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Health Maintenance of the Adolescent Male

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  1. Health Maintenance of the Adolescent Male Presented By: Kaitlyn Long SFNP, Tyler Mason Counseling, Bonnie Rogulj SDPT

  2. Goal: •  To provide information unto multidisciplinary health professionals regarding the maintenance of physical and mental health amongst the adolescent male population in order to promote an optimal quality of life and reduce the risk of mortality.

  3. Age: • The World Health Organization (WHO) has defined adolescence as pertaining to those within the age range of 10 and 19 years.

  4. Implication for health promotion: • Males within this age range have a higher tendency to engage in “risky” behaviors therefore, endangering their lives. • Adolescent males are more likely to die than adolescent females at every single year of age from 12 to 19 years (cdc 2012)

  5. Risk Factors: • Sexual Intercourse • Mental Health -Mood Disorders -Suicide -Attention Deficit Hyperactivity Disorder • Substance Abuse • Obesity, Eating, Physical Activity • Accidents

  6. Psychosocial Risk Factors. • Childhood Aggressive Behavior • Family and Social Environment • Socio-Economic Status (SES) • Sexual Orientation

  7. Special Issues Regarding Race / Ethnicity • Health Disparity • Health Care Access

  8. Screening • Past Medical History • Family Medical History • Occupation: Student? • Activity Level (frequency/duration) • Vaccination records

  9. Screening cont. • Stress Level (low, moderate, high) • Smoke? Drink? • Sexually Active? • Hobbies/ Activities

  10. Physical Findings: • Age • BP • Temperature • Height • Weight • BMI • Oxygen Saturation

  11. Physical cont. • Skin • Musculoskeletal • Respiratory • Neurologic Exam • Eye Exam • Genitalia Exam • Gait Analysis

  12. Physical Findings cont. • Video: What is Scoliosis?

  13. Additional Testing: • Cholesterol • Urine Analysis • Hemoglobin and Hematocrit • Purified protein derivative (PPD) • Complete blood count (CBC)

  14. Findings: • Findings may warrant further examination or the need to refer for additional services. • Inform Parents / Guardians of the adolescent male

  15. Referral List may include: • Nutritionist • Physical Therapist • Urologist • Neurologist • Chiropractor • Alternative medicine

  16. Referral cont. • Social Worker: • Counselor: • Psychiatrist: • Life Coach:

  17. Guidelines/Follow-up: • Patient & Parent/Guardian Education • Reason for referral • Referral Letter • Time / Date Appointment • Relevant material: medical history • Actual Appointment • Post- care protocol • Follow- up appointment

  18. Recommendations: • Stay Active! • Participation in regular counseling sessions • Schedule routine health appointments • Don’t give into peer pressure • Eliminate excess stress • Communicate • Stay safe

  19. Screening Tool Annual Comprehensive Male Adolescent Screening Assessment  Patient Name: Date of Birth: Race/Ethnicity: REASON FOR TODAY’S VISIT MEDICAL HISTORY CURRENT MEDICAL HISTORY Current health problems and concerns: Allergies: Current medications: Immunization History: \ Weight gain/loss over the last year:

  20. Screening Tool cont. Review of Systems (Subjective) WNL= within normal limits AB=abnormal ( appropriate box) HEENT=Head, Ears, Eyes, Nose, Throat (vision, oral care) Skin/nodes  Respiratory (Wheezing, cough, shortness of breath)  Cardiovascular (palpitations, swelling of extremities)  Gastrointestinal (Nausea, vomiting, stools)  Genitourinary (frequency, painful) Musculoskeletal Neurological (Headaches, emotional liability)

  21. Screening Tool cont. Physical Assessment (Objective) WNL= within normal limits AB=abnormal ( appropriate box) General appearance/affect  HEENT Skin: Respiratory  Cardiovascular  Gastrointestinal Genitourinary: Musculoskeletal: Neurological:

  22. Screening Tool cont. Psychosocial Screening using HEADSSS Home Living with: Length of time in current home: Recent changes: Strongest adult connections: _____________Family meals/celebrations: ____________ Environmental risks: __ inadequate housing __ TB exposure Education/Employment Sources of help/support at school:_______Favorite classes/school activities:____________ School difficulties/frustration:_________Current employment/hours:_____________________ Extracurricular activities:____________________Standardized Testing Results_____________

  23. Screening Tool cont. Activities After-school and weekend activities: ___________Peer relationships: ________ # hours/day watching TV, computer, video games:_____Volunteer/civic activities: ______ Weekly physical activities:________Food bingeing/purging: _____________ Religious/spiritual involvement:___________________Dating _________________________ Drugs/Alcohol/Tobacco Exposure to drugs/EtOH, tobacco ________________Steroids use/exposure:__________ Refusal strategies/skills:__________Use (last 3 months) ___________Binging:________Has/wants to quit: yes or no

  24. Screening Tool cont. Sexuality Age ofsexual debut_______________F/M partners _________________ Sexual ID____________Oral/vaginal/anal intercourse _________ STD/HIV exposure/hx__________________STD/pregnancy protection:_____________ Sex under the influence______________________Forced/pressured sex:________ Sadness/Self-Image/Depression/Suicide Family and/or personal changes/stresses in the past year: Body image_______________Stress/sadness/worries_____________________________ Suicide exposure/thoughts/plan:

