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İnterviewing with adolescents

İnterviewing with adolescents. Prof Dr Müjgan Alikaşifoğlu Cerrahpaşa Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Adolesan Bilim Dalı. Developmentally oriented approach.

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İnterviewing with adolescents

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  1. İnterviewingwithadolescents Prof Dr MüjganAlikaşifoğlu Cerrahpaşa Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Adolesan Bilim Dalı

  2. Developmentallyorientedapproach • Inthecourse of interviewingandevaluatingtheadolescent, thehealthcareprovidershould be conscious of theadolescent’sdevelopmentalprocessandtasks.

  3. Evaluativeexpectationsshould be based on thestage of emotionaldevelopmenttheadolescent has attained. • Earlyormiddleadolescents, certainlycannot be expectedtothinkandbehave as logically as adults.

  4. Thesearesamplequestionsregardingvariousadolescenttasks: Body image • “Do youhaveanyquestionsorproblemswiththephysicalchangesyouareexperiencing?” • “Do youlikeyourself as youare?”

  5. Peerrelationships • “Who is yourbestfriends?” • “Howmanyclosefriends do youhave?” • “What do you do forfun?” Independence • “Do yougetalongwithyourparent?” • “Overwhatissues do familyargumentsoccur?”

  6. Identity • “Areyousatisfiedwiththewaythingsaregoingforyou?” • “Ifyoucouldchangecertainaspects of your life, whatwouldyou do andwhy?” • “Whatareyourplansforthefuture?”

  7. Sexuality • “Areyoudating?” • “Do youhavequestionsorconcernsaboutsexualactivities, contraception….?”

  8. Weuse HEADSSS interviewtoobtainpsychosocial/developmentalinformation Itcovers: • Home • Education • Activities • Drugs • Sexuality • Suicide • Safety

  9. An advantage of thisapproach is thatthepractitionermovesfromlesspersonalquestionstomorepersonalandpotentiallythreatiningquestions.

  10. Home: • “Where is theteenliving?” • “Wholiveswiththeteen?” • How is theteengettingalongwithparentsandsiblings?” • “Havetherebeenanyrecentmoves?”

  11. Education • Is theteen at school? • What is theteengoodandbad at in school? • Whatclassesareparticularlyinterestingorboring? • Whatgradeaveragetheteenmaintain? • Has theteenrepetedorfailedanyclasses? • Has theteenreceivedanysuspansion? • How is theteengettingalongwithteachers? • Whatgoalsdoestheteenhavewhen he orshefinishesschool?

  12. Iftheteen is olderorout of school, thepractitionaireshould ask aboutemployment

  13. Activities • Whatdoestheteen do afterschool? • Whatdoestheteen do tohavefunandwithwhom? • Doestheteenparticipate in anysportsactivities? • Communityactivities? • Whatreadingdoestheteen do? • Whatmusicdoestheteenlike? • Whataretheteen’shobbies? • Doestheteenhavefriends? • A bestfriend? • Howmuch time doestheteenspendwatching TV orplayingcomputergamesorsearching internet?

  14. Drugs • Whattypes of drugsareusedbytheteen’speers? • Whattypes of drugs do familymembersuse? • Whattypes of drugsdoestheteenuseand in whatamountandfrequency?

  15. Sexuality • Is theteendating? • Whataredegreeandtypes of sexualexperiences? • Is theteeninvolvedwithanotherindividual in a sexualrelationship? • Has theteen had sexualintercourse? • Ifyes: owoldwastheteen in his or her firstsexualintercourse?

  16. Suicide • Has theteen had anypriorsuicideattempts? • Doestheteenhaveanycurrentsuicidalideation? • It is veryappropriateto ask directquestionsaboutsuicidalideation, such as “Haveyou ever thoughtaboutkillingyourself? Orhaveyou ever tried? OrWouldyoukillyourself? Or Do youhave a plan? • Directquestions do not precipitatesuicidalactionandarethebestwaytoobtainsuchinformation.

  17. Sexualorphysicalabuse. • Inanyteenwho has significantproblems in any of thepreviouslymentionedareas, it is criticalto ask aboutphysicalorsexualabuse

  18. Thisincludes: • Individualwithrunawaybehavior • Significantfamilydisfunction • Change in schoolgrades • Lack of friends • Substanceabuse • Earlyonset of sexualactivity • History of suicideattempt

  19. Physicalexamination • Thephysicalexaminationprovides an excellentopportunitytoeducatetheadolescentabout his or her changing body. Forexample, femaleadolescentmay be taughttoperformeroutinbreastexaminations • oryoungmaleadolescentmay be reassuredaboutgenitaldevelopment

  20. Whoshould be presentduringthephysicalexamination? • Someadolescentprefertohavetheparentpresent • Theteencould be askedfirstwhether he orshepreferedthattheparent be in theroomduringtheexamination. • Particularlyyoungeradolescentsanddevelopmentallydelayedadolescentsmaywishtohave a parentwiththem.

  21. Maledoctorsshoulduse a chaperonduringthebreastandgenitalexamination of femalepatients. • Theoritically, thesameconceptwouldholdfor a femaleexaminnerduringgenitalexamination of a male, althoughthisusually has not occured in clinicalpractice.

  22. Closure • At theclose of theinitialorfollow-upvisit, thehealthcareprovidershouldaddressthefollowingissues: • Provide a briefsummary of theproposeddiagnosisandtreatment, addressedprimarilytotheadolescent. • Parentwhoaccompanytheadolescenttothevisitshould be included in a final discussion of thenonconfidentialissues, sothatthey can helpsupporttheplans.

  23. Discussanyotherresourcesavailabletotheadolescent • Allowtheadolescent time todiscussany final questionsorconcerns • Schedule anyfollowupappointments • Informtheadolescentthatthehealthcareprovider is available at othertimes.

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