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PubMedDate not supplied

Sexual health: meeting adolescents' needs.

BACKGROUND: The UK has the highest rate of sexually transmitted infections (STIs), especially among young people, in western Europe. Knowledge of what influences young people's sexual behaviour is limited which highlights a need to understand adolescent development and recognise that they are at increased risk of acquiring an STI compared with other groups. This article examines the risks of acquiring STIs in adolescence and discusses how nurses feel about treating young people with sexual health needs. CONCLUSION: Postgraduate training needs to incorporate specific modules relating to young people within sexual health. Sexual health providers go some way to providing an adolescent-friendly service, but more creative approaches to service delivery such as flexible opening hours and contraception outreach services would make them more accessible to young people.

Adolescent↗
PubMed2003

Adolescent alcohol and other substance use: sharing the Australian experience.

Substance use is common among adolescents. Although substance use may be a manifestation of experimentation in adolescent development, it may have more serious implications. It may be an indicator of emotional disturbance, or may be associated with several other health risk behaviours in adolescence. Substance use may also progress to harmful levels that can have a significant impact on a young person's health. Health professionals are increasingly being exposed to teenagers who use alcohol and drugs. The following article aims to provide, based on clinical and research experience in a number of institutions in Melbourne, Australia, an overview of the epidemiology of adolescent drug use, a clinical approach to assess substance use in young people and the principles of management of drug use in adolescence.

Adolescent↗
PubMedDate not supplied

The role of family support programs in building developmental assets among young adolescents: a national survey of services and staff training needs.

A survey of 659 family support workers' regarding training and their provision of services for families with 10- to 15-year-olds showed that 30% to 50% rated their previous training as inadequate or poor, had inaccurate knowledge about young adolescent development, and felt they were doing an inadequate or poor job promoting developmental assets for youths. Higher quality training was significantly related to the programs' potential excellence. Implications for providing training for family support workers and promoting collaboration are discussed.

Adolescent↗
PubMed1987

Issues and advances in adolescent growth and development.

The differences between individuals in tempo of growth, leading to early or late appearance of puberty, are of great importance at adolescence. Late developers, and particularly those who are genetically small as well as late, often suffer acutely and may keep scars of their suffering for years afterward. These individuals need sympathetic support and counseling, which can only be forthcoming from someone who understands thoroughly the auxology of adolescence and is able to tell the adolescent precisely and correctly what will happen in the next six months, one year, and two years. Educating the counselors, and educating the children before they enter adolescence, is a task of importance and immediacy. The physiologic mechanism of tempo is entirely unknown at present, and the major job of research is to remove this ignorance. Close collaboration is needed with pediatric endocrinologists and endocrinologists working with nonhuman primates. A prime need here is for the building of further auxologic and endocrinologic tools and the development of testable models of growth regulation.

Adolescent↗
PubMedDate not supplied

Paternal remarriage as a modifier of proneness to depression in young adulthood.

BACKGROUND: The remarriage of a parent is a major event experienced by many children. Its role in children's depressive symptoms was examined in a follow-up study of a cohort from the age of 16 to 22 years. METHODS: The study population consisted of young people who had experienced parental divorce in childhood (N=356). Associations between a parent's remarriage and potential modifying factors in adolescence (atmosphere at home, school performance, dating behavior, life-events, the importance of siblings, and socioeconomic status) and depressive symptoms at 22 years of age were studied. RESULTS: A poor atmosphere at home at 16 years and father's remarriage (but not mother's) in childhood were associated with subsequent depression. Girls whose father had not remarried, but boys whose father had remarried, were more depressive than others. Dating behavior in adolescence modified proneness to depression in these groups. CONCLUSION: The findings indicate the importance of the father in adolescent development after divorce and that the processes involved may differ by gender.

Adolescent↗
PubMed1996

Lie as narrative truth in abused adopted adolescents.

Two case examples of abused adopted adolescents are discussed to highlight tension within the treatment relationship when the therapist is expected to accept without question a clearly unbelievable story. These examples illustrate how the lies of such youths can function as narrative truth. The unbelievable tales that emerge in the therapeutic work effectively alter the adolescents' perceptions about the perplexing loss of continuity, both internal and external, that occurred when they were removed from their homes. Characters in the stories represent fragmented self- and object-representations as victim, abuser, rescuer, and passive onlooker. Counterparts to the patient as victim, abuser, rescuer, and passive onlooker can be recognized in the therapist's subjective responses. If the therapist can use countertransference to inform an understanding of the treatment process, an appreciation emerges that the truth of the lie is in its impact. Decisions about how to intervene can then be crafted. The second separation-individuation intrinsic to adolescent development is understood to provide a ripe opportunity for this working-through process.

Adolescent↗
PubMed2000

Human immunodeficiency virus-infected adolescents: a descriptive study of older children in New York City, Los Angeles County, Massachusetts and Washington, DC.

