This appeared last week:
When doctors explain privacy, teens raise more sensitive topics
Understanding confidentiality paves the way for more open discussions between adolescents and their doctors
17th January 2019
Adolescents and young adults may be more willing to talk about sensitive topics with their doctors if they've had a talk about confidentiality, new findings suggest.
Only about one-third of adolescents talk about confidentiality with their healthcare provider, but those who report doing so are more likely to discuss potentially sensitive issues, according to the US study in Pediatrics.
"Sometimes we forget that adolescents don't understand the way the practice operates, the way the clinic operates, so we need to explain that to them," says study author Dr John Santelli of Columbia University in New York.
To investigate factors that could facilitate these conversations, Dr Santelli and colleagues surveyed more than 1500 13-26-year-olds about whether they had discussed any of 11 specific topics with their doctor at their most recent visit.
On average, young women discussed 3.7 of the topics, while males averaged 3.6.
Topics most frequently discussed were mental health and emotional issues (55%), drug or alcohol use (46%), tobacco use (44%) and school performance (43%).
Study participants who said they had previously talked about confidentiality with their doctor discussed an average of 4.4 topics vs 2.9 for those who had not had the same discussion.
Here is the link:
Here is the abstract.
Discussion of Potentially Sensitive Topics With Young People
Abstract
OBJECTIVES: To identify modifiable factors that facilitate discussion of potentially sensitive topics between health care providers and young people at preventive service visits after Patient Protection and Affordable Care Act implementation.
METHODS: We used data from a national internet survey of adolescents and young adults (13–26 years old) in the United States. Questionnaire construction was guided by formative research and Fisher’s Information-Motivation-Behavioral Skills model. Those who had seen a regular health care provider in the past 2 years were asked about 11 specific topics recommended by national medical guidelines. Four multivariable regression models were used to identify independent predictors of discussions of (1) tobacco use, (2) drug and/or alcohol use, (3) sexually transmitted infections or HIV, and (4) the number of topics discussed.
RESULTS: Fewer than half of young people reported having discussed 10 of 11 topics at their last visit. Predictors were similar across all 4 models. Factors independently associated with health discussions included the following: ever talked with a provider about confidentiality (4/4 models; adjusted odds ratio [aOR] = 1.85–2.00), ever had private time with a provider (1 model; aOR = 1.50), use of health checklist and/or screening questionnaire at last visit (4 models; aOR = 1.78–1.96), and time spent with provider during last visit (4 models). Number of years that young men had seen their regular provider was significant in 1 model. Other independent factors were positive youth attitudes about discussing specific topics (3/3 models) and youth involvement in specific health risk behaviors (3/3 models).
CONCLUSIONS: Discussions about potentially sensitive topics between health care providers and young people are associated with modifiable factors of health care delivery, particularly provider explanations of confidentiality, use of screening and/or trigger questionnaires, and amount of time spent with their provider.
This confirms that consultation with teens are better and more likely to address crucial issues if confidentiality from all other agents (parents etc.) is assured.
The #myHealthRecord has its head in the sand on this issue.
Dr Bob Walker in Tassie is clearly right to abandon his clinic to protect his patients from unwarranted intrusion.
David.
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