Adolescent development is a dynamic biopsychosocial process that has to be understood by both parents or caregivers and health care providers to guide children through the transition from childhood to adulthood (Neinstein, Woods, Gordon, Katzman, & Rosen, 2009). No one would deny that adolescent development does not occur outside the context of familial and peer relationships. Therefore, it could be argued that the most important distinguishing characteristics of an adolescent are products of family and peer influence. Adolescents develop their identities and beliefs about their role in surrounding cultural environments through interaction with different social groups. Therefore, their ability to cope with the developmental process is directly influenced by their familial and peer relationships (Neinstein et al., 2009).
Unlike Western cultures, the traditional cultures of India and China are associated with a strong pattern of closeness to extended family members (Arnett, 2013). Even though American minority cultures often display a similar proclivity for living in immediate proximity to their grandparents, uncles, aunts, and cousins, Western majority cultures engage in less frequent contact with their extended families. Taking into consideration the fact that “closeness to grandparents is positively related to adolescents’ well-being” (Arnett, 2013, p. 181), it could be argued that Western society could benefit from this practice. Moreover, traditional cultures promote caregiver relationships between siblings, thereby strengthening their bond and substantially reducing the amount of conflict in a family.
There is ample evidence suggesting that health problems faced by adolescents are likely to result in negative consequences in their lifetime (Reilly & Kelly, 2011). For example, adolescent obesity that adversely influences the developed world for the last few decades is positively related to adult morbidity, specifically cardiometabolic morbidity (Reilly & Kelly, 2011). There is also a large body of evidence that shows that exposure to major psychological stressors during adulthood leads to “elevated rates of morbidity and mortality from chronic diseases of aging” (Miller, Chen, & Parker, 2011, p. 959). Health problems faced by adolescents have a lingering influence on their adult life; therefore, it is necessary to take a careful and systemic approach to their treatment.
Even though a fourteen-year-old female patient is perfectly capable of grasping the specifics of the physical exam it is necessary to address the issue of “self-consciousness about their own body” (Sanfilippo, Lara-Torre, Edmonds, & Templeman, 2012, p. 120). The challenge stems from the fact that adolescents develop at varying ages; therefore, it might be necessary to precede an examination with educational videos that explain the process of examination. Even though the child’s parent is present at the exam, it is necessary to talk directly to the child to establish rapport. The child should be provided with a confidential screening questionnaire. It is also necessary to check adolescent-specific history, immunizations, substance abuse, depression, and eating disorders among others (Schuiling & Likis, 2013). The child should be encouraged to allow a doctor to become “the liaison between her and her family” (Sanfilippo et al., 2012, p. 212) so she could be provided with health information.
A doctor should “discuss issues of confidentiality with an adolescent and their parent/guardian” (Sanfilippo et al., 2012, p. 263) before taking their sexual history. Even though teenagers are allowed to legally consent to “confidential diagnosis and treatment of STDs” (Sanfilippo et al., 2012, p. 263), they should be informed that if a patient’s disease poses a significant threat to either their or someone else’s life, the clinician has a right to disclose such information. A doctor has to provide a patient with information on abstinence, STD risk reduction, and condom use among others (Sanfilippo et al., 2012, p. 263).
References
Arnett, J. (2013). Adolescence and emerging adulthood: A cultural approach. New York, NY: Pearson.
Miller, G., Chen, E., & Parker, K. (2011). Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving towards a model of behavioural and biological mechanisms. Psychological Bulletin, 137(6), 959-997.
Neinstein, L., Woods, E., Gordon, C., Katzman, D., & Rosen, D. (2009). Handbook of adolescent health care (1st ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Reilly, J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review. International Journal of Obesity, 35(1), 891-898.
Sanfilippo, J., Lara-Torre, E., Edmonds, K., & Templeman, C. (2012). Clinical pediatric and adolescent gynecology. New York, NY: Informa Healthcare
Schuiling, K., & Likis, F. (2013). Women’s gynecologic health (1st ed.). Sudbury, MA: Jones & Bartlett Learning.