of schizophrenia Individuals suffering from schizophrenia-spectrum disorders with persistent negative... | 2009 | Case study | |
| Mindfulness-Based Cognitive Therapy for Problem Gambling A female problem gambler | 2011 | Case study | n = 1 |