Quality Of Care For Adolescents Research Articles

Problems of quality of dermatological care for acne in adolescents

Relevance. The quality of dermatological care in the treatment of acne in adolescents is under-researched. Therefore, it is relevant to analyze the problems that negatively affect the quality of care for adolescents suffering from acne.Target. To identify problems in the quality of dermatological care in relation to the treatment of acne in adolescents.Materials and methods. 20 literature sources over the past 6 years have been found. Standard methods of literature analysis (induction, synthesis and comparison of the presented information) were used.Results. The following have not been sufficiently studied: the psychological aspect of the influence of acne and its treatment on the condition of a teenager; anti-relapse effect of retinoids depending on their dose and course duration; mechanisms of acne formation in adolescents. Information about the possibility of chronic disease and/or relapse of acne in adolescents is fragmentary. Maintenance therapy in adolescents to minimize the side effects of acne treatment has practically not been developed. Problems with compliance of adolescents undergoing treatment for acne are fragmentarily studied.Conclusions. Problems in the development of individualized acne treatment algorithms for adolescents have been identified. At the same time, adolescents are at risk of developing acne and require a special approach in the treatment of acne due to their unstable psyche and the importance of young citizens as a valuable asset of the state.

Improving the quality of care for adolescents and young adults on an adult medical ward

Adolescents and young adults have health needs that are distinctly different from children and adults. A lack of education and training is reported by clinicians to be one of the main barriers to providing comprehensive developmentally appropriate care to young people, including the provision of confidential healthcare and taking a holistic approach. This study documents the current provision of care to young people on an adult inpatient medical ward at a large tertiary teaching hospital in Auckland. Forty-three staff and 40 patients aged 16-24 years on an adult medical ward completed surveys, which were based on the Northern Regional Alliance, Northern Regional Youth Health Network Standards for Quality Care for Adolescents and Young Adults in Secondary or Tertiary Care. Few (12%) staff had completed any specific training in looking after adolescent and young adult patients. Confidentiality was not routinely discussed with young people by 50% of clinicians, and only 23% of staff reported that they see a young person alone as part of their consultation or admission. Less than half of young people reported receiving a comprehensive psychosocial assessment that included sexual health, mental health and suicide, and safety. Key components of comprehensive developmentally appropriate healthcare were not regularly carried out by staff on an adult medical ward. These findings suggest that further education and training, and service improvements are needed in tertiary adult hospital settings.

Improving the Quality of Care for Adolescents and Adults With Sickle Cell Disease—It’s a Long Road

Improving the Quality of Care for Adolescents and Adults With Sickle Cell Disease—It’s a Long Road

Quality of facility-based family planning services for adolescents in Malawi: Findings from a national census of health facilities.

The main objective of this study was to describe the quality, in terms of provision and experience of care, of facility-based family planning services for adolescents compared to older clients in Malawi. Secondary data analysis was performed on data obtained from the Service Provision Assessment survey 2013-14, a census of all formal health facilities in the country. For the present study the inclusion criterion was that the client's age was recorded in the data set, which gave a weighted total of 1388 observations of consultations, reflecting provision of care, and client exit interviews, reflecting experience of care. The youngest clients (age group 13 to 19 years) had twice the odds of reporting a better experience of care compared to clients aged 26 and older (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.15 to 3.54, P = 0.013). The standard of observed provision was low, typically with half or more of the mandated elements of care omitted. Compared with clients aged over 25, provision of care was slightly better for adolescents, with a coefficient of 4.56 on a percentage scale (95% CI 0.90 to 8.23, P = 0.015) and a coefficient of 2.33 for those aged 20-25 (95% CI 0.21 to 4.44, P = 0.032). Clients seen in facilities under nongovernmental management had better provision of care compared to government facilities, with a coefficient of 12.35 (95% CI 6.70 to 18.01, P < 0.001); care was worse for clients seen in clinics compared to hospitals (coefficient -6.88, 95% CI -11.41 to -2.35, P = 0.003) and also for clients seen by health surveillance assistants compared to those seen by a clinician (coefficient -9.41, 95% CI -15.53 to -3.29, P = 0.003). Quality of care for adolescents attending facility-based family planning services was slightly better than for older clients, but this is overshadowed by the finding of a low standard of care overall. Health system strengthening, especially at the clinic level, is a policy and programming priority that will contribute to adolescent reproductive health in Malawi.

Determinants of Quality of Care for Adolescents and Young Adults With Chronic Illnesses: A Mixed Methods Study

Measuring the quality of service and user experience is an acknowledged priority for healthcare services; however it seems that healthcare systems have to work very hard to achieve this goal as evidenced by reports of gaps and disparities in the quality of care provided to clients, especially within pediatric and adolescent populations. To identify quality determinants for healthcare services for adolescents and young adults with chronic conditions based on the perceptions and the experiences of adolescents and young adults themselves. A sequential exploratory mixed method design guided this study. The initial qualitative phase employed semi-structured in-depth interviews to elicit the elements and determinants of quality of care as identified by adolescents and young adults living with chronic conditions. The second phase employed a questionnaire developed from the data gathered during the qualitative phase to survey the target population. This was distributed to a larger sample of adolescents and young adults with chronic conditions to determine and confirm the relevance of the identified care elements and quality determinants. The study revealed 4 main determinants: the provision of adolescent friendly information relating to all aspects of living with chronic conditions, services that facilitate and encourage independence, services characterized by structure with the capacity to be both dynamic and responsive, and finally health care professionals knowledgeable and skilled in relation to adolescent specific issues.

