The Importance of Providing Clinical Services to Young People - Article Example

Critique Sexual Health, Contraception and Teenage Pregnancy. This is not a research study per se. It is an article written by these two with the aim of raising awareness and informing about the importance of sexual health in adolescence. There is not enough information on who the authors are to tell how valid their discussion will be in the article. The introduction is very brief. The authors only state the fact that as the adolescent stage begins sexual health becomes of graver concern. They emphasize that risk behavior is common at this stage and that there are serious adverse consequences. There is no mention of the authors’ interest in the issue or what moves them to engage with the topic. Nor is there an indication of what the rest of the paper will be about. However it seems that they are both very concerned about the issue. The rest of the article is divided into sections which present facts and data on various aspects of sexual behavior in adolescents. Each section is accompanied by detailed graphs and charts showing statistics relevant to the topic of the section. There is not much discussion in the sections. The main aim of the article seems to be to provide this data to show that there is crisis in sexual health among teenagers. The section on relationships and sexual behavior provides data on the incidence of first sexual intercourse. Statistics are provided of the median age for first sexual intercourse in the United Kingdom from 1964-1998. It also provides statistic for percentage of fourteen year olds in Scotland engaging in sexual activities. The point is made that much of this early sex in adolescents is unsafe sex. The source of these graphs and statistics is not indicated in the body of the text. The statistics in the section on sexually transmitted infection refer to the high incidence of STI’s (sexually transmitted infections) in the UK. The authors state that …”some studies suggest that 30- 40 % of sexually active teenage girls in high risk groups are infected”, but they do not cite the source of these studies. Teenage pregnancy is discussed not only in the UK but across Europe. The incidence of teenage birth rates is compared across Western Europe. The authors present a discussion of the relationship between teenage pregnancy and cultures in the UK, (particularly Asian cultures) but again with no indication of the source of the data or how they are drawing conclusions. Statistics are also presented for infant mortality rates in teenage mothers and other risks of teenage pregnancy. The authors use subjective and indefinite terms such as ‘about 60% higher’, and ‘those infants are more likely to ..” Contraception is another topic that is presented. Again percentages are quoted with no source, “in the United Kingdom about 75% of young people in early adolescence, and 85% in mid-adolescence…”. The use of the term ‘about 75%’ leads the reader to wonder what is the accuracy with which the data was collected. Repeatedly they site figures such as “over 75% reported that they used condoms…”, but there is nowhere that tells the reader where and how the data was collected and to whom these were reported. The discussion on the use of contraception among teenagers also lacks valid sources for the data and uses general and subjective terms such as “teenagers have a relatively high failure rate…” The article ends with an emphasis on the importance of providing clinical services to young people in an appropriate way that they will not feel intimidated or embarrassed to access these services. Generally the article is not necessarily written in an academic style. It seems to be geared for public consumers. At first it seemed that there were no sources for the data in the graphs and charts but the authors did write a paragraph, almost like an appendix indicating the source of these. Although the article is mainly data and statistics and not much of the perspective of the authors, it does make the reader want to delve deeper into the reasons for the statistics and to learn more about the sexual behavior of teenagers and how they can be helped. One of the positives of the article is that it covers a wide range of issues related to adolescents and their sexual health. The article is effective in raising anxiety and even fear of both adults and teenagers in the hope of guiding them to make good choices regarding sexual behavior. Motivational Interviewing in Health Promotion. This article is written by six authors from two different universities and a Center for Health Research. It provides an overview of Motivational Interviewing (MI) explaining what it is and examining the use of this technique in public health and health promotion. The main aim of the article seems to be to examine the feasibility of applying this strategy (MI) which was initially developed for addiction counseling to addressing chronic health conditions in a more positive and proactive way. The article first presents an overview of MI. This is very clearly written so that the reader can easily follow and understand what MI is and what is not and how it is used. This is followed by a detailed account in sections of the four core MI techniques. The major body of the paper is focused on explaining how MI differs from and compares to other theoretical models of therapy. This is done with several relevant examples to make the points clearer. MI is first compared to Rogerian therapy. The major difference pointed out is that MI is focused on resolving discrepancies in behavior and motivating the client to change (for example quit smoking), whereas Rogerian therapy may focus on helping the client accept behavior and socially unacceptable attributes. MI is also compared to Transtheoretical Model (TTM) but the perspective of the authors is that there are only subtle differences. And thirdly MI is distinguished from cognitive behavioral therapy. The authors then present a detailed and rich account of the numerous studies done to examine the efficacy of MI. They present a convincing argument by the amount of studies reviewed and the variation in the types of studies- the sample populations and the varying uses of the MI in these studies. They discuss six studies in which MI is used to modify diet and physical activity. These studies span a number of years, they were all done between 1995- 