Young Patients Do Not Open Up to Doctors About Sensitive Topics

Adolescents and young adults are hesitant to have certain conversations with their physicians, a recent survey has found.

A total of 1,509 patients aged between 13 and 26 years who had seen their primary physician in the past two years completed an online survey. They responded to questions about 11 specific topics spanning subjects such as tobacco use, sexual health, mental health, school performance, gun safety, and physical/sexual abuse. Researchers implemented multivariable regression models to determine indicators of conversations regarding tobacco use, drug/alcohol use, sexually transmitted infections/HIV, and how many topics were discussed.

Fewer than half of respondents said they discussed 10 of the 11 selected topics at their last visit with their doctor. Independent risk factors linked to certain discussions were similar in all four multivariable models; predictors included: ever talked with a provider about confidentiality (4/4 models; adjusted odds ratio [aOR] = 1.85–2.00), ever had private time with a provider (1 model; aOR = 1.50), use of health checklist and/or screening questionnaire at last visit (4 models; aOR = 1.78–1.96), and time spent with provider during last visit (4 models). In three out of three measured models, positive youth attitudes about discussing specific topics and youth involvement in specific heath risk behaviors were also independent risk factors.

Patients were at least 50% more likely to engage in certain conversations if they had discussed confidentiality with, received private time with, or had enough time to interact with their provider, and if they had filled out a health screening questionnaire.

“The good news is that some basic changes to healthcare practice could greatly improve opportunities for young people to discuss health with their care providers,” said lead study author John Santelli, MD, professor of Population and Family Health at Columbia Mailman and a specialist in adolescent medicine, in a press release. “Describing confidentiality to a young person, providing private one-to-one time, using health questionnaires in the office, and taking time to listen to young people—all are things that providers can do to improve dialogue with young people. Talking about confidentiality can create safe spaces for discussion. Health questionnaires can signal to young people that a healthcare provider is interested in discussing sensitive issues.”

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Source: Pediatrics