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PubMed2003

Early risk factors for violence in Colombian adolescents.

OBJECTIVE: Violence and homicide are more prevalent in Colombia, South America, than in the United States, but the role of psychosocial factors in the violent behavior of Colombian adolescents remains unclear. The objective of the study was to identify personality, familial, peer, and ecological variables associated with violence in Colombian adolescents. METHOD: A survey of adolescents was conducted in 1995-1996. A standard self-report measure was adapted to ensure linguistic and cultural relevance. A total of 2,837 adolescents ages 12-17 years from various self-reported ethnic groups were randomly selected from the community in three Colombian cities: Bogota, Medellin, and Barranquilla. Eighty percent of eligible adolescents agreed to participate. Data were collected concerning the adolescent's personality attributes, family characteristics, peer characteristics, and ecological/cultural factors, including the availability of illicit drugs and the prevalence of violence in the community. The dependent variable was the adolescent's self-reported frequency of violent behavior. RESULTS: Violence directed at the adolescent and the adolescent's own drug use were both more highly correlated with the adolescent's violent behavior than were other risk factors. Significant risk factors of less importance included tolerance of deviance, peer drug use, peer deviance, and exposure to violence on television. CONCLUSIONS: The results supported a model in which violent behavior was correlated independently with a number of risk factors from several domains. The findings point to the use of specific intervention procedures for adolescents to prevent their own subsequent acts of violent behavior.

Adolescent↗
PubMed2004

Use of medical and behavioral health services by adolescents with bipolar disorder.

OBJECTIVE: This study compared use of medical and behavioral health care by adolescents with bipolar disorder and other adolescents and identified areas in need of more clinical attention. METHODS: Medical and behavioral health insurance claims from 1996 for 100,880 adolescents were examined and categorized. Differences between and among various categories of disease were explored by using multivariate analyses. RESULTS: Among the 10,970 adolescents who used at least one behavioral health service, adolescents with bipolar disorder (N=326) had significantly higher behavioral health costs than those with mood or non-mood disorders, a result driven by these adolescents' significantly higher hospital admission rates for behavioral health care. Adolescents with bipolar disorder also had significantly higher medical admission rates compared with adolescents who had other behavioral health diagnoses. More than half of the 14 medical admissions for adolescents with bipolar disorder were due to drug overdose. CONCLUSIONS: Reallocation of medical and behavioral health resources to improve ambulatory treatment of bipolar disorder among adolescents has the potential to decrease the use and costs of health care while improving the welfare of these adolescents and their families.

Adolescent↗
PubMedDate not supplied

Behavioral health in multiracial adolescents: the role of Hispanic/Latino ethnicity.

OBJECTIVES: The purpose of the present study was twofold: (1) to determine whether adolescents who self-identify as multiracial have more adverse health behaviors than their monoracial counterparts, and (2) to examine whether the health behaviors of adolescents who are multiracial and Hispanic are more similar to those who identify as monoracial Hispanic or those who are multiracial and non-Hispanic. METHODS: Secondary analyses of data in a subsample from the Youth Risk Behavior Survey of 3,704 (27.2%) adolescents who identified as Hispanic/Latino only, multiracial Hispanic, or multiracial non-Hispanic were conducted. Regression analyses were conducted using SUDAAN for the complex sampling to test for differences in health behaviors (i.e., smoking, exercise, substance abuse, and suicide risk) among the three ethnicity/race groups. RESULTS: Each health behavior scale yielded significant between-group differences according to ethnic/racial identity: Hispanic/Latino adolescents scored significantly lower than both multiracial groups on the measure of cigarette smoking, lower than multiracial Hispanic adolescents on the substance abuse scale, and lower than multiracial non-Hispanic adolescents on the measure of exercise. The multiracial Hispanic group was also at marginally increased risk for suicide compared to the Hispanic/Latino group. CONCLUSIONS: The results support the hypothesis that multiracial Hispanic adolescents have more behavioral health problems than monoracial Hispanic adolescents. The second hypothesis--that multiracial Hispanic adolescents are more similar to multiracial non-Hispanic adolescents--was also supported. The implications of these findings for the classification of Hispanic adolescents in terms of ethnicity and race in relation to health behaviors are discussed.