2001. A summary is given on each study to include the sample involved, how the MI treatment was delivered and whether or not MI showed significant advantages as a treatment. Smoking cessation was treated by MI in other studies. Nine studies were cited, but only four were described in brief detail. However there are enough references cited to encourage the reader to dig deeper into this research. Two studies are discussed where MI is used in the treatment of people with psychosis. And finally, studies done using MI with HIV- Risk behavior were summarized. All the results of the studies were then summarized by the authors and some of the limitations not only of the studies themselves but the consequences of using MI are presented in a balanced form. Although generally the studies indicate that MI has potential as a counseling tool in improving public health and chronic diseases, there were many issues not yet resolved by all these studies, for example, the training and competency of the counselors and the fact that MI interventions were frequently additive to other interventions. Following the analysis of the research on the effectiveness of MI, the authors present a useful discussion on the factors that could affect the use of MI. They explore the pros and cons of MI in addictive versus non-addictive behavior. The availability of time, mode of delivery and training of practitioners have been presented as important issues when considering the use of MI. Generally the article is well presented. The message is very clearly outlined in sections and well referenced. The authors effectively challenge the use of conventional therapy models for treating physical health issues and especially addictions. They present an argument that the emotional issues attached to physical illness need different treatment methods. The MI model presented seems a viable option. However more research and analysis are needed in order to fully embrace MI. The article was written in 2002 and presents research up to 2001. Perhaps there has been further research and development in the use of MI that will strengthen the arguments for its use. Use of male condoms. This article is co-written by four authors, one doctoral student and three senior lectures in Nursing. The paper is actually a review of literature to explore the issue of condom use in heterosexual adolescents. In the introduction the authors state clearly that sexually transmitted infections (STIs) are a major health issue and the efforts to promote condom use as one way of arresting this problem have not been successful. The review is therefore undertaken to find out what are the factors that prevent more condom use in young people. The literature search which took four months seemed to quite thoroughly cover at least eight academic sources. This paper is part of a larger literature review and only covers research papers. The results of the review revealed five themes that influence adolescents and young people and their use of male condoms. These five- contraception and safer sex; condom use and romantic love; perceived risk, knowledge and vulnerability; male resistance to condom use; and women, condoms and tainted love are each discussed in a separate section. The authors refer to several papers to explain the ambiguity in the terms contraception and safer sex. Studies are quoted to show the low rate of condom use in young people, not only in Australia where the paper is written but also Korea and Taiwan. The authors analyze several studies to point out how young people are not clear about the connection between contraception and protection against STIs, thinking that using oral and other contraception’s meant there was no need for condoms even though these other forms did not protect them from STIs. Studies exploring the attitudes of safer sex and love were reviewed. The idea that love entails trust interfered with the use of condoms as they may indicate mistrust. The review of the literature also showed that the whole idea of condom use takes away from the romanticism of the relationship. Literature is reported to show that young people feel invincible and therefore do not see themselves as vulnerable to STIs. And although they know about STIs their behavior did not reflect their knowledge of the dangers. Literature is cited to document men’s general resistance to the use of condoms. But this section also explores the way this resistance impacts women, and the difference in gender attitude to the use of condoms. This final section has many references to literature on the extent to which women can control condom use in men. The authors then present a bulleted list of what is already know about the topic to highlight subsequently what the paper adds. These lists seem condensed and it may have been helpful to have more detailed lists. The recommendation for nursing focus on recognizing and working on the strong emotions involved in romantic love with young people and how these emotions affect their decision-making and choices. For women, it is important to empower them to effectively negotiate condom use. They also recommend that gender-specific information must be incorporated into health education programs. The conclusion is brief but to the point. It is directed at nursing and health care professionals. Further research is suggested into why young people still participate in unprotected sex, despite the information they have. Generally the writing is clear and easy to follow. The paper is well structured and offers valuable information on the topic. It is clear that the authors are concerned about the risk of unprotected sex in young people and they felt it necessary to first find out what has already been written and what are the factors that affect condom use in order to come up with strategies that will be effective with young people to inspire them to protect themselves. East, L., Jackson, D., OBrien, l., Peters, K. (2007). Use of the male condom by heterosexual adolescents and young people: literature review. Journal of Advanced Nursing. Volume 59(2), July 2007, p 103–110 Resnicow, K., DiIorio, C., E. Soet, J.E., Borrelli, B., Hecht, J., Ernst, D. (2002). Motivational Interviewing in Health Promotion: It Sounds Like Something Is Changing. Health Psychology 2002, Vol. 21, No. 5, 444–451 Tripp, J., & Viner, R. (2005). Sexual health, contraception and teenage pregnancy. BMJ. 330, 590-593. Read More