Conception Through Adolescence Client Education. The development of children ages 12 through 18 years old is expected to include predictable physical.

Conception Through Adolescence Client Education

The development of children ages 12 through 18 years old is expected to include predictable physical and mental

milestones.

During adolescence, children develop the ability to: Understand abstract ideas, such as higher math concepts, and

develop moral philosophies, including rights and privileges Establish and maintain satisfying relationships by learning to

share intimacy without feeling worried or inhibited Move toward a more mature sense of themselves and their

purpose Question old values without losing their identity

PHYSICAL DEVELOPMENTDuring adolescence, young people go through many changes as

they move from childhood into physical maturity. Early, prepubescent changes occur when the secondary sexual characteristics appear.

Girls:

Girls may begin to develop breast buds as early as 8 years old. Breasts develop fully between ages 12 and 18.

Pubic hair, armpit and leg hair usually begin to grow at about age 9 or 10, and reach adult patterns at about 13 to 14 years.

Menarche (the beginning of menstrual periods) typically occurs about 2 years after early breast and pubic hair appear. It may occur as early as age 10, or as late as age 15. The average age of menstruation in the United States is about 12.5 years.

Girls have a rapid growth in height between ages 9.5 and 14.5, peaking at around age 12.

Boys..

Boysmay begin to notice that their testicles and scrotum grow as early as age 9. Soon, the penis begins to lengthen. By age 16 or 17, their genitals are usually at their adult size and shape.

Pubic hair growth -- as well as armpit, leg, chest, and facial hair -- begins in boys at about age 12, and reaches adult patterns at about 15 to 16 years.

Boys do not start puberty with a sudden incident, like the beginning of menstrual periods in girls. Having regular nocturnal emissions (wet dreams) marks the beginning of puberty in boys. Wet dreams typically start between ages 13 and 17, with the average at about 14.5 years.

Boys' voices change at the same time as the penis grows. Nocturnal emissions occur with the peak of the height spurt.

BEHAVIOR... The sudden and rapid physical changes that adolescents go through

make adolescents very self-conscious, sensitive, and worried about their own body changes. They may make painful comparisons about themselves with their peers.

Because physical changes may not occur in a smooth, regular schedule, adolescents may go through awkward stages, both about their appearance and physical coordination. Girls may be anxious if they are not ready for the beginning of their menstrual periods. Boys may worry if they do not know about nocturnal emissions.

During adolescence, it is normal for young people to begin to separate from their parents and establish their own identity. In some cases, this may occur without a problem from their parents and other family members. However, in some families, the adolescent's rebellion may lead to conflict as the parents try to keep control.

As adolescents pull away from their parents in a search for their own identity, their friends become more important.

Their peer group may become a safe haven, in which the adolescent can test new ideas.

In early adolescence, the peer group usually consists of non-romantic friendships, often including "cliques," gangs, or clubs. Members of the peer group often try to act alike, dress alike, have secret codes or rituals, and participate in the same activities.

As the youth moves into mid-adolescence (14 to 16 years) and beyond, the peer group expands to include romantic friendships.

In mid- to late adolescence, young people often feel the need to establish their sexual identity by becoming comfortable with their body and sexual feelings. Through romantic friendships, dating, and experimentating, adolescents learn to express and receive intimate or sexual advances. Young people who do not have the opportunity for such experiences may have more difficulty with intimate relationships when they are adults.

Adolescents usually have behaviors that are consistent with several myths of adolescence:

The first myth is that they are "on stage" and other people's attention is constantly centered on their appearance or actions. This normal self-centeredness may appear (especially to adults) to border on paranoia, self-love (narcissism), or even hysteria.

Another myth of adolescence is the idea that "it will never happen to me, only the other person." "It" may represent becoming pregnant or catching a sexually-transmitted disease after having unprotected sex, causing a car crash while driving under the influence of alcohol or drugs, or any of the many other negative effects of risk-taking behaviors.

SAFETY..Adolescents become stronger and more independent before

they've developed good decision-making skills. A strong need for peer approval may entice a young person to try dangerous feats, or take part in risk-taking behaviors.

