Adolescent Health Flashcards
What is adolescence?
- Specific, unique developmental stage
- Occurs between 11-25 years
- Period of rapid and significant developments & challenges including social, emotional and physical (brain)
What social development do adolescents undergo?
- Establishing independence: shift in focus from parents to peers
- Developing self-identity
- Starting to develop sexual identity
- Characterised by various transitions and changes in social circumstances
What emotional development do adolescents undergo?
- Growing ability to regulate emotions
- Emotional outbursts can be triggered by barriers to development
- Increase in connections between amygdala and other brain areas
What changes with mental health are associated with adolescence?
- 10-20% will experience mental health disorders
- Most develop late childhood
What brain development do adolescents undergo?
- 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
- Understanding brain development and associated strengths/ limitations can enhance the care we provide to young people
What characteristics are associated with the prefrontal cortex of an early adolescent?
- Here and now focus
- Bullet proof mind-set
- Risk taking
- Winging it
- Impulsivity
- Difficulty controlling emotions
What impact does adolescence have on health?
- Increased mortality
- Highest graft failure rates
- Deterioration of HbA1c in diabetes
- Consistent across medical conditions
Why is chronic disease control worse in adolescents?
- 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
How should an adolescent consultation be set up?
- Offer to see adolescent patients in their own
- Introductions (may wish to use first name)
- Identify their agenda
How should you adapt the communication style for an adolescent consultation?
- Aim for a conversation, rather than an interrogation
- Open questions are usually less successful
- Avoid medical jargon
- Explore their priorities and concerns
- Discuss adherence to treatment
- Explore their understanding of their disease and treatments
What structure can be used to take an adolescent social history?
HEADSS
- Home
- Education/employment
- Activities
- Drugs/alcohol
- Sexuality
- Suicide/self-harm
What should you ask about regarding home?
- 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?
What should you ask about regarding education (employment)?
- 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?
What should you ask about regarding activities?
- What do you enjoy doing outside of school?
- Are you in any clubs or teams?
- Who do you meet up with at weekends?
What should you ask about regarding drugs?
- Do any of your friends smoke cigarettes or drink alcohol?
- How about you?
- Have you ever tried cannabis?
- How much do you smoke/drink?
What should you ask about regarding sexuality?
- Do any of your friends have boyfriends/girlfriends?
- How about you?
- Have you ever had sex?
- Do you use condoms/the pill?
What should you ask about regarding suicide and self-harm?
- 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?
How can transition from child to adult services be improved?
- 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
how many teens visit GP in 1 year?
70%
teenss account for ~12% of inpatient activity
Is there an increased mortality in patients?
yes
what are the chronic disease problems in teens?
Highest graft failure rates
Deterioration in HbA1c in diabetes
what age usually do you differentiate between adult and paediatric services?
16
