[How are Effects of Patient Education Programs Influenced by Psychosocial Risk Factors in Pediatrics?] / Wie beeinflussen psychosoziale Risiken den Erfolg von Patientenschulungen in der Pädiatrie?

BACKGROUND: Modular patient education programs are effective in children with chronic conditions and their families. Little is known about the influence of socioeconomic status (SES), migration background (MB) and children's mental-health problems on the programs' effects. OBJECTIVES: Do SES, MB or mental-health problems influence the success of education programs (disease-specific knowledge, children's health-related quality of life (HRQoL) and life satisfaction and parents' condition-specific burden)? MATERIALS AND METHODS: Children with different chronic conditions and their parents participated in modular patient education programs. Before and 6 weeks after the participation SES, MB, children's mental-health problems, parents' und children's disease-specific knowledge, children's HRQoL and life satisfaction and parents' condition-specific burden were assessed by standardized questionnaires. The influence on the programs' effects of SoS, MH and mental-health problems were examined with variance and correlation analyses. RESULTS: 398 children (mean age 10.2 yrs) and their parents participated. Irrespective of SoS, MH and mental-health problems the programs were associated with improved disease-specific knowledge, children's HRQoL and life satisfaction and parents' disease-specific burden. At follow-up SoS, MH and mental-health problems were associated with reduced knowledge, reduced children's' HRQoL and life satisfaction and increased parents' disease-specific burden. CONCLUSIONS: Disadvantaged families and children with mental-health problems benefit from education programs, but have an increased need of education due to special challenges.

[Outcomes of prevention and treatment of adolescent psychiatric disorders in Turkish immigrants with reference to resources and risks]. / Ergebnisse zur Prävention und Behandlung jugendpsychiatrischer Störungen in türkeistämmigen Zuwandererfamilien unter Berücksichtigung von Ressourcen und Risiken.

Semi-structured bilingual interviews were conducted with 223 adolescents from Turkey and their parents in 77 volunteering immigrant families (field group) and in 40 outpatient families attending the adolescent service (CAP treatment group). Risks and resources for mental health were assessed in a qualitative approach based on contextual family theory, cohesion and adaptability according to Olson's Clinical Rating Scale. While adolescent psychiatric morbidity in the field group equalled an expected rate of 24%, families with psychologically healthy offspring significantly excelled in parental and child resources. Yet, resources did not separate symptomatic and non-symptomatic families (referring to child symptoms) as well as risks did. A parent without work constituted a risk factor of its own. Differentiating CRS from 3 to 4 steps of adequacy for child health (introducing a range of high cohesion or high rigidity alone as another step between normal and dysfunctional) led to classify 80% of non-symptomatic families as functional. Following our results, a resource oriented family therapy seems to be the most promising therapeutic approach. Social case management should be provided for at the same time.