Adolescent health

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Adolescent Development

Teenagers go through varied physical, mental, emotional, and social changes. In today’s society, these adolescents face a range of developmental issues. Utilizing your learning from your readings and the South University Online Library, respond to the following questions.

1. In your opinion, what are the two most important factors that influence adolescent development?

Over the previous 20 years, research reveals a wide array of factors that may influence adolescent development. Throughout this time span, changes have occurred in the factors that influence adolescent development, sexual activity, decision making, and contraception which might include the following.

One of the initial studies by researchers suggested that biological, family, peer, school, and community factors influence adolescent development and the age of initiation of sexual intercourse.
Further research in this area of study purposed that cultural factors, sexual desire, media, biological factors, emotional factors, social cognitive factors, and environmental factors (peers and parents) influence adolescent development, sexual well-being, and sexual behavior (Commendador, 2010, pp. 147-148).
2. In the Western culture, there are a variety of health services available for adolescents. What is missing in Western society that would benefit health promotion for adolescents?

Many healthcare providers and family planning clinics do not address adolescent sexuality until the adolescent is old enough to become a patient in these clinics. Perhaps discussion of sexuality and sexual decision making should be incorporated in the education system, as well as is part of the pediatric healthcare providers’ educational practice and pediatric clinics serving older school age children. Discussion between nurse practitioners (NPs), parents, sons, and daughters could foster interchange around sexuality, such as pubertal development, changing body, decision making as to sexual activity, and contraception (Commendador, 2010, p. 150).

3. How do the health problems faced by adolescents impact their health and wellness in their lifetimes?

Although the impact of health problems on an adolescent and his or her family varies by diagnosis and severity, chronic conditions, by definition, last longer than three months, alter activities of daily living, and often require significant medical care (Jacobs & Popick, 2012, p. 228). Health problems faced by adolescents may impact their health and wellness in their lifetimes in the following ways.

Adolescents with chronic conditions may experience mental health and behavior problems due to challenges related to peer socialization and body image, altered peer/family relationships, missed school, regression in development, pain, physical limitations, and modified routines.
In the absence of effective coping skills and supportive peer relationships, these challenges can lead to participation in risky behaviors, including unprotected sex and substance abuse, which can have immediate and long-term consequences on an adolescent’s health. These behaviors may compound the already existing risk of complications from the chronic condition.
The challenges of living with a chronic condition extend beyond the adolescents themselves. Families of adolescents with chronic conditions may struggle to understand and manage the additional stressors of condition management, caretaking, and modified routine (Jacobs & Popick, 2012, p. 228).

Note. One way pediatric providers and NPs can address the needs of the adolescent and family is to recommend reputable online health resources for social support suited to the specific needs of the adolescent and family, such as blogs, discussion boards, and other social networking modalities (Jacobs & Popick, 2012, p. 228).

4. Discuss how you would take the sexual history from an adolescent. Which areas would you need to address during your discussion with an adolescent?

Some NPs prefer to see the family and adolescent together first. This technique can produce a great deal of information in the first few minutes regarding medical concerns and family dynamics. Another straightforward technique is to start by interviewing the adolescent alone, which is particularly important for older adolescents. At some point, the family may be brought into the interview; however, the adolescent should be present to hear what is being said (Woods & Neinstein, 2009, p. 18).

The sexual history interview should be in private with the adolescent. Adolescents may delay medical care if privacy is not ensured. The format of the visit should be explained. Because of the sensitive nature of information shared by the adolescent during the visit, confidentiality should be maintained. Before proceeding, inform adolescent patients of what the limits of confidentiality are, such as not sharing answers to personal questions unless someone is hurting them or they are hurting themselves (Sizer, 2013, p. 51). An assurance of confidentiality is an important aspect of obtaining an accurate sexual history in adolescents (Fortenberry, 2014, p. 4).

The sexual history (see Table 1) should be straightforward and nonjudgmental, with appropriate counseling regarding risk-taking behaviors, as necessary (Fortenberry, 2014, p. 4).

The Five P’s

1. Partners

Do you have sex with males, females, or both?
In the past 2 months, how many partners have you had sex with?
In the past 12 months, how many partners have you had sex with?
Is it possible that any of your sex partners in the past 12 months had sex with someone else while they were still in a sexual relationship with you?
2. Prevention of Pregnancy

What are you doing to prevent pregnancy?
3. Protection from STDs

What do you do to protect yourself from STDs and HIV?
4. Practices

To understand your risks for STDs, I need to understand the kind of sex you have had recently.
Have you had vaginal sex, meaning ‘penis-in-vagina’ sex?
If yes:
Do you use condoms: never, sometimes, or always?
Have you had anal sex, meaning ‘penis-in rectum/anus’ sex?
Do you use condoms: never, sometimes, or always?
Have you had oral sex, meaning ‘mouth-on-penis/vagina’
For condom answers:
If never:
Why don’t you use condoms?
If sometimes:
In what situations (or with whom) do you not use condoms?
5. Past History of STDs

Have you ever had an STD?
Have any of your partners had an STD?
Additional questions to identify HIV and viral hepatitis risk

Have you or any of your partners ever injected drugs?
Have you or any of your partners exchanged money or drugs for sex?
Is there anything else about your sexual practices that I need to know about? (Fortenberry, 2014, p. 4).
Abbreviations

Sexually transmitted disease (STD); Human immunodeficiency virus (HIV).

Table 1. The five P’s. Note. Adapted from “Sexually Transmitted Diseases: Overview of Issues Specific to Adolescents,” by J.Fortenberry, 2014, p. 4. Retrieved from http://www.uptodate.com/contents/sexually-transmitted-diseases-overview-of-issues-specific-to-adolescents

Note. Although it is important for NPs to respect their adolescent patients’ confidentiality, it is also important to encourage the adolescent to talk with his or her parents about issues that affect health (Middleman & Olson, 2012, p. 10).
References

Commendador, K. (2010). Parental influences on adolescent decision making and contraceptive use. Pediatric Nursing, 36(3), 147-170. Retrieved from http://web.b.ebscohost.com.southuniversity.libproxy.edmc.edu/ehost/pdfviewer

Fortenberry, J. (2014). Sexually transmitted diseases: Overview of issues specific to adolescents. Retrieved from http://www.uptodate.com/contents/sexually-transmitted-diseases-overview-of-issues-specific-to-adolescents

Jacobs, H. S. & Popick, R. (2012). Utilization of internet resources for adolescents coping with chronic conditions. Pediatric Nursing,38(4), 228-235. Retrieved from http://web.b.ebscohost.com.southuniversity.libproxy.edmc.edu/ehost/pdfviewer

Middleman, A. & Olson, K. (2012). Confidentiality in adolescent health care. Retrieved from http://www.uptodate.com/contents/confidentiality-in-adolescent-health-care

Sizer, C. (2013). Adolescent issues. In T. Buttaro, J. Trybulski, P. Bailey, & J. Sandburg-Cook (Eds.), Primary care: A collaborative practice. (4th ed.). (p. 51). St. Louis, MO: Elsevier Mosby.

Woods, E. & Neinstein, L. (2009). Office visit, interview techniques, and recommendations to parents. In L. Neinstein, C. Gordon, D. Katzman, D. Rosen, & E. Woods (Eds.), A handbook of adolescent health care. (1st ed.). (p. 18). Philadelphia, PA: Lippincott Williams & Wilkins.