{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:21:48Z","timestamp":1779099708473,"version":"3.51.4"},"reference-count":27,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Saint Luke\u2019s Health System Nursing Grant"},{"name":"Creative Activities Award (FRACAA) from Western Michigan University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: Psychological resilience is associated with improved quality of life after stroke, yet less is known about how resilience and mindfulness interact over time in long-term recovery. This qualitative instrumental case study aimed to describe how psychological resilience and mindfulness unfolded in one stroke survivor with high psychological resilience and to identify processes that may inform future research on long-term stroke rehabilitation. Method: We conducted an instrumental qualitative case study involving a stroke survivor and his spouse (carepartner), using an in-depth interview framework for data collection and grounded theory procedures to support analysis. Data sources included interview transcripts and contextual artifacts, such as personal and professional websites, emails, and informal conversations. Findings: Three interrelated themes described how resilience unfolded in this case: (a) antecedents to poststroke resilience: personality traits, values, behavioral modeling, and environmental factors; (b) the obstacle is the way to posttraumatic growth; and (c) poststroke resilience: mindfulness embodied. Together, these themes suggest how prestroke strengths, responses to adversity, and mindfulness practice interacted in this participant\u2019s long-term recovery. Conclusions: This exploratory case study offers a detailed account of how resilience and mindfulness may interact after stroke in one highly resilient individual. The findings are hypothesis-generating and may help guide future research on mindfulness-based and holistic approaches to long-term stroke recovery in larger and more diverse populations.<\/jats:p>","DOI":"10.3390\/healthcare14101370","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T08:56:27Z","timestamp":1779094587000},"page":"1370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sand Mandala: A Case Study in the Essence of Psychological Resilience, Growth, and Thriving in Life After Stroke"],"prefix":"10.3390","volume":"14","author":[{"given":"Erin","family":"Doan","sequence":"first","affiliation":[{"name":"Saint Luke\u2019s Neurological Consultants, Saint Luke\u2019s Marion Bloch Neuroscience Institute, BJC Saint Luke\u2019s Health System, Kansas City, MO 64109, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7442-2458","authenticated-orcid":false,"given":"Lori","family":"Gray","sequence":"additional","affiliation":[{"name":"Holistic Health and Contemplative Well-Being, School of Interdisciplinary Health Programs, Western Michigan University, Kalamazoo, MI 49008, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8652-5922","authenticated-orcid":false,"given":"Heather","family":"Noble","sequence":"additional","affiliation":[{"name":"Independent Contractor, Prairie Village, KS 66208, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1609-1122","authenticated-orcid":false,"given":"Julie","family":"Bertram","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Missouri-St. Louis, St. Louis, MO 63121, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sisto, A., Vicinanza, F., Campanozzi, L.L., Ricci, G., Tartaglini, D., and Tambone, V. 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