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Introduction Al  Adolescente ( Spanish)
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Introduction Al Adolescente ( Spanish)

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  • 1. La Visita al Adolescente Santiago García - Tornel Florensa Servicio de Pediatría Hospital Sant Joan de Déu (Barcelona)
  • 2. OBJETIVOS
    • Identificar los estadios del desarrollo psicosocial del adolescente
    • To set the stage for an adolescent interview
    • Obtener una historia clínica completa
  • 3. Definition of Adolescence
  • 4. Overview of the Adolescent Visit
    • During adolescence- visits to a health care provider may be limited
    • Teens may seek care from a variety of providers
    • Goal of provider is to complete a thorough physical and psychosocial evaluation
    • THINK PREVENTION!
  • 5. Stages of Psychosocial Development
    • Early adolescence (11-14 yrs)
    • Middle adolescence (15-17yrs)
    • Late adolescence (18-21 yrs)
  • 6. Early Adolescence
    • Period of rapid growth and physical change
    • Characteristics-egocentrism, concrete thinking
    • Relations-same sex friends
    • Problems-injuries
  • 7. Middle Adolescence
    • Secondary sexual characteristics develop, growth rate decreases
    • Emancipation from parents
    • Abstract thought
    • Opposite sex friends
    • STD’s,MVA’s
  • 8. Late Adolescence
    • Physically mature
    • Vocational goals important
    • Individual friendships over peer group
    • Stress induced illness
  • 9. Setting the Stage
  • 10. Setting the Stage
    • Make the adolescent the primary historian
    • Establish confidentiality
    • Use understandable language
    • Use open-ended questions
    • Be non-judgemental
    • Listen to the patient!
  • 11. Obtaining a History
    • Chief Complaint
    • Past Medical history
    • Family Medical History
    • Psychosocial History
  • 12. Psychosocial History
    • H
    • E
    • A
    • D
    • S
  • 13. Psychosocial History
    • H-Home
    • E-Education
    • A-Activities
    • D-Diet,Drugs,Depression
    • S-Sexuality, Safety
  • 14. HOME
    • Who lives at home?
    • Who can you talk to?
    • How are things going with your parents/family members?
  • 15. EDUCATION
    • How are your grades?
    • Do you enjoy school?
    • What are your plans for the future?
  • 16. ACTIVITIES
    • What do you do for fun?
    • Are you involved in sports or extracurricular activities?
    • How many hrs/day- TV? Computers? Video games?
  • 17. DIET
    • Do you eat breakfast? Regular meals?
    • Are you concerned about your weight?
    • Do you drink milk?
  • 18. DRUGS
    • Do you or your friends drink alcohol?
    • Do you or your friends smoke cigarettes?
    • Do you or your friends smoke marijuana? Use other drugs?
  • 19. DEPRESSION
    • Have you been feeling sad?
    • Have you been crying frequently?
    • Do you feel that life is not worth living?
    • Are you sleeping at night?
    • Have you gained or lost weight?
  • 20. SEXUALITY
    • Have you ever had a sexual relationship with anyone?
    • Have you been forced to have sex against your will?
    • Do you use protection?
  • 21. SAFETY
    • F-Fights
    • I-Injuries
    • S-Sexual Violence
    • T-Threats
    • S-Self defense
  • 22. Physical Exam
    • Ensure privacy
    • Do thorough exam
    • Document Tanner Staging
    • Consider pelvic exam if sexually active or over 18 yrs
  • 23. Screening tests
    • Routine-refer to GAPS guidelines
      • CBC,Cholesterol
      • Document varicella status, Hep B vaccine,tetanus. Consider meningococcal vaccine for college age students
      • Recommend annual dental visit
    • High Risk
      • female-RPR, GC/CH
      • male-UA
  • 24. Wrap up
    • Interpret findings and discuss plans directly
    • Identify strengths and weaknesses
    • Discuss anticipatory care and PREVENTION
    • Provide educational materials
    • Encourage patients to return!
  • 25. SUMMARY
    • Set the stage
    • Establish confidentiality
    • Use HEADS
    • Consider FISTS
    • Prevent High-risk Behaviors
    • Encourage teens to return
  • 26. QUESTIONS?