Motor vehicle safety should be stressed, focusing on the roles of the driver/passenger/pedestrian, the risks of substance abuse, and the importance of using seat belts. Adolescents should not have the privilege of using cars and recreational motor vehicles unless they can show that they can use these vehicles safely.

Other safety issues are:Adolescents who are involved in sports should learn to use

equipment and protective gear or clothing. They should be taught the rules of safe play and healthy approaches to activities that require more advanced skills.

Young people need to be very aware of possible dangers -- including sudden death -- which may occur with regular substance abuse, and with the experimental use of drugs and alcohol.

Adolescents who are allowed to use or have access to firearms need to learn how to use them safely, properly, and legally.

PARENT’S TIPS ABOUT SEXUALITYAdolescents usually need privacy to understand the changes taking place in

their bodies. Ideally, they should be allowed to have their own bedroom. If this is not possible, they should have at least some private space.

Teasing an adolescent child about physical changes is inappropriate, because it may cause self-consciousness and embarrassment.

Need to remember that it is natural and normal for their adolescent to be interested in body changes and sexual topics. It does not mean that a child is involved in sexual activity.

Adolescents may experiment with or consider a wide range of sexual orientations or behaviors before feeling comfortable with their own sexual identity. Parents must be careful not to call new behaviors "wrong," "sick," or "immoral”.

INDEPENDENCE AND POWER STRUGGLES The teenager's quest to become independent is a normal part of

development. The parent should not see it as a rejection or loss of control over the child. Parents need to be constant and consistent. They should be available as a sounding board for the youth's ideas, without dominating the child's newly independent identity.

Although adolescents always challenge authority figures, they need or want limits, which provide a safe boundary for them to grow and function. Limit-setting means having pre-set rules and regulations about their behavior.

Power struggles begin when authority is at stake or "being right" is the main issue. These situations should be avoided, if possible. One of the parties (typically the teen) will be overpowered, causing the youth to lose face. This can cause the adolescent to feel embarrassed, inadequate, resentful, and bitter.

Parents should be ready for and recognize common conflicts that may develop while parenting adolescents. The experience may be affected by unresolved issues from the parent's own childhood, or from the adolescent's early years.

Parents should know that their adolescents will repeatedly challenge their authority. Keeping open lines of communication and clear, yet negotiable, limits or boundaries may help reduce major conflicts.

Most parents feel like they have more wisdom and self-growth as they rise to the challenges of parenting adolescents.

PATIENT EDUCATION..

Patient education is defined as any set of planned educational activities designed to improve patients’ health behaviors and health status. Its main purpose is to maintain or to improve patient health or, in some cases, to slow deterioration.

However, patient and family education goes beyond this main purpose.

An informed and educated patient can actively participate in his or her own treatment, improve outcomes, help identify errors before they occur, and reduce his or her length of stay.

THE BENEFITS OF PATIENT EDUCATION INCLUDE:

Increasing the patient's ability to cope with and manage his or her health Facilitating understandings of health statuses, diagnosis and treatment

options, and consequences of care for patients and their families Empowering patients to make decisions related to their care Increasing patients’ potential to follow a health care plan Helping patients learn healthier behaviors Promoting recovery and improved function Increasing patient confidence in his or her self care Decreasing treatment complications

Other Benefits of Patient Education

Increases patient understanding of needs. Informed patients who understand their conditions are more prepared to understand options for treatment and consequences of care.

Improves coordination of multiple parts of a condition. Patient education can help improve coordination of care for patients with complex conditions.

Increases patient self-management and ability to self-advocate. Education empowers patients to take an active role in managing their own health care. For instance, if an asthmatic patient understands that being around smokers can be harmful to them, they can actively avoid secondhand smoke and ask others to refrain from smoking around them.

Increases patient motivation and adherence. Informed patients who understand their conditions and needs are more motivated to follow a care plan and adhere to guidelines.

Improves outcomes. When patients are more motivated and adhere to guidelines, they are more likely to achieve better outcomes.

Increases satisfaction and experience. When patients' experience better outcomes, satisfaction and patient experience generally increase.

