title: Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy.
abstract: OBJECTIVE
  To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition.
  
  
  METHODS
  Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland.
  
  
  RESULTS
  Mental health problems were perceived as being more severe (p < 0.001) and exerting a larger impact upon the family (e.g., financial impact) than physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p < 0.001). The odds of low health literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p < 0.001); this finding held generally for mental health problem (although only a trend was observable for internalizing problems).
  
  
  CONCLUSIONS
  The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia, michelle.dey@unimelb.edu.au.
authors.forename: Michelle
authors.initials: M
authors.lastname: Dey
authors.forename: Jen
authors.initials: J
authors.lastname: Wang
authors.forename: Anthony Francis
authors.initials: AF
authors.lastname: Jorm
authors.forename: Meichun
authors.initials: M
authors.lastname: Mohler-Kuo
mesh_terms: D000293:Adolescent; D002648:Child; D017281:Cost of Illness; D005260:Female; D057220:Health Literacy; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010465:Perception; D012720:Severity of Illness Index; D013557:Switzerland
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