Analysis on adolescent healthcare capacity at health centers for women and children at district and county level in Chongqing / 中华医院管理杂志

Objective:To analyze and evaluate the capacity of adolescent healthcare at health centers for women and children at district and county level in Chongqing, for theoretical basis in promoting adolescent healthcare.Methods:From January to February 2021, a unified questionnaire was used to collect the information of adolescent healthcare and data of human resources from 39 health centers for women and children at district and county level in Chongqing. The survey data were analyzed by descriptive statistics.Results:Among the 39 health centers for women and children at district and county level in Chongqing, 32 (82.1%) institutions maintain adolescent outpatient clinics, most of which under gynecology (40.6%) instead of independent departments. 37(94.9%) institutions could provide health care services for adolescents, and 26 (66.7%) institutions could provide the services both in and out-institution services. All the institutions could provide services of prevention and treatment for regular reproductive health diseases, but the numbers of institutions providing such services as nutritional assessment, common problems consultation and guidance, psycho-behavioral screening, mental health consultation and guidance, accidental injury prevention and guidance, violence injury prevention and guidance, as well as Internet addiction assessment and guidance, were 25, 20, 16, 10 and 8, respectively. There were 273 medical workers engaged in adolescent healthcare, mostly part-time (98.9%).Conclusions:The construction of outpatient clinics for adolescent health care is expected to be strengthened at health centers for women and children at district and county level in Chongqing. Meanwhile, services provision and human resources of medical workers for adolescent health care are inadequate.

O papel do pediatra no PSF-Paidéia de Campinas (SP) / The pediatrician's role in the Paidéia-Family Health Program in Campinas, São Paulo State, Brazil

O Brasil vem implantando o Programa de Saúde da Família, em sua atenção básica à saúde. A composição das equipes do programa tem sido questionada como insuficiente, sendo uma das críticas a ausência do pediatra. Este trabalho analisou parte da experiência do município de Campinas (SP), que implantou o programa com adaptações, entre as quais a existência de pediatra em suas 140 equipes. Utilizando metodologia qualitativa e entrevistas semi-estruturadas, foram entrevistados pediatras e médicos de família de dez equipes, indicadas pelos gestores como as de melhores resultados. O objetivo foi conhecer a visão dos mesmos sobre a atenção à saúde da criança por eles praticada, o papel de cada um e a existência do pediatra no programa. Há uma quase unanimidade de defesa da importância do pediatra na atenção básica por aumentar a resolubilidade da equipe. Porém, são apontadas críticas à sua atuação, muito focada no referencial biomédico e no consultório médico, havendo necessidade de maior envolvimento com o trabalho em equipe, os aspectos psicossociais, a família e o território. É essencial uma melhor capacitação do médico de família e do pediatra frente à complexidade da missão da atenção básica atual.

Brazil is developing a Family Health Program in the Primary Health Care. The Family Health Program's team composition has been criticized as insufficient. One of the criticisms has been about the absence of the pediatrician. This study analyzed the experience of the city of Campinas, São Paulo State, which implemented this program with adaptations specifically with the presence of the pediatrician in its 140 teams. Using qualitative methodology and semi-structured interviews, pediatricians and ten family physicians teams were interviewed. The objective was to know their visions about their practice with children's primary health care, the role of each one and about the pediatrician's presence in the team. It was almost an unanimity about the importance of the pediatrician's participation in Primary Health Care, not as a specialty, but because of the improvement of the team's resolubility. Though, the pediatrician's work was considered too focused in the biomedical paradigm and in the office. There is a need for the pediatrician to have more engagement with the psychosocial aspects, the family and territory. It is essential the improvement of the training of pediatricians and family physicians to deal with the complex mission of the primary health care of nowadays.

A Survey on the Adolescent Health Care in Pediatric Practice

PURPOSE: This study was designed to establish standard guidelines to meet the growing health care needs of adolescents by direct assessment of pediatricians' current practices, attitude and obstacles to the primary care of adolescents. MEHTODS: A questionnaire consisting of 9 questions, including personal characteristics of respondents, current health care practice of adolescents, attitude, obstacles to providing adolescent care, interest in further training, roles of Korean Pediatric Society for adolescent medicine, etc., was completed by 214 pediatricians. RESULTS: Among the respondents, 87.4% were in the 4th or 5th decade of age, and 88.8% of respondents were working for private clicins. More than 60% of respondents were managing patients without age limits. Most of the respondents were interested in adolescent medicine. However, approximately one half of all respondents answered that they could not currently provide satisfactory care to their adolescent patients. Obstacles to providing adolescent care include : their image as "baby doctors", lack of knowledge and skills in adolescent medicine, lack of separate hours for adolescents and concern that parents would object to certain types of care. Among respondents who wanted to further training, many were interested in Continuing Medical Education(CME) course, lecture series, introducing reading lists and publishing textbooks, while others expressed their interest in a newsletter and mini-fellowship. Respondents expected the Korean Pediatric Society to play a role in activating the adolescent medicine as a field for pediatric practice through educating adolescents, pediatricians and advertising via mass media. CONCLUSION: Future policy decisions and medical education must respond to these realities in pediatric practice.

Major health related problems among adolescents in Seoul area

BACKGROUND: Adolescence offers unique opportunities for investment in health and well-being. The purpose of this study was to examine the common physical symptoms and diseases and medical utilization rate and the prevalence of health behaviors among school-aged adolescents. METHODS: This study was carried in 1998. Subjects consisted of 3,771 adolescents (ages 10 to 18) who attended an elementary, middle, and high school in Seoul and 3,246 parents. Self-report questionnaire was administered to the students and their parents to measure self-reported physical and psycho\social problems, practice of health behavior, medical care utilization rate, and the most common diagnosis. RESULTS: 1) Academic performance was the most common psycho\social problem for adolescents and their parents. 2) The perceived health status was highest in middle school students, lowest in female high school students. 3) As adolescents went to higher grades, the medical institute and dental clinic utilization rate tended to be decreased, and oriental clinic utilization rate did not change. The most common diagnosis during the past year was dental caries. The next most common diagnosis was respiratory infection. Accidents (males), headache (females) were more common in high school than middle school. 4) The most frequently reported symptom was fatigue in middle and high school students. More than half of female high school students reported fatigue, dizziness, headache, dysmenorrhea, hypersomnia during the last month. 5) The higher their grade was, the less adolescents practiced health behaviors. 21.9% of males and 1.9% of female high school students were smokers. 34.5% of males and 13.3% of female high school students drank alcohol on a regular basis. The prevalence of obesity was 12.0% in males, 10.0% in female high school students. Male adolescents tended to deal with stress with leisure activities, female adolescents did by talking about their problems with related people. CONCLUSION: This overview of health associated issues among adolescents provided a unique view of differences in health care needs between younger and older teens and between male and female teens. These data have meaningful implications for health promotion program for adolescents.