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Y3 paediatrics > adolescent health > Flashcards

adolescent health Flashcards

• Understand key aspects of adolescent brain development • Appreciate the unique social, psychological and behavioural challenges present during adolescence • Discuss how young people may present within healthcare settings, including health outcomes • Be familiar with the impact of adolescence on chronic conditions such as diabetes • Consider important systemic and communication adaptations to enable the delivery of high quality, effective and person-centred care

1
Q

how common are adolescents in GP and inpatient care

A

~70% of adolescents visit their GP in any one year

account for ~12% of inpatient activity

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2
Q

mortality in adolescence

A

increased mortality in adolescents compared to other groups 20-40/100 000

higher than in earlier childhood 10-15/100 000

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3
Q

causes of mortality in adolescents

A

non intentional injuries and poisoning
cancer
RTA

congenital 
infection
cancer
nervous system and development
endocrine, nutritional and metabolic
circulatory 
respiratory 
other
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4
Q

chronic disease in adolescence - graft failure

A

highest graft failure rates
~35% lose kidney
1.8x the rate of people <17 and >24 y/o

substantial costs to individuals and NHS

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5
Q

chronic disease in adolescence - DM

A

deterioration in HbA1c in DM

associated w/ lasting complications e.g. CV disease, neuropathy, retinopathy

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6
Q

patterns of chronic disease in adolescence

A

poorer outcomes are consistent across medical conditions

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7
Q

what is adolescence

A

specific, unique developmental stage - biological, psychological and social changes

11-25yrs (not teenagers, not just puberty)

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8
Q

brain changes in adolescence

A

undergoes significant development during period of adolescence

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9
Q

how are adolescent brains different

A

brain matures

pre-frontal cortex matures later on towards the end of adolescence

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10
Q

features of prefrontal cortex in early adolescence

A

here and now focus

winging it

bullet-proof mindset

risk taking and impulsivity

egocentricity

difficulty controlling emotions

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11
Q

features of prefrontal cortex in adulthood

A

abstract thinking

planning and organising

decision making

reasoning

cognitive flexibility

emotion regulation

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12
Q

social development in adolescents

A

developing self-identity - increased self-consciousness

growing independence from parents and increased focus on peer relationships

questioning of different views and developing - can lead to increased family conflict

development of romantic relationships/sexual orientation

seeking new experiences and increased risk taking behaviours

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13
Q

prevalence of mental health disorders in adolescence

A

critical period for mental health and wellbeing

1/7 11-16y/o have a diagnosable mental health disorder

over 50% of mental health problems are established by age 14 and 75% by age 24

prevalence may be rising

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14
Q

differences in healthcare provisions for adolescents

A

may have different priorities to us/parents

skills necessary to manage LT conditions still developing

growing independence from parents

navigating multiple changes often with competing demands

developing identity - sensitive to criticism

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15
Q

setting up consultations for adolescents

A

offer to see adolescent pts on their own

  • easier if standard practice
  • easier if follow up appointment
  • consider chaperones
  • follow up by bringing parents/carers into consultation

introductions

agenda setting - what does the young person want to discuss

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16
Q

adapting communications for adolescents

A

conversation rather than interrogation

avoid jargon

open and closed questions
- offer choice of answers if necessary

explore their priorities and concerns
- validate concerns and tailor management to acknowledge their priorities

discuss adherence to treatment

  • accept this will never be 100%
  • non-judgemental e.g. how often do you forget to take your medication
  • likely to differ between treatments even in the same individual

explore their understanding of their disease and treatments

assess motivation

17
Q

what is the HEADSS model

A

makes sure we ask about the right things in adolescent SHx

allows us to identify challenges pressures and any supportive factors in place

home
education/employment
activities
drugs/alcohol
sexuality
suicide/self harm 
(sleep)
18
Q

HEADSS - home

A

where do you live
who do you live with
how do you get on with the people you live with
who would you talk to if you had a problem

19
Q

HEADSS - education/employment

A

which school do you go to
what year are you in
which subjects do you enjoy, what are you good at
who do you spend time with at school

20
Q

HEADSS - activities

A

what do you enjoy doing outside of school
are you in any clubs or teams
who do you meet up with at weekends

21
Q

HEADSS - drugs and alcohol

A

do any of your friends smoke cigarettes or drink alcohol
how about you
how much do you smoke/drink
have you ever tried cannabis

22
Q

HEADSS - sexuality

A

do any of your friends have boyfriends/girlfriends
how about you
have you ever had sex
do you use condoms/the pill

23
Q

HEADSS - suicide/self harm

A

how would you describe your mood
do you ever get really down
some people who fell really down often feel like hurting themselves or even killing themselves, have you ever felt like that

24
Q

HEADSS - sleep

A 
do you have difficulty falling asleep
tiredness during the day/difficulty waking up
what time do you go to bed
what time do you fall asleep
electronic screens before bed
napping during the day
25
Q

when do people tend to move from paediatric to adult patients

A

~16y/o

26
Q

differences between paediatric and adult services

A

paeds:
- parental responsibility
- greater skills in developmental assessment
- lower patient volume
- not always greatly suited for adolescents

adults:
- individual responsibility
- greater skills in alcohol/drug/sexual hx
- higher pt volume
- not always greatly suited for adolescents

27
Q

improving transition between peads and adult services

A

treat transition as a process rather than an event

begin process early (11-12y)

ensure good understanding of condition and medications

initial joint appointments w/ adult and paeds teams

use checklists/toolkits to improve e.g. ready, steady, go

Y3 paediatrics (45 decks)

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