Is it all about knowledge? A survey of attitudes toward ADHD among German pediatricians.

Aim: Sometimes treatment is not necessarily according to guidelines, which is partly due to attitudes rather than lack of knowledge. In Germany, regional differences concerning prevalence rates of ADHD exist without valid explanation. We contribute with our data to the question of attitudes toward ADHD among pediatricians in Germany. Method: A specially designed questionnaire based on the Knowledge of Attention Deficit Disorders Scale and previous surveys was sent to pediatricians. In addition to descriptive statistics, we performed factor analysis and multiple linear regression analysis. Results: The vast majority (85.5%) of 581 respondents have a positive attitude toward ADHD, i.e., ADHD exists and should be treated appropriately. Physicians with positive attitudes were older and more often had a neuropediatric specialization. Conclusion: Most of the pediatricians surveyed in Germany assess ADHD and treatment in line with medical guidelines and treat as part of multimodal therapy. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01758-4.

The impact of the COVID-19 pandemic on pediatric developmental services: a cross-sectional study on overall burden and mental health status.

BACKGROUND: The COVID-19 outbreak has taken a heavy toll on the mental well-being of healthcare workers, even those who have not been directly involved in the care of acutely ill patients. The aims of this study were to identify the overall burden and mental health status of healthcare workers in pediatric developmental services under the influence of the COVID-19 pandemic, and to identify the risk and protective factors associated with mental health. METHODS: This cross-sectional web-based study was part of a large multicenter VOICE study conducted among employees ((neuro-)pediatricians, psychologists, speech therapists, occupational therapists, etc.) from various pediatric developmental services between June and July 2020. A total of 1291 questionnaires regarding overall burden, mental health status (depression, generalized anxiety disorder and emotional exhaustion) and risk and protective factors for mental health (working conditions, potential problems during the COVID-19 pandemic and psychological resources) were analyzed. Descriptive statistics and multiple linear regression were used for data analysis. RESULTS: A total of 44.5% (574/1291) participants felt a high or very high overall burden during the COVID-19 pandemic. Of all the participants, 14.6% (171/1173) reported clinically significant levels of depressive symptoms, 17.0% (199/1173) reported generalized anxiety disorder symptoms and 44.6% (532/1192) reported emotional exhaustion. Multiple linear regression analyses identified several common risk and protective factors for mental health status variables. The burden of an increase in the quantity of work, fear of work and fear of becoming infected showed the strongest negative associations, whereas psychological resources and sufficient relaxation in leisure time exhibited the strongest positive associations. CONCLUSION: Employees who were not directly involved in the care of acutely ill patients were also exposed to considerable stress, some of which was not different from that experienced by professionals who were directly affected. These employees should not be lost sight of and must be offered appropriate support.

[Communicating test results in a comprehensible manner: A randomized controlled trial of word usage in doctor-patient communication]. / Befundergebnisse verständlich vermitteln ­ Eine randomisiert-kontrollierte Studie zur Wortwahl in der Ärzt*innen-Patient*innen-Kommunikation.

