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Teens, Parents Favor Physicians Who Discuss Risks.

NEW ORLEANS - Teenagers and their parents want physicians to talk about risk behaviors during well-child visits.

Many physicians think that talking about risk behaviors--alcohol and drug use, sex, diet, seat belt use, etc.--takes too much time and is best done by parents. But a survey of 15 physicians and 19 adolescents and their "parents showed that parents overwhelmingly say, '[Doctor], please talk to my children,"' Shayna R. Rubin said at the annual meeting of the Southern Society for Pediatric Research.

The survey included 13 pediatricians and 2 family physicians in the Galveston, Tex., area, and 19 adolescents, aged 9-17, who came in for a well-child visit. Each visit was observed by a member of the research group, and a survey was given to each physician, child, and parent. The average age of the children was 14; 74% were girls; 89% were white. Teens were accompanied by their mothers 79% of the time.

The observer monitored whether the physician took a history and counseled the teen about risk or risk-reduction behaviors, including alcohol use, tobacco use, drug use, diet, exercise, sex, contraception, seat belt use, helmet use, and safe driving.

The observer classified visits as "ample" if the physician took a history for at least four topics and counseled on at least three. During "minimal" visits, the physician took a history on up to two topics and gave no counseling. Eight of the 19 visits were rated as ample, another 8 were rated as minimal, and 3 fell in between these and were omitted from many of the analyses.

Some of the questions posed were:

"If I had a problem with drugs, alcohol, or cigarettes, I would talk to my doctor." Among the teens who had ample visits, 75% answered yes, compared with 25% among those with minimal visits.

"If I need advice about sex, I would talk with my doctor." Half of the teens with ample visits said yes, compared with 13% of those with minimal visits.

"I would recommend my doctor to my friends." All of the teens with ample visits said yes, compared with 50% of those with minimal visits, said Ms. Rubin, a medical student at the University of Texas, Houston.

Parent responses showed overwhelmingly that they want their child's physician to discuss risk behaviors. (See chart below.) The physicians who gave minimal visits often said they did not discuss behavior topics with teenagers because parents did not want them to, Ms. Rubin noted.

The parents' questionnaire also asked, "Would you recommend this physician to others?" All of the parents whose physicians gave ample visits said yes, compared with 57% of parents whose physicians gave minimal visits.

The physicians' survey included these statements:

"It takes too much time to talk to adolescents about risk behaviors." Among the physicians who gave ample visits, 17% said yes, compared with 67% of those who gave minimal visits.

"I'm comfortable talking to adolescents about their alcohol use." One hundred percent of the physicians who gave ample visits said yes, compared with 50% of those who gave minimal visits.

"It is up to parents to teach their children about sex." Of those who gave ample visits, 33% said yes, compared with 67% of those who gave minimal visits.

The survey completed by parents included these questions:

* A doctor should help teenagers with their problems.

94% of the parents said yes.

* A physician should discuss high-risk behaviors with teenagers.

88% of the parents said yes.

* A physician should discuss sex and sexual issues with teenagers.

71% of the parents said yes.

* A physician should talk to a teenager alone.

94% of the parents said yes.
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Author:ZOLER, MITCHEL L.
Publication:Family Practice News
Geographic Code:1USA
Date:Jul 1, 2000
Words:603
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