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Purpose: To test the hypothesis that ethnic minority status of patients is associated with specific psychotic disorder treatment characteristics.Methods: Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register in the Netherlands. The sample consisted of 30,655 episodes of mental health treatment for 23,122 patients with psychotic disorders. Information was available about waiting time and treatment duration, source of referral, occurrence of crisis contacts, admittance to clinical care and compulsory admissions. In addition, information was available about ethnicity (based on country of birth), gender, age and marital status. Results were calculated for ethnic and gender groups separately. In addition, a number of multivariate regression analyses were conducted to correct for differences in age and marital status.Results: There was substantial variation between ethnic minority and gender groups in relation to the treatment characteristics. Compared with a Dutch ethnic background, ethnic minority background was generally associated with less waiting time, and more police referrals, crisis contacts, admittance to clinical care and compulsory admission, but shorter treatment duration. Characteristics appeared to be least favorable in episodes that involved male patients with Antillean and Surinamese backgrounds, whereas episodes were quite similar for ethnic Dutch and Turkish patients.Conclusions: Characteristics of mental health treatment for psychosis in the Netherlands are different for ethnic minority patient groups than for patients with an ethnic Dutch background. However, there were substantial differences between ethnic minority groups. [ABSTRACT FROM AUTHOR]

The Kessler Psychological Distress scale (K10) is an instrument that is widely used to screen for mental disorders, but information is lacking on its psychometric qualities in non-Western samples. This study used a population-based sample (N = 725) to assess the reliability and validity of the K10 across ethnic groups in an urban area. The results were generally supportive of the K10 as a reliable and valid instrument to screen for anxiety and depression in all three groups. Cronbach's alpha was high (0.93) and the results indicated the existence of a solid single factor structure. Item bias in relation to ethnic background was minor. In each group, there was good criterion validity with respect to one-month DSM-IV diagnosis for depressive and/or anxiety disorder. The results nevertheless highlight the importance of cross-cultural validation, as we found different cut-off values for ethnic subgroups to obtain optimal sensitivity and specificity for detecting depressive and/or anxiety disorders. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Active listening is a prerequisite for a successful healthcare encounter, bearing potential therapeutic value especially in clinical situations that require no specific medical intervention. Although generally acknowledged as such, active listening has not been studied in depth. This paper describes the development of the Active Listening Observation Scale (ALOS-global), an observation instrument measuring active listening and its validation in a sample of general practice consultations for minor ailments. METHODS: Five hundred and twenty-four videotaped general practice consultations involving minor ailments were observed with the ALOS-global. Hypotheses were tested to determine validity, incorporating patients' perception of GPs' affective performance, GPs' verbal attention, patients' self-reported anxiety level and gender differences. RESULTS: The final 7-item ALOS-global had acceptable inter- and intra-observer agreement. Factor analysis revealed one homogeneous dimension. The scalescore was positively related to verbal attention measured by RIAS, to patients' perception of GPs' performance and to their pre-visit anxiety level. Female GPs received higher active listening scores. CONCLUSION: The results of this study are promising concerning the psychometric properties of the ALOS-global. More research is needed to confirm these preliminary findings. PRACTICE IMPLICATIONS: After establishing how active listening differentiates between health professionals, the ALOS-global may become a valuable tool in feedback and training aimed at increasing listening skills. [ABSTRACT FROM AUTHOR]

