Adolescence is a distinct stage that marks the transition between childhood and adulthood. Adolescents are capable of abstract reasoning. Although you may still include the family in education, adolescents themselves are a major focus of teaching since they have considerable independence and are, consequently, in more control of the degree to which recommendations will be carried out. Adolescents have many important developmental tasks to achieve. They are in the process of forming their own identity, separating themselves from parents, and adapting to rapidly changing bodies. Bodily changes at puberty may cause a strong interest in bodily functions and appearance. Sexual adjustment and a strong desire to express sexual urges become important. Adolescents may have difficulty imagining that they can become sick or injured. This may contribute to accidents due to risk taking or poor compliance in following medical recommendations. Because adolescents have a strong natural preoccupation with appearance and have a high need for peer support and acceptance, health recommendations that they view as interfering with their concept of themselves as independent beings may be less likely to be followed.
As sexual adjustment and strong sexual urges characterize this age, the nurse may do significant teaching about sex education and contraception. In addition to teaching adolescents about why and how their bodies are changing, the nurse is also in a good position to dispel misconceptions young patients may have about sexual development or sexual behavior. Teaching adolescents about sexuality requires a special sensitivity and understanding. Respect for the patient’s modesty, privacy, and opinions are critical to establishing an atmosphere of openness and trust. In addition to sex education, other important patient teaching areas are alcohol and drug abuse and general health measures, such as the importance of good nutrition and exercise as the basis for life-long health. Regardless of the topic, health education for adolescents is more effective when the nurse establishes trust by respecting the adolescent’s needs, shows empathetic understanding, and answers questions honestly. Patient teaching for adolescents should take the form of guidance rather than lecturing. Nurses who gain credibility with an adolescent patient establish themselves as the teen-ager’s advocate rather than representatives of the parents. The nurse may increase health teaching effectiveness by including the family. The nurse can give guidance and support to family members that can help them understand and respect adolescent behavior. Parents should be encouraged to set realistic limits for adolescents while still allowing them to become increasingly responsible for their own health care management.
To the extent possible, children of all ages should be included as much as appropriate for their age level in the teaching process. With the exception of adolescents, however, in most instances it is the child’s parent or parents who will be supervising the degree to which the treatment regimen or recommendations for prevention are followed. Therefore, the nurse conducting patient teaching must establish rapport not only with the child as a patient but with the parents as well. In preparation for teaching both the child and parent, the nurse should assess the quality of the relationship between parent and child. Some parents are open and honest with their children and foster independence. Other parents provide structure and guidance while allowing the child latitude to make some choices of his or her own. Still other parents are less flexible and allow their children little participation in the process. In other instances, parents provide little structure or guidance, enforcing no rules and essentially abandoning the child emotionally. The approach to patient teaching the nurse takes in each of these situations differs depending on each unique parent-child relationship. It is important to remember that instead of judging the relationship, the nurse should use whatever relationship exists as a starting point for teaching.