Adolescent↗
PubMed1999

The influence of parental drinking and closeness on adolescent drinking.

OBJECTIVE: This study examines the relationship of parental drinking and adolescent's closeness to parents to adolescent drinking behavior by focusing on three related issues: (1) the independent effects of parental drinking and closeness to parents on adolescent drinking, (2) the mediating role of closeness to parents for the effect of parental drinking, and (3) their interactive effects. METHOD: The issues were addressed with use of data from 378 respondents in a random-digit dialing sample of 625 male adolescents at age range 16 to 19 in the Buffalo area. Mother's and father's drinking and adolescent's closeness to mother and father were measured separately. Regression analyses were used to assess the effects of these measures on adolescent drinking regarding the three related issues. RESULTS: Only father's drinking has a direct effect on adolescent drinking. Although closeness to mother is a significant protection against adolescent drinking, mother's drinking has no effect on closeness to mother. In contrast, father's drinking has a significant effect on closeness to father, but closeness to father has no direct effect on adolescent drinking. Therefore, there is no mediating role of closeness to parents for the effect of parental drinking. Finally, there is an interaction between mother's drinking and closeness to mother, which indicates that adolescents whose mothers are heavy drinkers and who have low closeness to their mothers drink more heavily. CONCLUSIONS: Findings suggest that for the mother and the father there are different patterns of the relationship between parental drinking and closeness at work in explaining adolescent drinking.

Adolescent↗
PubMed2001

Predictors of mother-adolescent discussions about condoms: implications for providers who serve youth.

OBJECTIVE: To examine predictors of mother-adolescent communication about condoms. METHODS: Interviews were conducted with 907 mothers of adolescents aged 14 to 17 years in the Bronx, New York; Montgomery, Alabama; and San Juan, Puerto Rico, to determine whether mothers had talked with their adolescent about condoms. RESULTS: By univariate analysis, mother-adolescent communication about condoms was associated with greater knowledge about sexuality and acquired immunodeficiency syndrome, perception of having enough information to discuss condoms, information from a health-related source, less conservative attitudes about adolescent sexuality, perception that the adolescent was at risk for human immunodeficiency virus, greater ability and comfort in discussing condoms, stronger belief that condoms prevent human immunodeficiency virus/acquired immunodeficiency syndrome, and a more favorable endorsement of condoms. In multivariate analyses, mother-adolescent communication about condoms was associated with a less conservative attitude about abstinence until marriage (odds ratio [OR]: 0.73; 95% confidence interval [CI]: 0.54-0.74), greater skill in communicating about sex (OR: 1.13; 95% CI: 1.06-1.20), greater comfort in communicating about sex (OR: 1.31; 95% CI: 1.01-1.69), a more favorable endorsement of condoms (OR: 1.85; 95% CI: 1.17-2.78), and the perception that the adolescent's friends were sexually active (OR: 3.53; 95% CI: 1.97-7.16). CONCLUSION: Parents who communicate effectively about sexuality and safer sex behaviors can influence their adolescents' risk-taking behavior. Health care providers, particularly physicians, can facilitate this communication by providing to parents information about the sexual behavior of adolescents, the risks that adolescents encounter, condom use, condom effectiveness, and how to discuss condoms. They also can make referrals to programs that teach communication skills.

Adolescent↗
PubMed2003

Adolescent subjective well-being and family dynamics.

The purpose of this study was to examine the relationships between adolescent subjective well-being (SWB) and family dynamics perceived by adolescents and their parents. A sample of 239 pupils (51% female) from seventh and ninth grades completed the Berne questionnaire of SWB (youth form), two subscales from an original Finnish SWB scale and the Family Dynamics Measure II, and one of their parents (n = 239) filled in the Family Dynamics Measure II. Results indicated that parents assessed family dynamics better than did their adolescent child. Furthermore, there was no association between family dynamics perceived by adolescents and family dynamics assessed by one of their parents or between the adolescent SWB and parental perception of family dynamics. Multiple stepwise regression analysis indicated that certain aspects of family dynamics perceived by adolescents were related to adolescent global satisfaction and ill-being. Specifically, adolescents' perception of high level of mutuality and stability in the family as well as male gender and lack of serious problems in family were predictors of adolescent global satisfaction. Furthermore, disorganization in the family and poor parental relationship perceived by adolescents, being female, serious problems and illness in family predicted a high level of adolescent global ill-being.

