Abstract
Background
The World Health Organization encourages the development of youth friendly services, yet little is known on how youth currently present in general practice.
Objective
To describe the perspectives, expectations, and service receipt of young people presenting to family doctors to inform the development of youth friendly services.
Design
Cross-sectional survey.
Participants and measurements
Consecutive young people attending 26 randomly selected practices were recruited in the waiting rooms. Standardized instruments were used to interview them before their consultation.
Results
Of 501 young people who were approached, 450 participated (91% participation rate). Most had respiratory (26%) or dermatological complaints (18%). When asked to assess their health status, 59% perceived they had neither a physical nor a mental illness. However, 43% stated they had fears about their health problem and 1 in 5 feared it could be life-threatening. Although only 10% presented with psychological complaints, 24% perceived they currently had a mental illness. The most common expectations were treatment (50%) and good communication (42%). Most youth were prescribed medication (60%), but 40% of those who received a prescription had not expected to receive a treatment. A follow-up appointment was offered to 57% of participants.
Conclusions
This study identifies a gap between young people’s perception of illness and their presentations to family doctors. It also highlights unexpected fears, and a mismatch between expectations and service receipt. These findings have implications for family medicine training and for clinical practice. They should inform the development of youth friendly services.
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References
WHO. Adolescent friendly health services: an agenda for change. Geneva: WHO; 2002. Report No.: WHO/FCH/CAH/02/14.
WHO. The World Health Report 2001. Mental health: new understanding, new hope. Geneva: World Health Organisation Publications; 2001.
Mathers C, Vos T, Stevenson C. The burden of disease and injury in Australia. Canberra: Australian Institute of Health and Welfare; 1999. Report No.: AIHW cat no PHE17.
Ozer EM, Macdonald T, Irwin CE, Jr. Health Care in the United States: implications and projections for the new millennium. In: Mortimer JT, Larson RW, eds. The Changing Adolescent Experience: Societal Trends and the Transition to Adulthood. England: Cambridge University Press; 2002.
Elster AB, Kuznets NJ. Guidelines for adolescent preventive services (GAPS): recommendations and rationale. Baltimore: Williams & Wilkins; 1994.
McPherson A. Adolescents in primary care. BMJ. 2005;330(7489):465–7.
Murdoch JC, Silva PA. The use of general practice services by 18 year olds in New Zealand. N Z Med J. 1996;109(1019):113–5.
Elliott BA, Larson JT. Adolescents in mid-sized and rural communities: foregone care, perceived barriers, and risk factors. J Adolesc Health. 2004;35(4):303–9.
Jeannin A, Narring F, Tschumper A, et al. Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland. Swiss Med Wkly. 2005;135:11–8.
Irwin CE, Jr. Adolescent health at the crossroads: where do we go from here? J Adolesc Health. 2003;33(1):51–6.
Donovan C, Mellanby AR, Jacobson LD, Taylor B, Tripp JH. Teenagers’ views on the general practice consultation and provision of contraception. The Adolescent Working Group. Br J Gen Pract. 1997;47(424):715–8.
Australian Institute of Health and Welfare. Australia’s young people: their health and wellbeing 2003. Canberra: AIHW; 2003.
Potts Y, Gillies ML, Wood SF. Lack of mental well-being in 15-year-olds: an undisclosed iceberg? Fam Pract. 2001;18(1):95–100.
Joffe A, Radius S, Gall M. Health counseling for adolescents: what they want, what they get, and who gives it. Pediatrics. 1988;82(3 Pt 2):481–5
Blum RW, Beuhring T, Wunderlich M, Resnick MD. Don’t ask, they won’t tell: the quality of adolescent health screening in five practice settings. Am J Public Health. 1996;86(12):1767–72.
Lustig JL, Ozer EM, Adams SH, et al. Improving the delivery of adolescent clinical preventive services through skills-based training. Pediatrics. 2001;107(5):1100–7.
Hing E, Cherry D, Woodwell D. National Ambulatory Medical Care Survey: 2004 Summary. Advance Data from Vital and Health Statistics; No. 374. Hyattsville, Maryland: National Center for Health Statistics; 2006.
Britt H, Miller GC, Knox S, et al. General Practice Activity in Australia 2004–2005. Canberra: Australian Institute of Health and Well-being; 2005.
