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Psychological stress has an established bi-directional relationship with obesity. Mindfulness techniques reduce stress and improve eating behaviours, but their long-term impact remains untested. CALMPOD (Compassionate Approach to Living Mindfully for Prevention of Disease) is a psychoeducational mindfulness-based course evidenced to improve eating patterns across a 6-month period, possibly by reducing stress. However, no long-term evaluation of impact exists.
This study retrospectively evaluates 2-year outcomes of CALMPOD on patient engagement, weight and metabolic markers.
All adults with a body mass index >35 kg/m2 attending an UK obesity service during 2016–2020 were offered CALMPOD. Those who refused CALMPOD were offered standard lifestyle advice. Routine clinic data over 2 years, including age, gender, 6-monthly appointment attendance, weight, haemoglobin A1C and total cholesterol, were pooled and analysed to evaluate CALMPOD.
Of 289 patients, 163 participated in the CALMPOD course and 126 did not. No baseline demographic differences existed between the participating and non-participating groups. The CALMPOD group had improved attendance across all 6-monthly appointments compared with the non-CALMPOD group (P < 0.05). Mean body weight reduction at 2 years was 5.6 kg (s.d. 11.2, P < 0.001) for the CALMPOD group compared with 3.9 kg (s.d. 10.5, P < 0.001) for the non-CALMPOD group. No differences in haemoglobin A1C and fasting serum total cholesterol were identified between the groups.
The retrospective evaluation of CALMPOD suggests potential for mindfulness and compassion-based group educational techniques to improve longer-term patient and clinical outcomes. Prospective large-scale studies are needed to evaluate the impact of stress on obesity and the true impact of CALMPOD.
Little attention has been given to assessing the importance of self-care and communication in the caregiving setting, especially caregiving for those who are terminally ill. The Caregiver Inventory (CGI), a measure of self-efficacy for caregiving that includes these two dimensions, was subjected to psychometric analyses.
One hundred and thirty-three primary caregivers completed the CGI; of those, 81 also completed the Perceived Stress Scale (PSS), Caregiver Burden Inventory (CBI), and a measure of caregiver tasks (ADLR-CG). Based on home visits, social workers also rated the caregiver tasks required (ADLR-SW). Exploratory Factor Analysis, as well as reliability and validity analyses were conducted.
Fit indices in M + I (V. 5.1) indicated a four factors solution: Managing Medical Information (α = 0.64), Caring for Care Recipient (α = 0.78), Caring for Oneself (α = 0.88), and Managing Difficult Interactions/Emotions (α = 0.76). The CGI was highly negatively related to stress (PSS, r = −0.54, p = 0.001) and burden (CBI, p = −0.37, p = 0.001); ADLR-CG was related to burden (r = 0.43, p = 0.001) but not stress. In regression and relative importance analyses, Care of Oneself and Managing Difficult Interactions/Emotions emerged as equal in terms of having the strongest and most robust negative relationships with stress and burden.
Significance of Results:
Results suggest that the CGI is a reliable and valid measure of self-efficacy for caregiving, and indicate the importance of self-efficacy for self-care and for managing difficult communication in successfully navigating the demands of caregiving for terminally ill persons.
We evaluated the utility of the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) and measured the prevalence of major depression six weeks after confinement among Chinese women in Hong Kong.
A prospective cohort of 145 women completed the EPDS, the 12-item General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) six weeks after giving birth. They were then assessed with the Structured Clinical Interview for DSM–III–R, non-patient version (SCID–NP) to establish psychiatric diagnosis. The criterion validity of EPDS was tested against this clinical diagnosis, and the concurrent validity against the GHQ and BDI scores was also evaluated. The internal consistency of the scales was measured by Cronbach's α coefficient.
The Chinese EPDS had satisfactory psychometric properties and a cut-off score of 9/10 is recommended for screening depressive illness in a general postnatal population. At six weeks postpartum, 5.5% of the study population suffered from major depression.
The Chinese EPDS will be useful for screening for postnatal depression.
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