INTRODUCTION: Doctor-patient communication is one of the hallmarks of good medical treatment. Mutual understanding is of foremost importance, in particular when communicating non-numerical test results. METHODS: Using a two-step approach, this study analyses the influence of wording on the correct understanding of medical test results by people without a medical background. In a first step, a qualitative analysis of physicians' letters helped to identify adjectives that are frequently used to communicate test results. In a second step, a parallel randomised study was conducted to test the comprehensibility of particularly relevant adjectives, combining the written communication of test results with a subsequent survey. 1,131 participants, representing the population of Germany with regard to age, gender, and educational level, were recruited via an online platform. The participants read a scenario involving the communication of the results of a breath test, whereby non-numerical test results were described as being either "positive" vs. "negative" (n=566) or "abnormal" vs. "normal" (n=565). Participant assignment to one of these groups took place in a randomised way. The outcomes measured included the subjective and objective understanding of test results as well as the participants' subjective comprehension of the physician communicating with them. RESULTS: People without a medical background can understand medical test results more readily when neutral, descriptive adjectives are used rather than adjectives considered as being judgmental in everyday language. 54 % of the participants who read test results using the adjectives "positive" vs. "negative" and 65 % of the participants who read test results using the adjectives "abnormal" vs. "normal", respectively, understood the results correctly. This relative difference of 20.4 % in the number of participants with a correct understanding is statistically significant (Chi square=13.061; p=0.001). There was also a considerable difference in the subjective understanding (means of 5.04 of "positive" vs. "negative" and 5.47 for "abnormal" vs. "normal" on a 7-point Likert scale; absolute mean difference 0.42 [95 % CI: 0.20; 0.64]) as well as in the subjective comprehension of the communicating physician (means of 4.49 for "positive" vs. "negative" and 4.95 for "abnormal" vs. "normal" on a 7-point Likert scale; absolute mean difference 0.45 [95% CI: 0.23; 0.67]). A higher level of comprehension for the words "abnormal" vs. "normal" was consistent across the overall sample. It is mainly people with no school-leaving certificate and a lower educational level who benefit from the changed wording. CONCLUSIONS: In the process of communicating non-numerical medical test results, people without a medical background understand neutral, descriptive adjectives better than adjectives that are considered judgmental in everyday usage. A corresponding change of written and oral communication can easily be implemented by medical experts in their everyday practice and particularly supports a population group that already suffers disadvantages in the medical system.

[Internet-based Information on Genetic Testing in Children with Intellectual Disability and Epilepsies: a Systematic Survey]. / Informationen im Internet zu humangenetischen Untersuchungen (bei Kindern) zur Ursachenklärung von Intelligenzminderung oder Epilepsien.

BACKGROUND: Genetic testing is of increasing diagnostic relevance in the evaluation of children with developmental disorders, intellectual disability and epilepsies. The complexity of genetic analyses constitutes a challenge with respect to obtaining informed consent. Internet-based information might facilitate this process. METHOD: We systematically screened and evaluated the available internet-based information of the German pediatric societies and human genetic institutes using standardized methods (e. g. DISCERN Genetics, LIDA, LIX). RESULTS: We found information on 111 homepages. Appearance and navigation could be classified as satisfactory. However, the content was often incomplete and difficult to understand. Forms for informed consent sometimes lacked adequate options for individual decisions. Complexity of informational texts was rated "high" to "very high". Information using plain language was not at all available. There was a limited number of homepages containing information in a language other than German. CONCLUSION: Internet-based information might be helpful for achieving adequately informed consent in complex medical situations. In terms of genetic testing, this information might facilitate the preparation for the pre-diagnostic discussion. Information should be easily accessible including options like plain language, audio versions and foreign language material.

["Because we feel, we have to do something" - Barriers in the prevention of violence and key areas requiring action : A qualitative interview study with professional nurses and managers in the field of elderly care]. / "Weil wir spüren, da müssen wir was tun" ­ Barrieren in der Gewaltprävention sowie zentrale Handlungserfordernisse : Eine qualitative Interviewstudie mit professionellen Pflegefachkräften und Führungskräften aus dem Bereich Altenpflege.

BACKGROUND: In recent years, politics and society have shown an increasing interest in the prevention of violence. Despite the scientific studies and prevention programs that have been conducted over the past few years, there is no indication that the prevalence of violence in elderly care is falling. A high number of unreported cases may still be assumed. OBJECTIVE: The present study examined the barriers in transferring research knowledge into practice. Furthermore, it dealt with the requirements of an interventional approach which is practical and which effectively addresses the barriers. MATERIAL AND METHODS: The data were collected in qualitative interviews (n = 20) and analyzed by using qualitative content analysis. RESULTS: The study revealed uncertainties in dealing with violence. The institutions lacked a clear definition of violence and the respondents did not have a clear concept of when and where violence starts. A high proportion of the respondents stated that violence occurred in various forms in daily nursing care but that there were no specific strategies for action. Only very few cases were documented at all. Moreover, a lack of practical further training was reported. The visibility of these barriers opens up new approaches to developing preventive measures which work in practice. CONCLUSION: A common definition of violence, clear and binding standards, regular training and education measures are central to the prevention of violence in care.