Concepts and issues related to adolescent health in nursing education

descriptive observational study conducted in Colombia, Ecuador and Peru. Data was collected by the Instrument for (self-)evaluation of the adolescent health and development component in undergraduate nursing programs, and investigated using descriptive statistics.

Results:

A total of 95 nursing schools participated in the study (84.1% of the total). Of the faculty responsible for teaching contents relating to adolescent health, 31.6% had no specific training on the topic and 18.9% had no educational/pedagogical training. Behavior, gender identity and sexual orientation, bullying and cyberbullying, use of digital technologies, partner violence, parenting, and pubertal delay were the main topics which could be incorporated into nursing education.

Conclusion:

the faculty of the schools analyzed have limited education in pedagogical/educational topics and specific adolescent health issues. Curricula should be updated, including knowledge of laws and policies, thus expanding nurses’ ability to generate, analyze and use data for decision making.

Descriptors:
Adolescent Health; Nursing; Curriculum; Education, Nursing, Diploma Programs; Teaching; Health Human Resource Training

Highlights:

(1) 31.6% of faculty have no specific education in adolescent health.

(2) 18.9% of faculty have no educational/pedagogical training.

(3) Progress is needed in the use of active methodologies and interactive multimedia.

(4) Knowledge of laws and policies for the adolescent population must be expanded.

(5) Current and relevant adolescent health issues need to be addressed in nursing education.

	Yes	No	Do not know
	n(%)	n(%)	n(%)
Adolescent health and development are taught “independently.”	42 (44.2)	43 (45.3)	1 (1.1)
Adolescent health and development is part of other disciplines:
• Women’s health	71 (74.7)	15 (15.8)	0 (0)
• Children’s health	79 (83.2)	6 (6.3)	1 (1.1)
• Community/family nursing	74 (77.9)	11 (11.6)	1 (1.1)
• Mental health nursing	68 (71.6)	17 (17.9)	1 (1.1)
A combination of the above.	66 (69.5)	18 (18.9)	2 (2.1)
There is a person or group in charge of coordinating all disciplines related to adolescent health and development.	62 (65.3)	24 (25.3)	0 (0)
Faculty in charge meet together to coordinate the content of their disciplines.	75 (78.9)	11 (11.6)	0 (0)
Faculty responsible for teaching adolescent health has received specific training on the subject.	56 (58.9)	30 (31.6)	0 (0)
Faculty responsible for teaching adolescent health has been trained in education/pedagogy.	66 (69.5)	18 (18.9)	2 (2.1)

	Yes, this subject is taught in our curriculum	No, this subject is not taught, but it should be	This subject is not taught and is not relevant
	n(%)	n(%)	n(%)
Understanding adolescence
Definitions and concepts of adolescence	90 (94.7)	2 (2.1)	0 (0)
Normal growth and puberty, including implications for body image	86 (90.5)	6 (6.3)	0 (0)
Cognitive development	83 (87.4)	9 (9.5)	0 (0)
Psychosocial development	86 (90.5)	6 (6.3)	0 (0)
Sexuality development	88 (92.6)	3 (3.2)	1 (1.1)
Assessment of developmental stages	89 (93.7)	3 (3.2)	0 (0)
Protective and risk factors related to adolescent development	81 (85.3)	11 (11.6)	0 (0)
Epidemiology of adolescent, health outcomes and health-related behavior	72 (75.8)	20 (21.1)	0 (0)
Local attitudes, beliefs, and practices regarding adolescents	68 (71.6)	24 (25.3)	0 (0)
Consultation environment and communication skills
How to create an atmosphere of trust during consultation (privacy, confidentiality)	67 (70.5)	25 (26.3)	0 (0)
Conduct an anamnesis, including a psychosocial evaluation	77 (81.1)	14 (14.7)	1 (1.1)
Physical examination	87 (91.6)	5 (5.3)	0 (0)
Factors influencing effective communication with adolescents	68 (71.6)	24 (25.3)	0 (0)
Communication with parents	70 (73.7)	21 (22.1)	1 (1.1)
Gender norms in adolescent health care	66 (69.5)	25 (26.3)	1 (1.1)
Health education	85 (89.5)	7 (7.4)	0 (0)
Motivational assessment	56 (58.9)	35 (36.8)	1 (1.1)
Laws and policies affecting adolescent health care provision
National laws and policies affecting adolescent health care provision.	67 (70.5)	25 (26.3)	0 (0)
Health care focus based on human rights	77 (81.1)	15 (15.8)	0 (0)
Ethics	81 (85.3)	11 (11.6)	0 (0)
Assessment of adolescent decision-making competence	60 (63.2)	31 (32.6)	1 (1.1)
School health and the role of schools in health promotion	75 (78.9)	17 (17.9)	0 (0)
Adolescent health promotion in the community	83 (87.4)	9 (9.5)	0 (0)

