Adolescent Health

Question 1

What are the key aspects of adolescent brain development?

Answer 1

Brain is typically being remodelled

• unused connections (grey matter) are being pruned away as others are being strengthened
• begins at the back of the brain, prefrontal cortex (eg decision making: plan, think about consequences, solve problems, control impulses) is remodelled last
• this means they may rely on amygdala (emotional, impulsive, instinctive) for decision making

Question 2

What unique social, psychological and behavioural challenges present during adolescence?

Answer 2

Mental health disorders usually present in adolescence

Socially adolescence is a period of establishing independence, self identity, sexual identity, peer relationships

Behaviourally, mortality increases in adolescence eg by non intentional injuries (accidents) and also by suicide

Question 3

How may young people present within healthcare settings?

Answer 3

Mental health conditions

Chronic disease

Question 4

How does adolescence impact chronic conditions such as diabetes?

Answer 4

Chronic disease tends to worse in adolescence, due to: 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

Question 5

What systemic and communication adaptations are considered in order to enable the delivery of high quality, effective, person centred care?

Answer 5

Offer to see them on their own
Introductions
Agenda setting
Aim for conversation rather than interrogation
Judge when to use open/closed questions
Avoid jargon
Explore their priorities and concerns 
Discuss adherence
Explore their understanding
Assess motivation
Social history - HEADSS (home, education/employment, activities, drugs/alcohol, sexuality, suicide/self harm) 

When transitioning to adult care, treat as an event, begin process early, ensure good understanding on condition, initially have joint appointments, use checklists