อาชีพพารวย “เลี้ยงไก่เบตง” ราคาพุ่งตัวละกว่าพันบาท ตลาดต้องการอย่างมาก

นายธนันท์รัฐ อุดมธันยรัตน์ หรือโกช้าง เกษตรกรมืออาชีพผู้มีชื่อเสียงโด่งดังในวงการคนเลี้ยงไก่เบตง จากอำเภอเบตง จังหวัดยะลา เปิดเผยว่า ณ ปัจจุบันไก่เบตงกำลังเป็นที่นิยมมากในกลุ่มผู้บริโภคไก่เนื้อ ด้วยจุดเด่นของไก่เบตงที่มีหนังกรอบ เนื้อนุ่ม ไม่มีมันผสม หนังมีสีเหลืองอ่อน ไม่ขาวเหมือนไก่ทั่วไป ด้วยเหตุนี้ไก่เบตงจึงกำลังมาแรง เป็นที่นิยม อีกประการหนึ่งที่ทำให้ไก่เบตงมีราคาที่สูง เพราะไก่เบตงเลี้ยงยาก ต้นทุนการผลิตสูง ใช้เวลาเลี้ยงนาน จึงทำให้เกษตรกรผู้เลี้ยงรายเก่าที่เคยเลี้ยงได้เลิกลากันไปหมด ส่งผลให้ไก่เบตงแท้ๆหากินได้ยาก

 

 

 

 

 

 

 

 

ขอบคุณภาพและข้อมูล : technologychaoban.com

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  220. Published online 2014 Jan 9. doi: 10.3402/qhw.v9.23033
    PMCID: PMC3888904
    PMID: 24434055
    Medical yoga: Another way of being in the world—A phenomenological study from
    the perspective of persons suffering from stress-related symptoms
    1Centre for Health Care Sciences, Örebro University Hospital, Örebro,
    Sweden
    Ulla Persson Lundholm
    Monica Köhn
    Elisabeth Westerdahl
    1Centre for Health Care Sciences, Örebro University Hospital, Örebro,
    Sweden
    3School of Health and Medical Sciences, Örebro University, Örebro, Sweden
    1Centre for Health Care Sciences, Örebro University Hospital,
    Örebro, Sweden
    2Nora Health Care Centre, Örebro County Council, Nora, Sweden
    3School of Health and Medical Sciences, Örebro University, Örebro, Sweden
    Correspondence: A. Anderzén-Carlsson, Centre for Health Care Sciences, Örebro University Hospital,
    P.. Box 1324, SE-701 13 Örebro, Sweden. Tel: +46 19 6025846.
    E-mail: [email protected]
    Copyright © 2014 A. Anderzén-Carlsson et al.

    This is an open-access article distributed under
    the terms of the Creative Commons Attribution License, which
    permits unrestricted use, distribution, and reproduction in any medium,
    provided the original work is properly cited.

    This article has been cited by other articles in PMC.

    Abstract
    The prevalence of stress-related illness has grown in recent years.
    Many of these patients seek help in primary health care.
    Yoga can reduce stress and thus complements
    pharmacological therapy in medical practice. To our knowledge,
    no studies have investigated patients’ experiences
    of yoga treatment in a primary health care setting
    or, specifically, the experiences of yoga when suffering from stress-related illness.
    Thus, the aim of the present study was to
    explore the meaning of participating in medical yoga as
    a complementary treatment for stress-related symptoms and
    diagnosis in a primary health care setting. This study has a descriptive phenomenological design and took
    place at a primary health care centre in Sweden during 2011.
    Five women and one man (43-51 years) participated.

    They were recruited from the intervention group (n=18) in a randomized control trial, in which they had participated in a medical yoga
    group in addition to standard care for 12 weeks. Data were collected by means of qualitative interviews, and
    a phenomenological data analysis was conducted. The essential
    meaning of the medical yoga experience was that the medical yoga was not an endpoint of recovery but the start of a process towards
    an increased sense of wholeness. It was described as a way of alleviating suffering, and it provided the participants with a tool for dealing with their stress and current situation on a practical level.
    It led to greater self-awareness and self-esteem, which in turn had an implicit impact on their lifeworld.

    In phenomenological terms, this can be summarized as Another way
    of being in the world, encompassing a perception of deepened identity.
    From a philosophical perspective, due to using the body in a new
    way (yoga), the participants had learnt to see things differently, which enriched and recast their perception of themselves and their lives.

