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Telenursing: clinical nurse consultancy for rural paediatric nurses.

Videoconferencing is increasingly being accepted as a medium for health-care. Telenursing is in its infancy in Australia but has enormous potential for nursing care in remote areas. The Child and Adolescent Psychological Telemedicine Outreach Service (CAPTOS) began in 1997 and in its first evaluation recommended more support for paediatric nurses. CAPTOS telenursing began as a new initiative in late 2001. The telenursing project aims to link ward nurses to CAPTOS and local community teams, and to provide both clinical consultancy on nursing and interdisciplinary issues and locally based professional development. Telenursing supports nurses via site visits, videoconferencing sessions, an interactive Website and sabbatical opportunities. Telehealth works with existing services to enhance the nursing care of young people with a complex mixture of psychological and physical health problems.

Journal Article↗

Reflections on beauty as it relates to health in adolescent females.

Because an attractive appearance is so essential to the feminine gender role, the search for beauty causes special adjustment problems for adolescent girls. Psychologically they suffer from negative body image, lowered self-esteem, and achievement conflicts. Physically their health is undermined by current beauty norms which foster eating disorders, cosmetic acne, and breast surgery. The effects of physical fitness programs, the role of the media, and the influence of changing gender roles are also discussed.

Acne Vulgaris↗

Family connectedness and sexual risk-taking among urban youth attending alternative high schools.

CONTEXT: Youth in alternative high schools engage in risky sexual behavior at higher rates than do their peers in regular schools, placing themselves at an increased risk of sexually transmitted disease and unintended pregnancy. Family connectedness is associated with reduced adolescent sexual risk-taking, although this association has not been tested among alternative school youth. METHODS: A sample of 976 urban, predominantly minority alternative high school students in Houston, Texas, were surveyed in 2000-2002. Survey data were analyzed using logistic regression to determine whether family connectedness is related to sexual risk-taking. RESULTS: Overall, 68% of students reported ever having had sex. Of sexually experienced students, 74% reported having had sex in the past three months and 29% reported ever having been involved in a pregnancy. The higher students scored on a scale of perceived family connectedness, the less likely they were to report ever having had sex, recently having had unprotected sex and having been involved in a pregnancy (odds ratio, 0.97 per unit increase for each outcome). Among females, higher perceived family connectedness was associated with reduced odds of ever having had sex or having initiated sex prior to age 13 (0.96 for each); males who perceived higher family connectedness had reduced odds of having been involved in a pregnancy (0.93). CONCLUSIONS: Family connectedness may be a protective factor related to sexual risk-taking, even among high-risk youth. Including activities that acknowledge the influence of family relationships and facilitate positive parent-child relationships may increase the efficacy of programs for reducing sexual risk-taking among alternative school youth.

Adolescent↗

Factors associated with the content of sex education in U.S. public secondary schools.

CONTEXT: While sex education is almost universal in U.S. schools, its content varies considerably. Topics such as abstinence, and basic information on HIV and other sexually transmitted diseases (STDs), are commonly taught; birth control and how to access STD and contraceptive services are taught less often. Factors potentially associated with these variations need to be examined. METHODS: Data on 1,657 respondents to a 1999 national survey of teachers providing sex education in grades 7-12 were assessed for variation in topics covered. Logistic regression was used to ascertain factors associated with instruction on selected topics. RESULTS: The content of sex education varied by region and by instructors' approach to teaching about abstinence and contraception. For example, teaching abstinence as the only means of pregnancy and STD prevention was more common in the South than in the Northeast (30% vs. 17%). Emphasizing the ineffectiveness of contraceptives was less common in the Northeast (17%) than in other regions (27-32%). Instructors teaching that methods are ineffective and presenting abstinence as teenagers' only option had significantly reduced odds of teaching various skills and topics (odds ratios, 0.1-0.5). CONCLUSIONS: Instructors' approach to teaching about methods is a very powerful indicator of the content of sex education. Given the well-documented relationship between what teenagers learn about safer sexual behavior and their use of methods when they initiate sexual activity, sex education in all U.S. high schools should include accurate information about condoms and other contraceptives.

Adolescent↗

Sexually active students' willingness to use school-based health centers for reproductive health care services in North Carolina.

