Meditation awareness training (MAT) for people living with cancer: A thematic analysis of weekly diary reflections

BACKGROUND: A cancer diagnosis presents significant psychological challenges, often resulting in lasting distress and dis-ruption to daily life. Mindfulness-based interventions (MBIs) are increasingly recognized as vital components of supportive oncology care. Second-generation MBIs (SG-MBIs), such as Meditation Awareness Training (MAT), integrate Buddhist wisdom principles such as impermanence, compassion, emptiness, and non-self, offering potential for transformative therapeutic outcomes. OBJECTIVES: This study explored the core subjective experiences, challenges, and benefits of cancer patients participating in an eight-week MAT programme, examining how integrated Buddhist wisdom teachings are engaged with and interpreted in real-world settings. METHODS: An inductive, realist thematic analysis was conducted on 102 anonymous online diary entries submitted by 20 participants undergoing the MAT intervention. The analysis followed Braun and Clarke's six-phase approach, with researcher reflexivity and consensus guiding theme development. RESULTS: Findings indicated a dynamic process of engagement. Individuals described a journey from uncertainty and ambivalence toward greater acceptance and emotional resilience, drawing on impermanence and other Buddhist principles to manage distress and reclaim identity beyond their illness. Participants shifted from relying solely on formal meditation practices to integrating mindfulness and wisdom flexibly into their daily lives, demonstrating a growing ability to adapt and embody the wisdom teachings introduced. Self-compassion and empathy developed, enhancing interpersonal relationships and connection both within the meditation group and with the natural world. The group setting provided vital validation and support, normalizing experiences and fostering community. CONCLUSIONS: MAT's integration of Buddhist wisdom principles proved therapeutically meaningful, facilitating resilience, self-compassion, values-driven identity reconstruction. The diary analysis illuminated the temporal progression of change, informing SG-MBI refinement and underscoring the importance of context-sensitive, flexible delivery in oncology care.