University of Virginia, Charlottesville, 22908, USA.
Am Fam Physician. 2012 Dec 15;86(12):1109-16.
Serious health problems, risky behavior, and poor health habits persist among adolescents despite access to medical care. Most adolescents do not seek advice about preventing leading causes of morbidity and mortality in their age group, and physicians often do not find ways to provide it. Although helping adolescents prevent unintended pregnancy, sexually transmitted infections, unintentional injuries, depression, suicide, and other problems is a community-wide effort, primary care physicians are well situated to discuss risks and offer interventions. Evidence supports routinely screening for obesity and depression, offering testing for human immunodeficiency virus infection, and screening for other sexually transmitted infections in some adolescents. Evidence validating the effectiveness of physician counseling about unintended pregnancy, gang violence, and substance abuse is scant. However, physicians should use empathic, personal messages to communicate with adolescents about these issues until studies prove the benefits of more specific methods. Effective communication with adolescents requires seeing the patient alone, tailoring the discussion to the individual patient, and understanding the role of the parents and of confidentiality.
尽管青少年能够获得医疗保健，但他们仍然存在严重的健康问题、危险行为和不良健康习惯。大多数青少年不会寻求有关预防其年龄组主要发病和死亡原因的建议，医生也常常找不到提供建议的方法。尽管帮助青少年预防意外怀孕、性传播感染、意外伤害、抑郁、自杀和其他问题是全社会的努力，但初级保健医生处于有利地位，可以讨论风险并提供干预措施。有证据表明，应定期筛查肥胖和抑郁，为某些青少年提供人类免疫缺陷病毒感染检测，并筛查其他性传播感染。关于医生就意外怀孕、帮派暴力和药物滥用提供咨询的有效性的证据很少。然而，医生应该使用富有同情心的个人信息与青少年就这些问题进行沟通，直到研究证明更具体的方法是有益的。与青少年进行有效的沟通需要单独与患者见面，根据个体患者的情况调整讨论内容，并了解父母的作用和保密性。