OBJECTIVE: School-based health centers (SBHCs) in North Carolina offer limited reproductive health care services. We investigate sexually active students' willingness to seek these services at SBHCs if available and predictors of willingness to seek services. METHODS: Cross-sectional survey of 949 sexually experienced students in 2 middle and 5 high schools in North Carolina in 1994. Bivariate and multivariate analyses tested the influence of sociodemographic characteristics, risk of pregnancy/sexually transmitted infections (STIs), and past health care utilization on willingness to use SBHCs for sexuality-related services. RESULTS: Participants were 52% female, 52% black, and median age at first coitus was 13.0 years. Many (49%) had sex at least once a month. Most (52%) reported inconsistent contraception use. One-fifth (18%) of females had been pregnant; 10% of males reported getting a partner pregnant. Seventy-five percent had used SBHCs. Most reported they would use SBHCs for information to protect against pregnancy and STIs (58%), pregnancy testing (51%), and birth control (48%) if available. Females were more likely than males to report they would use these services (adjusted odds ratio = 3.4, 95% confidence interval = 1.9-6.7), especially those receiving free lunch (adjusted odds ratio = 2.9, 95% confidence interval = 1.2-6.8]) and those with inconsistent use of contraception. We found no association between past health care and willingness to use SBHC services. CONCLUSIONS: Most sexually experienced students report they would use their SBHC for reproductive/STI services if they were available. Absence of these services in SBHCs represents a missed opportunity to provide health care to adolescents who are at substantial risk of pregnancy and STIs.

Adolescent↗

Socio-cultural factors influencing adolescent pregnancy in rural Nepal.

Early child bearing is a widely observed phenomenon in Nepal. However, little information is available in regard to its contributing factors. This retrospective exploratory study was carried out to determine factors contributing to adolescent pregnancy in rural Nepal. Cluster sampling technique was used to select the study settings. The findings on variable contributing to pregnancy from the sample of 575 mothers, who had their first pregnancy at an age below 19 years, were compared with the findings from an equal number of mothers who had their first pregnancy at the age of 20 years or above. The adolescent mothers were married at a comparatively younger age with a mean age of 15.9 years. Parents or elders, with/without the girl's consent, decided the majority of adolescent marriages. The age at marriage exposed women to early pregnancy regardless of who decided the marriage. Comparatively, most adolescent mothers were from a low social class, engaged in agricultural work, and they had low literacy rate. Majorities of the mothers from both groups had no prior knowledge about conception until they conceived. Peers were the main source of information regarding conception. Although the majority of the respondents knew at least one method of contraception, less than 1% had used it before their first pregnancy. To conclude, early pregnancy had put the adolescent mothers at the risk of unwanted pregnancy and obstetric complications. Women empowerment through compulsory girls' education would be the most effective strategy to prepare them for late marriage, planned and delayed pregnancy, and better motherhood.

Adolescent↗

Sexual Health Advice Centre.

This paper describes how some members of the Genito-Urinary Medicine Department of Addenbrookes Hospital, Cambridge surveyed local teenagers to ascertain whether they would be interested in attending a walk-in young persons sexual health clinic or accessing a sexual health website. Britain has the highest teenage birth rate in Western Europe and an increasing number of sexually transmitted infections in youngsters. A questionnaire was sent to all schools in the Cambridge area with nineteen responses. The results of the questionnaire showed that the majority of girls who answered expressed an interest in seeking advice at a teenage clinic, while the boys preferred to obtain information over the telephone or via a website. It is important for health professionals to be sensitive to the views of patients and potential patients, when it comes to providing new clinical services.

Adolescent↗

The experience of young people with contraceptive consultations and health care workers.

In the United Kingdom, services for contraceptive consultation and family planning were first opened in the 1960s. Early and relevant information to adolescents is of importance. The aim of this paper was to examine young people's attitudes towards and experiences of consultations with health care providers about contraception, taking account of the context of their contraceptive use. Young people aged 16-21 years were recruited to the study from health services (young people's contraceptive and sexual health clinics and a termination of pregnancy clinic), secondary schools and community projects (a youth club, a young mothers' support group, a community education project and a young women offenders unit). As part of the needs' assessment, in-depth interviews and focus groups were conducted. Thirty-two young male and females were interviewed. Knowledge about contraception, sexually transmitted infections and the risk of pregnancy was often high. Many respondents noted that in a five to ten minute consultation there was not the time to discuss personal factors that may affect contraceptive decision making and effective use of methods. Many described a feeling of being rushed through the service and did not feel they had the opportunity to ask questions. What young people said they wanted from consultations with health care workers and their experiences of the consultation process often conflicted. They wanted the time and opportunity to discuss their options. Often the young men, who were accessing services, described how initially they had gone in to collect condoms, but once they knew the clinic and staff would consider making an appointment. It is concluded that young people want to be given choices and information regarding contraception that fit their lifestyles. Improving the structures of contraceptive and sexual health services for young people will help to remove some of the barriers that prevent some young people from accessing them. However, it is just as important that barriers in the service delivery are tackled to ensure young people receive effective contraceptive advice.

Adolescent↗

Adolescent pregnancy in Israel.