BACKGROUND: Children infected with HIV are entering adolescence with challenging and changing medical and social needs. Through chart review we describe certain medical and social characteristics of adolescents who acquired HIV as children. METHODS: HIV-infected children 12 years of age and older in 1995 were monitored through the Pediatric Spectrum of HIV Disease study from four US sites. In addition to standard 6-month medical chart reviews, a special chart abstraction in 1997 collected available psychosocial and sexual history information. RESULTS: A total of 131 adolescents HIV-infected as children were studied: 52 infected perinatally; 44 infected through a contaminated blood transfusion; 30 through receipt of contaminated blood products for hemophilia; and 5 with unknown transmission mode. Mean age at last medical contact was 15.5 years, 67% were Hispanic or African-American, 12% were employed, 66% attended regular school, 66% knew their HIV status and 48% (8% for the perinatally infected) lived with their biologic mother. Information on sexual activity showed that 18% had sexual relations, 28% did not and for 53% sexual activity was not recorded in the medical chart. Four percent used illicit drugs, which along with sexual activity showed a positive association with age. Forty-two percent had an AIDS-defining opportunistic infection, and 56% had a recent CD4+ lymphocyte count <200 cells/microl. CONCLUSIONS: Adolescents in this study represent a heterogeneous group of surviving HIV-infected children some of whom are sexually active and potential sources of HIV transmission. Clinicians who treat HIV-infected and high risk adolescents face the challenges of providing care and prevention services appropriate to adolescent development.

Adolescent↗
PubMed2004

Issues relating to effective pain management in young people.

Adolescents deserve the same standards of pain management as children and adults. But to achieve this, health professionals need to consider additional psychological and philosophical issues in this age group. This paper examines how adolescent development impacts on pain assessment and areas such as capacity and consent, and concordance to treatment.

Adolescent↗
PubMed1978

Understanding the adolescent patient.

The chapter has presented a frame of reference with which to approach adolescent patients with skin disease. To be most effective, the physician must understand the complexities of adolescent development and the various biological, social, and psychological circumstances and reactions with which young people must cope. Suggestions are made regarding approaches to the management of the adolescent skin patient, in the wish to maximize the usefulness of the physician--patient relationship as a resource for helping young people to health and happiness.

Adaptation, Psychological↗
PubMed1982

Dysgenesis of testicular and streak gonads in the syndrome of mixed gonadal dysgenesis: perspective derived from a clinicopathologic analysis of twenty-one cases.

The clinical and pathologic aspects of 21 cases of mixed gonadal dysgenesis (MGD) were studied. The gonads in 15 patients consisted of a macroscopic testis and a streak gonad; six patients had variants, including two with bilateral testes and four with bilateral streak gonads or tumors. Functionally, the gonads were incompetent. Testes 1) failed to completely inhibit müllerian development, 2) failed to support full differentiation of mesonephric duct structures, 3) failed to adequately masculinize development of the external genitalia, or 4) often failed to mediate their own descent, resulting in asymmetry of the internal and external genitalia. None of the streak gonads mediated normal female adolescent development or fertility. Microscopic examination revealed that every gonad, regardless of its gross appearance, was morphologically abnormal. Although gonads with seminiferous tubules usually developed to a moderately advanced state, macroscopically resembling testes, the hilar zone remained architecturally disorganized; the cortex invariably lacked more than a rudimentary tunica albuginea or exhibited partial ovarian differentiation, sometimes even with a rare primordial follicle. Over time, the seminiferous tubules atrophied and hyalinized. Gonads that grossly resembled streak gonads were observed microscopically to be composed of a stroma resembling that of normal ovarian cortex. In patients more than several years of age, the entire complement of germ cells in streak gonads disappeared. It is suggested that patients with MGD be raised as females. Early removal of gonads will prevent the development of gonadoblastoma and dysgerminoma. If the uterus is retained and the patient is subsequently given exogenous estrogen, care should be taken to detect early any signs of the development of endometrial carcinoma or its precursor, to which these patients may be prone.

Adolescent↗
PubMed1983

The effect of juvenile-onset manic-depressive disorder on the developmental tasks of adolescence.

The impact on the individual of manic-depressive disorder can be devastating. This is most evident in adolescence, an epoch during which many cases first declare themselves. Adolescence is a crucial developmental phase during which confidence, initiative, and sociability are consolidated. Core symptoms of manic-depressive disorder involve all these functions, and appropriate adolescent development can be further undermined by the knowledge that these same functions can be driven out of control by the illness. An illustrative case of an articulate young lady suffering from manic-depression is described, and her feelings about the uncertainty introduced into her life by the illness are compellingly presented in a poem. The major implication of our observations is that adolescent-onset manic-depressives need not be burdened additionally by developmental arrest or delay. They frequently need psychotherapy to adjust to the handicap of their illness.

Adolescent↗
PubMed1990

Health promotion for adolescents: preventive and corrective strategies against problem behavior.

