Abstract
BackgroundChildren and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians. As such discordance between young patients and clinicians may obstruct treatment adherence and compromise treatment outcomes, it is important to understand the factors associated with it. We therefore investigated the factors associated with patient–clinician discordance with regard to care needs in various areas of functioning.MethodsA cross-sectional study involving 244 children/adolescents aged 6–18 participating with their clinicians in treatment at a specialized mental healthcare center. As a previous study conducted by our research group had found the greatest patient–clinician discordance in three CANSAS care needs—“mental health problems,” “information regarding diagnosis and/or treatment,” and “making and/or keeping friends”—we used univariable and multivariable statistics to investigate the factors associated with discordance regarding these three care needs.Resultspatient–clinician discordance on the three CANSAS items was associated with child, parent, and family/social-context factors. Three variables were significant in each of the three final multivariable models: dangerous behavior towards self (child level); severity of psychiatric problems of the parent (parent level); and growing up in a single-parent household (family/social-context level).ConclusionsTo deliver treatment most effectively and to prevent drop-out, it is important during diagnostic assessment and treatment planning to address the patient’s care needs at all three levels: child, parent and family/social context.
Highlights
Children and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians
We conducted a set of univariable binary logistic regression analyses by using (i) concordance/discordance between young patients and their clinicians for each of the three outcomes variables (“mental health problems,” “information regarding diagnosis and/or treatment,” and “making and/or keeping friends”); and (ii) candidate predictors at all three levels of the Bronfenbrenner model
Our a priori hypothesis was that discordance between clinicians and children/adolescents would be predicted by predictors at child level, parent level, and family/social-context level
Summary
Children and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians. Care needs can be defined as physical, psychological, social or environmental calls for aid, care or service in solving a problem [9] These needs can either be ‘met’, which implies that a patient is receiving appropriate care, or ‘unmet’, which means that they are not being addressed adequately [10]. (CANSAS) to examine the extent to which children and adolescents agreed or disagreed with their clinicians on a broad range of care needs, such as physical needs (e.g. do you have a physical disability or physical illness for which you have a need for care/help?), psychological needs (e.g. do you have any mental health problems for which you have a need for care/help?), social needs (e.g. do you have problems with making and/or keeping friends for which you have a need for care/help?), and environmental needs (e.g. do you have problems with getting access to or/and using modern communication tools for which you have a need for care/help?) [13]. The highest discordance was found on the CANSAS items “mental health problems,” “information regarding diagnosis and/or treatment,” and “making and/or keeping friends”
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
