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This week’s discussion post will focus on an adolescent Hispanic/Latino boy living in a middle-class suburb. Adolescence can be a very difficult time for children due to the many physical, emotional, and environmental changes occurring that are out of their control. It is also a time of vulnerability and a tendency to experiment in risky behavior (Ball et al, 2015). Adolescence is an important time for prevention and detection of health risk behaviors and factors and their early intervention, such as drug or alcohol use, risky sexual practices, and mental health concerns (Kadivar et al, 2014). As the practitioner, it is important to build an open and trusting relationship with patients in this age group. Developing communication skills that foster open communication with the adolescent population is a key element to creating a solid relationship between the provider and patient. Several studies within this patient population show that adolescents prefer when the provider speaks to them with a direct tone and avoids using vague language (Zelazny et al, 2019). Many studies have focused on the need for providers to communicate in relatable, casual, and a friendly manner (2019). Adolescents’ perception of relatable language involves a balance between non-jargon use, non-slang use, and casual but still professional language (2019). .Assessment of any language barriers should take place at the beginning of the encounter. Language barriers between health care providers and patients with limited English proficiency can have serious consequences, including medical errors, delays in treatment, issues with informed consent, and physical harm to patients (Hu, 2018). Medical information is at times difficult for even patients that English is their native language (2018). Research has found that the use of professional interpreters positively influences the quality of care for limited English proficient patients (2018).
The visit would begin with the adolescent and the parent in the room and when the physical exam began, I would ask the parent to leave the room for the physical exam and sensitive interview questions. Prior to the parent leaving, I would explain confidentiality to the parent and the patientThe screening tool that I would use with this patient would be the HEEADSSS tool (2015). The HEEADSSS review of systems is a tool to understand adolescent behavior and assess risk-taking behaviors to provide appropriate interventions (Smith & McGuinness, 2017). HEEADSSS is an acronym of pertinent factors associated with adolescent health: home, education/employment, eating, activities, drugs and alcohol, sexuality, suicidality, and safety (2017). Using the HEEADSSS review of systems is an effective way to engage in dialogue with teens and address many of the challenges faced by this age group (2017). It may be beneficial to have the patient answer a pre-screening questionnaire in order to give them the opportunity to write any concern or allow a choice of concerns to be addressed during the examination (2015).