Publication informationMindfulness, 6 (3): 405-416Publisher Springer Item record/more information http://hdl.handle.net/10197/7216 Publisher's statementThe final publication is available at www.springerlink.com. Publisher's version (DOI)http://dx.doi.org/10.1007/s12671-013-0272-0

Objectives The Chronic Disease Self-Management Program (CDSMP) is a standardized self-management intervention for patients with various chronic diseases. CDSMP provides self-management skills to enhance patient health, well-being, and coping skills. The present study evaluates the effectiveness of CDSMP delivered in routine clinical services on health, health behaviors and healthcare utilization in patients with various chronic illnesses. Methods A pragmatic single group pre-post design evaluated the effectiveness of the CDSMP in an Irish cohort using self-report data collected by service providers in hospital, community health and patient organizations. Data on health, health behavior and healthcare utilization were collected at baseline ( n = 263), immediately post-program ( n = 102), and six months ( n = 81) after enrollment. Results CDSMP participants reported statistically significant increases in activity levels, self-efficacy, energy and quality of life, and a significant decrease in depression scores at six months follow-up. There was a significant decrease in self-reported visits to the GP and in total nights spent in hospital. Discussion This national pre-post study provides preliminary evidence for the potential effectiveness of CDSMP delivered during routine care in improving important health outcomes and reducing health care utilization among a heterogeneous sample of chronic disease patients.

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Clinicians are routinely subjected to intense and stressful working environments, and the current COVID-19 crisis increases their risk of psychological distress. Mindfulness has been shown to improve life satisfaction, resilience to stress, self-compassion, compassion and general well-being in healthcare workers. Based on their clinical experience, the authors present mindfulness moments for clinicians (MMFC), a selection of short, simple and accessible mindfulness practices to promote resilience and compassion among clinicians working in this pandemic. The practices can be used on the job and are accessible to both novice and experienced meditators. Most of these practices are extracted from evidence-based mindfulness programmes. Further research is indicated to assess the effectiveness of using MMFC to support clinicians in their work and to promote resilience.

A number of risk factors for malnutrition in the elderly have been identified, but their relative importance has yet to be established. General practitioners and public health nurses were interviewed to elicit the relative weights placed on 6 major risk factors when assessing nutritional risk in the elderly (living alone, recent bereavement, denture problems, mobility problems, psychiatric morbidity and multiple medication use). Participants rated risk for 35 hypothetical cases, described by their status on the 6 risk factors. Multiple regression models of these judgments revealed a consistently high weight for psychiatric morbidity compared to the other factors. Little group variation in diagnostic policies was observed between general practitioners and public health nurses or by case gender. These policies may reflect the perception that psychiatric problems pervade many areas of life functioning related to nutritional intake and are therefore more likely to cause malnutrition than other, more specific risk factors.