The various burdens of relatives and their expectations towards psychiatric services point to necessary improvements of mental health services in the sense of a consumer-oriented psychiatric care.

No abstract

Background Asylum-seeking children and adolescents (ASCs) resettled to western countries show elevated levels of psychological distress. While research on the mental health of ASCs is increasing, less is known about their day-to-day living experiences such as their daily mood, sleep patterns, and post-migration factors. Moreover, no examination in situ, using smartphone-assisted ecological momentary assessment (EMA), has been conducted up to now among ASCs. Furthermore, we do not know if screening measures succeed in reflecting the daily mood of ASCs experienced in everyday life. Methods We undertook a smartphone-assisted EMA study over a two-week period with 3 measurements a day. Participants were N = 40 ASCs from 10 different countries who had resettled to Germany. They completed standardized questionnaires screening for history of trauma and clinical symptoms (post-traumatic stress symptoms, depression, and anxiety) that were carried out in interview-like settings, and they participated in the subsequent EMA where they rated mood, sleep parameters, and post-migration factors on a daily basis. Multilevel models of clinical symptoms, daily mood, and sleep parameters were computed based on a total of 680 measurements. Results The multiply traumatized and highly distressed participants reported different levels of discrimination, and various social activities and contacts in the EMA. The overall compliance rate was shown to be 40.5%. Higher PTSS and anxiety scores were associated with lower levels of daily mood and poorer outcomes of some sleep parameters. Depression scores were not associated with any of the variables assessed in the EMA. Conclusions Smartphone-assisted EMA among ASCs resettled to Germany proved to be implementable despite a rather low compliance rate. Not only do ASCs show high symptom levels, they are also affected by these symptoms in their daily lives. The results emphasize the need for concise screenings and psychological treatment for this high-risk population. Limitations include the convenient nature of the sample and the lack of a comparison group.

Using a sample of school teachers, we conducted an ambulatory assessment study to investigate HRV as (1) a state outcome measure of job demands and resources and (2) a trait moderator in the relationship between job demands and emotional exhaustion. In total, 101 participants wore an electrocardiogram device on two school days and rated their level of job demands (emotional demands and time pressure), job resources (control and support), and exhaustion six times a day. Based on 669 measurements, multilevel models of the 5-minute state HRV measure and emotional exhaustion were built. Results: The results supported the health-impairing effects of job demands on emotional exhaustion but not state HRV. There was no evidence of the moderating effects of job resources. Notably, the 48-hour trait HRV measure significantly buffered the effect of emotional demands on exhaustion. Conclusions: These findings highlight the stress-buffering potential of trait HRV as theoretical research extension and practical intervention goal.

ZusammenfassungBasierend auf der qualitativen Inhaltsanalyse von Interviews mit Patienten (n = 38), Angehörigen (n = 32), niedergelassenen Allge− meinärzten (n = 24) und Nervenärzten/Psychiatern (n = 27) so− wie Mitarbeitern sozialpsychiatrischer Dienste (n = 40) wurden Fragebogen generiert, die Erwartungen und Zufriedenheit der je− weiligen Nutzer mit der psychiatrischen Klinik auf zwei Ant− wortskalen erfassen. Die Fragebogen wurden an Stichtagen von Patienten einer psychiatrischen Fachklinik (n = 253), Patienten einer psychiatrischen Abteilung (n = 91), Angehörigen (n = 58), niedergelassenen Allgemeinärzten (n = 138) und Nervenärzten/ Psychiatern (n = 18) sowie Mitarbeitern sozialpsychiatrischer Dienste (n = 40) beantwortet. Durch das Forschungsprojekt konnten ein Nutzerzufriedenheitsinventar entwickelt und bis− lang nicht bekannte Daten zur Struktur−, Prozess− und Ergebnis− qualität der stationär−psychiatrischen Behandlung und zur Zu− sammenarbeit psychiatrischer Institutionen aus Sicht der Betrof− fenen gewonnen werden, die auch für gesundheitspolitische und gesundheitsökonomische Fragestellungen relevant sind und bei der Psychiatrieplanung berücksichtigt werden sollten. Schlüsselwörter Nutzerzufriedenheit´Qualitätssicherung´Psychiatrische KlinikṔ sychiatrie AbstractBased upon content analyses of interviews with patients (n = 38), relatives (n = 32), general practitioners (n = 24), psychiatrists in private practice (n = 27), and staff members of social−psychiatric services (n = 40) self−report questionnaires were developed to evaluate consumers' expectations and satisfaction on two scales.At key days the questionnaires were completed by patients of a psychiatric state hospital (n = 253), patients of a psychiatric de− partment of a general hospital (n = 91), relatives (n = 58), general practitioners (n = 138), psychiatrists in private practice (n = 18), and staff members of social−psychiatric services (n = 40). By this research project a consumer satisfaction inventory could be de− veloped and new findings regarding structure, process and out− come of inpatient care and regarding collaboration of psychiatric institutions could be revealed from the consumers' point of view.The results also have impact on current health policies and eco− nomics and should be considered in mental health care planning.