Internet-delivered interventions can be effective in treating mental disorders. However, their rate of use in German psychiatric inpatient routine care is low. The current study aimed to investigate the attitude of mental health care professionals working in inpatient care regarding internet-delivered interventions, including presumed benefits, barriers and facilitators. In total, 176 health professionals from ten inpatient psychiatric hospitals throughout Germany were surveyed on site. The professionals’ attitude towards internet-delivered interventions in inpatient care was assessed by an adapted version of the ‘Attitude toward Telemedicine in Psychiatry and Psychotherapy’ (ATTiP) questionnaire. To identify benefits, barriers and facilitators, we developed open-response questions that were based on the ‘Unified Theory of Acceptance and Use of Technology’ (UTAUT) and analyzed by a qualitative content analysis. Professionals reported little experience or knowledge about internet-delivered interventions. Their attitude towards internet-delivered interventions in psychiatric inpatient care was rather indifferent. The most frequently mentioned potential benefits were an optimised treatment structure and patient empowerment; the most frequently anticipated barriers were too severe symptoms of patients, the feared neglect of face-to-face contacts and insufficient technical equipment; and the most frequently mentioned facilitators were high usability of the internet-based intervention, a sufficient functional level of the patient and further education of staff. For successful implementation in the inpatient sector, internet-delivered interventions must be adapted to the special needs of severely mentally ill patients and to the hospital management systems and workflow. In addition, technical preconditions (internet access, devices) must be met. Last, further education of mental health care professionals is needed.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00406-021-01251-1.
These quality criteria serve as a starting point for the establishment of a certification process. This could help to make internet-based self-management interventions for mental disorders part of routine care in the German healthcare system.
ZusammenfassungZahlreiche Selbstmanagement Interventionen haben in randomisierten Studien ihre Wirksamkeit in der Behandlung von einer Reihe von psychischen Störungen gezeigt. Dennoch sind diese Interventionen gegenwärtig noch nicht überall in der klinischen Routine angekommen. Das liegt unter anderem daran, dass neben den evidenzbasierten Interventionen auch Interventionen angeboten werden, die nie wissenschaftlich untersucht worden sind und teilweise noch nicht einmal auf evidenzbasierten Psychotherapiemethoden beruhen. Die vorliegenden Qualitätskriterien der beiden Fachgesellschaften DGPs und DGPPN sollen Betroffenen, Behandlern und Entscheidern im Gesundheitswesen helfen, sichere und wirksame Interventionen zu identifizieren. Im Mittelpunkt der Qualitätskriterien stehen die Sicherheit der Patienten und ihrer Daten; die Sicherstellung der therapeutischen Qualität durch Rückgriff auf evidenzbasierte Psychotherapiemethoden und Begleitung der Entwicklung durch approbierte Psychotherapeuten oder Fachärzte; das Vorliegen eines Wirksamkeitsnachweises aus mindestens einer randomisierten Studie; und die Transparenz bezüglich zentraler Informationen, z. B. der Kosten der Intervention. Wir hoffen, dass diese Kriterien dazu beitragen können, dass Selbstmanagement Interventionen in den Leistungskatalog der Krankenkassen aufgenommen werden.
BackgroundWhile ethnic discrimination emphasizes boundaries between different cultures, the concept of transculturality focuses on the fact that cultures can merge and that individuals integrate novel cultural elements into their identity. This is an exploratory study that investigates the interplay between perceived ethnic discrimination, psychological adjustment and transcultural identity.MethodsStructured interviews were conducted using a sample of 46 adolescents with a Turkish migratory background and 45 adolescents who were native born Germans.ResultsCorrelational and multiple regression analyses revealed that perceived discrimination was clearly associated with a poorer psychological adjustment among adolescents with a migratory background. Transcultural identity moderated this relationship. That is, adolescents who showed higher levels of transcultural identity displayed a better psychological adjustment when compared to adolescents who showed lower levels of transcultural identity—provided that they did not feel discriminated against. This is congruent with the idea that transcultural identity can involve considerable benefits for personality. However, when adolescents perceived higher rates of discrimination, higher levels of transcultural identity came attached to a poorer psychological adjustment.ConclusionsThe findings suggest that perceived discrimination has negative effects on the well-being of immigrant adolescents—particularly for those who describe their identity as transcultural. The findings are discussed considering specific characteristics of transcultural identity, and how they stand in opposition to discrimination.
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