Zeitschrift für Medizinische Psychologie

Objectives: The instruments Disabkids and Kidscreen are intercultural developed questionnaires assessing health related quality of life of children and adolescents. While the questionnaire Disabkids has been designed for children and adolescents suffering from a chronic disease, the questionnaire Kidscreen can be applied for diseased as well as healthy children. In this study, the sensitivity to change of both instruments is compared, in the context of inpatient rehabilitation for children with chronic diseases.

Methods: In three medical inpatient rehabilitation treatment centres for children and adolescents n = 109 patients completed the questionnaires Disabkids (27 item chronic generic module) and Kidscreen (27 item version) at the measuring points “beginning of rehabilitation” (t0) and “3 weeks after beginning of rehabilitation” (t1). The collected data was analysed and compared by using a t-test for independent samples and by measuring effect sizes.

Results: The questionnaire Disabkids recorded a significant increase in quality of life in 4 out of 6 scales. Thus, evidence for effect sizes between 0.20 and 0.40 could be shown for most of the scales. In Kidscreen, however, merely the scale “physical well-being” shows a significant improvement of quality of life. In general, variations in the questionnaire Kidscreen turned out with smaller effect sizes (0.00–0.68), but still the strongest effect of the two questionnaires can be found in the Kidscreen scale “physical wellbeing”.

Conclusion: Within the presented study, improvements in quality of life of diseased children and adolescents during inpatient rehabilitation were captured through a high number of scales by the questionnaire Disabkids whereas the questionnaire Kidscreen could only reflect change on one scale. These results seem coherent with the differences in the conceptual orientations of both instruments.

Objectives: Unhealthy diet and physical inactivity are main causes of many diseases and hence, the development of effective interventions is warranted. However, targeting both health behaviors simultaneously might overburden participants. Thus, the aim of the study was to (a) investigate the relationship between these two health behaviors, (b) assess the perceived intergoal conflict and coherence, and (c) test the effects of stage-matched and mismatched interventions on perceived intergoal conflict and coherence.

Methods: Based on the Health Action Process Approach (HAPA; Schwarzer, 2008), which describes behavior change as a process with qualitatively different stages, an internet-based health prevention program was tested. The quasi-experimental study with two different interventions included N = 1260 and a longitudinal subsample with n = 300 participants.

Results: Results showed that both health behaviors are correlated, and that participants perceived more intergoal facilitation than conflicts. Perceived conflict varied between participants in the different HAPA stages. Stagematched interventions successfully reduced intergoal conflict.

Conclusion: Health promotion programs that simultaneously target physical activity and dietary behavior seem not to overburden participants. On the contrary, participants report high levels of intergoal coherence between the two goals. Nonetheless, intergoal conflicts do play a role in the early stages of behavior change and intention formation. Health promotion programs should take these results into consideration when more than one health behavior is to be targeted.

Objective: It is well-established that children of parents with psychiatric diagnoses have a higher risk of developmental disorders. However, research addressing developmental disorders in children often solely relies on assessments made by the afflicted parents. It is unclear whether these parental judgments are diagnostically accurate.

Methods: N = 50 parents suffering from schizophrenia were asked to complete the Child Behavior Checklist (CBCL). At the same time, structured psychiatric interviews were conducted with the children. The results of these instruments were statistically compared.

Results: 52% of the parents assessed their children within the clinical or borderline range in at least one of the CBCL second-order syndrome scales. Psychiatric interviews revealed that more than half of the children had a diagnosis according to DSM-IV. Statistical analysis yielded a moderate correlation of the CBCL syndrome scales and the clinical diagnoses.

Conclusions: Assessments of parents with schizophrenia as to possible developmental disorders in their children are quite dependable on a general level. Thus, our findings indicate that questionnaires such as the CBCL could be useful for screening purposes, in order to detect possible developmental disorders and risks in the children of psychiatric patients.

Objectives: Successful patient-provider communication is characterized by a high level of congruence between the patient's communication preferences and the provider's interaction style and is associated with better treatment results.

In this study, a qualitative approach was used to identify relevant aspects of successful patient-provider communication from the patients’ as well as the providers’ viewpoints. (1) What expectations do patients have of communication with different providers? (2) Are there differences among the preferences of patients with varying clinical indications and (3) how great is congruence with the providers¡¯ attitudes about communication?

Methods: 57 patients (30 with chronic back pain and 27 with chronic ischemic heart disease) and 50 providers (17 physicians, 11 nurses, and 22 therapists) were questioned about relevant aspects of patient-provider communication. The recorded focus groups were transcribed and subjected to a qualitative content analysis in a multi-stage process using the ATLAS.ti software.

Results: A total of 38 categories of patient preferences were identified which showed both indication-specific and provider-specific communication preferences. The most frequently named patient preferences were related to “providing information”, answering “patients’ questions”, and “taking enough time”.

28 (73.7%) of the preferences identified in the patient focus groups were also mentioned by the providers; however, the providers sometimes indicated other priorities.

Conclusion: The results show not only what patients consider especially important when communicating with their providers, but also that patient preferences can differ depending on the provider or indication. Not all aspects of communication considered important by patients are also named by providers. This underlines the importance of an individual assessment of patient preferences that enables providers to adopt patient-centered communication behavior.

Objectives: The conditions for successful cooperation in medical networks were analysed using the example of the Netzwerk Essst?rungen im Ostalbkreis e. V. (NEO; Ostalbkreis Network for Eating Disorders). The questions under investigation were: What motivates participants to join the network? Which expectations were fulfilled and which disappointments were faced? Which strategies of communication and cooperation proved to be of value? What types of miscommunication and conflicts arose?

Methods: The Network participants were polled using a method-mix of issue-focussed qualitative interviews and quantitative questionnaires.

Results: The results show that non-monetary motives and benefits turned out to be far more important than economic interests. There is little tolerance for excessive bureaucracy. It is apparent that not all participants have the same benefit from, or satisfaction with the program.

Conclusion: Being part of a medical network may have beneficial “side effects” relevant for stress relief and work satisfaction: participants can feel integrated, competent, valued and experience joy while cooperating. A wellestablished cooperation structure seems to be more adequate for building new medical networks than a merely formal association in integrated system of care.