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Year 3 > Adolescent Health > Flashcards

Adolescent Health Flashcards

1
Q

how are adolescents different?

A

social development
emotional development and mental health
brain changes

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2
Q

what is adolescence

A

specific, unique developmental stage

occurs between 11-25 yrs - not just puberty

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3
Q

what is adolescence

A

period of rapid and significant developments and challenges: social, emotional, physical

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4
Q

how are adolescents different: social development

A
  • Establishing independence
  • Shift in focus from parents to peers; increasing responsibility
  • Less acceptance of authority figures/ advice
  • Developing self-identity
  • Desire for social acceptance
  • Identity exploration/ role confusion
  • Eventually integrate different possibilities into single self concept
  • Starting to develop and explore a sexual identity
  • Characterised by various transitions and changes in social circumstances
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5
Q

how are adolescents different: emotional development

A

• Growing ability to regulate emotions
• Early adolescence: seemingly spontaneous outbursts
• Greater reliance on amygdala
• Emotional outbursts can be triggered by barriers to
development
• Increase in connections between amygdala and other brain areas during adolescence
• Experience new and more complex emotions
• Ability to control emotional reactions and behaviour

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6
Q

how are adolescents different: mental health

A

• 10-20% of adolescents experience mental health
disorders
• Greater proportion- sub-threshold
• Most develop late childhood- early adolescence
• 1/2 of all MH disorders develop by 14 years
• 3/4 by 20􀀁s
• Is prevalence on the rise?
• Universities UK (Gunnell, 2018; BMJ) - five fold increase
in students disclosing MH problems
• UK analysis (Morgan, 2017; BMJ)- 68% increase in
hospital self-harm presentations in 13-16 year old girls

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7
Q

how are adolescents different: brain development

A
  • Brain development during adolescence helps to explain many of the behaviours common during this period (including health-related behaviours)
  • Brain continues to develop into 20’s
  • Area of most radical change is prefrontal cortex
  • Responsible for high level cognitive function
  • Characteristic of adult behaviours/ abilities
  • Understanding brain development and associated strengths/ limitations can enhance the care we provide to young people
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8
Q

developing the prefrontal cortex early adolescence vs adulthood

A 
Here and now focus
Bullet-proof mindset
Risk taking
Winging it
Impulsivity
Difficulty controlling
emotions
Planning
Organising
Decision making
Reasoning
Emotion regulation
Abstract thinking
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9
Q

what impact does adolescence have on health?

A

increased mortality
highest graft failure rates
deterioration in HbA1c in diabetes
consistent across medical conditions

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10
Q

why is chronic disease control worse in adolescents?

A
  • Different priorities
  • Different thought processes/ability to process long term outcomes
  • Both chronic disease and adolescence are emotional journeys with a need to restructure identity
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11
Q

differing priorities in chronic disease: IBD

A
  • Medical goal of Paediatric IBD therapy is mucosal healing
  • Correlates well with reduced relapse, better effect of maintenance therapy
  • Quality of life scores correlate well with absence of symptoms but not necessarily mucosal healing
  • Increased medication burden?
  • Broader impact of chronic disease on Quality of Life than symptoms?
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12
Q

setting up the consultation with adolescents

A
  • Offer to see adolescent patients on their own
  • Easier if standard practice
  • Easier if follow up appointment
  • Consider chaparones
  • Follow by bringing parents/carers into consultation
  • Introductions
  • First name or Dr Chalmers?
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13
Q

adapting communication styles for adolescents

A
  • Aim for a conversation, rather than interrogation
  • Open questions usually less successful
  • Are all adolescents “fine”?
  • Offer choices of answers
  • Avoid medical jargon
  • Explore their priorities/concerns
  • Validate concerns
  • Tailor management to acknowledge their priorities
  • Discuss adherence to treatment
  • Accept that this will never be 100%
  • “How often do you forget to take your medicine?” rather than “Do you ever forget to take your medication?”
  • Likely to differ between treatments even in the same individual
  • Explore their understanding of their disease and treatments
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14
Q

what does HEADSS stand for?

A 
Home
• Education (or Employment)
• Activities
• Drugs/Alcohol
• Sexuality
• Suicide/Self Harm
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15
Q

asking about the right things: home

A
  • Where do you live? Who lives with you?
  • How do you get on with the people you live with?
  • Who would you talk to if you had a problem?
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16
Q

asking about the right things: education/emplyment

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?
17
Q

asking about the right things: 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?
18
Q

asking about the right things: drugs/alcohol

A
  • Do any of your friends smoke cigarettes or drink alcohol? How about you?
  • Have you ever tried cannabis?
  • How much do you smoke/drink?
19
Q

asking about the right things: sexuality

A
  • Do any of your friends have boyfriends or girlfriends? How about you?
  • Have you ever had sex? Do you use condoms/the pill?
20
Q

asking about the right things: suicide/self-harm

A
  • How would you describe your mood? Do you ever get really down?
  • Some people who feel really down often feel like hurting themselves or even killing themselves. Have you ever felt like that?
21
Q

transitioning from paediatric to adult services. how do they differ

A 
• Move from paediatric to adult services around age 16 years
Paediatric Services
• Parental responsibility
• Greater skills in
developmental assessment
• Lower patient volume
• Cartoons on the walls?
 Adult Services
• Individual responsibility
• Greater skills in
alcohol/drug/sexual history
• Higher patient volume
• Blood on the walls?
22
Q

how to improve the transition from child to adult services

A
  • Treat transition as a process rather than an event
  • Begin process early
  • 11-12 years
  • Ensure good understanding of condition and medications
  • Initial joint appointments with adult and paediatric teams
  • Use checklists/toolkits to improve

Year 3 (164 decks)

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