Adolescent-friendly health services: What have children's hospitals got to do with it?
Adolescent-friendly health services: What have children's hospitals got to do with it?
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DOI：
10.1111/j.1440-1754.2010.01729.x
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发表时间：
2010-05-01
影响因子：
1.7
通讯作者：
Towns, Susan J.
中科院分区：
文献类型：
--
作者：
Sawyer, Susan M.;Proimos, Jenny;Towns, Susan J.
世界卫生组织采用了有利于青少年的保健服务一词，作为向年轻人提供优质保健服务的框架。1这些原则是促进卫生服务的可获得性、可接受性、适当性、公平性和有效性，重点是初级保健。颁布这一框架的一个关键原因是，年轻人从初级保健临床医生那里寻求的服务类型(通常是呼吸系统和皮肤病，以及急性损伤的护理)与他们所经历的更复杂的健康负担(由危险行为、精神障碍和慢性病引起)之间存在差距。这一框架对儿科专科服务可能有什么相关性？Tan等人的文章。2在最近一期的杂志中提醒我们，青少年在澳大利亚儿童医院的入院人数中占相当大的比例：在过去的8年里，珀斯玛格丽特公主医院的入院者中有五分之一的年龄在12岁到19岁之间。澳大利亚三个州政府承诺重建他们的专科儿童医院，这提供了一个机会来反思青春期本身是如何变化的，影响年轻人的健康问题是如何变化的，以及青少年友好型儿童医院可以或应该是什么样子。在过去的一个世纪里，青春期的社会背景发生了变化，用于中学和高等教育的年限大幅增加，历史上标志着青春期结束的社会里程碑的实现年龄也显著增加，如离家、婚姻和孩子。同样重要的是，影响儿童和年轻人的健康问题也同样发生了变化。直到上世纪中叶，患有复杂慢性病的儿童才首次大量存活到青春期。在过去的几十年里，这一趋势更加引人注目。同样值得注意的是，儿科实践的范围不断扩大，现在通常包括对发育、行为和精神障碍(如欺凌、进食障碍、肥胖、注意力缺陷/多动障碍)的管理。
The term adolescent-friendly health services has been adopted by the World Health Organization as a framework for providing quality health-care delivery to young people. 1 The principles are to promote accessibility, acceptability, appropriateness, equity and effectiveness of health services, with a strong emphasis on primary care. A key reason this framework has been promulgated is the gap between the type of services young people seek from primary care clinicians (commonly respiratory and dermatological concerns, and the care of acute injuries) and the more complex health burden they experience (arising from risk behaviours, mental disorders and chronic illness). What relevance might this framework have for specialist paediatric services? The article by Tan et al. 2 in a recent edition of the journal reminds us that adolescents comprise a considerable proportion of admissions to Australian children’s hospitals: Over the past 8 years, one in five admissions to the Princess Margaret Hospital in Perth was aged between 12 years and 19 years. That three Australian State governments have committed to rebuild their specialist children’s hospitals provides an opportunity to reflect on how adolescence itself has changed, how the health issues affecting young people have changed and what adolescent-friendly children’s hospitals could–or should–look like.Over the past century, the social context of adolescence has been transformed, with a dramatic increase in years spent in secondary and post-secondary education, and an equally remarkable increase in the age at which the social milestones that historically marked the end of adolescence have been achieved such as leaving home, marriage and children. Just as significantly, the health issues affecting children and young people have been equally transformed. It was not until the middle of last century that children with complex chronic conditions first survived through adolescence in large numbers. This trend has been even more striking over the past few decades. Equally noticeable is the widening scope of paediatric practice that now commonly includes the management of developmental, behavioural and mental disorders (eg bullying, eating disorders, obesity, attention-deficit/hyperactivity disor-