  25. Screening Tool cont. Safety Weapon carrying ___________________Anger control _________________________________ Comfort going to school/friends/work _____________Guns in house/bldg _______ Emotional/sexual/physical abuse:_________If in danger, safe place/person to go to __________ Labs/Imaging __Urine analysis- if sexually active __Complete blood count- if signs and symptoms of infection are present or anemia is suspected __Cholesterol screening __Purified protein derivative (PPD)- if exposure to tuberculosis is expected __X-ray- if physical assessment warrants further evaluation of suspected skeletal abnormalities Referrals Warranted

  26. References: Brooks, T. L., Harris, S. K., Thrall, J. S., et al. (2002). Association of adolescent risk behavior with mental health symptoms in high school students. Journal of Adolescent Health, 31, 240-246. Conger, R. D., Conger, K. J., Elder, Jr., G. H., Lorenz, F. O., Simons, R. L., & Whitbeek, L. B. (1992). A family process model of economic hardship and adjustment of early adolescent boys. Child Development, 63, 526-541. Cornette, R. (2008). The emotional impact of obesity on children. Worldviews on Evidence Based Nursing, 5, 136–141. D'Augelli, A. R., & Hershberger, S. L. (1993). Lesbian, Gay, and Bisexual Youth in Community Settings: Personal Challenges and Mental Health Problems. American Journal of Community Psychology, 21, 421-448. Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronicconduct problems in adolescence. Developmental Psychology, 39,  349–371. Forman, S., & Emans, S. (2000). Current goals for adolescent health care. Hospital Physician.36(1), 27. Gandhi, TK, Sittig, D F, Franklin M, Sussman, AJ, Fairchild DG, Bates DW. (2000) Communication Breakdown in the Outpatient Referral Process. J Gen Intern Med. 15(9), 626–631. http://www.youtube.com/watch?v=Hx-hU-0q_kM. Accessed 02/09/2013.

  27. References Kirby, J. B., & Kaneda, T. (2010). Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach. Demography. 47, 1035–1051. Knopf, D., Park, M. J., & Paul Mulye, T. (2008). The Mental Health of Adolescents: A National Profile, 2008. San Francisco, CA: National Adolescent Health Information Center, University of California, San Francisco. Kodjo, C. M., & Auinger, P. (2004). Predictors for emotionally distressed adolescents to receive mental health care. The Journal of Adolescent Health, 35, 368-73. Kodjo ,C. M., Auinger, P., & Ryan, S. A. (2004). Prevalence of and factors associated with adolescent physical fighting while under the influence of alcohol or drugs. J.Adolesc.Health, 35, 346. Marcell, A. (2006). Making the most of the adolescent male health visit: part 2: the physical exam. Contemporary Pediatrics, 23(6), 38-46. Marcell, A., & Bell, D. (2006). Making the most of the adolescent male health visit: part 1:history and anticipatory guidance. Contemporary Pediatrics, 23(5), 50-63.

  28. References Marshal, M.P., Friedman, M.S., Stall, R., King, K.M., Miles, J., Gold, M.A., Bukstein, O.G., & Morse, J.Q. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103, 546-56. Melnyk, B. M., L., Morrison-Beedy, D., Strasser, A., Spath, L., Kreipe, R., Crean, H., Jacobson, D., & Van Blankenstein, S. (2006). Mental health correlates of healthy lifestyle attitudes, beliefs, choices, and behaviors in overweight adolescents. Journal of Pediatric Health Care, 20, 401-406. Minino, A. M. (2010). Mortality among teenagers aged 12–19 years: United States, 1999–2006. NCHS Data Brief, 37, 1-8. Nagin, D., & Tremblay, R. E. (1999). Trajectories of boys’ physical aggression, opposition, hyperactivity on the path to physically violent and nonviolent juvenile delinquency. Child Development, 70, 1181–1196. National Institute of Mental Health (NIMH). (2009). Depression in boys and adolescent males. Retrieved from http://www.nimh.nih.gov/health/publications/menanddepression/depression-in-boys-and-adolescent-males.shtml Presnell, K., Bearman, S. K., & Stice, E. (). Risk factors for body dissatisfaction in adolescent boys and girls: A prospective study. Int J Eat Disord 36, 389–401.

  29. References Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. Am J Public Health, 88, 57–60. Saluja, G., Iachan, R., Scheidt, P. C., Overpeck, M. D., Sun, W., & Giedd, J. N. (2004). Prevalence of and risk factors for depressive symptoms among young adolescents. Arch Pediatr Adolesc Med, 158, 760-5. Substance Abuse and Mental Health Services Administration (SAMHSA). (2008). Results from the 2007 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-34, DHHS Publication No. SMA 08-4343). Rockville, MD. Thomas, J. F., Temple, J. R., Perez, N., & Rupp, R. (2011). Ethnic and gender disparities in needed adolescent mental health care. J Health Care Poor Underserved, 22, 101-10. Westwood, M., & Pinzon, J. (2008). Adolescent male health. Peadiatrics & Child Health, 13(1),31-36. Zoe, AK Walker, Townsend, J. (1999). The role of general practice in promoting teenage health: a review of the literature. Oxford Journal Medicine Family Practice.16(2),164-172.