Dr Linda Milnes,
Associate Professor in Children and Young People’s Nursing,
School of Healthcare, University of Leeds
As the 2015 update of Key Data for Adolescence (Association for Young People’s Health) was published, last September, once again we are alerted to the fact that one fifth of the UK’s population are 10-24 years old, which is 11.7 million young people. One in seven of this population have a diagnosis of a long-term condition or disability. Many of these young people will be cared for by specialist services in paediatric centres but will also access primary care services. An example of this is young people with asthma, reported as 800,000 in the UK. Young people talk of experiencing daily symptoms, restrictions on activities, having good days and bad days and feeling different to their peers (Callery et al., 2003). Health care for this group should be patient-centred and focus on skilling young people to self-care effectively as they move towards adulthood a transition we know can bring many challenges for them.
Consultations between health professionals and young people are an opportunity to develop and build therapeutic relationships, gain young people’s perspectives on their condition and understand their priorities for effective self-care. However, research tells us that young people’s participation in consultations can be limited (Lyte et al., 2007; Cahill and Papageorgiou, 2007). Using asthma as an exemplar, young people report a lack of confidence in asking questions (Dixon-Woods et al., 2002), feeling intimidated (Milnes et al., 2014) and uncomfortable about attending asthma appointments alone (Edgecombe et al., 2010).
It is here that my research interests lie, supporting the development of young people’s communication skills and promoting their participation in consultations. Participating in consultations, communicating health needs and concerns, taking part in complex decisions about disease management all require high level communication and interpersonal skills. Doctors and nurses receive high level training in communicating with young people and can learn from experiences, but there is still a problem. In response to a call by young people for health professionals to improve their communication skills further training is now available (http://www.mefirst.org.uk/). I would argue that this is an excellent way forward but we know that communicating with health professionals requires confidence and practice in a, sometimes, paternalistic environment so why not train patients to participate? Alongside young people and experts in the field of respiratory care and health psychology, I developed an intervention to promote young people’s participation in primary care consultations. more…