Barriers and Facilitators to Mindfulness-Based Interventions in Diabetic Peripheral Neuropathy: A Qualitative Inquiry to Inform Intervention Design

Abstract:

Objectives: Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes, with neuropathic pain and sensory abnormalities severely affecting patients’ quality of life. Current pharmacological treatments have limitations including insufficient efficacy and adverse reactions. Mindfulness-based interventions (MBIs) show potential in chronic pain management, yet their implementation in DPN populations remains low and the influencing factors are not systematically clarified. This study explored the cognitive basis and misunderstandings of DPN patients regarding MBI, identified multidimensional barriers and facilitators influencing MBI adoption, and revealed the core contradiction between patients’ disease management needs and their actual life circumstances to generate empirical evidence for personalized MBI implementation.

Method: A descriptive qualitative design with phenomenological orientation was adopted. Using purposive sampling, 14 DPN patients meeting the inclusion criteria were recruited from a tertiary hospital. Semi-structured in-depth interviews were conducted, and data were analyzed using Colaizzi’s seven-step phenomenological method. Member checking and peer debriefing were employed to ensure research rigor.

Results: Three core themes and seven subthemes were identified. Theme 1—Psychological anxiety caused by physiological symptoms—comprised three subthemes: “Physical and psychological distress in the context of chronic disease,” “Therapeutic stress caused by changes in social roles,” and “Dissatisfaction with current treatment effectiveness.” Theme 2—Cognition and acceptance of MBI—included “Definition and understanding of MBI” and “Willingness to accept MBI.” Theme 3—Differentiated expectations for MBI implementation—covered “Differentiated expectations for therapeutic effects” and “Preference for implementation methods.”

Conclusions: DPN patients demonstrate substantial demand for MBI but are constrained by cognitive misconceptions, socioeconomic limitations, and insufficient healthcare system support. Future implementation strategies should focus on developing DPN-specific mindfulness programs, integrating digital health solutions, and establishing multidisciplinary collaborative pathways. These findings provide preliminary implementation science evidence for integrating MBI into comprehensive DPN management. Preregistration: This study is not preregistered.