Primary caregivers of patients with congestive heart failure withstand enormous burden, often sacrificing their own quality of life. The relationship between caregiver burden and depression and patient quality of life and depression in this setting is unknown. Fifty outpatients were prospectively administered the Minnesota Living with Heart Failure Questionnaire and Beck Depression Inventory II (BDI-II). Caregivers were administered the Zarit Caregiver Burden Interview and BDI-II. The mean quality of life score was 35, and 26% had a BDI-II score >10. The mean Zarit Caregiver Burden Interview score was 16. Minnesota Living with Heart Failure Questionnaire, BDI-II, and Zarit Caregiver Burden Interview scores were all associated with lower ejection fraction, need for hospitalization, increased number of medications, and comorbidities. Patient Minnesota Living with Heart Failure Questionnaire score correlated with patient BDI-II, caregiver BDI-II, and Zarit Caregiver Burden Interview scores. Caregiver burden score correlated with both caregiver BDI-II and patient BDI-II. Death or hospitalization at 6 months was associated with caregiver burden and depressive symptoms and with patient quality of life and depressive symptoms. Caregivers of patients with congestive heart failure experience high caregiver burden and prevalence of depressive symptoms, which are related to the patient disease burden.
There has been little attention paid to the motivation of adolescents entering treatment for an eating disorder. The present study investigates a questionnaire designed to assess readiness to change based on Prochaska and DiClemente's model. The Motivational Stages of Change for Adolescents Recovering from an Eating Disorder (MSCARED) was examined with 34 adolescent girls attending one of six eating disorder treatment groups. The assessment prior to, and at the termination of the groups, included the MSCARED; Children's Depression Inventory (CDI); Perceived Body Image Scale (PBIS); Eating Disorders Inventory (EDI-2-pre-only); and, the Group Evaluation Form (post-only). The MSCARED proved to be easy for youth to complete, reliable, and demonstrated concurrent and predictive validity. While the group was beneficial to girls at each stage of change, greater gains were reported by those who started at a more advanced stage. The clinical and research implications of measuring motivation to change are discussed.
There was no evidence to suggest that those with pre-surgical psychological difficulties did more poorly with VBG. These data call into question screening out individuals with psychological problems from gastroplasty surgery. Furthermore, psychological difficulties, if they exist, appear more related to the nature of morbid obesity than to the character of the individual. Psychological difficulties pre-surgery were normalized following surgery.
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