26 Sep Case Study Read the following excerpt and answer t
Case Study Read the following excerpt and answer the questions below. Dealing with adolescent health holds many promises and challenges for researchers, health educators, and clinicians. This stage of the life span is often perceived as a healthy time, compared with vulnerable periods for small children or the elderly. Adolescence has been associated with high-risk behaviors such as unsafe sexual behavior, tobacco use, substance abuse, poor nutritional habits, physical inactivity, and exposure to violence. According to the World Health Organization, one-third of diseases and almost 60% of premature deaths among adults are associated with behaviors or conditions initiated during adolescence. Some adolescent behaviors may contribute to the development of cancer, obesity, diabetes, stroke, and cardiovascular disease in future years. Rosen (2004) noted that adolescent health efforts should emphasize prevention, as much of the disease burden is preventable, and prevention is a cost-effective strategy. However, Lule et al. (2006) suggest that efforts to improve the health of young people may be more complex and difficult than for other age groups because many of their health problems are behavior based. On the positive side, their behaviors are less entrenched and they are still involved in institutional activities in schools where programs with high coverage can be sustained (Lule et al., 2006). Focusing attention on risk factors rooted in adolescence makes sense for prevention and early identification purposes. Research reveals that adolescents want to talk about their lives, but seldom have the opportunity to discuss important issues with their health care providers. The City of Berkeley conducted a cross-sectional study on the primary health care needs of adolescents and found that adolescents had a wide range of health care concerns and often engage in risky behaviors, but do not always have access to appropriate adolescent friendly health care. Churchill et al. (2000) stated that the challenge for researchers and clinicians is to be able to identify adolescents most at risk of adverse consequences and evaluate interventions that result in improved long-term outcomes. Little research has been conducted on the nature and effectiveness of physician consultations with teenagers. Walker et al. (2002) explored the research question regarding health promotion for adolescents with primary care physicians: Does inviting teenagers to general practice health consultations and appropriate follow-up care regarding healthy lifestyles result in behavior change? They found few published reports of screening or health promotion involving adolescents in family practice settings. They reported on the use of the American Medical Association (AMA) approach for consultations to promote self-efficacy for healthy lifestyles with 14- and 15-year-old adolescents who took part in an intervention involving a 20 minute consult with a practice nurse (41% attendance rate). Unhealthy behavior was similar at baseline for attendees and non-attendees. After 3 months, marginally more study attendees than controls reported positive change, but no statistical significance was found at 12 months. According to 200 adolescent health care providers in 34 U.S. cities, youth are at a point in their development when health interventions could make a significant difference. They found that preventive, primary, reproductive, and behavioral health care are not well-matched to the needs of adolescents, with behavioral health care being the most problematic. Too few teen-friendly sites of care are accessible: care is available only on scheduled weekdays, health services are difficult for teens to access, privacy and confidentiality are not always respected, parent involvement is often an afterthought, physical and behavioral services are seldom co-located, and providers are often more comfortable serving younger children or adults and relate to adolescents in ways that seem culturally and linguistically ineffective. The Canadian Task Force on Preventative Health Care (2000) suggested providing an adolescent-friendly atmosphere. Teens rated what was important to them in the delivery of primary care: (a) confidentiality, (b) confidential access to telephone information, and (c) good written information. Follow-up telephone calls after receiving written invitations to attend preventive health visits resulted in increased participation, and health promotion consults with family physicians were welcomed by teens. Rosen (2004) identified principles for the effective delivery of family friendly health care to adolescents to provide information they need to make life choices. He suggested, “Where school enrollment is high, a cost-effective and important approach is to reach students through schools” (p. 8). Research has explored adolescent compliance related to the use of medications or compliance with therapeutic regimens for cancer, mental health, and headaches. There are few studies on compliance related to referrals to physicians, especially from school health programs or nurse initiated referrals. Personal, family, and illness variables have been explored in relation to compliance of adolescents. Pidgeon found that the factors of self-esteem, social functioning, and perceived autonomy positively influence health compliance with adolescents. Source: Kitty, HL, and Prentice, D: Adolescent cardiovascular risk factors: A follow-up study. Clin Nurs Res 19:6, 2010 -Answer the Following questions after reading the study: -Identify pertinent background information leading to the proposed study. -Provide information on the significance or importance of the proposed problem in relation to nursing. -Based on the information provided within the problem statement and literature review, evaluate the existing knowledge on the proposed problem. What is the purpose of the study? -Identify the gaps that this study intends to fill.
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