Abrams, Roberta B.

Henry Ford Health System Scholarly Commons

Henry Ford Hospital Medical Journal Volume 38 Number 2 Article 21 6-1990 Adolescent Health Problems: A Model for Their Solution Roberta B. Abrams Follow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournal  Part of the Life Sciences Commons, Medical Specialties Commons, and the Public Health Commons Recommended Citation Abrams, Roberta B. (1990) "Adolescent Health Problems: A Model for Their Solution," Henry Ford Hospital Medical Journal : Vol. 38 : No. 2 , 160-161. Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol38/iss2/21 This Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Henry Ford Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons. Adolescent Health Problems: A Model for Their Solution Roberta B. Abrams, RNC, MA' We participated in developing a model for health care de-livery to promote preventive health care and health edu-cation among adolescents and their families. The project began through interest expressed by nurses and physicians at Henry Ford Hospital and has evolved as a collaborative effort by the hospital staffi the involved school, and the community. We began this project by surveying the students at a local middle school to determine the scope and nature of their health problems. The problems were legion. Few of the children were enrolled in preventive health care programs, routine immuniza-tions were incomplete, and the children suffered from a variety of stress-related problems including sleep disorders, anxiety at-tacks, and gastrointestinal disorders. Experience in health care delivery systems has demonstrated that preventive health care is not widely valued in our society. Most ofthe health care in this country is aimed at restoration of health; thereby increasing cost and decreasing efficacy. In fami-lies with economic problems, health care is demonstrably not a fiscal priority, and preventive health care may not appear at all in the family value system. Some truisms about adolescents contribute to an understand-ing of problems in adolescent health care delivery; 1. Adolescents exist in a here-and-now time frame; they nei-ther worry about yesterday nor plan for tomorrow, thereby de-creasing the probability of preventive health care. 2. Adolescents believe that they are infallible and therefore are not concemed about disease or illness. 3. Adolescents have major problems with self-image and therefore feelings of self-worth. They tend to vacillate between total narcissism and total self-abnegation. Health care does not seem congruent with either pole. 4. Health care to adolescents is neither a priority nor a pleas-ant experience. Childhood visits to the physician or dentist may have created associations between health care and pain. 5. Adolescents have access problems in seeking health care. School and social activities both preclude attendance during usual clinic hours. One attempt to deal with the aforementioned issues and to provide preventive heatth care for adolescents is a teen health care clinic based in a local urban middle school. As previously stated, the students at this school suffer from a myriad of health and health-related problems. In addition, the surrounding area is plagued by repeated episodes of violence, significant amounts of which involve children. The program, therefore, is aimed at promoting both physical and emotional well-being. The purpose of the program may be summarized as follows; 1. To work with the students and their families to build and enhance the students' self-esteem. 2. To establish a clinic to provide health assessment and refer-rals for the students at the middle school. 3. To provide basic immunizations for students at the middle school. 4. To establish monthly programs in health education for stu-dents and their families. 5. To provide screening for selected health problems includ-ing sickle cell disease, anemia, and scoliosis. 6. To provide oral/dental examination and referral. The Teen Health Clinic wilt be staffed primarily by clinical nurse specialists and will collaborate with existing health care, social, and volunteer organizations in its attempts to fulfill its purpose A board, consisting of school personnel, students, and community and health care personnel, wilt meet regularly to plan, implement, and evaluate programs and their delivery. We feel that ownership by the school and community is vital to the success of the program. Too often, welt-meaning health care providers attempt to impose programs on the community only to discover that the consumers' needs are not met by the program, and therefore there is tack of participation. It is too eariy to provide detailed descriptions of clinic activi-ties. However, the preliminary plan for services includes the fol-lowing; 1. Routine health screens including immunizations, physical examination, and laboratory screens for anemia, sickle cett test-ing, and screening for infectious disease (including sexually transmitted diseases). •Associate Adminislralor—Nursing. Henry Ford Hospital. Address cortespondence to Ms. Abrams, Nursing Division 1, Henry Ford Hospital 2799 W Grand Blvd, Detroit, Ml 48202. 160 Henry Ford Hosp Med J—Vol 38. Nos 2 & 3. 1990 Teen Health Clinic—Abrams 2. Referral and follow-up for treatment of disorders/problems discovered through the aforementioned screens. 3. Nutritional screens and teen-focused diet therapy. 4. Dental screens and referral for follow-up care. 5. Educational programs for students and family members on topics of interest to the group including hypertension control, sexuality, communication skills, and health care careers. 6. A "drop-in center" for individual counseling on specific health interests or problems. 7. Work with the students on issues surrounding their self-image and self-esteem, both on group and individual bases. 8. Work with the students on programs of impulse control and conflict resolution, aimed at reducing the incidence of violence for the group. We have no guarantees that this clinic or others like it can have a positive effect on the health and well-being of its in-tended clients. Our only certainty is that the current systems have failed to provide for the health care needs of the students in this specific middle school. In a time when atl health care pro-viders must become health economists, the investment in pre-ventive health care for children is fiscally sound and socially im-perative. Henry Ford Hosp Med J—Vol 38. Nos 2 & 3. 1990 Teen Health Clinic—Abrams 161 

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