	Yes, the subject is included, and focused on the adolescent	Yes, the subject is included, but not focused on the adolescent	No, the subject is not included, although it should be, focusing on the adolescent	No, the subject is not included and is not relevant
	n(%)	n(%)	n(%)	n(%)
Male pubertal delay	46 (48.4)	17 (17.9)	22 (23.2)	4 (4.2)
Female pubertal delay	47 (49.5)	16 (16.8)	22 (23.2)	4 (4.2)
Short stature	46 (48.4)	21 (22.1)	20 (21.1)	2 (2.1)
Precocious puberty	52 (54.7)	13 (13.7)	21 (22.1)	3 (3.2)
Immunization	66 (69.5)	20 (21.1)	2 (2.1)	1 (1.1)
Abdominal pain	43 (45.3)	32 (33.7)	11 (11.6)	3 (3.2)
Anemia	49 (51.6)	32 (33.7)	5 (5.3)	3 (3.2)
Fatigue	39 (41.1)	36 (37.9)	10 (10.5)	4 (4.2)
Headache	41 (43.2)	35 (36.8)	9 (9.5)	4 (4.2)
Skin conditions	48 (50.5)	14 (14.7)	20 (21.1)	7 (7.4)
Poor vision	36 (37.9)	35 (36.8)	13 (13.7)	5 (5.3)
Poor hearing	36 (37.9)	35 (36.8)	14 (14.7)	4 (4.2)
Respiratory infections, pneumonia, asthma	45 (47.4)	35 (36.8)	5 (5.3)	4 (4.2)
Orthopedic problems	30 (31.6)	39 (41.1)	16 (16.8)	4 (4.2)
Endemic diseases	31 (32.6)	41 (43.2)	13 (13.7)	4 (4.2)
Dental problems and oral health	35 (36.8)	32 (33.7)	16 (16.8)	6 (6.3)
Gender identity and sexual orientation	43 (45.3)	20 (21.1)	20 (21.1)	6 (6.3)
Sexual attitudes and behaviors	57 (60)	15 (15.8)	11 (11.6)	6 (6.3)
Anamnesis of sexual and reproductive health	61 (64.2)	17 (17.9)	9 (9.5)	2 (2.1)
Normal menstruation and menstrual hygiene	58 (61.1)	18 (18.9)	11 (11.6)	2 (2.1)
Menstrual pain	55 (57.9)	19 (20)	13 (13.7)	2 (2.1)
Menorrhagia/metrorrhagia, irregular menstruation	54 (56.8)	23 (24.2)	9 (9.5)	3 (3.2)
Diagnosis of STI* including HIV^†	52 (54.7)	27 (28.4)	7 (7.4)	3 (3.2)
Prevention of STI* including HIV^†	55 (57.9)	24 (25.3)	7 (7.4)	3 (3.2)
STI* treatment	45 (47.4)	31 (32.6)	10 (10.5)	3 (3.2)
HIV^† treatment	45 (47.4)	33 (34.7)	8 (8.4)	3 (3.2)
Special problems of adolescents infected with HIV^† in the perinatal period	36 (37.9)	34 (35.8)	14 (14.7)	5 (5.3)
Preputial problems	28 (29.5)	29 (30.5)	25 (26.3)	7 (7.4)
Acute scrotal pain	24 (25.3)	28 (29.5)	29 (30.5)	8 (8.4)
Contraception, including emergency contraception	41 (43.2)	30 (31.6)	13 (13.7)	5 (5.3)
Teenage pregnancy, prenatal and postnatal care	55 (57.9)	28 (29.5)	3 (3.2)	3 (3.2)
Adolescent parenthood	40 (42.1)	22 (23.2)	23 (24.2)	4 (4.2)