Adolescent↗
PubMedDate not supplied

Adolescent self reported reproductive morbidity and health care seeking behaviour.

BACKGROUND: Addressing reproductive health issues of women is now on the global social agenda in the new millennium. Maternal mortality has long been the only indicator of women's health even though reproductive morbidity occurs far more frequently and seriously affects women's lives. In this paper, an attempt was made to assess the magnitude of self reported gynaecological morbidity unrelated to childbearing among the adolescents irrespective of their marital status. The paper also explored the determinants of health care seeking behaviour of the adolescents for their reproductive ailments. METHODS: Both quantitative and qualitative data were collected for this study. Cross sectional study was conducted both in rural and urban areas using a multistage cluster sampling technique. A nationally representative data on 2883 adolescents irrespective of their marital status were analysed. RESULTS: Analysis revealed that a large proportion of the adolescents (64.5%) reportedly has been suffering from gynaecological morbidity. The most frequent form of morbidity was menstrual disorders (63.9%) followed by lower abdominal pain (58.6%), burning sensation during urination (46.1%), genital itching (15.5%), vaginal discharge (3.4%) etc. Multivariate logistic regression analysis revealed that older adolescents aged 15-19 years, family income, type of family, type of residence and hygienic practice during menstruation appeared to be influencing factors for adolescents reproductive morbidity. The results also revealed that about one fifth (18.0%) sought health care for their gynaecological ailments indicating that adolescents were unaware about their reproductive morbidity (p<0.05). For assessing the factors influencing their health care seeking for reproductive morbidity, multivariate logistic regression analysis found significant positive association with adolescents aged 15-19 years, having autonomy in treatment, working status, adolescents of joint or extended family (p<0.05). DISCUSSION: Adolescent reproductive health in Bangladesh indicates high incidence of maternal morbidity. The incidence of these health problems varied by socio-economic and demographic characteristics of the adolescents. Recommendations to address these problems include encouragement of female education, introduction of family life education in school curricula, creating community awareness for seeking health care and empowerment of women in household decision making process.

Adolescent↗
PubMed2004

Adolescent propensity for depressed mood and help seeking: race and gender differences.

BACKGROUND: Studies investigating the correlates of adolescent depression and suicidal tendencies have found that the probability of such tendencies vary by race and gender. However, while there exists evidence that most adolescents suffering from the above problems fail to seek (and obtain) help, the role of race and gender in determining the propensity to seek help for depression remains largely unexplored. AIMS OF STUDY: The study uses data from the 1996 round of Health Behavior in School-Aged Children' (HBSC), USA, which surveys a representative sample of more than 9000 adolescents enrolled in grades 6-10. Respondents are asked if they suffered from persistent depressed moods (lasting two weeks or more) over the past year, and whether they sought help while suffering from depressed mood, and if so, from whom. Questions are also asked about whether the respondent had self-injury ideation or actually attempted self-injury. Demographic and other information on respondents is also provided. The primary aim is to test whether there are significant differences between genders, and between non-Hispanic whites, non-Hispanic blacks, Hispanics and Asians in the likelihood of seeking help, and from whom, when depressed. Gender and race-ethnicity differences in the likelihood of being depressed are also explored to find if they correspond to results in the extant literature. METHODS: Multinomial logit models are used to estimate the likelihood of being depressed or at self-injury risk, and help-seeking behavior in event of depressed mood. Models are estimated for the full-sample and sub-samples who report depressed mood or are at self-injury risk. In addition to race and gender, all models control for additional demographic characteristics such as age, family structure, and family socio-economic status. RESULTS: Adolescent females are significantly more likely than adolescent males to suffer from depressed mood. However, adolescent males are less likely to ask for help than females (odds ratio: 0.72). All minority groups are more likely to suffer from depressed mood compared to non-Hispanic whites, but blacks are at lower self-injury risk. Blacks and Asians are especially prone not to ask for help, with the problem being particularly acute in case of black males and Asian males. DISCUSSION: The lower propensity of adolescent males to seek help for depression compared to females are in keeping with previous research. However, predicted values show that the majority of males and females with depressed mood or at self-injury risk do not seek help from anyone. Certain racial groups are also at greater risk for not asking for help for depression. This may have implications regarding racial differences in suicide rates, as well as racial differences in future life outcomes. The study suffers from the drawback that because the survey is confined to those enrolled in school, adolescents who are institutionalized for mental health problems or who have dropped out of school due to problems related to depression are not represented in it. IMPLICATIONS FOR HEALTH POLICIES: There have been efforts in the USA to educate the population about the problems of adolescent depression. However, the above results suggest that it may be useful to have additional educational efforts targeted at specific population groups, to educate them about the risks associated with depression, help overcome any stigma associated with depression and encourage help-seeking when suffering from depressed mood. IMPLICATIONS FOR FURTHER RESEARCH: A number of directions of future research are suggested. It would be useful to obtain information on the outcomes of help seeking - whether it actually led to obtaining help. It would also be useful to know the probability of an adolescent being diagnosed with depressed mood (perhaps by a primary care physician) even without actively seeking help. Regarding the racial differences, it would be useful to examine the extent to which such differences arise from immigration status, and also to have more extensive information about attitudes, familial expectations, religiosity, community ties, confidence in the medical system and other factors, so as to analyze further why some races are more prone to depression and averse to seeking help for depression than others. Finally, it would be useful to periodically revisit this topic with more contemporary data to see whether recent efforts at awareness raising has increased the odds of help-seeking among adolescents with depressed mood.

