Exploring associations and indirect effects between mindfulness, psychological flexibility and wellbeing in adults with cystic fibrosis: Informing future interventions

Objectives Increased psychological support is required to assist the long-term well-being of the adult Cystic Fibrosis (CF) population. This research aimed to identify relationships between mindfulness, psychological flexibility, and wellbeing, as well as potential mediating effects of mindfulness to increase wellbeing in adults with CF. Methods In a cross-sectional study, 114 (56 female, 58 male) adults with CF completed and returned a series of validated questionnaires that assessed mindfulness, psychological flexibility, and wellbeing. Results Participants who demonstrated better psychological flexibility also had higher levels of mindfulness and wellbeing, and similarly, those who reported higher levels of mindfulness had better wellbeing. Mindfulness subscale scores indicated additional associations. Mindfulness partially mediated the relationship between psychological flexibility and wellbeing. A second mediation model suggested that specifically ‘acting with awareness’ (i.e., a mindfulness subscale) also partially mediated the relationship between psychological flexibility and wellbeing, highlighting the significance of mindfulness within promoting wellbeing through psychological flexibility. Discussion This research demonstrates the importance of mindfulness in the relationship between psychological flexibility and wellbeing. The findings provide promising preliminary evidence to suggest that Acceptance and Commitment Therapy (ACT), a therapy enhancing psychological flexibility through mindfulness, to be beneficial for enhancing the wellbeing of adults with CF.