    Keywords: Complementary therapy, medical yoga, phenomenology, stress-related illness, qualitative research
    The prevalence of stress-related symptoms and diseases
    has grown in recent years. An elevated level of stress over a long
    period increases the risk of high blood pressure,
    heart disease, musculoskeletal disorders, chronic pain, and psychological symptoms such as
    anxiety and depression (Chrousos, 1995 ; Kuiper,
    Olinger, & Lyons, 1986 ). Other problems associated with stress are disturbed sleep, cognitive limitations, and abnormal fatigue (Ekstedt et al.,
    2006 ; Taibi & Vitello, 2011 ).
    Many patients seek help in primary health care for stress-related symptoms and
    diagnoses (Rosendal, Vedsted, Sparle Christensen, & Moth,
    2013 ), and an increasing number are sick-listed as a result (Holmgren, Fjällström-Lundgren, & Hensing, 2013 ;
    Milczarek, Schneider, & Gonzales, 2009 ).
    There is no recognized gold standard” treatment guideline or plan for the management of patients with stress-related symptoms, and pharmacological treatment
    is often the first choice. Other methods are therefore necessary.
    Yoga is one complementary treatment that has been provided
    within primary health care (Köhn, Persson Lundholm, Bryngelsson, Anderzen-Carlsson, & Westerdahl,
    2013 ).
    For a long time, yoga has been used in wellness programmes worldwide.
    In recent years, it has also been introduced in the
    health care system as a treatment option to alleviate both mental and physical problems (Büssing, Michalsen, Khalsa, Telles, & Sherman, 2012a ).
    There are numerous schools of yoga, most of which include breathing exercises (pranayama), postures (asanas), and meditation (dyana).

    Medical yoga is specifically designed for people who
    are severely ill, as the starting position can be sitting, lying, or standing,
    and the movements are generally slower than in traditional
    forms of yoga ( ).
    Yoga can reduce stress and anxiety symptoms, thus complementing
    pharmacological therapy in medical practice (Li & Goldsmith, 2012 ).

    Studies have demonstrated the effects of different types of yoga on stress (Köhn et al., 2013 ; Granath, Ingvarsson, von Thiele, & Lundberg, 2006 ),
    pain (Büssing, Ostermann, Lüdtke, & Michalsen, 2012b ;
    Carson et al., 2010 ; Michalsen et al., 2012 ), hypertension (Cohen et
    al., 2011 ), anxiety (Köhn, Persson Lundholm, Bryngelsson,
    Anderzen-Carlsson, & Westerdahl, 2013 ; Javnbakht, Hejazi Kenari, & Ghasemi, 2009),
    sleep (Taibi & Vitello, 2011 ), and quality of life (Fulambarker et al., 2012 ; Lin, Hu,
    Chang, Lin, & Tsauo, 2011 ). Likewise, improved
    overall health ratings have been reported (Köhn et al., 2013 ).

    When it comes to depression, the results are somewhat contradictory.
    Woolery, Meyers, Sternlieb, and Zelter ( 2004 ) found that
    yoga had a positive effect, but Javnbakht et al.

    ( 2009 ) and Köhn et al., ( 2013 ) reported no significant changes after
    a yoga intervention. A recent review by Li and
    Goldsmith ( 2012 ) identified design limitations in many of the included studies.
    They therefore recommended further studies with a more appropriate design before suggesting
    yoga as a treatment option for relieving anxiety and stress.

    A qualitative approach is appropriate for exploring and attributing
    meaning to participants’ subjective experiences during interventions (Cramer
    et al., 2013 ) and provides an additional
    perspective to effect studies that measure a range of
    variables. Qualitative research can provide increased understanding of the intervention process
    and its contextual impact (Verhoef, Casebeer, & Hilsden, 2002 ).
    To our knowledge, no studies have investigated patients’
    experiences of yoga treatment in a primary health care setting,
    or specific experiences of yoga when suffering from stress-related symptoms or diagnosis.
    Thus, the aim of the present study was to explore the
    meaning of participating in medical yoga as a complementary treatment for stress-related symptoms or diagnosis in a primary health care setting.

    Method
    Design
    This study has a descriptive design, in which a phenomenological method has been employed.
    The philosophical underpinnings for the method are grounded in the work
    of Husserl (Giorgi, 1997 ), who stated that reality is only an object of human consciousness; reality is something
    apparent being presented to the consciousness (Husserl, 1999
    ). In line with this, language is the key to get hold of
    the individual’s objects of consciousness (Giorgi, 1997 ), and a phenomenological analysis strives to find the
    meaning in these (Dahlberg, Drew, & Nyström, 2001 ).
    In accordance with this, data were gathered using
    qualitative interviews, and a phenomenological analysis
    was undertaken.
    Sample and setting
    The participants in the present study were recruited from the
    intervention group in our previous randomized control trial (RCT), in which 37 patients with stress-related symptoms or
    diagnoses were randomized either to a medical yoga group that
    also received standard care (n=18) or to a control group (n=19) that only received
    standard care (Köhn et al., 2013 ). The RCT took place at a primary health care centre in Sweden during 2011,
    and the interviews were conducted within the 3 weeks following completion of the RCT.

