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.

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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.

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.

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.

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ObjectiveThis is the first study to use a daily diary design to investigate the relationship between daily work-related rumination (WRR), daily well-being, and burnout symptoms among psychotherapeutic practitioners.MethodIn total, N = 58 psychotherapeutic practitioners participated in the study. For 4 weeks, the participants received a daily evening prompt on weekdays asking about their WRR and well-being. The burnout level of the psychotherapists was assessed using Maslach Burnout Inventory (MBI) prior to the daily diary period and afterward. The MBI measures the level of work-related distress on three subscales: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). Two main analyses were performed: Based on the hierarchical structure of the data we performed random intercept and slopes models. These models examined the association between daily WRR and daily well-being, and the relationship between pre-burnout and daily WRR and daily mood. Secondly, linear regressions with the post-MBI subscales as criterion and the daily diary variables as predictors were calculated to assess their contribution to post-burnout.ResultsThe compliance rate in our study was 76.8%. Daily WRR and pre-assessment EE were associated with all aspects of reduced daily well-being: bad mood, increased nervousness, and tiredness after work. Daily tiredness and nervousness played a differential role in predicting post-burnout.ConclusionOur results indicated that daily rumination and pre-EE were associated with reduced daily well-being. As we are the first to present a daily diary study among psychotherapists, we examined the feasibility of the daily diary design in particular and ecological momentary assessment (EMA) in general in this population. Compliance rates compared well with other EMA studies, indicating that EMAs were a feasible assessment option for psychotherapeutic practitioners.

Exposure to recreational noise is becoming increasingly important due to a change in leisure behavior amongst children and adolescents. The aim of this pilot study was to assess exposure of 6 grade pupils to recreational noise from portable listening devices (PLD). Furthermore, preventive measures to reduce recreational noise exposure should be identified. In "Ohrkan Kids", 38 Bavarian pupils aged 11 to 14 were interviewed regarding their music listening behavior using a standardized questionnaire. In addition, measurements of commonly used volume settings on the children's portable listening devices were carried out. Furthermore, the German Social Accident Insurance (DGUV), health insurance companies as well as health and education ministries of the German federal states were surveyed regarding their activities in the prevention of recreational noise exposure. Based on the questionnaire data for weekly usage, 10 out of 31 children (32.3%) exceeded the upper exposure value of 85 dB recommended by labor protection law. Taking actually measured values, 9 out of 31 children (29%) exceeded this level. The DGUV and some federal states carry out specific projects for the prevention of recreational noise exposure. The large number of children with hazardous music consumption indicates that measures for the prevention of noise-induced hearing loss are already required for 11 to 14 year olds. To maximize the number of children addressed, age-appropriate and target-group-specific preventive measures are needed. As there are only few studies which examined the effectiveness of awareness campaigns for the prevention of recreational noise, any future prevention projects should be evaluated with an increased focus on estimating their effectiveness.