Decreases patient attrition. Educated patients who achieve positive outcomes and have positive experiences are more likely to stay with their current provider and recommend that provider to friends.

Decreases complications. When patient outcomes improve as a result of

patient education, the likelihood of complications decreases, as well.

Decreases unnecessary phone calls, visits, readmissions. When patients are informed and educated, they are less likely to call with questions or come in for unnecessary visits.

Decreases malpractice risk through engagement and expectation setting. When patients are more engaged, adherent and satisfied, the risk of malpractice claims is greatly reduced.

ORGANIZATIONS THAT PROVIDE TARGETED AND APPROPRIATE PATIENT AND FAMILY EDUCATION CAN REAP OTHER BENEFITS AS WELL, INCLUDING:

Increased customer satisfaction Compliance with regulatory standards Improved efficiency through cost-effective care Better informed patients and a lessened chance for malpractice

claims

EDUCATION PROVIDERS|May include: physicians, physician assistants, pharmacists, registered dietitians, registered nurses, advanced practice nurses, health librarians, hospital discharge planners, medical social workers, psychologists, disease or disability advocacy groups,

special interest groups, health advocates and pharmaceutical

companies.

Patients education techniques Computer-aided teaching:  Computer or other output devices allow patients to

view and to hear patient education materials in the hospital and some of these materials can be reviewed at home. Manuals are often made available to accompany the computerised programs. And there is usually a test to evaluate learning once the program is completed.

Video education: Video education is very similar to computer-based training. But, it is more difficult to evaluate learning. A written post-test could be used after the video is reviewed. But, it is important with both of these media to consider the patients’ educational level, language, and hearing/seeing abilities.

Demonstration: Demonstration is another effective patient-teaching technique. Patients can be showed how to complete a task or how a process works in a one-on-one setting, and then they can do the task more effectively at home. However, in an acute care setting this might be more difficult to do. The pace is much faster, but case managers or patient care assistants can be used to assist the nurse if needed. And, demonstration does ensure that patients fully understand the teaching, and it allows them to get feedback and ask questions in a safe arena.

Written material:  Written material seems so easy and routine. But, it can be effective. For instance, material with pictures can offer instructions or explanations.  Written material related to prescribed medicines is also a necessity.  And, it can offer instructions in a step by step fashion. Once again, it is important to evaluate the patients’ literacy level, language, and sight before handing out routine teaching materials. 

Discharge instructions:  At the time of discharge, patients can be equipped with a set of instructions with follow-up appointments, medication teaching, and phone numbers. Many discharge instructions can easily be printed using PHR and EMR software systems. These instructions usually give phone numbers (of whom to call with questions) and follow-up appointment instructions. 

Discharge prescriptions:  Prescriptions for discharge medications are usually included in these instructions.  It is important to verify that the patient knows the names, the purpose, and the dosage instructions for these medications.  If needed, verify with the case manager that the patient can afford these medications; and if needed, call them into their pharmacy before discharge. 

Evaluating patient learningEffective patient teaching also requires evaluation and

documentation. Learning can be evaluated  in the following ways:

Asking questions: Simply ask the patient questions to see whether they is information that needs reinforcing.

Observe return demonstration: Watch the patient perform a task (i.e. self inject insulin) to see if the technique is correct.

Assess the data: Ask the patient to record his blood pressure, blood glucose, or weight at home.  And, review the records at the next visit.  These records will demonstrate how effective the current treatments have been. 

Talk with the patient/family: At the next visit, or before discharge, talk with the family to see how the patient has been doing, or before they leave the hospital, engage in open dialogue about barriers or concerns. This is very similar to the idea of “asking questions, “ but both methods are useful. 

Documenting patient teaching  There are many computerised systems out there. And some

offices might still use hand-written documentation. Whatever method you use remember that the information must become a part of the patient’s permanent medical record.  You can include in the documentation:

Information and skills you have taught Teaching methods used – brochures, models, videos,

demonstration Patient and family response to teaching Evaluation of what the patient and family have learned and

how learning outcomes were determined