    All 19 patients who completed the 12-week medical yoga intervention were invited to take part in the interviews.
    They received oral and written information about the
    study at the start of the RCT and were again approached at one of the
    last yoga sessions and asked whether they wanted to participate.
    The yoga intervention, which has previously been described more in detail (Köhn et al.,
    2013 ), was performed as a 60 min group activity once a week during the
    12-week period, with 11 participants in each class.
    The classes were based on a number of postures and stretching exercises, breathing techniques, mantras, and meditation,
    and they were led by a physiotherapist (MK)
    who is a certified medical yoga instructor ( ).
    Six participants (five women and one man) agreed to be interviewed.
    Their ages ranged between 43 and 51 years
    (mean: 46). Five of them explicitly reported
    experiencing stress. In addition, they suffered from sleep disturbances, various pains, migraine, burnout syndrome, anxiety, and depression.
    Two were on sick leave, and four were working.

    Data collection
    The second author (UPL) conducted the interviews.

    She was not involved in the yoga sessions but had helped to collect the data in the RCT.
    The interviews took the form of a conversation between the researcher
    and the participant, based on the aim of the study
    (Kvale, 1996 ). An interview guide was used, and the participants were encouraged to describe their
    overall experience of the medical yoga classes, as well as
    their expectations, their perceived barriers, and whether they experienced any positive or
    negative effects during and after the 12-week intervention. They were also asked whether
    the yoga intervention could have been structured in another or a
    better way. The interviews were held at the primary
    health care centre where the yoga sessions had taken place, which was also the interviewer’s workplace.

    Data analysis
    The first crucial aspect of conducting a phenomenological
    analysis is for the researcher to enter into an attitude of phenomenological
    reduction. This implies bracketing previous knowledge of the phenomenon during the analysis, being open to the phenomenon, and
    describing its meaning as experienced and revealed by the individual (Giorgi, 1997 ).
    The researcher who conducted the analysis deliberately intended to adapt
    to such a perspective.
    The interviews were transcribed verbatim by an experienced secretary.
    In accordance with the phenomenological methodology originally described by Giorgi ( 1997 ) and modified by Dahlberg, Drew,
    and Nyström ( 2001 ), the interviews were first read in their entirety in order to gain a sense
    of the whole. Thereafter, the text was divided into meaning units, which in the following step were
    abstracted while retaining the participants’ voices. In the
    next step, the content was expressed from a more scientific perspective, in which
    the content of the units were reformulated in line with phenomenology, by focusing
    on the meaning of the experiences. In this
    part of the process, the researcher reflected on the variation in the descriptions of the phenomenon that were given by the participants.

    Finally, the researcher moved between the various parts and the whole in order to link the transformed meanings into
    a logical pattern, thus providing a more abstract level of understanding (Dahlberg et al.,
    2001 ). As pointed out by Dahlberg et al. ( 2001 ), this process is not linear
    but is a back-and-forth movement between the parts and the whole.

    Ethical considerations
    The participants received oral and written information about the study and the voluntary
    nature of participation. Prior to the interviews, they signed their informed consent.
    The Regional Ethical Review Board in Uppsala, Sweden, granted approval for the study (2011/043).

    Results
    The essential meaning of the experience of participating in medical yoga
    was that the yoga was not an endpoint of recovery but the
    start of a process towards an increased sense of wholeness.
    Despite various points of departure and different expectations,
    the participants described medical yoga as a way of alleviating suffering from their primary stress-related symptoms as
    well as their other symptoms and lack of well-being. It provided the participants with a tool for
    dealing with their stress and current situation on a practical level.

    It also led to greater self-awareness and self-esteem, which in turn had
    an implicit impact on their lifeworld. In phenomenological
    terms, this can be summarized as Another way of being in the world, which encompasses
    a perception of deepened identity.
    The general structure of the meaning of participating in medical yoga
    will be illuminated below by its four constituents: Perceiving immediate and embodied sensations, Increased
    perception and awareness of the self, Re-evaluation of the self, and A sense of increased well-being ( Table I ).
    Contextual aspects that had an impact on the experience
    were the content of the initial information about the
    yoga intervention, individual barriers and expectations, and the personality of the group leader.