Gleeson C, Robinson M, Neal R. A review of teenager’s perceived needs and access to primary health care: implications for health services. Primary Health Care Research and Development. 2002;3:184–93.
Sanci LA, Kang MSL, Ferguson BJ. Improving adolescents’ access to primary health care. Med J Aust. 2005;183(8):416–7.
Lloyd KR, Jacob KS, Patel V, St Louis L, Bhugra D, Mann AH. The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders. Psychol Med. 1998;28(5):1231–7.
Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.
Ustun TB, Sartorius N. Mental illness in General Health Care: an International Study. Chichester Wiley; 1995.
International Classification Committee of Wonca. ICPC-2 International Classification of Primary care, 2nd edn. Oxford: Oxford University Press; 1998.
Okkes IM, Becker HW, Bernstein RM, Lamberts H. The March 2002 update of the electronic version of ICPC-2: a step forward to the use of ICD-10 as a nomenclature and a terminology for ICPC-2. Fam Pract. 2002;19(5):543–6.
Intercooled Stata 9.0 for Windows. College Station, Texas: StataCorp LP; 2005.
Andrews G, Slade T. Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust N Z J Public Health. 2001;25(6):494–7.
Furukawa TA, Kessler RC, Slade T, Andrews G. The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med. 2003;33(2):357–62.
Wissow LS, Platt RE. Promoting adolescents’ use of medical services. Patient Educ Couns. 2006;62(2):159–60.
National Mental Health Strategy, (Keys Young). Research and Consultation among young people on mental health issues: final report: Commonwealth Department of Health and Family; 1997.
Booth ML, Bernard D, Quine S, et al. Access to health care among Australian adolescents young people’s perspectives and their sociodemographic distribution. J Adolesc Health. 2004;34(1):97–103.
Biddle L, Donovan JL, Gunnell D, Sharp D. Young adults’ perceptions of GPs as a help source for mental distress: a qualitative study. Br J Gen Pract. 2006;56(533):924–31.
Van Voorhees BW, Fogel J, Houston TK, Cooper LA, Wang NY, Ford DE. Attitudes and illness factors associated with low perceived need for depression treatment among young adults. Soc Psychiatry Psychiatr Epidemiol. 2006;41(9):746–54.
McGee R, Feehan M, Williams S, Verhulst FC, Koot HM. Long-term follow-up of a birth cohort. The Epidemiology of Child and Adolescent Psychopathology. Oxford: Oxford University Press, 1995. pp. 366–84.
The MaGPIe Research Group. The effectiveness of case-finding for mental health problems in primary care. Br J Gen Pract. 2005;55:665–9.
Rao JK, Weinberger M, Kroenke K. Visit-specific expectations and patient-centered outcomes: a literature review. Arch Fam Med. 2000;9(10):1148–55.
Sanchez-Menegay C, Stalder H. Do physicians take into account patients’ expectations? J Gen Intern Med. 1994;9(7):404–6.
Sanci L, Glover S, Coffey C. Adolescent health education programmes: theoretical principles in design and delivery. Ann Acad Med Singap. 2003;32(1):78–85.
Acknowledgments
We wish to thank the young people and the GPs for their kind participation. We are also grateful to Emeritus Professor Anthony Mann and Dr. Athula Sumathipala for providing us with the interview instrument and its original code book.
Conflict of Interest
D. Haller’s fellowship in Melbourne was supported by Geneva University Hospital, Geneva Academic Society and the Swiss National Science Foundation. She was awarded an International Postgraduate Research Scholarship from The University of Melbourne and a publication grant (Fonds Tremplin) from Geneva University. L. Sanci was in receipt of an Australian National Health and Medical Research Council Public Health Postdoctoral Fellowship. None of these funding sources had any control or influence over the research project or the decision to submit the final article for publication.
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APPENDIX
APPENDIX
Box 1
Questions used to assess young people’s perception of their physical and mental health (derived from the GP questionnaire used in a WHO collaborative study in primary care23)
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Haller, D.M., Sanci, L.A., Patton, G.C. et al. Toward Youth Friendly Services: A Survey of Young People in Primary Care. J GEN INTERN MED 22, 775–781 (2007). https://doi.org/10.1007/s11606-007-0177-5
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DOI: https://doi.org/10.1007/s11606-007-0177-5