Discrepancies between adolescents’ attributed relevance and experiences regarding communication are associated with poorer client participation and learning processes in psychosocial care

Jager, Margot; Reijneveld, Sijmen A.; Metselaar, Janneke; Knorth, Erik J.; Winter, Andrea F. de

doi:10.1016/j.pec.2014.08.020

Cited by 10 publications

(19 citation statements)

References 23 publications

(22 reference statements)

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“…Although we previously found an association between this type of discrepancy regarding affective quality of the communication and less improvement in self-confidence [18], in the present study that association had no statistical significance. The reason is that in the present study ‘improvement in self-confidence’ was taken into account as a continuous variable, whereas in the previous study we were interested in a specific group, and therefore, dichotomized the variables.…”

Section: Discussioncontrasting

confidence: 96%

“…We are not aware of literature describing potential mediators in these associations. We previously found an association between unmet needs for information provision and less improvement of understanding [18], but in our study this was no mediator for the association between unmet needs and less reduction of psychosocial problems. This indicates an independent effect of unmet needs for information provision on improvement of understanding and reduction of psychosocial problems.…”

Section: Discussioncontrasting

confidence: 84%

“…This was unexpected because affective quality of the communication is considered by adolescents in psychosocial care to be the most important communication domain [33], and these needs are often not met [18]. A reason for our finding may be that affective quality has its highest impact on outcomes in the first stage of the care process.…”

Section: Discussionmentioning

confidence: 89%

“…Patient-centered communication includes the active involvement of patients in the care process and regard for their individual needs and preferences [16, 17]. In a previous study we found that adolescents’ experiences in psychosocial care did not always match their needs with regard to three pivotal domains of communication: affective quality of the communication, information provision, and shared decision-making [18]. Furthermore, unmet communication needs were, over a period of 3 months, associated with poorer treatment adherence, less improvement of understanding, and less improvement in self-confidence, although patterns varied across the afore-mentioned domains [18].…”

Section: Introductionmentioning

confidence: 99%

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Less reduction of psychosocial problems among adolescents with unmet communication needs

Jager

Reijneveld

Almansa

et al. 2016

Eur Child Adolesc Psychiatry

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Patient-professional communication has been suggested to be a major determinant of treatment outcomes in psychosocial care for children and adolescents. However, the mechanisms involved are largely unknown and no longitudinal studies have been performed. Our aim was, therefore, to assess over the course of 1 year, the impact of patient-centered communication on psychosocial problems of adolescents in psychosocial care, including the routes mediating this impact. We obtained data on 315 adolescents, aged 12–18 years, enrolled in child and adolescent social or mental health care. We assessed patient-centered communication by comparing the needs and experiences of adolescents with regard to three aspects of communication: affective quality, information provision, and shared decision-making. Changes in psychosocial problems comprised those reported by adolescents and their parents between baseline and 1 year thereafter. Potential mediators were treatment adherence, improvement of understanding, and improvement in self-confidence. We found a relationship between unmet needs for affective quality, information provision, and shared decision-making and less reduction of psychosocial problems. The association between the unmet need to share in decision-making and less reduction of psychosocial problems were partially mediated by less improvement in self-confidence (30 %). We found no mediators regarding affective quality and information provision. Our findings confirm that patient-centered communication is a major determinant of treatment outcomes in psychosocial care for adolescents. Professionals should be aware that tailoring their communication to individual patients’ needs is vital to the effectiveness of psychosocial care.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-016-0901-y) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Less reduction of psychosocial problems among adolescents with unmet communication needs

Jager

Reijneveld

Almansa

et al. 2016

Eur Child Adolesc Psychiatry

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“…Treatment processes, i.e., treatment adherence and learning processes, were measured at 3 months, 1 year, and 2 years after intake. The assessment of these treatment processes was based on the previous studies using the Take Care data [9,23]. Treatment adherence was measured by the agreement of the professional with the statement 'the adolescent demonstrated adherence in between therapy sessions', on a scale of 0-10 with higher values indicating stronger adherence.…”

Section: Methodsmentioning

confidence: 99%

The role of functional health literacy in long-term treatment outcomes in psychosocial care for adolescents

Beukema

Reijneveld

Jager

et al. 2020

Eur Child Adolesc Psychiatry

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Although among adolescents with psychosocial problems low health literacy may increase the risk of poor treatment outcomes, the contributing mechanisms within treatment remain unclear. A better understanding of these mechanisms could contribute to improved treatment processes and outcomes. This study aims to examine the relationship between functional health literacy, treatment processes (treatment adherence, learning processes), and treatment outcome (level of psychosocial problems) in adolescents in psychosocial care. We used data from a prospective cohort study among adolescents aged 12-18 (N = 390), collected in four successive measurements: at entry into care, and 3, 12, and 24 months thereafter. We used a mixed effect model to investigate the association between level of functional health literacy (adequate vs. inadequate) and treatment processes (treatment adherence, learning processes) and treatment outcome (level of psychosocial problems). Between adolescents with adequate and inadequate functional health literacy, we found no differences or change over time in adherence or learning processes. The level of psychosocial problems significantly declined over time (β = − 1.70, 95% CI [− 2.72, − 0.69], p = .001) to a similar degree in both groups, though, in all measurements, the level was consistently higher for adolescents with inadequate health literacy. We conclude that health literacy levels did not affect change in treatment processes nor in outcomes of psychosocial treatment. However, the consistently higher level of psychosocial problems among adolescents with inadequate health literacy suggests an unaddressed need in psychosocial care.

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Communication Education for Trainees to Enhance Adherence in their Patients

Barone,

McGeechan,

Samuels

2024

Pediatric Nonadherence

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Discrepancies between adolescents’ attributed relevance and experiences regarding communication are associated with poorer client participation and learning processes in psychosocial care

Cited by 10 publications

References 23 publications

Less reduction of psychosocial problems among adolescents with unmet communication needs

Less reduction of psychosocial problems among adolescents with unmet communication needs

The role of functional health literacy in long-term treatment outcomes in psychosocial care for adolescents

Communication Education for Trainees to Enhance Adherence in their Patients

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