    Table I
    Schematic overview of the essential meaning of participating in medical yoga.

    Another way of being in the world
    Perceiving immediate and embodied sensations
    Increased perception and awareness of the self
    Re-evaluation of the self
    The yoga sessions were described as evoking immediate and embodied sensations, which some participants found difficult to define and explain. Feelings of being focused, relaxed, in harmony, and in love with oneself and one’s body, as well as
    calmness, peacefulness, and a sense of spirituality,
    were described. Some found these emotions almost too strong to bear:
    Once when we were doing a special kind of meditation it was so very strong that I
    sort of couldn’t cope, I had to stop because the feeling
    became overwhelming. The feeling wasn’t unpleasant but sort of.… I felt
    very happy and kind of in love with myself, my body and everything was more or less Yes!
    (P5)
    Despair and sadness were described as being transformed into a restful
    melancholy by the yoga, which also evoked feelings of thankfulness.

    Some became overwhelmed and started to burst into
    tears during particular exercises. Transcendent experiences, such as the body becoming larger, resulting
    in a sensation of it invading the entire room, were also described,
    as was floating around above the floor. One person recalled an embodied childhood
    memory of lying on the branch of a tree and floating gently in a soft breeze.

    The memory was associated with the ability to relax:
    Then a recollection emerged of when I was little and I used
    to lie in a tree. I used to climb those low fir trees that you can climb.
    The branches are almost like a hand. So you can crawl out and lie there and look up into
    the sky, swaying gently in the breeze. I used to do that often when I was young, lying there and singing.

    And I could sort of relax then. I was able to lie there in the tree.

    (P5)
    Although not completely comprehensible to the participants, the transcendental experiences were positive for them.
    They described being able to retain the positive experiences within themselves,
    resulting in a state of well-being for some days after
    the yoga session. When they had completed
    the programme, they could still recall these positive feelings and longed to experience them again. They stated that
    a 12-week intervention was insufficient, as some inner processes had started but were not completed.

    Increased perception and awareness of the self
    The yoga increased the participants’ perception and knowledge of
    their bodies and bodily reactions, as well as of their
    emotions and emotional reactions. They gained new insights about themselves, the impact of earlier experiences, as well
    as unhealthy aspects in their present life. Overall, their knowledge and awareness of themselves increased, which made them experience a greater sense of wholeness in life.

    Because the yoga has deepened my self-awareness … it touches things that my consciousness can’t
    find. So I mean, that’s the way life is. It consists of a lot of different things that we have to deal with but that eventually
    should fall into place. And I can feel it, so I will continue
    yoga. For me it has been small things that made everything fall into place.

    (P4)
    For some, the medical yoga was a relief, providing a sense of peace, but it was also experienced as very emotional:
    Sometimes you had to let go a bit when it became overwhelming, I started crying uncontrollably in an unusual exercise when nobody else
    became upset but I became extremely unhappy and could not hold back my tears.

    (P6)
    Some participants described a fear of feelings and reactions that might surface
    during the yoga. This fear decreased over time, and they also accepted
    their own emotional expressions during the sessions to a greater degree.
    The yoga made the meaning of their own reactions more obvious, for example symptoms of stress
    or anxiety, which they considered a prerequisite
    for dealing with previously learned reactions and behaviour.
    Furthermore, yoga made them more conscious of others’ behaviour towards
    them, which in turn increased their awareness of the strategies to use in such encounters.

    Yoga was also described as preserving their limited energy resources.

    Yoga provided the participants with knowledge about the physical
    body and how to take better care of it. They became more aware of
    connections between tension in the body and both negative and positive
    external factors, such as the benefit of yoga:
    And then I feel that it’s good for my body, because I work so hard physically, it’s good for the body to stretch and
    be worked out. I feel how supple and agile I become. (P3)
    The participants recognized that the physical benefits of medical yoga were not long term and that they needed to continue the exercises.

    After the yoga sessions, some participants experienced muscular
    ache, which was painful yet pleasant:
    I felt it all over. My body ached. But it was still a good feeling.
    It’s like a body-building session, very hard sometimes and you think, why
    am I doing this, but it’s such a wonderful feeling afterwards.
    And you feel in your body that you have achieved
    something. And I suppose it’s the same thing with yoga.
    (P1)
    As a group activity, medical yoga provided a sense of belonging.
    The participants perceived themselves through the others in the group.
    They felt less alone with their problems as well as being
    accepted for themselves, irrespective of what problems they suffered from.

