ABSTRACT
Mindfulness, which means being aware of the moment and what is happening around and accepting it unconditionally, is especially valuable for children who are in the age of discovery and development. Research question: In the recent years Council of Higher Education (CoHE) Thesis Center publications, how has the mindfulness been studied in Turkish children? Searches were conducted of CoHE Thesis Center until October 2023 to identify dissertations (master of science, doctorate, specialization in medicine). Using the keywords “mindfulness” and “child”, “mindfulness” and “children” were scanned. Studies which did not have full text access and did not include assessment and intervention on mindfulness with children were excluded. Eighty-nine dissertations met the study’s inclusion criteria. Once duplicates were removed and were screened for eligibility, totally 27 studies between 2018 and September 2023 were reviewed. Types of these studies were as follows: 22 were master of science, 3 were doctorate and 2 were specialization in medicine. The most common field outcomes were psychology and education and training. Within the scope of this determination, there were two main themes: evaluation methods (n=20) and intervention methods (n=7). While there were 10 studies between 2017 and 2019, 17 studies were found in the last four years. It has been observed that postgraduate dissertations on mindfulness have increased in recent years. Although the researchers on the subject appear to be from different scientific fields and disciplines and that interest in the subject has increased, future studies are needed to create a general consensus.
Introduction
Aware is associated with aspects of individuals such as being open, non-judgmental, friendly, curious, accepting, compassionate and kind. Mindfulness is explained as moment-by-moment awareness of thoughts, emotions, bodily sensations and the environment (1). Mindfulness has recently begun to draw interest in scientific and popular discourses in daily life (2). It is also studied in various disciplines, especially psychology, physiology, health services, neuroscience and art. In this context, mindfulness research shows that mindfulness-based approaches are aimed at improving stress management, cognitive, emotional and interpersonal functions (3).
Mindfulness studies include various age and focus groups. Studies on its effects on children that one of the focus groups within this scope have started to improve. “Child” which includes the 0-18 age group, is the period before adulthood (4). For this reason, mindfulness studies implemented on individuals who have not yet stepped into adulthood provide that individuals in this age group are supported in terms of academic, social and cognitive functions. Additionally, mindfulness practices are emphasized in this critical period to support the development of different skills (5).
Considering that about half of mental disorders occur before the age of 14, it is clear that the period between the ages of 0-18 is especially transit for adulthood (6). It is important to screen child development, evaluations at an early stage, determine possible situations and apply appropriate protocols regularly. Besides all this, it has been shown that practices aimed at evaluating and improving individuals’ mindfulness are also successful in the treatment of medical conditions such as depression, anxiety, chronic pain, heart diseases and cancer (7). For this reason, mindfulness-based interventions are accepted as a hopeful approach and are followed with increasing interest in the field of mental health. Mindfulness practices include movement-based practices such as mindfulness meditations, breathing exercises, yoga, and approaches that protect attention and enhance focus by choosing a focus point (7, 8). Mindfulness-based intervention results in enhanced mindfulness through the mindfulness regulation process and a more integrated sense of personal accomplishment among key and common goals (7). Mindfulness-based rehabilitation approaches can be an effective keynote for developing self-regulation by facilitating the individual to learn how to be calmer or more relaxed in general and how to calm himself/herself in times of anxiety or potential threat (9).
As long as mindfulness-based assessment, practices and methods become gradually widespread, the concept of mindfulness is becoming a term that is increasingly heard and included in daily life, along with many academic researches, books, projects and trainings, especially in health services (7, 10). However, the scientific basis on which this issue is researched has not been clearly revealed to what extent it is addressed both academically and practically. For this reason, postgraduate theses that include the child population on mindfulness are an important data source. In this study, the postgraduate theses were examined according to their years, type, institute, subjects, theses types, methods and findings for children in Türkiye until October 2023. This research aimed to determine what the current situation was so far in theses whereby the focus group was children and to reveal the needs for future studies.
