[Access to Early Childhood Interventions in Children̛s Hospital: Screening as Clinical Routine Procedure - Exploration and Transfer by a Specialized Team]. / Zugang zu Frühen Hilfen in der Kinderklinik: Belastungsscreening als klinische Routine ­ differenzierte Exploration und Vermittlung durch das Fachteam.

BACKGROUND: In order to prevent risks associated with insufficient family care, it is mandatory to provide early childhood interventions for parents unable to cope with their young children in best time. Children̛s hospitals represent one pillar that hasn´t been fully explored yet. METHODS: As a proof-of-concept, we performed a study to determine the feasibility of a standardized risk assessment tool during routine work of doctors and nurses in a university department. RESULTS: Our data indicate that a standardized screen to assess stress is powerful in identifying stressed parents, especially those with children under the age of one year. In this context, psychosocial stress in families with newborns was most frequently indicated. The placement rates into early childhood interventions (8.5%) and youth welfare services (11.3%) correspond to the literature. DISCUSSION AND CONCLUSION: The standardized risk assessment tool can be used as a "call button" and delivers a basis for further differentiated exploration of the families by a specialized team and might be used to deliver services for these families. In summary children's hospitals might be useful to provide a low-threshold access into early childhood interventions.

Development and evaluation of a checklist assessing communication skills of oncologists: the COM-ON-Checklist.

OBJECTIVES: Communication skills training (CST) has to be proven effective, and therefore reliable instruments to evaluate CST are required. Most instruments assessing medical consultations do not take individual aspects of CST into consideration. Such assessment tools should naturally also be closely associated with the communication skills taught to the participants. Thus, we developed a new instrument which evaluates the effects of specific CST. DEVELOPMENT: Based on a literature review, we developed a checklist with questions ('items') which assess the behaviour of a doctor in a special doctor-patient consultation (The COM-ON-Checklist, COM-ON = communication in oncology). First, we developed items for general communication skills that are a requirement of every doctor-patient consultation, and in addition to this, we developed items for specific situations which present a particular challenge for doctors in terms of communication skills, namely: the situation in which the doctor is required to discuss the shift from curative to palliative care, and the disclosure of information about clinical trials. For assessment, a 5-point rating scale with anchor points was used. EVALUATION: Blinded raters were trained to use the COM-ON-Checklist. The intra-class correlation (ICC) was used to calculate the agreement between raters. RESULTS: The COM-ON-Checklist consists of two parts: the first part evaluates general communication skills; the second part evaluates content-specific aspects of the consultation. The ICC ranged from 0.5 to 0.8, which demonstrates moderate to very good results of inter-rater reliability. DISCUSSION: The COM-ON-Checklist can be used to evaluate specific CST. It is also a feedback source for clinicians because it assesses their personal communication skills in different settings. In conclusion, the COM-ON-Checklist provides a reliable, structured method for assessing communication skills in oncological settings.

Attentional bias in depressive patients and the moderating effect of concurrent anxiety.

BACKGROUND: Most previous studies finding positive results in the emotional Stroop test did not control for concurrent anxiety symptoms. This study investigated depressive patients without comorbid anxiety disorders in order to clarify existing inconsistent findings. Furthermore, we examined the relationship between anxiety level and the emotional Stroop effect in patients and healthy subjects. SUBJECTS AND METHODS: Twenty-three depressive patients without comorbid anxiety disorder and 27 healthy subjects performed a mixed computerized version of the emotional Stroop test (attentional bias test). We assessed the state and trait anxiety and examined its correlation with the emotional Stroop effect. RESULTS: We failed to find evidence for attentional bias in the patients as measured by longer reaction times to the emotional stimuli. However, there was a positive correlation between state anxiety and attentional bias in depressed patients. On the other hand, in healthy subjects the trait anxiety correlated negatively with attentional bias. CONCLUSIONS: Attentional bias is not found in depressed patients if only patients without comorbid anxiety disorders are included. Furthermore, healthy subjects with high trait anxiety levels may be vulnerable to affective disorders because they use avoidance strategies when encountering negative information.