Week 7 Clin

Question 1

Which psychosocial factors contribute to adolescent health and wellbeing?

Answer 1

• Friends/family support & social integration
• Sleep and exercise
• Health education (smoking/vaping, alcohol etc)
• Exposure to war, violence, and crime

Question 2

Outline a HEEADSSS assessment

Answer 2

H: Home
E: Education/employment
E: Eating
A: Activities/Hobbies
D; Drugs, alcohol, tobacco
S: Sex
S: Self-harm
S: Safety

Question 3

What are some strategies for communicating with reticent adolescents?

Answer 3

• Speculate/give options
• Talk about general others’ experiences
• Summarise during quiet moments (gives insight into expanding the next topic)
• Try to flatten hierarchy, but don’t be friends
• Match language to patients’ style
• Take curiosity stance (let them teach you slang etc)

Question 4

Why is taking a sexual health history important during routine medical history

Answer 4

• Sexual health issues can interplay with the rest of the body (e.g. HIV predisposes to other infections)
• Preventitive screening/discussions can eliminate further downstream problems

Question 5

How can chronic diseases affect a patient’s sexual health?

Answer 5

• Physically: vascular issues (e.g. ED), mobility issues (e.g. arthritis), sensory issues (e.g. diabetes), hormonal disorders (e.g. adrenal disorders), medication side effects
• Psychologically: altered body image, shifting relationship dynamics (e.g. from wife to carer), mood effects

Question 6

What are some confidentiality concerns specific to sexual health medicine? When can confidentiality be broken, and who is involved in this process?

Answer 6

• Consequences of breaking confidentiality are greater
• They can cause stigma, discrimination, damage to families, loss of trust, and medico-legal implications
• Confidentiality can only be broken in extremely rare situations (legal, ethical etc), and senior staff should be consulted before doing so

Question 7

What are key considerations we need to ask about in a sexual history?

Answer 7

• Symptoms
• All normal background hx (meds, conditions, fhx etc)
• Number of partners in last 3 months? regular vs casual? sex? type of sex?
• Use of barrier protection?
• Geography (are they from overseas?)
• STI Hx?
• Other risk factors (blood transfusions, tattoos, body piercings, sexual assaults, IVDU)