Adolescent↗
PubMed2005

Earning trust and losing it: adolescents' views on trusting physicians.

OBJECTIVE: To explore how adolescents with and without chronic illness perceive patient-physician trust and to identify physician behaviors related to these perceptions that might be modified to promote adolescent health care. METHODS: Fifty-four adolescents recruited from the community (healthy subjects) and from hospital-based clinics (subjects with chronic illnesses) participated in 12 focus groups divided by age (11-14 or 15-19 years old), gender, and health status. Major themes related to preferred physician characteristics and trusting one's doctor were derived through a multistep, team-based qualitative analytic process. RESULTS: Adolescents hold varied perspectives of trust in their physicians. They describe elements of patient-physician trust similarly to the comprehensive model developed with adults, including fidelity, confidentiality, competency, honesty, and a global perspective intersecting several of the more specific domains. However, adolescents differ in the relative importance of these dimensions. Younger adolescents express more concern about confidentiality of their health information, and adolescents with chronic illnesses are more interested in involving parents in their care than are adolescents without chronic illnesses. Examples of specific behaviors to improve trust include asking for adolescent's opinion, keeping private information confidential, not withholding information, and engaging in small talk to show concern. CONCLUSION: Understanding the importance of trust and listening to recommendations about behaviors to improve it, in the words of the adolescents, may help physicians build positive relationships with their adolescent patients.

Adolescent↗
PubMedDate not supplied

Tobacco use by adolescents: the role of the oral health professional in evidence-based cessation programs.

The use of tobacco products, especially cigarette smoking, represents the leading cause of preventable illness and death in the developed world. In the United States, major gains have been made to reduce smoking among adults. Similar gains, however, have not been realized with adolescents. In recent years, substantial interest has been directed to tobacco cessation studies with adolescents. The previously limited interest in adolescent cessation programs was attributable in large part to the mistaken assumptions that: (1) adolescent tobacco users were not dependent on nicotine and could stop at any time; (2) adolescents did not want to quit; and (3) adult tobacco cessation programs would be effective with adolescents. The need for programs to increase adolescent cessation attempts is underscored by the Healthy People 2010 goal that calls for an increase in tobacco use cessation attempts by adolescent smokers to 84%. Dental providers need to take steps to prevent tobacco use by adolescent patients. For those who are already addicted, they need to provide cessation counseling services or referral for appropriate treatment. The purpose of this paper was to provide dental clinicians with information on: (1) tobacco and health; (2) the epidemiology of adolescent tobacco use; and (3) tobacco cessation programs for parents and adolescents that can be implemented in the dental office setting.

