Puberty questions asked by early adolescents: what do they want to know?

Experiences of teen drivers and their advice for the learner license phase

OBJECTIVE

Teen drivers remain at considerable risk of injury and fatality during the earliest years of independent driving. Multistage licensing programs, such as graduated driver licensing (GDL), have been implemented in numerous jurisdictions as a form of exposure control, mandating minimum practice periods and driving restrictions such as night driving and passenger limits. However, the teen driver's experiences of GDL during the learner phase, and the driving and other advice they recommend be shared with all learners, remains unknown at this time.

METHODS

Thirty-seven learner drivers (aged 16-18 years, mean = 16.7, mode = 16; 9 males) from 2 high schools (one private, 3 males; one public) participated in one of 2 (group 1: private school, n = 17) 45-min group discussions.

RESULTS

Two themes emerged: (1) learning to drive and (2) supervision of the learner driver. A wealth of experiences and advice pertaining to the subthemes of supervisor behavior, GDL, road environment, vehicle logistics, and interacting with other road users were shared by learners. Numerous recommendations are made pertaining to each subtheme, such as clear instruction and feedback, tips for negotiating complex infrastructure, and normalizing of outcomes like stalled vehicles when first learning to drive. Furthermore, it appears that current approaches of issuing supporting literature at the commencement of the learner phase are insufficient.

CONCLUSIONS

The wealth of experiences and advice shared by the learner drivers should be considered in refining the content and process of the learner license phase. Moreover, the nonuse of learner resources suggests that alternative mechanisms of engagement and information dissemination need to be explored.

Youth-friendly reproductive health services in Jordan from the perspective of the youth: a descriptive qualitative study

PURPOSE

This study aims at describing the needs for reproductive health services among Jordanian youth, identifying problems youth encounter when using reproductive health services, and identifying youths' perceptions of the characteristics of youth-friendly reproductive health services.

METHODS

A qualitative study using focus groups was conducted on a convenience sample of 60 young men (n = 33) and women (n = 27) (age 12-18 years) selected from the three regions of Jordan. The focus groups were audio taped, and content analysis was used to analyse the data.

RESULTS

The results revealed that the participants' knowledge about aspects of reproductive health was limited or inadequate. The participants indicated their need for reproductive health information and quality services. The major barriers to using reproductive health services were unpleasant facilities, unprofessional conduct and ill-informed professionals. Youth expressed many ideas about how services could be improved to be more 'youth friendly'.

CONCLUSIONS

The findings of this study can be useful to health services planners and healthcare providers to improve services and start youth-friendly reproductive health services in Jordan and to develop educational programmes that may improve healthcare professionals' knowledge and attitudes and advance their interpersonal skills for working with youth.

Views of treatment decision making from adolescents with chronic illnesses and their parents: a pilot study

OBJECTIVE

Shared decision making may increase satisfaction with health care and improve outcomes, but little is known about adolescents' decision-making preferences. The primary purpose of this study is to describe the decision-making preferences of adolescents with chronic illnesses and their parents, and the extent to which they agree.

DESIGN

Survey.

SETTING AND PARTICIPANTS

Participants were 82 adolescents seen at one of four paediatric chronic illness subspecialty clinics and 62 of their parents.

MAIN VARIABLES

Predictor variables include sociodemographics, health parameters, risk behaviour, and physical and cognitive development. The main outcome variable is preferences for decision-making style.

RESULTS AND CONCLUSIONS

When collapsed into three response categories, nearly equal percentages of adolescents (37%) and parents (36%) preferred shared decision making. Overall, the largest proportion of adolescents (46%) and parents (53%) preferred passive decision making compared to active or shared decision making. Across five response choices, 33% of pairs agreed. Agreement was slight and not significant. Improved general health perceptions (OR=0.76, 95% CI=0.59-0.99) and improved behaviour (OR=0.75, 95% CI=0.56-0.99) were significantly associated with parents' preferences for less active decision making. Older age was significantly associated with agreement (OR 1.58, 95% CI=1.09-2.30) between parents and adolescents. The paucity of significant predictor variables may indicate physicians need to inquire directly about patient and parent preferences.

Health care preferences and priorities of adolescents with chronic illnesses

BACKGROUND

Efforts to make health care for adolescents with chronic illnesses more patient-centered must be grounded in an understanding and clear measures of adolescents' preferences and priorities.

OBJECTIVE

To develop a measure of health care preferences of adolescents with chronic illnesses and to determine demographic, developmental, and health factors associated with adolescents' preferences.

DESIGN

Mixed-method questionnaire development and survey.

SETTING

Subspecialty clinics of a tertiary care children's hospital.

PARTICIPANTS

All adolescents (age: 11-19 years) with juvenile rheumatoid arthritis, sickle cell disease, inflammatory bowel disease, or cystic fibrosis of at least 2-year duration who were being treated at the participating center were eligible to participate, and 155 of 251 did so (62%). The participants had a mean age of 15.5 +/- 2.4 years, 45% were male, and 75% were white.

INTERVENTION

None.

MAIN OUTCOME MEASURES

Ratings of 65 items related to quality of care and 17 items related to physician-patient communication styles.

RESULTS

An 82-item questionnaire, devised from qualitative analysis of focus group results, contained 65 Likert scale items that adolescents considered important for health care quality and 17 forced-choice items related to adolescents' preferences for communication. Among the first 65 items, the group of questions related to physician trust and respect had the highest rating of 5.24 +/- 0.62 of 6, followed by patient power and control (mean rating: 4.72 +/- 0.77) and then caring and closeness in the patient-doctor relationship (mean rating: 4.19 +/- 0.91). For the communication items, the adolescents, on average, preferred communication directly to them rather than to their parents and were nearly neutral regarding physicians' inquiries about personal issues.

CONCLUSIONS

Participants rated aspects of interpersonal care (especially honesty, attention to pain, and items related to respect) as most important in their judgments of quality. As in most previous studies of adults, technical aspects of care were also rated highly, suggesting that adolescents understand and value both scientific and interpersonal aspects of care.