Paediatric Nursing Skills for Australian Nurses

Introduction

This chapter will address the developmental needs of adolescents, the risks and challenges to which they are exposed and the key health and wellbeing issues with which they must contend. You will learn the skills required to engage with adolescents and their families, and explore an evidence-based psychosocial health assessment framework that facilitates the identification of risk factors, specific healthcare needs, individual strengths and available supports. More focused assessment techniques for eliciting concerns regarding mental health and wellbeing will also be outlined.

Adolescent development

Adolescence is not only a period of rapid growth and physiological change; it marks the transition between the dependence of childhood and the independence of adulthood through a process of individuation, socialisation and emotional maturation. Adolescents are predisposed to experimentation and participation in high-risk behaviours during this lifespan stage, which can impact on short- and long-term health outcomes as well as their response to healthcare intervention.

Change during adolescence involves physical, cognitive and social and emotional maturation across three sub-phases: early adolescence (10 to 13 years), middle adolescence (14 to 17 years) and late adolescence (18 to 20 years). Early adolescence generally is characterised by adjustment to the physical and emotional changes associated with puberty; middle adolescence entails transition to a dominant peer orientation and a strong need for identity to affirm self-image; and late adolescence involves transition into adulthood, including the assumption of adult work roles and relationships (Curtis, 2015). The age ranges are a guide only, as adolescent maturation can be influenced by genetics, gender and the socioeconomic and cultural contexts in which young people are raised (Blakemore, 2012; Curtis, 2015; Day et al., 2016; McBride et al., 2011).

Developmental needs of adolescents

Physical needs

Nutrition

Adolescents need to consume a wide variety of nutritious foods. Unfortunately, their diets often include excess fat, sugar, caffeine and sodium, and insufficient nutrient-dense foods such as fresh fruits and vegetables, and calcium-rich foods such as dairy products. Poor dietary intake and low fibre content mean that young people are at risk of being overweight or obese, as well as iron deficiency due to their increased blood volume and muscle mass during this period of growth and development, with girls particularly vulnerable due to menstruation.