6.2 Health services: setting expectations

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來自 The University of Melbourne 的課程

Global Adolescent Health

41 個評分

The University of Melbourne

Global Adolescent Health

41 個評分

This course will explore the dynamic factors affecting the health and wellbeing of young people around the world, and how important it is for individuals, communities and nations that we improve the health and life chances of this important population group. With over 25% of the world’s population aged between 10 and 24 years, today’s generation of young people is the largest in human history. As the future leaders and drivers of growth, productivity and innovation, young people are our greatest assets, and investment in their health and wellbeing has social, economic and other benefits that continue across the lifespan and into the next generation. In this course we will adopt a life-course framework to take a holistic view of youth health and wellbeing. We will explore changing patterns of adolescent health and development, including why adolescence is starting earlier and ending later; how puberty and adolescent brain development may shape future health; and how what happens in adolescence can affect the start to life for the next generation. We’ll also look at the major health and social issues affecting young people and ways of addressing these through policy, practice and programming. COURSE FORMAT: This course comprises short video lectures and interviews, required and recommended readings, online discussion, quizzes and written assignments. There is no required text for this course and all readings are provided. DO I HAVE TO PAY FOR THIS COURSE? No- you may access 100% of material in this course for free. You are also welcome to do as much or as little of the course as you like, including all (or none!) of the assessment tasks- it all depends on your learning goals. The option to pay for this course is there for those who wish to receive a Course Certificate as evidence of completion (which does require you to attempt and successfully pass the assessment tasks). WHO IS THIS COURSE FOR? This course will be relevant for anyone with an interest in the health and wellbeing of young people. You do not need to be of any particular personal or professional background to benefit from this course, but having some basic undergraduate study experience will be helpful to your learning (particularly if in a health related field). WHAT IS THE MOST INTERESTING THING I'LL LEARN IF I TAKE THIS COURSE? You’ll learn how so much of what happens during adolescence can impact not only the future health of individuals, but the health of the next generation as well. You’ll develop a greater understanding of the key factors impacting upon youth health and learn how to be a better advocate for the health and wellbeing of young people. View the MOOC promotional video here: http://tinyurl.com/z5l4mod

從本節課中

Week 6 - Adolescent health policy, programming and intervention (Part II)

This week we continue our exploration of the policy and practice context of adolescent health and development by focusing on the role of health services in responding to the burden of disease experienced by young people. We discuss the elements of quality healthcare for young people and what adolescent-friendly health care means at an individual practitioner and service level. We also highlight the challenge of monitoring and communicating the health status of adolescents at a national and global level, why nations need to be held to account for investing in appropriate actions that promote the health of their young people, and how to promote positive and meaningful youth participation. <br> <br>As this marks the final week of learning material for this course (Weeks 7 and 8 are devoted to the completion and evaluation of Assignment 2 for those interested), we also discuss learning and networking opportunities beyond GAH for those of you who would like to continue this journey.

6.1 Health services for adolescents: mind the gap!11:16

6.2 Health services: setting expectations8:30

6.3 Health services: clinical attitudes, knowledge and skills14:31

6.4 Making health services adolescent friendly10:54

6.5 Health services: platforms for healthcare delivery11:41

6.6 Bringing it all together: an accountability framework5:33

6.7 Bringing it all together: the role of young people6:28

6.8 Learning beyond GAH4:19

Interview with Prof Harish Pemde (India) 28:21

Interview with A/Prof Fadia AlBuhairan (Saudi Arabia) 16:41

Interview with Kikelomo Taiwo (USA/Nigeria) 16:37

Interview with Dakshita Wickremarathne (Sri Lanka) 19:44

與講師見面

Professor Susan Sawyer
Chair of Adolescent Health
Department of Paediatrics
Professor George Patton
Professorial Fellow
Adolescent Health Research

This lecture will focus on how health services and

clinicians can help set expectations for parents and young people alike.

An important aspect of ensuring that health services are appropriate and

acceptable for young people as well as for their parents.

Parents of young children carry a heavy responsibility for their children's health

and well being as I've tried to illustrate here on the yellow icon on the left.

But as we've discussed in the earlier lectures around family in particular,

an important role for parents is that they help set expectations for

their children about what happens as they get older.

This includes parents helping to set expectations with their children about

education, about gender norms and roles, about friendships and relationships,

about employment and finances, and around young people forming their own families.

This is as true for these young girls in South Asia as it is for the young

people on the right from Norway or for my own family members here in Australia.