Adolescent↗
PubMed1991

A critique of community-based primary prevention of adolescent pregnancy.

In summary, adolescent pregnancy is a major public health problem. Although the magnitude of mortality is low, the magnitude of morbidity is enormous. Even though adolescent pregnancy rates have not increased in recent years, these rates remain high. The economic and psychosocial costs of adolescent pregnancy are staggering. Admittedly, adolescent pregnancy does not fit a conventional infectious disease model of an easily transmitted disease with a high potential for rapid spread. However, it is possible that role identification and behavior modeling could influence the occurrence of adolescent pregnancy in susceptible adolescents. Moreover, for many years public health authorities have acknowledged the critical significance of noninfectious causes of unnecessary mortality and morbidity. Very importantly, adolescent pregnancy is preventable. I agree strongly with Dr. Norr that the nursing profession is ideally suited to take a leadership role in community-based adolescent pregnancy prevention. Dr. Norr has stressed the important role of nurses in family planning clinics, school health, and nursing education. I would like to stress the important role of nurses in two additional specialty settings. First, I believe nurse researchers can make tremendous contributions to better characterize the distribution, determinants, and effective prevention of adolescent pregnancy. Second, because of their appreciation of community needs and their knowledge of community resources, I believe nurses in public health departments may be in the very best position to take a leadership role in community-based prevention of pregnancy among adolescents. In closing, I commend Dr. Norr on her thoughtful review. The need to initiate and augment community action to prevent adolescent pregnancy is compelling.

Adolescent↗
PubMedDate not supplied

[Pregnancy, labor and the neonate of the adolescent female].

The authors studied pregnancies in adolescents, younger than 18, from 1973 to 1983. The control group, randomly selected, consisted of 1000 child-bearing-women from 1976 (excluding adolescents and multiple pregnancies). The frequency of their labours was 3.24% and for the past five and a half years it decreased from 3.56% to 2.93% (P 0.05). There were 17.86 labours per 1000 adolescents in the age between 15 and 18. Adolescents are considerably more often living in rural areas, are single and unemployed than pregnant women in the control group. (P 0.001). EPH gestosis and threatened miscarriage are more frequent in adolescents than in the control group (P 0.05). Premature labour in adolescents occurs in 11.13% of cases, and postmature labour in 1.81% of cases, which is more frequent than in the control group (P 0.01). Pregnancy in adolescents lasts on the average 39.0 and in the control group 39.4 weeks. Adolescents are mostly primiparas (95.7%) and their labour lasts up to 12 hours (89.37%). Labours are mostly spontaneous (94.34%) and the frequency of cesarean sections is lower than in the control group (P 0.05). Adolescents' newborn infants are lighter than newborn infants in the control group (P 0.05). The newborn infants' birth weight increases with the age of their adolescents mothers. At birth, newborn infants of adolescent mothers have lower values of Apgar index than infants in the control group, have early neonatal complications in 16.06% of cases while infants in the control group in 12.40% of cases (P 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1998

Reconsidering changes in parent-child conflict across adolescence: a meta-analysis.

A series of meta-analyses addresses whether and how parent-child conflict changes during adolescence and factors that moderate patterns of change. The meta-analyses summarize results from studies of change in parent-child conflict as a function of either adolescent age or pubertal maturation. Three types of parent-adolescent conflict are examined: conflict rate, conflict affect, and total conflict (rate and affect combined). The results provide little support for the commonly held view that parent-child conflict rises and then falls across adolescence, although conclusions regarding pubertal change as well as conflict affect are qualified by the limited number of studies available. Two diverging sets of linear effects emerged, one indicating a decline in conflict rate and total conflict with age and the other indicating an increase in conflict affect with both age and pubertal maturation. In age meta-analyses, conflict rate and total conflict decline from early adolescence to mid-adolescence and from mid-adolescence to late adolescence; conflict affect increases from early adolescence to mid-adolescence. Puberty meta-analyses revealed only a positive linear association between conflict affect and pubertal maturation. Effect-size patterns varied little in follow-up analyses of potential moderating variables, implying similarities in the direction (although not the magnitude) of conflict across parent-adolescent dyads, reporters, and measurement procedures.

