Katzman Caroline L, Rosenthal Susan L, Francis Jenny Kr
Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York; Department of Pediatrics, New York-Presbyterian Hospital, New York, New York.
Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
J Adolesc Health. 2025 Aug 21. doi: 10.1016/j.jadohealth.2025.06.010.
The AAP recommends that adolescents have time to speak alone with their health care provider, although adolescent time alone is increasingly less supported. In addition to allowing adolescents space to be more forthcoming, this time alone may have additional developmental benefits.
Adolescent-mother dyads were invited from an adolescent medicine clinic in Dallas, Texas, to complete a semistructured joint interview. As part of the interview, dyads discussed the portion of the visit where adolescents have time alone with the provider. Interviews were recorded, transcribed, and coded through an iterative approach.
Within the 11 dyads, the adolescents ranged in age from 13-20 years, and adolescents and mothers primarily self-identified as White or Hispanic. Dyads noted adolescent time alone allowed for increased autonomy in medical decision-making and an independent relationship with their provider. Dyads were concerned that adolescent discomfort and inexperience could lead to decreased self-advocacy in the medical visit.
From the perspective of dyads, adolescent time alone with a medical provider fosters autonomy and supports the transition from pediatrics to adult medicine. Concerns about adolescent discomfort and limited self-advocacy can be addressed by openly communicating with the dyad that this time alone will have a developmental approach and will support emerging autonomy.
美国儿科学会建议青少年有时间与他们的医疗服务提供者单独交谈，尽管青少年单独相处的时间越来越不受支持。除了让青少年有更多空间更坦率地交流外，这段单独相处的时间可能还有其他发展益处。
从得克萨斯州达拉斯的一家青少年医学诊所邀请青少年-母亲二元组来完成一次半结构化的联合访谈。作为访谈的一部分，二元组讨论了青少年与医疗服务提供者单独相处的那部分就诊过程。访谈进行录音、转录，并通过迭代方法进行编码。
在11个二元组中，青少年年龄在13至20岁之间，青少年和母亲主要自我认定为白人或西班牙裔。二元组指出，青少年单独相处的时间使得在医疗决策中自主性增强，并且与医疗服务提供者建立了独立关系。二元组担心青少年的不适和缺乏经验可能导致在就诊时自我主张减少。
从二元组的角度来看，青少年与医疗服务提供者单独相处有助于培养自主性，并支持从儿科向成人医学的过渡。通过与二元组公开交流，说明这段单独相处的时间将采用发展性方法并支持逐渐形成的自主性，可以解决对青少年不适和有限的自我主张的担忧。
