Clinical Conversations About Health: The Impact of Confidentiality in Preventive Adolescent Care

Gilbert, Amy; Rickert, Vaughn I.; Aalsma, Matthew C.

doi:10.1016/j.jadohealth.2014.05.016

Cited by 82 publications

(54 citation statements)

References 19 publications

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“…Similar to our study, others have found that no more than half of adolescents report having confidential care. 51,56 Our study suggests, however, that measures such as preventive counseling, screening, and confidential care are positively associated with report of PCC. Thus, providing PCC could be associated with improving other aspects of adolescent primary care.…”

Section: Discussionmentioning

confidence: 52%

Relationship Between Adolescent Report of Patient-Centered Care and of Quality of Primary Care

Toomey

Elliott

Schwebel

et al. 2016

Academic Pediatrics

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Objective Few studies have examined adolescent self-report of patient-centered care (PCC). We investigated whether adolescent self-report of PCC varied by patient characteristics and whether receipt of PCC is associated with measures of adolescent primary care quality. Methods We analyzed cross-sectional data from Healthy Passages, a population-based survey with 4,105 tenth-graders and their parents. Adolescent report of PCC was derived from four items. Adolescent primary care quality was assessed by measuring access to confidential care, screening for important adolescent health topics, unmet need, and overall rating of health care. We conducted weighted bivariate analyses and multivariate logistic regression models of the association of PCC with adolescent characteristics and primary care quality. Results Forty-seven percent of adolescents reported that they received PCC. Report of receiving PCC was associated with high quality for other measures such as having a private conversation with a clinician (AOR 2.2; 95%CI [1.9, 2.6]) and having talked about health behaviors (AOR 1.6; 95%CI [1.4, 1.8]); it was also associated with lower likelihood for self-reported unmet need for care (AOR 0.8; 95% CI [0.7, 0.9]) and having a serious untreated health problem (AOR 0.4; 95% CI [0.3, 0.5]). Conclusions Many adolescents do not report receiving PCC. Adolescent-reported PCC positively correlates with measures of high-quality adolescent primary care. Our study provides support for using adolescent-report of PCC as a measure of adolescent primary care quality.

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Section: Discussionmentioning

confidence: 52%

Relationship Between Adolescent Report of Patient-Centered Care and of Quality of Primary Care

Toomey

Elliott

Schwebel

et al. 2016

Academic Pediatrics

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“…38, 39 Ensured confidentiality is associated with improved delivery of sexual and reproductive health services. 27, 40 Therefore, to promote better outcomes, nurses should reassure adolescents that reproductive health care behavioral screenings and pregnancy and STI prevention counseling are confidential. Adolescents suggest that the best way to encourage nurse–adolescent discussions is to increase private consultation time with a nurse who has established trust and confidence.…”

Section: Calls For Improvementmentioning

confidence: 99%

Nurses on the Front Lines

Maria

Guilamo‐Ramos

Jemmott

et al. 2017

AJN, American Journal of Nursing

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Nurses care for adolescents in a variety of settings, including communities, schools, and public health and acute care clinics, which affords them many opportunities to improve adolescents’ sexual and reproductive health and reduce the rates of unplanned pregnancy and sexually transmitted infections. To ensure that adolescents have access to sexual and reproductive health care (which includes both preventive counseling and treatment) in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence-based counseling and services to adolescents and parents. Collectively, nurses can use their unique combination of knowledge and skills to make a positive impact on adolescent sexual and reproductive outcomes. Nurses have the capacity and opportunity to disseminate information about sexual and reproductive health to adolescents and their parents in communities, schools, public health clinics, and acute care settings. This article discusses the Society for Adolescent Health and Medicine’s goals and recommendations, which address adolescent sexual and reproductive health as both a health care and a human rights issue.

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“…It is important for HCPs to offer time without parents in the room to discuss these sensitive topics. Existing research has demonstrated time alone with HCPs results in increased discussion of sensitive health topics (Gilbert, Rickert, & Aalsma, 2014), and the current study found that some emerging adults had to advocate for this important time alone. Comfort with disclosure is a crucial skill for adult medical care, and HCPs and related health professionals like psychologists are in a unique position to facilitate these skills in pediatric care.…”

Section: Discussionmentioning

confidence: 66%

Health communication experiences of emerging adults with Type 1 diabetes.

Simms¹,

Baumann²,

Monaghan³

2017

Clinical Practice in Pediatric Psychology

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Objective In an effort to refine a model of clinical care identifying effective communication with health care providers (HCPs) as a key skill for successful transition to adult medical care, this study explored the perspectives of emerging adults with type 1 diabetes (T1D) about factors that impact the quality and content of communication with their HCPs. Methods Twenty emerging adults with T1D were interviewed about health communication experiences with their pediatric HCP and readiness for transition to adult diabetes care. Interviews were recorded and transcribed; three raters coded transcripts using conventional content analysis for broad themes. Results Five themes emerged from the data capturing factors that influence emerging adult-HCP communication: HCP interaction style, HCP consistency, HCP support for autonomy, parental involvement in medical care, and emerging adult comfort with disclosure. Most emerging adults had not discussed transition to adult diabetes care with their HCP; some expressed confidence in their ability to transition while others expressed anxiety about the transition process. Conclusions Findings support the conceptual model of communication and inform clinical implications for working with emerging adults with T1D. Continuity of care should be prioritized with transition-age patients. Additionally, HCPs should initiate conversations about engagement in risky behaviors and transition to adult medical care and ensure emerging adults have time without parents to discuss these sensitive topics. Psychologists can enhance the transition process by facilitating effective patient-HCP communication and coaching both patients and HCPs to ask questions about risky behaviors and transition to adult medical care.

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Clinical Conversations About Health: The Impact of Confidentiality in Preventive Adolescent Care

Cited by 82 publications

References 19 publications

Relationship Between Adolescent Report of Patient-Centered Care and of Quality of Primary Care

Relationship Between Adolescent Report of Patient-Centered Care and of Quality of Primary Care

Nurses on the Front Lines

Health communication experiences of emerging adults with Type 1 diabetes.

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