Adolescent↗
PubMed1993

Sexuality: sexual activity and contraception during adolescence.

Adolescent sexual activity is increasing. Premature sexual intercourse results in high figures of adolescent pregnancy and abortion, as well as in increased risk of sexually transmitted diseases (STDs). Lack of information on the prevention of STDs and poor hygiene in both boys and girls are also main reasons for increased morbidity because of STDs during adolescence. Contraceptive behaviour during adolescence varies between countries and communities. It seems, however, that the condom and oral contraceptives (OC) are popular contraceptive methods. Ineffective methods such as periodic abstinence, coitus interruptus, and withdrawal before ejaculation are in use. On the other hand, compliance of adolescents on contraception is poor. The above are additional causes for increasing rates of adolescent pregnancies. Countries providing sexual education programs in schools present lower rates of pregnancy and abortion. Adolescent pregnancy is safe if a careful follow up is accepted by the teenager. A significant number of homeless youth are homosexuals or lesbian adolescents. Most of them are at high risk for HIV infection, AIDS, and STDs. It is concluded that sexual education programs are absolutely necessary to offer adolescents the knowledge on the complications of premature sexual activity, as well as prevention of the undesired pregnancy and STDs.

Adolescent↗
PubMed1996

Adolescent contraceptive behavior: the impact of the provider and the structure of clinic-based programs.

OBJECTIVE: To characterize general trends in research on the impact of provider variables on adolescent contraceptive behavior and to identify useful frameworks for designing clinic-based programs aimed at reducing unintended adolescent pregnancy. DATA SOURCES: A computerized search of Psychological Abstracts, Sociological Abstracts, and MEDLINE identified English-language articles from 1990 to 1995 on adolescent contraceptive behavior in the United States. All relevant citations within these articles also were examined. METHODS OF STUDY SELECTION: Studies were selected that focused on any aspect of provider characteristics as they relate to adolescent contraceptive behavior. TABULATION, INTEGRATION, AND RESULTS: Based on a conceptual integration of the articles, three general research issues on provider characteristics were identified; 1) the effectiveness of adolescent-based clinic programs and provider variables that discriminate successful versus unsuccessful programs, 2) the effects of parental notification policies on adolescent clinic use, and 3) whether the presence of clinics promotes sexual activity on the part of adolescents. Issues that must be considered in the structuring of provider-based programs include the strategic focus of the program, the target behaviors, the target population, and the structuring of educational materials. CONCLUSION: The effectiveness of adolescent-based clinic programs is mixed. Parental notification of adolescent use of a clinic can, in some cases, decrease the likelihood of clinic use. There is little convincing evidence that the presence of adolescent clinics promotes sexual activity.

Adolescent↗
PubMed1999

Choice of feeding method of adolescent mothers: does ego development play a role?