Methods
This research was fulfil through the document analysis, which is one of the qualitative research techniques of postgraduate theses conducted for children in Türkiye. Qualitative research is a type of research in which methods such as observation, interview and documentation are used to collect data. In other words, it is an approach that is based on theory creation and prioritizes research and understanding of social phenomena within the framework to which they depend (11). In this research, postgraduate theses were collected by document analysis. Document analysis consists of a series of processes that occur within the examining and evaluating printed and/or electronic (computer-based and internet-accessible) materials (12). The data obtained were examined by the content analysis method, and similar data were brought together within the framework of categories and interpreted through content analysis (11).
In recent years, it has been observed that the number of mindfulness-based studies has increased with intense interest. For this reason, postgraduate theses published on mindfulness in children in Türkiye were accessed. In accessing theses documents; the keywords “mindfulness”, “child” and “children” were used in selecting theses on the subject from the Council of Higher Education (CoHE)-Thesis Center (2023) website (https://tez.yok.gov.tr/UlusalTezMerkezi/). Master of science, doctorate and specialization of medicine postgraduate theses accessed with these keywords were transferred to the computer in pdf format. Published theses fulfilling the following criteria were included: (a) open to full text access, (b) in Turkish or English language, and (c) focus group should be children. Theses on different focus groups were excluded. Twenty-seven postgraduate theses that met the inclusion criteria were reached. The flow chart of the study is given in Figure 1. The aforementioned theses were subsequently collated within the context of main categories through the application of content analysis, and the primary findings were subsequently summarised and interpreted.
Results
Firstly only the word “mindfulness” was scanned in the CoHE National Thesis Center and 494 postgraduate theses were found between May 2011 and October 2023. Then, when the words “mindfulness” and “child” were searched, 60 theses were found between August 2013 and October 2023; when the words “mindfulness” and “children” were searched 29 postgraduate theses were found between June 2018 and October 2023. Duplicate studies (n=20) were excluded, the titles and abstracts of the remaining 69 studies were examined. Forty-two of these studies were excluded because the focus group was not children, and as a result, 27 studies were examined (13-39). Those studies were published between 2017 and October 2023. Looking at the distribution by years, there was 1 study in 2017, 3 studies in 2018, 6 studies in 2019, 5 studies in 2020, 4 studies in 2021, 3 studies in 2022 and 5 studies in 2023. Twenty-four of the studies were authored in Turkish, while three were written in English.
The most postgraduate theses on mindfulness in children were master of science theses (n=22) with 81.48%, doctorate theses with 11.11% (n=3) and specialization in medicine theses with 7.4% (n=2), respectively. Distribution of these theses according to the institutes and departments they were affiliated with were as follows: education [(n=16); institute of education (n=6), institute of educational sciences (n=9), institute of educational technology (n=1)], social [(n=8); institute of social sciences (n=7), institute of economics and social sciences (n=1)], health [(n=1); institute of health sciences (n=1)], psychiatry [(n=2); department of child and adolescent mental health and diseases].
Of the studies 74.07% that met the inclusion criteria consisted of evaluation studies (n=20). The names of the studies, theses type, methods, main findings and results of these studies are given in Table 1. It was observed that 22 had a quantitative, 1 had a qualitative, and 4 had a mixed (quantitative and qualitative) study design.
Of the studies 25.92% that met the inclusion criteria consisted of intervention (n=7) studies. The names of the studies, theses types, methods, interventions, main findings and results of these studies are given in Table 2.
Discussion
In this study, postgraduate theses were researched through mindfulness in children in Türkiye and it was revealed that it was a multidisciplinary field that attracted attention in recent years. Researchers who study mindfulness emphasize that although the field has gained popularity recently, it is still a developing field (40). It is thought cherish the hope to plan mindfulness-based studies with qualitative, quantitative and mixed methods, as well as to disseminate studies with a high level of evidence and examining with follow-up.