Teenage or adolescent pregnancy requires the extensive involvement of health care workers in respect to the medical and social aspects of pregnancy, delivery, and later care of both mother and child. Trends in adolescent pregnancy over the last few years from the United States, Canada, and the United Kingdom are presented and related to data from Israel. Adolescent pregnancy in Israel has been on the decline, but in 1999 it was still 3.4% of all live births (131,936 children) with more pregnancies in this group among the non-Jewish population (7.2%) than in the Jewish population (1.7%).

Adolescent↗

Helping children and families deal with divorce and separation.

More than 1 million children each year experience their parents' divorce. For these children and their parents, this process can be emotionally traumatic from the beginning of parental disagreement and rancor, through the divorce, and often for many years thereafter. Pediatricians are encouraged to be aware of behavioral changes in their patients that might be signals of family dysfunction so they can help parents and children understand and deal more positively with the issue. Age-appropriate explanation and counseling is important so children realize that they are not the cause of, and cannot be the cure for, the divorce. Pediatricians can offer families guidance in dealing with their children through the troubled time as well as appropriate lists of reading material and, if indicated, can refer them to professionals with expertise in the emotional, social, and legal aspects of divorce and its aftermath.

Adaptation, Psychological↗

Psychosocial correlates of adolescent males' pregnancy intention.

OBJECTIVE: To identify psychosocial differences between sexually experienced male adolescents who indicate intentions to get someone pregnant and those who do not. METHODOLOGY: Cross-sectional study of 101 sexually experienced adolescent males recruited from a sexually transmitted disease clinic in northern California. We used Student's t tests and regressions to examine psychosocial differences between males who reported any intention versus no intention to get someone pregnant in the next 6 months, and we used analyses of variance to examine differences among different combinations of pregnancy plans/likelihood. RESULTS: Adolescents' reports of their plans for getting someone pregnant differed from their assessments of the likelihood that they would do so (chi2 = 24.33; df = 1). Attitudes toward pregnancy and participants' mothers' educational attainment differentiated those with clear pregnancy intentions (planning and likely) from those with clear intentions to avoid pregnancy (not planning and not likely) CONCLUSIONS: To reduce the rates of adolescent childbearing, males' pregnancy intentions must be assessed and asked about in multiple ways.

Adolescent↗

[Adolescence and contraception: 1. A study knowledge and use among women hospitalized for childbirth or abortion].

A study of the knowledge and utilization of contraceptive methods by adolescent is presented. An analysis was carried out based on data collected from interviews with and recorded case histories of 78 puerperal adolescents (childbirth or abortion), assisted by an obstetric service in the county of Cotia, SP, Brazil, between May 1 and July 31, 1986. Of all the adolescents studied, 61.5% had some knowledge of contraceptive methods; the findings showed that such knowledge was influenced by factors such as: age, school background, parity and marital status. The main sources of information on contraception were: friends, relatives and partners, in this order; those least sought for in this regard were health professionals. Only one in each ten adolescents made use of some contraceptive measure, the most prevalent methods being the contraceptive pill, the Ogino-Knauss method, condoms and coitus interruptus. In all of the cases of the utilization of these methods the same had been "recommended" by persons belonging to the adolescents' social group, and had been acquired in shops, without any health control.

Adolescent↗

[Experiencing motherhood in early adolescence].

OBJECTIVE: Although still scarcely studied in Brazil, motherhood in early adolescence among girls aged 10 to 14 years is mostly unwanted and it is an important public health issue. Most investigations are based on biomedical paradigms and few take into consideration the adolescent's point of view. This study aimed to explore the different patterns of experiencing early motherhood from the adolescent's own point of view. METHODS: William Stephenson's Q methodology was applied. The study population was selected from 2 public mother and child health units in Rio de Janeiro, Brazil, and comprised 20 adolescents who became pregnant at the age of 10 to 14 years and were followed up for a period of 6 to 24 months after giving birth. Q-sorts underwent factor analysis and then the factors were interpreted. RESULTS: Four qualitatively and statistically (p<0.01) perception patterns were found. Two factors were well defined: Factor I - Satisfied with motherhood/ Dependent on the child's affection: motherhood is a positive and rich experience; and Factor II - Depressed/ Stressed out: motherhood is a negative and stressful experience. Other two potential factors need confirmation in further studies with a larger sample size. CONCLUSIONS: It was observed that motherhood's experience is distinct and heterogeneous. For some adolescents, motherhood could be a rewarding experience

Adolescent↗

Providing information for young people in sexual health clinics: getting it right.

BACKGROUND: The need to improve the quality and availability of information on sexual health is identified as a key element in achieving the aims set out in the National Strategy for Sexual Health and HIV. Providing information about sexual health to young people poses particular challenges because of the sensitive nature of the issues and because of the difficulties that young people may face in sourcing information and asking questions of professionals.

Adolescent↗