title: Discrepancies between adolescents' attributed relevance and experiences regarding communication are associated with poorer client participation and learning processes in psychosocial care.
abstract: OBJECTIVE
  To examine adolescents' attributed relevance and experiences regarding communication, and whether discrepancies in these are associated with clients' participation and learning processes in psychosocial care.
  
  
  METHODS
  Adolescents receiving psychosocial care (n=211) completed measures of communication in three domains: affective communication, information provision, and shared decision-making. Participation involved clients' attendance and adherence (professional-reported). Learning processes involved clients' improved understanding and improved confidence (client and professional-reported).
  
  
  RESULTS
  Important but less often experienced affective communication was associated with low adherence (odds ratio, 95% confidence interval: 2.8, 1.1-6.8), less improvement in understanding (3.7, 1.5-9.0), and less improvement in confidence (4.5, 1.8-11.6). If information provision or shared decision-making was important but less often experienced, adolescents were more likely to demonstrate less improvement in understanding (3.1, 1.1-8.5; 4.2, 1.7-10.8). The combination "less important but experienced" only had an effect regarding affective communication; these adolescents were more likely to demonstrate less improvement in confidence (6.0, 2.3-15.4).
  
  
  CONCLUSIONS
  Discrepancies between attributed relevance and experiences frequently occur. These discrepancies negatively affect adolescents' participation and their learning processes, although the pattern differs across communication domains.
  
  
  CONCLUSIONS
  Care professionals should pay considerable attention to their clients' communication preferences and adapt their communication style when necessary.
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: m.jager02@umcg.nl.
authors.forename: Margot
authors.initials: M
authors.lastname: Jager
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
authors.affiliation: Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Metselaar
authors.affiliation: Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Knorth
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Andrea F
authors.initials: AF
authors.lastname: De Winter
mesh_terms: D000293:Adolescent; D002648:Child; D003142:Communication; D003156:Community Mental Health Services; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007858:Learning; D008297:Male; D009426:Netherlands; D010358:Patient Participation; D017060:Patient Satisfaction; D017064:Process Assessment, Health Care; D011369:Professional-Patient Relations
keywords: Adolescents; Mental healthcare; Participation; Professional–client communication; Treatment adherence