    I think the fact that we were so open and honest towards each other made it relaxing in a way”
    (P2). However, some considered medical yoga an activity performed with others, not a
    shared activity, while others found it difficult to focus on themselves.
    Furthermore, one participant became slightly irritated about the number of physical complaints mentioned within the group, yet
    accepted it as natural among individuals suffering from stress-related symptoms.
    Belonging to a group of fellow human beings allowed opportunity to
    relate one’s own life to others’ way of living.
    Re-evaluation of the self
    Medical yoga made the participants aware of and legitimized
    their personal value, a re-evaluation of the self. They stated that they had started a process of accepting and feeling
    proud of themselves, but were aware that they had not yet
    attained their goal. The participants also described how
    they had become more tolerant towards and prioritized themselves:
    But it’s got something to do with valuing myself, believing that I’m worth it medical yoga and allowing it to take time at the expense of other activities.
    Being able to prioritize myself. (P5)
    Besides yoga, the participants described prioritizing other activities that they considered strengthened their well-being, instead of doing routine tasks
    they were expected to do or had previously done and taken for granted.
    Some examples were spending time in nature or at one’s weekend house,
    reading a book despite being aware of the need to do household chores, and redefining the meaning and level
    of one’s professional ambition. A new ability to take initiatives to change behaviour was mentioned, but
    a contentedness was also evident in the narratives:
    This is the way I look and have been like that for many years.
    And if I lose weight as a result, it’s a good thing.
    But the main thing is that I experience well-being
    and that’s what I’m trying to do now. (P1)
    Somewhat similar to contentedness was the description of accepting the
    outcome of various actions. Things do not always have
    to be perfect or even good. The participants realized that it was not
    necessary to constantly evaluate and judge everything they did.
    Furthermore, the yoga helped them to determine boundaries between themselves and others.

    They reported not letting others interfere with their inner sphere and that
    the medical yoga had taught them to set explicit rules
    for socializing with others:
    Sometimes I feel very very low and that it’s difficult to climb up
    again. But then I can feel that No, bloody hell, I’m trampling on you like an elephant, because I’ve had enough.
    Now I’m the one who decides. Previously I agreed to everything, I
    don’t do that anymore. And that’s a big part
    of it. (P1)
    The yoga made some of the participants re-evaluate their relationships with family
    and friends in terms of whether or not they were valuable.
    They described feeling satisfied as a result of prioritizing and accepting themselves and that the strategies they initiated due to the medical yoga
    led to a positive outcome. Several related how they had
    sensed a positive response to their new attitude from colleagues and others in their
    environment. For some, participation in the medical yoga class was a form of training
    in leaving control to someone else and being a follower.
    Several reported that prior to the yoga intervention, control
    had been an important strategy, which they had now re-evaluated:
    Because it’s basically about being in control of oneself and one’s environment so that everything will be
    the way I want, as I believe that it will lead to everybody and everything being
    fine. And then you realise that it’s not like that at all.
    (4)
    Medical yoga taught the participants to adopt a more laid-back
    and wait-and-see attitude in daily life. They appreciated
    the relaxed and accepting atmosphere during the yoga
    sessions, where they perceived that they could be themselves and
    did not have to adapt to conventional rules. They believed that
    there were no musts that they had to comply
    with.
    Thanks to yoga, the participants dared to do things
    that they would previously never even have considered, such as revealing experiences in front of the other group
    members, travelling alone and meeting with strangers,
    opening up and sharing their vulnerability, or entering other social arenas: I have
    become more courageous in myself, sort of. Yes, I have become more daring.
    I think I have grown a great deal as a result” (P2).
    As illustrated by this quotation, managing such challenges led to personal growth and an awareness of and satisfaction with one’s own competence.

    A sense of increased well-being
    The yoga intervention was described as a pleasant experience, which the participants longed for,
    both during the intervention and at the time of the interview.
    Between sessions, as well as afterwards, they tried to recall the sense
    of well-being they had experienced. Someone expressed an embodied longing for some of the exercises and spontaneously performed them when experiencing stress-related symptoms.

    The yoga was described as alleviating the discomfort caused by their stress-related symptoms.
    Numerous spin-off effects were mentioned, for example improved breathing, quality of sleep, and memory function.
    The urine-genital organs and bowel function were also experienced as better.
    Alleviation of various pains, stiffness, and tenderness was reported as well as the impact
    this had on the participants’ daily life, such as less medication, increased mobility, and better sleep.

    Someone mentioned that yoga helped to create peace in relation to
    one’s own body: that all of a sudden I like my body even if it aches sometimes.
    Yes, I felt at peace with myself and my body” (P5).