STUDY OBJECTIVES: The purpose of this study was to determine whether, among childbearing adolescents, ego development was associated with intention to breast-feed and with actual breast-feeding behavior at birth and at 2 weeks postpartum. In addition, we sought to determine whether positive attitudes toward breast-feeding influenced pregnant adolescents' intentions to breast-feed and actual breast-feeding at the hospital and at 2 weeks postpartum. We hypothesized that adolescents with higher levels of ego development and positive attitudes toward breast-feeding would be more likely to intend to breast-feed and to actually breast-feed. DESIGN: Prospective cohort study of pregnant adolescents who completed questionnaires, Loevinger's Sentence Completion Tests, and attitudes toward breast-feeding scales before delivery and a follow-up questionnaire at 2 weeks postpartum assessing feeding practice in the hospital and at 2 weeks postpartum. SETTING: Two adolescents' clinics and two "teen-and-tot" clinics in urban teaching hospitals. PARTICIPANTS: Fourteen- to 22-year-old pregnant adolescents who had never given birth and who planned to carry their pregnancy to term and parent their children. MAIN OUTCOME MEASURES: 1) Intended feeding practice during pregnancy, 2) feeding method in the hospital, and 3) feeding method at 2 weeks postpartum. RESULTS: Of the 125 subjects enrolled in the study, 106 were at 2 weeks postpartum or more. Of these 106 participants, 75% (n = 78) completed more than 75% of the attitudes toward breast-feeding scale and Loevinger's Sentence Completion Test and are included in these analyses. Mean age at entry was 17.8 +/- 1.5 years (range, 14.3 to 21.8 years). Mean gestational age at enrollment was 21.2 +/- 11.6 weeks (range, 4 to 41 weeks). Of the 78 participants, 12% (n = 9) were at the preconformist, 85% (n = 66) at the conformist, and 4% (n = 3) at the postconformist level of ego development as determined by the Sentence Completion Test. Attitudes toward breast-feeding, intention to breast-feed, breast-feeding in the hospital, and breast-feeding at 2 weeks postpartum were not significantly associated with adolescents' stages of ego development. Almost three fourths of the adolescents intended to breast-feed, and 85% tried breast-feeding in the hospital. A total of 97% (56 of 58) of those who intended to breast-feed tried breast-feeding in the hospital compared with 40% (4 of 10) of those who did not intend to breast-feed (P < .0001). At 2 weeks postpartum, 58% of the participants were still breast-feeding. Of those participants who intended to breast-feed, 67% (39 of 58) were breast-feeding at 2 weeks postpartum compared with 10% (1 of 10) who did not intend to breast-feed (P = .001). The mean breast-feeding attitude score was 53.7 +/- 11.6 (range, 25 to 72). The mean breast-feeding attitude score was higher for those who intended to breast-feed than for those who intended to formula-feed (P = .009), but the score was not associated with breast-feeding in the hospital or at 2 weeks postpartum. CONCLUSION: Adolescent mothers were predominantly in ego stages 4 and 5, the conformist level. Because ego development was not associated with outcome measures in this study, ego development may not be a crucial factor when designing interventions to facilitate breast-feeding among adolescents. Attitudes toward breast-feeding were associated with the intention to breast-feed but not behaviors; the intention to breast-feed was significantly associated with breast-feeding behaviors.

Adolescent↗
PubMed2005

Consumer perspectives in adolescent ward design.

AIMS: The aim of the study was to gain an understanding of the environment and facilities that adolescents require in a purpose-built adolescent ward. BACKGROUND: People who are hospitalized have limited control over their care and environment. The experience of hospitalization is also considered a highly stressful event. It is essential that patients have an opportunity to participate in the planning and design of ward environments in order to reduce their stress and better accommodate their treatment needs. METHODS: An interpretative qualitative design was used. Seven chronically ill adolescents were asked to design their own ward in order to obtain consumer input about what the perceived necessary facilities for adolescent wards. FINDINGS: The adolescents provided clear information about the facilities that should be incorporated into an adolescent ward to maintain their privacy and independence. Further research needs to be conducted seeking consumer input, especially if it can enhance the stay of adolescent patients while they are hospitalized. RELEVANCE TO CLINICAL PRACTICE: Adolescent voice is more often than not represented by nurses, or other healthcare professionals in the patients' best interest. This practice acts on the assumption that the adult knows best and/or that adolescents are unable to articulate their own needs. Adolescent consumers contribute worthwhile recommendations to how a ward is run providing insight about their needs in the ward environment.

Adolescent↗
PubMed1999

AIDS: risk behaviors and situations as perceived by adolescents in Gaborone, Botswana.

While AIDS continues to escalate in Botswana, no systematic investigation has been done of the contextual (behavioral and situational) variables important to the tailoring of AIDS educational prevention program for adolescents. A cross-sectional descriptive study identified the specific behaviors and situations placing adolescents at risk for AIDS as perceived by a convenience sample of 48 adolescents. Adolescents attended gender-specific focus groups and completed a demographic questionnaire. Content analysis revealed that gender and age could categorize the adolescents' perceptions of contextual variables. For younger adolescents AIDS-related behaviors involved sex and intravenous drug use; for older adolescents AIDS-related behaviors involved multiple sexual partners and sexual relationships between older men and adolescent girls. Though a consensus existed regarding the situational variables, gender and age influenced the situation that was most challenging to these adolescents. The data support that AIDS educational prevention programs must be tailored to the adolescents' gender and age.

Acquired Immunodeficiency Syndrome↗