The same applies to health care.

The United Nations Convention on the Rights of the Child recognises the growing

maturity of adolescents to make independent choices and

judgements about matters affecting them and their future, including their health.

In the earlier lectures we discussed that at times there we can

teach in between the special rights that legal minors have for protection

versus their growing maturity to make decisions about their lives.

The convention on the rights of the child empowers children and young people in

the context of their evolving capacities to make autonomous decisions.

As we've discussed previously, [INAUDIBLE] for example,

the British common law concept of the mature minor doctrine.

However, we cannot expect parents to appreciate the details of

the United Nations Convention on the Rights of the Child.

It's the role of communities and especially of health care professionals to

assist parents appreciate this growing autonomy and independence that young people

have to make independent decisions about their health and well being.

Hopefully, supported by their families.

The United Nation Convention does not describe the specific age that young

people become competent to make important decisions about their health.

However, I thought these data might be of interest as they are a reminder that even

young adolescents typically make similar decisions to young adults around

in this case a series of hypothetical, complex ethical health scenarios.

As clinicians in health services that consult with adolescents

we retain responsibilities to parents as I've attempted to articulate

in the first column here.

And as already stated we have responsibilities to support parents

to assist children take on growing responsibilities for

their health as they mature.

And to help parents understand the changing patterns of health in

young people and

the changing responsibilities that health services have to address these.

Not just the problems that young people present to health services with.

Showing in the middle column are the responsibilities we

have as health services to ensure that both parents and adolescents

are informed about the specific legal context of health consultations.

We want parents and young people to understand that in addition to

consultations with parents, that consultations with young people alone

can enhance young people's capacity to engage in their own healthcare,

to become involved and to gain greater responsibility.

And as shown in the last column, health services also have responsibilities to

support young people themselves to engage more with their healthcare.

And to help them anticipate the changing nature of health issues

that may affect them with increasing age, what this might mean for them and

the responsibilities that health services have

to address these together with the problem that they actually presented with.

Sounds complicated.

Well it is and it isn't.

The main thing to understand is that health professionals must balance both

parents and young people's issues and concerns.

Often this can be straight forward.

It might simply involve pointing out to parents that it is for

these reasons that you are going to be starting to address questions to the young

person directly rather than to have the parent speak on behalf of the adolescent.

It includes point out to the adolescent,

that it is due to health needs changing with age and

young people gaining greater sensitivity about these, that you will be starting to

ask them a number of wider questions, not just about what they came to see you for.

And that you will be doing this confidentially without their parent

present and that this is part of your clinical role.

At other times though, I think we can appreciate,

it can be more challenging to balance both of these perspectives.

In addition to what clinicians might say, there are other ways that they can

help set expectations such as through the health information,

health promotional material displayed on the walls of clinics,

all through community services or school based approaches.

You can appreciate that health services for infants and younger children

will have a heavy focus on health promotional material that are relevant to

to their age group such as posters around the importance of breast feeding or

immunisation for infants.

But adolescent friendly health services can also help set expectations about what

clinicians might discuss in consultations with the young by displaying

materials that address relevant health issues for adolescents.

This might include posters on human papillomavirus immunisation,

about the importance of contraception or of the dangers of smoking, alcohol or

other drugs.

Importantly, schools are a setting that can also help

set expectations around a variety of health issues.

This includes the traditional areas that schools have in terms of delivering

comprehensive sexuality education including gender norms but

can also be wider in terms of promoting health literacy.

For example, around the importance in changing nature of mental health and

well being and interpersonal violence.

Schools can also be reassuring to young people about the confidentiality and

sensitivity, hopefully of local health services.

And posters such as the one on the right that we developed locally

can be a resource in schools, health services and the community to help for

example, in this case, increase health literacy about the range of

emotional responses that can be experienced at any time.

Setting expectations is also about ensuring

that young people with chronic physical health and mental health conditions learn

about the importance of remaining actively engaged in health services as they mature.

And that they equip young people to have the skills to do so.

This is referred to as transition to adult health care and

is recognised increasingly as a challenge across the world not just in high-income

settings which have, for the last two decades focused in this space.

On the left is a copy of some of the documentation that my own hospital has

developed to support parents and their adolescents

maintain their involvement in healthcare as the adolescent matures.

Many, many health services globally have developed information

of particular relevance to young people in their local communities.

This is important that communities do this work and

make sure they bring them to the attention of their young patients.

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