Background: Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction. Methods: The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes). Discussion: This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users' motivation. Insights gained from this study can inform other patient safety interventions and health policy developments.

COVID‐19 restrictions such as lockdowns or quarantines may increase the risk for social isolation and perceived loneliness. The mechanisms can be modeled by Cacioppo's Evolutionary Theory of Loneliness (ETL), which predicts that a lack of perceived social connectedness may lead, in the long‐term, to mental and physical health consequences. However, the association between COVID‐19 pandemic distress, mental health, and loneliness is not sufficiently understood. The present longitudinal study examined the relationship between distress and depression, and the mediating effects of anxiety and loneliness in a German rehabilitation sample ( N = 403) at two timepoints (≤6 weeks pre‐rehabilitation; ≥12 weeks post‐rehabilitation; mean time between T1 and T2 was  52 days). Change scores between T1 and T2 were examined for the variables COVID‐19 Peritraumatic Distress Index (CPDI), anxiety, loneliness, and depression. The results of the serial mediation analysis indicated that anxiety and loneliness were able to explain the relationship between distress and depression with 42% of variance in depression accounted for. Findings extend research on the relationship between COVID‐19 and mental health by considering anxiety and loneliness as sustaining factors of depressive symptoms, thus, successfully applying the ETL. Results stress the necessity to consider anxiety and loneliness in the treatment or prevention of depression.

Zusammenfassung Hintergrund Soziale Isolation ist ein Risikofaktor für Einsamkeit und damit für gesundheitliche Beeinträchtigungen. Veränderungen im Zusammenhang mit der Coronapandemie in Deutschland gilt es besser zu verstehen. Fragestellung Ziel der Studie war es, Einsamkeit und assoziierte Faktoren vor und während der Coronapandemie in Deutschland systematisch zu untersuchen. Die Fragestellungen waren: 1. Wie einsam fühlen sich Menschen vor und während der Coronapandemie? 2. Wie viele Menschen fühlen sich seit Beginn der Coronapandemie einsamer? 3. Wie viele Menschen berichten über gesundheitliche Belastungen während der Coronapandemie? Material und Methoden Im Jahr 2019 (vor der Coronapandemie) wurden 1003 und im Jahr 2020 (während der Coronapandemie) 1050 Erwachsene online befragt (51 % Frauen; 18–90 Jahre). Ergebnisse Es fühlten sich 10,8 % vs. 26,6 % der Befragten vor bzw. seit der Coronapandemie mehrfach pro Woche oder täglich einsam. Alleinlebende, Frauen und Jüngere fühlten sich häufiger einsam. Seit der Coronapandemie fühlten sich 30,8 % einsamer, v. a. Jüngere. Von starken gesundheitlichen Belastungen berichteten 18,9 %, dies hing mit jüngerem Alter, verschiedenen Sorgen/Ängsten und Einsamkeit zusammen. Diskussion Die höhere Ausprägung der Einsamkeit und Sorgen während der Coronapandemie sollte bei verhaltensbezogenen Maßnahmen zur Prävention der psychischen und körperlichen Beeinträchtigungen sowie behördlichen Maßnahmen berücksichtigt werden. Jüngere Menschen und Alleinlebende könnten profitieren, indem sie zu gezielten Bewältigungsstrategien (z. B. angemessener Nutzung digitaler Medien) ermutigt werden.

(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched for studies published in peer-reviewed journals in English or German between 2000 and 2020. Out of 7018 results, 71 studies were included and evaluated in this synthesis using the Oxford Level of Evidence Scale. (3) Results: The 63 studies that included a communication component revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies revealed a beneficial effect of communication trainings on distal performance indicators (i.e., patient safety), but only to a limited extent. Most studies simultaneously examined different groups, however, those addressing healthcare providers were more common than those with students (61 vs. 12). Only nine studies targeted expectant mothers. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies with an evidence level I-II, 35 with level III, and 10 with level IV. (4) Conclusions: Communication trainings should be more frequently applied to improve communication of staff, students, and pregnant women and their partners, thereby improving patient safety.

Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoiding masses, wearing face masks, and complying with hand hygiene recommendations became imperative. The current study aims to determine factors interrelating with hygiene behaviors. Methods: A total of 4049 individuals (1305 male, 2709 female, aged 18–80 years) were recruited from rehabilitation clinics or freely on the internet. They were surveyed via online questionnaires between May 2020 and August 2021. Sociodemographics, hygiene behaviors, and fear of COVID-19 infection were assessed. Results: Overall prevalence for hygiene behaviors was: keeping a distance—88.1%; avoiding mass gatherings—88.0%; wearing face masks—96.9%; and hand hygiene—81.6%, with 70% of the study participants complying with all four researched behaviors. Hygiene behaviors were significantly related to fear in a linear and quadratic fashion. Conclusion: Patients are more compliant according to their self-reported responses than the general population. To improve hygiene behavior, hand hygiene in particular provides options for improvements. A medium level of fear seems to be more functional than too-elevated fear. Behavioral interventions and targeted communication aiming at improving different behaviors in orchestration can help individuals to protect their health and to remain healthy. Accordingly, communication is required to ensure high hygiene standards and patient safety, and to prevent adverse effects.