    The participants experienced that yoga left them with a greater
    sense of well-being, calmness, as well as a tendency to worry less and be more
    even-tempered. Although the effects were often reported to diminish after the 12-week intervention, the yoga was to some
    degree viewed as a tool for coping with stress or worries:
    It feels as if it’s there at the back of my mind like a kind of
    safety valve. That these twelve weeks gave me something I can use and
    even if I don’t utilise it fully, it’s still there”
    (P6).
    The participants experienced a new attitude towards the problems in their lives.
    Some realized that it was better to accept the past
    and focus their energy on the future, as that was something they could improve.
    Some realized that the yoga had made them less vulnerable, as they now managed to distance themselves from the harm that others or life events could cause.
    The yoga made negative thoughts more positive
    and facilitated the sorting of thoughts in situations where they had previously experienced frustration or anger
    or been overwhelmed by anxiety:
    On my way home from work yesterday I felt that Gosh,
    here it anxiety is again. I did yoga and afterwards all was well.
    It was as if everything became sorted out and all the parts somehow just fell into the right place in my head.
    (P4)
    Although being positive about yoga, the participants expressed some uncertainty about whether it was yoga or something else that was responsible
    for their improved well-being. Other positive factors mentioned were
    various physical activities and medications, counselling, acupuncture, changes in life situations, education, and the fact that yoga provided an opportunity to leave
    their home for a few hours. The participants also believed that the combination of participating in yoga and receiving
    other treatment was valuable:
    I can sort of manage it in a different way now.
    I like the combination of a small dose of pain killers and exercise, and I had both injections
    and massage and they are more into combining them now.
    It need not be one-track, not just one or the other, but a combination. (P2)
    There was a variation in the degree to which the participants continued the medical yoga after the intervention. One
    had practised every day due to the increased ability to relax, but generally
    the participants stated that it was difficult to carry on alone, although
    they were well aware of the personal benefit just when it’s stressful
    like it is now. I know that it’s precisely then that I need yoga most but I don’t allow myself time to
    do it” (P3). They tried to fit yoga into their lives, but one participant found it slightly disappointing that it was necessary to
    continue practising in order to maintain the benefits:

    So when I think about all this and about the future, it dawned on me that
    I will probably have to practise yoga for the rest of my life,
    every or every other day, if I want to feel like I do now.
    At first I became a bit tired because you want a quick fix.
    You want to be healthy without exerting yourself.
    Because that’s the way the human being is. But then I
    may have realised that perhaps you have to exert yourself in order to feel well in our society.
    (P4)
    Discussion
    The essential meaning of the experience of participating in medical yoga was that it was not just a matter of an endpoint
    of recovery, but an embarkation on a journey towards an increased sense of wholeness.
    On a theoretical level, this is similar to what Bullington, Sjöström-Flanagan, Nordemar, and Nordemar ( 2005 ) described as the move
    from disorientation towards a sense of coherence” (p.

    269). This is part of the theoretical concept of Meaning out of chaos,
    ” where being put together again” encompasses bodily,
    emotional, and cognitive-level experiences, including self-understanding
    and identity, in which the body is again experienced as mine” and not as a troublesome broken machine.
    Emotions are experienced and accepted, memories can be captured and understood in relation to feelings and bodily
    sensations, while the experience of the self can be
    connected temporally to the past, present, and future.

    The ordering of chaos is a process which begins with a diagnosis, where
    increased self-awareness leads to a growing responsibility taking on the part of the patient (Bullington et
    al., 2005 ). This is similar to the process identified in our study, and although the
    concept of Meaning out of chaos” was coined within chronic pain care, it also seems highly relevant in the
    context of stress-related symptoms. We find such a conclusion to
    be reasonable, as pain is a common symptom of stress (Chrousos,
    1995 ; Kuiper et al., 1986 ).
    When comparing the findings to other qualitative studies where the experience of yoga has been explored in different groups of patients, such as those suffering from chronic back and neck pain (Cramer et al., 2013 ; Tul,
    Unruh, & Dick, 2010 ), cancer (Van Uden-Kraan, Chinapaw, Drossaert, Verdonck-de Leeuw, & Buffart, 2013 ), stroke (Garett, Immik,
    & Hillier, 2011 ), and rheumatoid arthritis (Evans et al., 2011 ),
    many interesting similarities were found. One of these is the renewed awareness of the
    body. Here, as well as in previous studies, this was described as
    becoming open to potential alternative behaviours and habits related to stress and as
    facilitating increased control (Cramer et al., 2013 ;
    Tul et al., 2010 ; Van Uden-Kraan et al., 2013 ). It has also been described as leading to an enhanced use of active coping strategies (Cramer et al.,
    2013 ; Evans et al., 2011 ; Garett et al., 2011 ), as well
    as a greater acceptance of pain and burden in life (Cramer et al., 2013
    ; Tul et al., 2010 ; Van Uden-Kraan et al., 2013 ). In the
    present study, the findings related to pain and to life situation were described more in terms of viewing
    them from a new perspective rather than merely accepting them.
    On the contrary, according to McCracken, Carson, Eccleston, and Keefe ( 2004 ), the term acceptance does not mean resignation to suffering, but
    implies facing suffering and following a healthy course of action. When some aspects of a problem are accepted, positive changes may occur in the quality of a patient’s life
    (McCracken et al., 2004 ). Nevertheless, in the present
    study, pain was one particular symptom that was alleviated by yoga, something also found
    by Evans et al. ( 2011 ). Furthermore, as in earlier studies (Evans et al., 2011 ;
    Garett et al., 2011 ), better sleep was reported after yoga.
    Other improvements previously described from a
    patient perspective are increased confidence and self-acceptance (Garett et al., 2011 ).

