Adolescent Health

Adolescence defines the period of developmental transition from childhood to adulthood including physical, social, and cognitive changes. It is a challenging time for a teenager, and often for involved loved ones and professional caretakers. Indeed, nurses working with adolescents must be as skilled in the art of effective and compassionate communication as with nursing or medical knowledge. Adolescent health care has emerged as a specialty in the last several decades for just this reason; it demands a special sensibility from the health care provider. Teens deserve to be treated with respect and tolerance even when their attitudes and behaviors threaten the common-sense orientation of the care provider.

Because adolescents are by and large a physically healthy population, most of their morbidity and mortality results from behavior rather than disease processes. In fact, 72% of all deaths of adolescents result from behavior-related causes such as motor vehicle accidents, substance use, suicide, and homicide (MMWR National Youth Risk Survey 1999). These social and behavioral choices of today's teenagers predict the health of tomorrow's adults. This issue on “Adolescent Health” offers nurses an overview of some of the most compelling health-related challenges currently facing adolescents.

The opening article introduces a review of “adolescent resiliency,” reexamining a decades-old view of the teenager as survivor, achiever, and producer in contrast with the more recent portrayal as risk-taker, delinquent and burden to society. “For those of us dedicated to supporting youth in their successful navigation of adolescence the most important issue becomes: how can we enhance a young person's ability to not only survive, but to thrive throughout the adolescent years” (Monasterio).

Teare and English synthesize issues of medical rights with regard to consent by a minor, sexual debut, and statutory rape; several of the more confounding aspects of providing ethical care for the sexually active teen. Moon and her coauthors give thorough guidelines for sensitive care of sexual minority youth, including medical-legal rights issues, comprehensive history taking, and advocating for a tolerant and nonalienating approach to care. Pharris and Stoddard present a wealth of combined experience in assisting teenagers to recover from sexual assault. This article may be the first and most comprehensive guide for clinical nurses in direct care of the sexually traumatized adolescent. It offers concrete take-home pearls as well as a current review of the social milieu in which assault may occur.

Articles addressing some of the diverse challenges faced by immigrant teens, homeless young people, and issues unique to boys further expand a framework from which nurses can offer informed and sensitive care. Specific topics on sexually transmitted infection, pregnancy, contraception, eating disorders and substance use address several of the most costly adolescent issues facing the United States as a country.

It is not uncommon to hear that nurses and other medical providers either “love or hate” adolescents in the professional setting and that effective communication with teens is an inborn trait rather than a learned nursing skill. Due to the changing face of health care delivery such as the increased use of urgent care, the growing independence and visibility of adolescents in society, and the ongoing shortage of nurses nationally, it is imperative that nurses are informed and confident to provide appropriate care to any age, including those people between the ages of 12 and 21. This issue of The Nursing Clinics of North America seeks to offer an overview to interested nurses on some of the major issues facing teens and how to best have a positive influence on an adolescent in their care. It is our hope that this author-group of advanced practice pediatric and adolescent specialists conveys the vibrancy, resilience, and strengths that may be encountered in any teenager when compassionate, well-informed and developmentally appropriate care is provided by the invested, educated, and loving nurse.