Safe abortion	34 (35.8)	34 (35.8)	15 (15.8)	6 (6.3)
Preventive interventions for safe sexual practices	46 (48.4)	23 (24.2)	18 (18.9)	2 (2.1)
Epidemiology of adolescent chronic diseases	43 (45.3)	23 (24.2)	19 (20)	4 (4.2)
Psychosocial problems and chronic conditions	44 (46.3)	25 (26.3)	16 (16.8)	4 (4.2)
Adherence to treatment	33 (34.7)	32 (33.7)	18 (18.9)	6 (6.3)
Transition to adult care	32 (33.7)	19 (20)	29 (30.5)	9 (9.5)
Assessment of mental health problems	43 (45.3)	33 (34.7)	10 (10.5)	3 (3.2)
Depression	45 (47.4)	34 (35.8)	8 (8.4)	2 (2.1)
Body image issues and eating disorders	56 (58.9)	24 (25.3)	8 (8.4)	1 (1.1)
Self-harm and suicide	48 (50.5)	30 (31.6)	9 (9.5)	2 (2.1)
Anxiety disorders and phobias	42 (44.2)	35 (36.8)	9 (9.5)	3 (3.2)
Attention Deficit Hyperactivity Disorder (ADHD)	33 (34.7)	35 (36.8)	16 (16.8)	5 (5.3)
Mental disorders and delirium	29 (30.5)	39 (41.1)	15 (15.8)	6 (6.3)
Developmental disorders	50 (52.6)	25 (26.3)	10 (10.5)	4 (4.2)
Use and misuse of digital technologies	31 (32.6)	24 (25.3)	28 (29.5)	6 (6.3)
Epidemiology of substance use	46 (48.4)	25 (26.3)	13 (13.7)	5 (5.3)
Tobacco use	50 (52.6)	25 (26.3)	11 (11.6)	3 (3.2)
Alcohol use and related disorders	49 (51.6)	26 (27.4)	11 (11.6)	3 (3.2)
Drug use and related disorders	48 (50.5)	28 (29.5)	9 (9.5)	4 (4.2)
Medication and self-medication of mental disorders	28 (29.5)	39 (41.1)	17 (17.9)	5 (5.3)
Nutrition and healthy eating, nutritional needs	53 (55.8)	31 (32.6)	3 (3.2)	2 (2.1)
Overweight and obesity	51 (53.7)	34 (35.8)	2 (2.1)	2 (2.1)
Underweight and starvation	28 (29.5)	36 (37.9)	19 (20)	6 (6.3)
Malnutrition and micronutrient deficiencies	40 (42.1)	39 (41.1)	7 (7.4)	3 (3.2)
Bullying and cyber bullying	22 (23.2)	26 (27.4)	33 (34.7)	8 (8.4)
Family and intimate partner violence	38 (40)	40 (42.1)	10 (10.5)	1 (1.1)
Youth and partner violence	37 (38.9)	22 (23.2)	24 (25.3)	6 (6.3)
Sexual assault	37 (38.9)	33 (34.7)	16 (16.8)	3 (3.2)
Injuries caused by traffic accidents	34 (35.8)	34 (35.8)	14 (14.7)	7 (7.4)
Other injuries	30 (31.6)	33 (34.7)	19 (20)	7 (7.4)
Physical activity and sports	42 (44.2)	36 (37.9)	7 (7.4)	4 (4.2)

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E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Silvia Helena De Bortoli Cassiani E-mail: cassianis@paho.org https://orcid.org/0000-0003-0914-7511