12. Paediatric Adolescent Health Flashcards
What is Adolescence?
Transition from Dependence on Parents to an Independent, Self-Reliant Adult
What Changes is Adolescence Characterised by?
- Physical Changes
- Emotional Changes
- Behavioural Changes
What happens to the Brain during Adolescence?
Significant Brain Changes in the Prefrontal Cortex
Note - Demonstrated by Functional MRI
What happens to the Prefrontal Cortex in Adolescence?
Use it or Lose it, Rapid Growth of Grey Matter followed by Pruning of Synapses and Connections:
- Brain becomes more efficient and so loses Synapses
- Grey Matter Becomes White Matter
- Areas involved in Basic Functions mature (into White Matter) First
What are Actions more likely to be Guided by in Earlier Stages of Adolescence?
Amyglada - Emotional / Impulsive Part of the Brain
What are the Functions of the Pre-Frontal Cortex?
- Decision Making
- Planning / Organising
- Reasoning
- Controlling Emotion / Behaviour
- Abstract Thinking
What Social Development Changes occur in Adolescence?
- Developing Self-Identity
- Seeking Independence and Responsibility
- Greater Focus on Peer Groups
- Start to Develop / Explore Sexual Identity
- Increased Engagement in Risk-Taking Behaviours
What Emotional Well-Bring Changes occur in Adolescence?
- Period of New / Intense Emotions
- May have Difficulty Regulating Emotions
- Mental Health Problems are common:
- a) Anxiety / Depression
- b) Conduct Disorder
Why does Adolescence impact on Healthcare?
- Struggle to Self-Manage Treatment Tasks
- Illness-Related Conflict
- Embarrassment / Self-Consciousness
- Risk Taking / Testing Boundaries
- Question Validity of Advice / Diagnosis / Treatment
- Deterioration in Health Related Markers
How is Diabetes affected in Adolescence?
Resentment of Treatment / Complex Management leads to Increased HbA1C
Note - Psychological Difficulties are common (Anxiety / Depression)
How is Kidney Disease affected in Adolescence?
Highest Graft Failure Rates due to Challenges with Self-Management
- How might Adolescents appear in Hospital?
2. What might this Reflect?
- a) Disinterested / Disengaged
- b) To Disregard Advice
- c) “Dishonest”
- d) Oppositional / Non-Compliant
- a) Anxiety / Low Mood
- b) Bullet-Proof Mindset
- c) Avoidance of Difficult Thoughts / Feelings
- d) Efforts to Establish Independence
What is the Best Approach to an Adolescent?
- Language Familial to the Young Person
- Respect Young Persons Growing Independence
- Think Creatively about how we Engage - e.g. Letters Written to Adolescent and Copied to Parents