212. The Teen Health Improvement Program: A System-wide Initiative to Improve the Quality of Care for Adolescents Served by the Country's Largest Public Hospital System

The New York City Health and Hospitals Corporation (HHC) is the country's largest public hospital system, providing primary care services to nearly 50,000 adolescent patients annually. HHC started the Teen Health Improvement Program (THIP) in 2012 to improve population health outcomes among adolescent patients by ensuring access to high quality health care services. Most adolescent patients at HHC are seen in pediatric clinics by general pediatricians. Clinicians and staff in these settings may require support to better serve patients as they transition from childhood to adolescence to young adulthood.

Shifting the Odds of Lifelong Mental Illness Through an Understanding of the Profiles of Adolescents and Young Adults with Serious Mental Health Conditions

Every day families and mental health providers are called upon to make tough decisions in determining the best quality of care for adolescents and young adults with serious mental health conditions. This study profiles the behavioral and emotional needs and risk behaviors of adolescents and young adults seeking mental health services based on assessment of strengths and needs at program entry.

166. An Intervention to Improve Quality of Care for Adolescents Living With HIV/AIDS

Currently there are over one million people living in the US with HIV/AIDS. While rates of new infections have stabilized overall, incidence is increasing among youth age 13-29. Youth living with HIV/AIDS (YLWH) often have poor health outcomes and lack access to quality medical care. In 2007 the Health Resources Services Administration (HRSA) developed performance measures to evaluate quality of care for people living with HIV/AIDS. The objective of this study was to evaluate whether a novel intervention improved quality of care for youth living with HIV/AIDS across three categories of performance measures: retention in care, routine screening, and preventive medical care.

Use of an Institutional Intervention to Improve Quality of Care for Adolescents Treated in Pediatric Ambulatory Settings for Pelvic Inflammatory Disease

Purpose To evaluate the impact of a quality improvement intervention for outpatient management of pelvic inflammatory disease (PID) on provider compliance with published guidelines and to explore issues affecting patient adherence to outpatient care regimens. Methods This study utilized an interrupted time series design. The intervention included an algorithm and clinical practice guideline based on the 2002 Centers for Disease Control STD Guidelines, a complete course of medications to be given at discharge after initial doses given in the site, standardized discharge instructions, close follow-up at 24–48 hours and after two weeks of treatment by a member of the PID team, and a referral for follow-up. Results At baseline, 38% of patients did not receive an appropriate medication regimen and only 10% of clinic outpatients returned for follow-up evaluations within 72 hours. In the postintervention group, 91% of patients received an appropriate outpatient regimen and 43% of emergency department and clinic patients returned for care. Based on the results of logistic regression models, adolescents in the postintervention group were 8.4 times more likely (adjusted odds ratio [AOR]: 8.4, confidence interval [CI]: 2.6–26.8, p <. 001) to receive an appropriate outpatient medication regimen than girls in the baseline group. Follow-up interview revealed that 61% of postintervention patients completed all doses of the medication, 67% practiced temporary abstinence, 86% notified their partner for treatment, and 96% were satisfied with their care. Conclusions Interventions utilizing a multi-level approach to the management of outpatient PID improve provider compliance with published guidelines and quality of care delivered to adolescents in academic settings. Many adolescents, however, continue to have difficulty with adherence. Additional research is warranted to address adherence to outpatient regimens for the treatment of PID in adolescent girls.

Use of an institutional intervention to improve quality of care for adolescents treated in pediatric ambulatory settings for pelvic inflammatory disease

Every year approximately 200,000 adolescent girls in the United States are affected by pelvic inflammatory disease (PID) and each episode of PID puts these girls at risk for tubal scarring, future infertility and ectopic pregnancy. Despite the efficacy of outpatient regimens in randomized controlled trials, additional research indicates that adolescents diagnosed with PID in outpatient settings often do not receive adequate evaluation, medications, and instructions for self-care at discharge. As a result, patient adherence to therapy and follow-up recommendations may be impaired. The purpose of this study is to evaluate the impact of a quality improvement intervention for outpatient management of PID on provider behavior and patient adherence.

Use of health and mental health services by adolescents across multiple delivery sites

Purpose To assess the role that school-based health centers (SBHCs) play in facilitating access to care among low-income adolescents and the extent to which SBHCs and a community health center network (CHN) provide similar or complementary care. Methods A retrospective cohort design was used to compare health care service use among adolescents relying on SBHCs compared with adolescents relying on a CHN. The study sample consisted of 451 inner-city high school students who made 3469 visits between 1989 and 1993. Encounter data were abstracted from medical records. Frequency of use and reason for use are examined according to various sociodemographic and health insurance characteristics. Results SBHC users averaged 5.3 visits per year. Minority youth who used the SBHC had the highest visit rates (Hispanic, 6.6 visits/year; African-American, 10.6 visits/year). Visits to SBHCs were primarily for medical (66%, p < .001) and mental health services (34%, p < .001). Visits at CHN sites were 97% medical ( p < .001). Visits by adolescents were 1.6 times more likely to be initiated for health maintenance reasons ( p = .002; confidence interval [CI], 1.17–2.06) and 21 times more likely to be initiated for mental health reasons ( p = < .001; CI, 14.76–28.86) at SBHCs than at CHN facilities. Urgent and emergent care use in the CHN system was four times more likely for adolescents who never used a SBHC ( p < .001; CI, 3.44–5.47). Conclusions This study supports the view that SBHCs provide complementary services. It also shows their unique role in improving utilization of mental health services by hard-to-reach populations. The extent to which community health centers and other health care providers, including managed care organizations, can build on the unique contributions of SBHCS may positively influence access and quality of care for adolescents in the future.