This paper, in its first part, gives an overview of research on "problem behavior" in adolescence. Adolescence is considered to be a stage in life characterized by more experimentation, exploration, risk-taking, and rebellion than any other stages. Many health-damaging behaviors (drug consumption, precocious sexual activity, riskful driving, aggressive behavior, etc.) have important psychosocial functions in adolescents' developments. Some of these behaviors can be signals of "stress", defined as a bio-psycho-social state of tension resulting from a variety of stressors which confront adolescents daily in modern industrial societies. In the second part of the paper, the implications of this research for strategies of intervention are discussed. The systematic analysis distinguishes between different stages in the process by which problem behavior emerges and separates "preventive" from "corrective" forms of intervention. Additionally, the analysis differentiates between the dimensions targeted by the measures: interventions addressed toward individual behavior ("personal resources") on the one hand, and living conditions ("social resources") on the other hand. The resulting types of intervention approaches are illustrated with examples and discussed in view of how appropriate they are for health promotion in adolescence. Implications for "social policy for adolescents" are discussed.

Adolescent↗
PubMed2006

Overprotection and lowered expectations of persons with disabilities: the unforeseen consequences.

Lowered expectations and overprotection of the individual with a disability can cause lowered self esteem which can result in a life time of underachievement and failure to reach their full potential. Both lowered expectations and overprotection are forms of discrimination. Internalization of discrimination causes the person with a disability to believe that they are less capable than a person without a disability. Parents and care providers of children with disabilities may overprotect the child to shield them from harm; however this can actually cause more damage. Successful parenting skills are required to help children and adolescents develop a positive self concept and high self esteem. Guidelines have been developed to assist parents, educators and other professionals regarding the effects of overprotection and lowered expectations.

Adolescent↗
PubMedDate not supplied

Grief of an adolescent when a sibling dies.

Grieving for losses that normally occur during adolescent development, and at the same time grieving the loss of a sibling cannot be clinically separated.

Adolescent↗
PubMedDate not supplied

Teaching adolescents self-advocacy skills.

The changing face of health care is requiring all consumers to be more responsible for their own care. At the same time, opportunities to lay the foundations for self-advocacy with adolescents are becoming more limited. Pediatric nurses are in an ideal position to help adolescents develop skills in self-advocacy that they will need throughout their lives.

Adolescent↗
PubMed1994

Developmental previewing: enhancing the adolescent's predictions of behavioral consequences.

The adolescent years are a time of significant biopsychosocial change. Adolescents develop a variety of cognitive skills that enable them to evaluate future consequences, weigh alternatives, and select behaviors. If these cognitive skills have not matured fully, however, the female adolescent may be predisposed to enact risk-taking behaviors, such as becoming pregnant. An intervention technique that encourage adolescents to predict the consequences of their actions may therefore be beneficial. One such technique, labeled previewing, promotes the cognitive skills necessary for averting future unplanned pregnancies and, in the event the adolescent has become a mother, for establishing a more adaptive relationship with the infant.

Adolescent↗
PubMedDate not supplied

Children with HIV becoming adolescents: caring for long-term survivors.

As children infected with HIV live longer, pediatric nurses who care for these patients need to be familiar with adolescent development and to anticipate physiologic and behavioral changes that will occur in this population. Concerns regarding confidentiality, autonomy, medication needs and compliance may become paramount. Learning how to interview adolescents and becoming comfortable with adolescent sexuality issues will enhance the patient-provider relationship.

Adolescent↗
PubMed2006

Parent and health professional perspectives in the management of adolescents with diabetes: development of assessment instruments for international studies.

OBJECTIVE: Assessment of quality of life (QOL) in adolescents with diabetes requires patient, parent and health professional input. Psychometrically robust instruments to assess parent and professional perspectives are required. RESEARCH DESIGN AND METHODS: Questionnaires concerning adolescent QOL were developed for completion by parents and health professionals. In an international study assessing QOL in 2,101 adolescents with diabetes (median age 14 years, range 10-18; from 17 countries including Europe, Japan and North America), parents and health professionals completed their respective questionnaires between March and August 1998. RESULTS: Feasibility and acceptability of the new questionnaires were indicated by high questionnaire completion rates (adolescents 92%; parents 89%; health professionals 94%). Internal consistency was confirmed (Cronbach's alpha coefficients 0.80 parent; 0.86 health professional). Correlations of Diabetes Quality of Life Questionnaire for Youths (DQOLY) scores with parent and health professional global QOL ratings were generally low (r ranging from 0.12 to 0.36). Parent-rated burden decreased incrementally across adolescence, particularly for girls. Professional-rated burden followed a similar profile but only after age 15 years. Until then, burden was rated as uniformly high. Clinically relevant discrepancies in parent and professional burden scores were noted for one-parent families and families where adolescents had been referred for psychological help. In both cases, health professionals but not one-parent families perceived these as high burden situations. The clinical significance of this relates to the significantly poorer metabolic control recorded for adolescents in both situations. CONCLUSIONS: Parent and health professional questionnaires were found to have adequate internal consistency, and convergent and discriminant validity in relation to key clinical and QOL outcomes. The questionnaires are brief, easy to administer and score. They may also enable comparisons across countries and languages to facilitate development of international health outcome parameters. The inclusion of the parent and health professional perspectives completes a comprehensive assessment of adolescent QOL relevant to diabetes.

Adolescent↗