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Journal Club8.11.19
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Acceptability of a mindfulness intervention for depressive symptoms among
African-American women in a community health center: A qualitative study
Inger Burnett-Zeigleraa, Maureen D. Satyshura, Sunghyun Honga, Katherine L. Wisnera ,Judith Moskowitzb
a Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, United Statesb Northwestern University, Feinberg School of Medicine, Medical Social Sciences, Chicago, IL, United States
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• Concept been explored by Buddhist traditions
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Mindfulness is a method of paying closeattention to your thoughts, moods, sensation,emotions in the moment with out judgementwhich one can develop through the practice ofmeditation and through other training.
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• Jon Kabat-Zinn in the early 1980s.
• MBSR is a form of integrative therapythat taps into the powerful interactionof the mind and body.
• MBSR is a nonreligious program thatfocuses on cultivating an enhancedmoment-to-moment awareness ofexperience
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MBSR• MBSR is an 8-week treatment program that is
aimed at reducing stress via enhanced mindfulness skills developed through regular meditation practices.
• The Programme consists of 2 to 2.5 hours of group classes with a trained yoga instructor & provides a audiotaped home practice as well.
• Chronic Pain, Stress, Anxiety.
• Still evidence is not established.
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MBCT
• Segal, Williams, and Teasdale.• MBCT programme is mainly for recurrent
depression.• Goal is to interrupt the automatic process and
teach the participant to focus less on incoming stimuli.
• MDD.• This is a evidence based technique.
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• MBCT is an adaptation of MBSR.• same basic format and structure – an 8-week
class.• MBCT was developed to prevent future
episodes of depression in people with a historyof recurrent depression.
• MBCT replaces some of the content of MBSRwith a focus on specific patterns of negativethinking that people with depression arevulnerable to, but which we all experiencefrom time to time.
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• Mind-Body practices: Mind and bodypractices are a large and diverse group oftechniques that are administered or taught toothers by a trained practitioner or teacher.Examples include acupuncture, massagetherapy, meditation, relaxation techniques,spinal manipulation, and yoga.
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Aim
Explore participant perspectives on theacceptability and perceived utility of themindfulness intervention content, andsuggestions for modifications of the contentand delivery format of the intervention
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MethodSetting and study population
• African American or Hispanic
• Age:18-65
• Score:15-69
• Advertised in brochures and posters displayed
in the clinics.
Screening and eligibility
• Quick Inventory of Depressive symptomatology –Clinician (QIDS-C)16item / 0-3 point scale, QIDS-C=6–24(15-20min )
• Inventory of Depressive Symptomatology –Clinician (IDS-C) 30item/ 0-3 point scale IDS-C=15-69(30-40 min)
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Inclusion/Exclusion
• Met criteria for a mild-severe depressive episode.
• Suicidal plan or attempts(past 30 days)• Not fluent English.• Meditation or yoga practice of once a week or
more.
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Design• Eligible women's- 8 week M-Body.• 60 min focus group completion M-Body group.• MBSR been tailored for the community. • Focus groups were audiotaped & transcribed by a
transcription company• 86 individual were referred.• 55 screened• 50 were eligible• 31 enrolled
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• 14 women enrolled in the 1st pilot, at least 1session- attendance 6.4
• 17 women enrolled in the 2nd pilot, 15 attended at least 1 session 6.6
• 4 Women : change in schedule, no response, disconnected number, medical complaints, not a patient at community center and concern about ability to do yoga
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Experiences
• Reading bible.• Reconnect the past practice of yoga• Cope up with I. Stress,II. Depression,III. Social support
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4 main themes
• Anger: control • Control: thoughts• Awareness/ Focus: increased awareness in
daily activities• Calm/ relaxation: inner voice
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Barriers
• Transportation, Employment, Family responsibilities and Child care.
• They did not have enough time to complete the formal home practice.
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Critique
• Verbal Consent/ Informed consent.• Current meditation/Yoga.• Reimbursement-$25 gift card?(unethical).• Scales.• Significant proportion.
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• Mainly addresses the importance of thedisease in the modern era, it causes significantmortality and morbidity.
• To be conducted on a community healthcentre population.
Good Points
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