Discussion of Sensitive Health Topics with Youth During Primary Care Visits: Relationship to Youth Perceptions of Care
Discussion of Sensitive Health Topics with Youth During Primary Care Visits: Relationship to Youth Perceptions of Care
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DOI：
10.1016/j.jadohealth.2008.06.018
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发表时间：
2009-01-01
影响因子：
7.6
通讯作者：
Wissow, Lawrence S.
中科院分区：
文献类型：
--
作者：
Brown, Jonathan D.;Wissow, Lawrence S.
目的：青少年关注敏感的健康问题，如毒品、性和心理健康，许多人希望与初级保健提供者讨论这些问题。研究尚未确定初级保健访问期间敏感健康话题的讨论是否与青年对护理的看法独立相关。本研究调查了初级保健访问期间敏感健康话题的讨论是否与青年对提供者和参与治疗的看法有关。方法：在访问了13个地理位置不同的办公室和诊所的54名初级保健提供者后，11-16岁的青少年（N = 358）直接报告了访问是否包括情绪，行为，与他人相处，药物，烟草，酒精，性行为，节育，父母情绪或家庭问题的讨论。青少年还报告了提供者是否理解他们的问题，是否缓解了他们的担忧，是否允许他们对治疗做出决定，是否给予他们对治疗的一些控制权，是否要求他们对治疗承担一些责任。提供者报告了他们对非医疗问题提供咨询的能力的信心，以及他们对治疗非医疗问题的信念和态度。结果：青年对提供者有更积极的看法，并且当访问包括讨论敏感的健康话题时，更有可能报告在治疗中发挥积极作用。多变量随机效应logistic回归结果表明，青少年更有可能报告提供者理解他们的问题（OR = 3.62, CI = 1.57-8.31），缓解他们的担忧（OR = 2.13, CI = 1.06-3.92），允许他们做出治疗决定（OR = 2.71, CI = 1.44-5.10），给予他们对治疗的一些控制（OR = 2.51, CI = 1.32-4.71），并要求他们对治疗承担一些责任(OR = 2.00，CI = 1.04-3.86)，当访问包括一个或多个敏感健康主题的讨论时。当访问包括讨论更多敏感话题时，这些结果的几率也更高。年轻人对女性提供者也有更积极的看法。青年人口统计、心理健康状况和其他提供者特征与青年对护理的看法无关。结论：在初级保健访问期间讨论敏感的健康话题可能对青少年的护理观念产生积极影响。未来的研究需要了解敏感健康话题的讨论与青少年健康结果之间的关系。(c) 2009年青少年医学会。版权所有。
Purpose: Youth have concerns about sensitive health topics, such as drugs, sex, and mental health, and many wish to discuss those concerns with a primary care provider. Research has not determined whether the discussion of sensitive health topics during primary care visits is independently associated with youth perceptions of care. This study examined whether the discussion of sensitive health topics during primary care visits was associated with Youth's perceptions of the provider and of participation in treatment.Methods: Directly after visits to 54 primary care providers in 13 geographically diverse offices and clinics, youth age 11-16 years old (N = 358) reported whether the visit included the discussion of mood, behavior, getting along with others, drugs, tobacco, alcohol, sexuality, birth control, parent mood, or family problems. Youth also reported whether the provider understood their problems, eased their worries, allowed them to make decisions about treatment, gave them some control over treatment, and asked them to take some responsibility for treatment. Providers reported confidence in their ability to offer counseling for nonmedical concerns and their beliefs and attitudes toward treating nonmedical concerns.Results: Youth had more positive perceptions of the provider and were more likely to report taking an active role in treatment when the visit included the discussion of a sensitive health topic. Results from multivariate random effects logistic regression suggested that youth were more likely to report that the provider understood their problems (OR = 3.62, CI = 1.57-8.31), eased their worries (OR = 2.13, CI = 1.06-3.92), allowed them to make decisions about treatment (OR = 2.71, CI = 1.44-5.10), gave them some control over treatment (OR = 2.51, CI = 1.32-4.71), and asked them to take some responsibility for treatment (OR = 2.00, CI = 1.04-3.86) when the visit included the discussion of one or more sensitive health topics. The odds of each of these outcomes Were also higher when the visit included the discussion of a greater number of sensitive topics. Youth also had more positive perceptions of female providers. Youth demographics, mental health status, and other provider characteristics were unrelated to youth perceptions of care.Conclusions: The discussion of sensitive health topics during primary care visits may have a positive impact on youth perceptions of care. Future research is needed to understand the relationship between the discussion of sensitive health topics and health outcomes among youth. (c) 2009 Society for Adolescent Medicine. All rights reserved.