Transcript ADOLESCENT TO YOUNG ADULT

ADOLESCENT TO YOUNG
ADULT
TASKS OF ADOLESCENCE
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SELF ESTEEM
FRIENDSHIPS
INDEPENDENCE
VALUES
GOALS
TRANSITIONING FOR
“SICK” ADOLESCENTS
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Parent Oriented to Patient Oriented
Nurturing to Empowering
Vision of the Future
Specialty AND Primary Care
(Parents may feel “Left Out”)
TRANSITIONING FOR
“WELL” ADOLESCENTS
• Age - “Rules of the Practice”
• Age - May feel “Out of Place”
• Different Insurance
• Need Health Supervision Visit for:
– College
– Sports
– Job
INTERVIEWING
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H
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Home
Education/Employment
Activities/Acquaintances
Drugs
Sexuality
Suicide/Depression
PHYSICAL EXAM/
SCREENING
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Breast/Testicular Exam
STD Screening
PAP test
Cholesterol
?Hgb, UA
IMMUNIZATIONS
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3 Hep B
2 MMR
2 Varicella
1 dT
(Influenza, Pneumococcal, Hep A)
HIGH RISK BEHAVIORS
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INJURIES
SEXUAL BEHAVIORS
TOBACCO USE
ALCOHOL/DRUG USE
DIETARY PATTERNS
PHYSICAL ACTIVITY
WHY RISKY BEHAVIORS?
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Jessor’s Model
Group Socialization Theory
Biopsychosocial Model
“Intractable to simple explanation”
INJURIES
• UNINTENTIONAL/HOMICIDE/SUICIDE
70% of deaths for 15-24 y/o
– use of alcohol/drugs
– failure to use safety devices
– access to firearms
INJURIES: VT YOUTH
• Use seatbelt when driving: 81%
• Drove under the influence: 24%
• Carried weapon to school: 19%
SEXUAL BEHAVIORS
• MORTALITY (HIV, cervical ca, hep B)
HIV = 19% of deaths for 25-44 y/o
• MORBIDITY (STD’s, infertility, ectopic
pregnancies)
SEXUAL BEHAVIORS:
VT YOUTH
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Ever had sex:
Used condom:
Used alcohol/drugs:
Multiple partners:
63%
54%
28%
19%
TOBACCO USE
• Leading cause of preventable death
• 80% start before 18
TOBACCO USE: VT YOUTH
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Ever smoked:
77%
Smoked past month: 43%
Ever tried to quit:
34%
Chewing tobacco:
9%
ALCOHOL/DRUGS
• MORTALITY: 100,000 deaths/yr
• MORBIDITY: violence, injury,
child/spousal abuse, HIV/AIDS, adolescent
pregnancy, school failure, car crashes, low
work productivity, homelessness
ALCOHOL/DRUGS:
VT YOUTH
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Alcohol in past month:
Binged in past month:
Tried marijuana:
Marijuana in past month:
Ever used inhalants:
Ever used cocaine:
65%
44%
61%
39%
22%
12%
DIETARY PATTERNS
• MORTALITY: cancers, cardiovascular
disease, diabetes
• MORBIDITY: obesity, eating disorders
– 14% children
– 12% adolescents
DIETARY PATTERNS:
VT YOUTH
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Think they are overweight:
Trying to lose weight:
Vomited/took laxative:
Took pills:
38%
60%
10%
8%
PHYSICAL ACTIVITY
• Together with diet =
• 20-60% of fatal cancers
PHYSICAL ACTIVITY:
VT YOUTH
• Daily phys ed:
14%
• School sports team: 51%
WHAT PROTECTS
ADOLESCENTS FROM
RISKS?
• CONNECTIONS
• RESILIENCY
WHAT CAN YOU DO?
• ACT AS A CHANGE AGENT!
6 STAGES OF CHANGE
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PRE-CONTEMPLATIVE
CONTEMPLATIVE
DETERMINATIION
ACTION
MAINTENANCE
RELAPSE
CAGE QUESTIONS
• Have you ever felt the need to CUT DOWN on
your drinking?
• Have you ever felt ANNOYED by criticism
about your drinking?
• Have you ever felt GUILTY about something
you did while drinking?
• Have you ever taken a morning EYE-OPENER?
REMEMBER. . .
• Ask about one behavior at each encounter
• Encourage one change step
• Don’t nag!