    The medical yoga led to greater self-awareness
    and self-esteem. Increased body awareness
    has previously been described in relation to becoming more accepting of oneself.
    This in turn can play a role in that individuals make lifestyle choices that lead
    to a difference, thus facilitating enhanced quality of life (Cramer et al., 2013 ; Garett et al., 2011 ;
    Tul et al., 2010 ). Patients suffering from cancer, stroke, and rheumatoid
    arthritis have reported improved self-esteem by practising yoga (Evans et al., 2011 ; Garett et al., 2011 ; Van Uden-Kraan et al., 2013 ).
    In one study, the meaning of yoga was described as regaining confidence
    in one’s own body, due to reduced physical symptoms and increased
    mental strength and resilience (Van Uden-Kraan et al., 2013 ).
    Similar to our findings, Van Uden-Kraan et al.
    ( 2013 ), Garett et al. ( 2011 ), and Evens et al. ( 2011 ) described a positive effect on mood and feelings of being
    more relaxed after participating in yoga. Patients with cancer experienced improved stress management, learned to set limits (Van Uden-Kraan et al.,
    2013 ), and tended, as in the present study and that by Evens et al.
    ( 2011 ), to feel kinder to their bodies.

    In the present study, setting limits was related to increased perception, awareness, and re-evaluation of the self.

    Similar to the findings of the present study, patients suffering from rheumatoid arthritis described
    being more connected to themselves, and some also reported spiritual transformation (Evans et al.,
    2011 ). Likewise, in the study by Garett et al. ( 2011 ), the participants
    described a sense of connection that allowed
    them to become not only more physically and sensually aware of their body but also more emotionally attached to it.

    In the present study, some of the participants defined this as
    being in harmony and love with oneself and one’s body, at the
    same time as others described feelings of calmness and peacefulness.

    Another similarity with other groups of patients is
    the description of the social benefits of meeting with other people suffering from
    the same condition (Evans et al., 2011 ; Posadzki, 2011 ; Van Uden-Kraan et al., 2013 ).
    Despite the many positive outcomes, some previous results indicate an inadequate effect
    on anxiety and relaxation in persons suffering from severe panic attacks (Van Uden-Kraan et al., 2013 ) or negative aspects, such as the fact
    that increased attentiveness to the body and its signals can cause greater awareness of pain (Tul et al.,
    2010 ). However, no such experiences were reported in our study, where the
    only negative aspects mentioned were the short duration of
    the programme and the difficulties involved in performing
    the exercises on one’s own, in order to maintain the benefits.
    The participants were aware of the need to continue in order to derive
    further benefit. In a previous study, the participants experienced that the physical benefits brought
    about by yoga had only started at the end of the 6-week programme (Evans et al.,
    2011 ).
    We have previously evaluated the medical yoga intervention focused on in the
    present study in terms of stress, anxiety, depression, severity of insomnia, pain, and self-rated overall health.
    We found that patients in the medical yoga group showed significantly greater improvements on measures of
    general stress, anxiety, and overall health status compared to the controls (Köhn et al., 2013 ).
    In order to obtain a more comprehensive picture, it was deemed valuable to evaluate the intervention also
    from a lifeworld perspective. Thus, the present interview study was designed to contribute a
    deeper understanding of the participants’ experiences (Patton, 2002 ).

