Ecological momentary assessment of parent-child attachment via technological devices: A systematic methodological review.

Despite extensive research about parent-child attachment using observational and self-report studies, complementary measures are needed to assess this construct objectively with ecological validity, as well as less obtrusiveness and reactivity than traditional measures. This systematic review describes existing technology-based ecologically momentary assessment (EMA) tools examining attachment-related emotions, cognition, and behaviors between the child and its parents. From the study's inception until March 2021, four databases were searched resulting in 11,910 screened citations. Finally, 18 records were included, characterized by a broad variety of assessment tools, sample characteristics, study designs, and attachment outcomes. Technology-based EMA methods comprised audio, video, diary, and sensory assessment modalities, each occuying its methodological niche. When reported, the psychometric properties of the EMA methods were evaluated as very good; however, the included studies' psychometric data was not completely examined. The main attachment outcomes assessed by EMA were emotional and cognitive reactions and actions of the children, the parents, and the dyad. Cognition was rarely assessed using EMA methods. Future research should focus on the complexity of attachment considering different ethnic backgrounds, multiple caregivers' viewpoints, gender aspects, as well as cognitive and dyadic contents in the naturalistic environment.

Routine Screening for Peripartum Depression in the Gynecologic and Pediatric Setting - Evaluation of an Adapted EPDS Version.

PURPOSE: The aim of the study was to investigate the feasibility and acceptability of a routine screening for peripartum depression (PD) by gynecologists and pediatricians. In addition, it was investigated whether two separate Plus Questions (PQ) of the "EPDS-Plus" are valid for screening experiences of violence or a traumatic birth and whether they can be associated with symptoms of PD. METHODS: Using the EPDS-Plus the prevalence of PD was investigated in 5235 women. The convergent validity of the PQ with the Childhood Trauma Questionnaire (CTQ) and Salmon's Item List (SIL) was assessed using correlation analysis. The association between the experience of violence and/or traumatic birth experience and PD was subjected to the chi-square test. Furthermore, a qualitative analysis for acceptance and satisfaction by the practitioners was performed. RESULTS: The prevalence was 9.94%/10.18% for antepartum/postpartum depression. The convergent validity of the PQ showed strong correlation with CTQ (p<0.001) and SIL (p<0.001). For violence and PD, a significant association was found. There was no significant association for traumatic birth experience and PD. There was a high level of satisfaction and acceptance of the EPDS-Plus questionnaire. CONCLUSION: Screening for peripartum depression is feasible in regular care and can help to identify depressed as well as potentially traumatized mothers, especially in preparing trauma-sensitive birth care and treatment. Therefore, specialized peripartum "psych" treatment for all affected mothers in all regions has to be implemented.

[Palliative Care from the Perspective of Providers of General and Specialised Palliative Care - A Cross-Sectional Survey]. / Die allgemeine und spezialisierte Palliativversorgung aus Sicht von Leistungserbringern der Hospiz- und Palliativversorgung ­ eine Querschnittserhebung.

BACKGROUND: Palliative care is a particular challenge in rural regions with low population density. Every patient should have access to palliative care regardless of age, diagnosis, prognosis, place of residence and economic aspects. The aim was to identify problem areas in palliative care in rural regions and to find possible solutions from the perspective of health service providers. METHODS: A standardised written survey was conducted among providers of general and specialised palliative care in the federal state of Mecklenburg-Western Pomerania. In total, 489 service providers were sent a questionnaire. A random sample of general palliative care providers and all specialised palliative care providers in Mecklenburg-Western Pomerania were contacted. For the evaluation of the structure of palliative care and to identify problem areas, the German school grading system was used (1=very good, 6=insufficient). The results of the survey were descriptively analysed. RESULTS: The response rate was 19% (n=93). Identified problems were the interface between outpatient and inpatient care as well as between general and specialised palliative care. The cooperation between specialised outpatient palliative care teams and hospital with a palliative care unit was rated with an average of 1.9. The cooperation between specialised outpatient palliative care teams and hospitals without a palliative care unit was rated with an average of 3.6. The knowledge of palliative care of nurses in nursing homes was graded 4.0; 54.8% (n=51) of the participants could consider providing telemedicine care to palliative patients in addition to conventional care. The establishment of a palliative care coordination unit was rated as highly important by 34.4% of the participants. CONCLUSIONS: The results indicate infrastructural, organisational and quality-related problems in providing palliative care. The provision of palliative care in rural areas could be strengthened through targeted training, outpatient consultation services, coordination units and the integration of telemedicine functionalities.