Consultations with adolescents: the gap between their expectations and their experiences

Abstract

Aim: To study the expectations and experiences of adolescents when in consultation with doctors, particularly with regard to issues of confidentiality. Methods: In a cross‐sectional study, 613 seventh‐ and ninth‐grade students (347 students aged 13 y and 266 students aged 15 y) completed a 40‐item questionnaire specifically developed for this study. Students anonymously completed the self‐administered questionnaire at school. Results: Of these adolescents, 89% aged 13 y and 57% aged 15 y were accompanied by one of their parents to appointments with private practitioners. Of the respondents, 33%/52% (13‐y‐olds/15‐y‐olds) said that seeing the doctor alone for some time was important but only 18%/20% were given the opportunity to do so. Although 79%/90% of respondents stated that it was important for the doctor to keep information confidential, on request, only 37%/40% of private practitioners had spoken about confidentiality; 64%/78% of adolescents said that doctors should give assurance of confidentiality even with regard to their parents. However, only 26%/27% of private practitioners explicitly assured confidentiality with regard to parents. Acceptance of conditional confidentiality was high in all subpopulations. Short waiting times and the opportunity to talk about topics such as nutrition, drugs and sexuality were rated as important. Conclusion: Physicians should adapt their consultation style to the needs of adolescents by seeing the adolescent patient alone for some time and by assuring them of conditional confidentiality. Furthermore, they should provide opportunities to talk specifically about issues of potential concern to adolescents such as nutrition, drugs and sexuality. To accomplish these tasks, educational curricula in adolescent healthcare are required for physicians.

Informative privacy and confidentiality for adolescents: the attitude of the Flemish paediatrician anno 2010

“…This percentage is independent of the work environment (p=0.09), gender (p=0.43) and age of the paediatrician (p=0.90). These data are in alignment with the study of Rutishauser et al, performed in Switzerland, stating that paediatricians offer in 33-52% of the consultations with adolescents a private moment [22]. The adoption of this recommendation in the day-to-day practice should not present a major obstacle, since the majority of parents, if adequately informed, see the point of the advantage of such a private moment during consultation [16].…”

“…This figure is even lower that the already low incidence of 9% in Israel, as reported by Urkin et al [27]. Unaccompanied visits are widely practiced and accepted by the parents and the public opinion [22,26]. Information campaigns focussing on the target population of adolescents are needed to increase the number of unaccompanied visits [26].…”

Challenges of Providing Confidential Care to Adolescents in Urban Primary Care: Clinician Perspectives

“…5,16,22,23 Expert guidelines recommend routine discussions of confi dentiality protections, including the limitations of confi dentiality protections, with both adolescents and their parents. 7 The self-report data in this study suggest clinicians perceive that they routinely explain confi dentiality to youth but are much less likely to include parents in the discussion.…”

Comment bien identifier les adolescents présentant une consommation alcoolique excessive?

“…Dans ce cas il y a aussi un déséquilibre entre ce qu'offrent les professionnels de la santé et ce qu'attendent d'eux leurs jeunes patients. Une étude suisse signalait que moins de 40% des médecins avaient discuté de la confidentialité avec leurs patients, alors que plus de 79% d'entre ces jeunes, âgés de 13-15 ans, pensaient que c'était pourtant important de le faire [6].…”