    The finding of decreased stress and anxiety is similar but more detailed in the present study.
    On the contrary, it was described that various types of pain were alleviated by the yoga, which had an impact on daily
    life, a result not identified when comparing the intervention group with a
    control group, but found within both groups in the previous study
    (Köhn et al., 2013 ). The divergent findings, as well as the converging and
    complementary findings from these two studies, support our belief that when it comes to evaluating interventions, mixed
    methods or triangulation of methodology can provide a more comprehensive picture than a single methodology (Heale & Forbes,
    2013 ). Nevertheless, it is important to bear in mind that the participants in the present study are just a sample from the RCT study, who could have experienced a larger number
    of positive effects and were therefore more eager to participate and share their views than those who declined participation. On the other hand, a previous study of yoga
    for patients suffering from rheumatoid arthritis also found an overall impact on emotional well-being and mood, as well as improvements in anxiety and depression, which in turn influenced many aspects of their functioning
    (Evans et al., 2011 ).
    The results can also be viewed from a phenomenological perspective.

    The scholar Maurice Merleau-Ponty ( 2006 ) has in his writings described
    human perception as a beam of light which reveals the objects there where they are and manifests their presence, latent until then” (p.

    185). In the interviews, there were descriptions embracing embodied experiences, which
    the participants at times found hard to fully comprehend
    and describe, and which until the interview situation might have been latent to them.
    The findings also reveal bodily changes and bodily awareness by the yoga.
    The participants experienced an increased well-being and could better notice
    and understand bodily experiences. In accordance with
    the phenomenological tradition, we deliberately tried to adopt a view where the body and soul are not regarded as separate entities
    (Merleau-Ponty, 2006 ), although the participants in fact at times talked about their
    physical and mental beings as two separate parts
    of themselves. This natural attitude (Husserl, 1999
    ), might not come as a surprise, as the participants at inclusion were suffering
    from symptoms from various parts of the body (e.g., their perception was turned
    towards the body as manifesting various discomforts). Nevertheless, the essence of
    the meaning of participating in medical yoga was found to be more
    comprehensive than the decrease of individual symptoms, which from a
    phenomenological perspective could be understood as the perceptions from our various senses being translated and unified within the individual body, and the body
    in itself is the one unifying the perceptions (Merleau-Ponty,
    2007 ). Finally, we would like to once more use Merleau-Ponty’s ( 2007 ) words to highlight the essence of
    the meaning of participating in medical yoga: To learn to see colours it
    is to acquire a certain style of seeing, a new use of one’s
    own body: it is to enrich and recast the body schema” (p.
    177). We believe that due to using the yoga (a way to use the body in a new way), the
    participants learned to see themselves and their lives differently, which enriched and recast
    their perception of their body schema and altered their way of being in the world.

    Methodological considerations
    We consider it valuable that the interviewer had met the participants prior to the interview, thus enabling them to feel secure.
    On the other hand, there is a risk that the participants
    could have provided the researcher with answers that they believed
    she would like to hear, as they were aware of her involvement in the intervention (Polit
    & Beck, 2004 ). However, the rich and vivid descriptions obtained do not indicate that this was the
    case. In line with descriptive phenomenology (Dahlberg et al.,
    2001 ), the analysis aimed to describe the meaning of
    participating in yoga based on the participants’ experiences.

    The intention was to avoid interpretation and explanations and bracket the researcher’s pre-understanding (Dahlberg et al., 2001 ).

    We therefore believe that a strength of the study is the fact
    that the researcher who primarily conducted the analysis had no prior experience of yoga and had no contact with the participants during the intervention. Her professional background is that
    of a paediatric nurse with a great deal of experience of qualitative research.
    In order to further increase the credibility of the findings,
    the analysis was repeatedly discussed among
    all the authors. All three co-authors are physiotherapists; two of them were directly involved in the intervention, and the third had a supervisory role.

    Conclusions
    The essential meaning of participating in medical yoga was summarized as Another way of being in the world, encompassing a perception of a new and deepened
    identity. Due to using the body in a new way (yoga), the
    participants had learnt to see things differently, which enriched and recast their perception of themselves and their lives.
    In the future, it would be interesting to perform metastudies
    based on findings from qualitative studies conducted after a yoga intervention, as there seem to be many similar
    experiences, irrespective of diagnosis.
    Acknowledgements
    We acknowledge the contribution of the interviewees who generously shared their experience with us
    and Maria Ekholm Takman for excellent assistance with transcribing the interviews.

    Conflict of interest and funding
    The study was funded by grants from the Research Committee of Örebro County Council and The Swedish Research Council (Reg.
    no. 2009-1385).
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    Articles from International Journal of Qualitative Studies
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