Objective: There are widespread concerns about the quality of mental health care for ethnic minority groups. This is supported mainly by studies from the U.S. and Great-Britain, raising doubts about the generalisability to (other) European countries. This study investigates ethnic differences in quality of care (QoC) for common mental disorders (CMD) in primary and outpatient mental health care in the Netherlands. Methods: Data from electronic records of 89 primary care practices in 2007 (6,246 cases), and longitudinal data (2001 - 2005) from a nationwide psychiatric case register (17,270 cases). Quality of primary care indicators were ‘detection of CMD’, ‘adequate follow-up’, ‘adequate prescription of psychotropics’ and ‘referral to specialised mental health care’. Outpatient mental health care indicators were ‘waiting times’, ‘treatment intensity’, ‘early dropout’ and ‘early re-registration. Results: Compared with ethnic Dutch, quality of primary care was less for Turkish clients (CMD less likely to be detected) and Surinamese/Antillean clients (less than adequate prescription of psychotropics). Outpatient mental health treatment was less favourable for Moroccan and Turkish clients (longer waiting times and lower treatment intensity), but more favourable for Surinamese/Antillean clients (shorter waiting times and lower dropout). Conclusions: The data do not provide sufficient support for a generalising statement that quality of CMD treatment is less favourable for ethnic minority clients. Though negative findings are not to be disregarded, positive findings - which may be related to the promotion of culturally sensitive care approaches in mainstream mental health services - deserve attention as well. [Copyright &y& Elsevier]

BACKGROUND: Consultations for minor ailments constitute a large part of the workload of general practitioners (GPs). As medical interventions are not always available, specific communication strategies, such as active listening and positive communication, might help GPs to handle these problems adequately. This study examines to what extent GPs display both strategies during consultations for minor ailments and investigates how each of these relate to the patients' perceived health, consultation frequency and medication adherence. METHODS: 524 videotaped consultations between Dutch GPs and patients aged 18 years or older were selected. All patients presented a minor ailment, and none of them suffered from a diagnosed chronic illness. The observation protocol included the validated Active Listening Observation Scale (ALOS-global), as well as three domains of positive communication, i.e. providing reassurance, a clear explanation, and a favourable prognosis. Patients completed several questionnaires before, immediately after, and two weeks after the consultation. These included measures for state anxiety (STAI), functional health status (COOP/WONCA charts) and medication adherence (MAQ). Consultation frequency was available from an ongoing patient registration. Data were analysed using multivariate regression analyses. RESULTS: Reassurance was related to patients' better overall health. Providing a favourable prognosis was linked to patients feeling better, but only when accompanied by a clear explanation of the complaints. A clear explanation was also related to patients feeling better and less anxious, except when patients reported a low mood pre-visit. Active listening alone was positively associated with patients feeling worse. Among patients in a good mood state, active listening was associated with less adherence. CONCLUSION: To some extent, it seems helpful when GPs are at the same time clear and optimistic about the nature and course of minor ailments. Yet, it does not seem helpful always and in all cases, e.g. when patients feel low upon entering the consulting room. Although communication strategies might to some extent contribute to the management of minor ailments, the results of this observational study also indicate that it is important for a physician to pay attention to the mood of the patient who enters the consulting room. [ABSTRACT FROM AUTHOR]

Background: Personal continuity in general practice is considered to be a prerequisite of high quality patient care based on shared knowledge and mutual understanding. Not much is known about how personal continuity is reflected in the content of GP -- patient communication. We explored whether personal continuity of care influences the content of communication during the consultation.Methods: Personal continuity was defined as the degree of familiarity between GP and patient, rated by both the GP and the patient. 394 videotaped consultations between GPs and patients aged 18 years and older were analyzed. GP -- patient communication was evaluated with an observation checklist, which rated the following topics of conversation: (1) medical issues, (2) psychological themes, and (3) the social environment of the patient. For each of these topics we coded whether or not it received attention, and was built upon prior knowledge. Data were analyzed using multilevel logistic regression analyses.Results: No relationship was found between GP -- patient familiarity and the discussion of medical issues, psychological themes, or the social environment of the patient. But if the patient and the GP knew each other very well, the GP more often displayed prior knowledge with the topic in question. Few patient and GP characteristics were associated with differences in content of communication.Conclusion: Given the relatively small sample size, we carefully conclude that familiarity between a GP and a patient does not influence the content of the communication (medical issues, psychological themes nor topics relating to the social environment). This is remarkable because we expected that familiarity would 'open up the communication' for more psychological and social themes. GPs seem to have the communication skills to put both familiar and non-familiar patients at ease enabling them to freely raise any issue they think necessary. [ABSTRACT FROM AUTHOR]