Every human is considered a child until the age of 18, and with the special status provided, the rights of children to life and development are protected (4). For this reason, studies involving children cover the ages of 0-18. In the studies examined, it was seen that the sample groups were determined according to age. However, there is no mention of a standardized categorization. Given as examples: the study by Kıdil (13) titled “Investigation of the Awareness of 5-6 Years Old Children and Their Families on Correct Nutritional Behaviors” and conducted with 5-6 age group; the study by Dursun (14) titled “Investigation of the Effect of Parent Attitudes on the Self-Comfort Levels and Conscious Awareness Based Self-Efficiency of Special Talent Children Aged 9-13” and conducted with 9-13 age group, and the study by Alpay (36) titled “The Effect of Mindfulness Based Physical Education Lessons on the Mindfulness, Emotional and Psychological Well-Being Levels of Primary School 3rd and 4th Grade Students” and conducted with 3-4 grade students (Tables 1, 2). Studies in the literature on mindfulness include different age groups and life span (41). Mindfulness needs to be evaluated and examined for specific age groups in intervention programs.
Although the concept of mindfulness has its origins in the teachings of Buddha (42), the first scientific publication was found in 1857. The subject of mindfulness in children has been in the literature since 1872. Despite the fact that there has been an increasing interest in the studies examined in our study for years, the most studies were found in 2019. However, the difference in the number of studies compared to other years is negligible. When looking at the literature, it can be seen that the interest in studies on the subject continues to increase. The creation of environments where researchers can present and share their information on the subject will be a source of motivation.
For all that mindfulness is a field that develops with its roots in psychology, it is seen to be involved in many different scientific fields such as neuroscience, medicine, psychiatry (43). Additionally, mindfulness has been studied on various topics such as addiction, chronic pain, immunity, health behaviors, depression relapse, depression and anxiety symptoms, attention control and focus (41). From this perspective, mindfulness has a rich scope. Similarly, many different areas were included in the studies examined. However, it has been observed that it is not discussed as in the studies examined in scientific fields such as occupational therapy, cardiac rehabilitation, vocational rehabilitation and cognitive rehabilitation, which have an important place in the literature (41, 44-46). In this respect, it seems that there is a need for postgraduate theses on the subject of mindfulness in these scientific fields in Türkiye. In addition, studies in the national literature such as “Effect of Mindfulness Based Cognitive Therapy Program on Psychological Symptom Levels of Schizophrenia Patients” (47) and “Mindfulness-Based Cognitive Therapy: A Review” (48) were achieved.
Qualitative research is a subjective, holistic and process-oriented type of study that investigates the nature of real-life phenomena (11). However, in quantitative studies, this is the opposite. Quantitative research comprehends objective, targeted and result-oriented research types that objectify situations, facts and events and reveal them in a way that can be observed, measured and expressed numerically (49). The majority of the studies examined were created with a quantitative design. When the studies on mindfulness in the literature are examined, it is stated that very few studies have qualitative design, but the results are similar to quantitative studies (9). Therefore, findings of this study are similar to the literature. Some of the studies examined included information about their design in the method section, some studies did not. This situation caused the researchers to have difficulty in determining the methods. Besides, study designs need to be clearly stated. The lack of sharp separation of qualitative and quantitative research methods leads to confusion in the evaluation of research results. All qualitative studies emphasize the issues and events that develop in the natural environment, and when examining these facts, the questions of how and why are answered instead of how many or how much. In consequence, instead of collecting numerical data, administering interventions or treatments as in quantitative research, qualitative research helps further explore and understand quantitative data as well as generate hypotheses. A study can be conducted entirely with qualitative or quantitative methods, as well as a mixed-method research combining qualitative and quantitative approaches can also be planned (49).
Study Limitations
This study, which is based on the examination of postgraduate studies on mindfulness for children, draws attention that most of the postgraduate theses are evaluation-oriented. Due to increasing evidence of the positive impact of mindfulness on psychological health, emotional well-being, learning and physical health, assessing mindfulness has become important (31). However, the limitations of this study are that assessment and intervention methods related to mindfulness are not compared with each other, only postgraduate theses are examined, and mindfulness studies related to only children are included.
Conclusion
Researches are needed with professional groups such as occupational therapy, physiotherapy rehabilitation, psychology, and neuroscience in order to develop a further comprehensive understanding of the studies on mindfulness more collaborative/multidisciplinary. Although it seems likely that interest in mindfulness will continue, considering the progress made so far, it is recommended that the impact and development of mindfulness-based studies on human life be examined in populations with different characteristics and with various methods.
Footnotes