Date of Award

Spring 2008

Degree Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Nursing

First Advisor

Haglund, Kristin

Second Advisor

Malin, Shelly

Third Advisor

Weiss, Marianne

Abstract

Objective: Adolescents make up a distinct patient population. They face unique barriers to accessing primary care and see office-based health care providers less than any other age group. The manner in which health care providers interact with adolescent clients can be an impediment to participating in primary care. The purpose of this study was to understand adolescents' preferences for primary care provider interactions. Design: The concept of adolescent development and Donabedian's quality of care theory provided the framework. A descriptive, mixed-method design was used. Data were collected via focus groups and an anonymous 82-item survey. Setting: Teens were recruited from a teen advisory council of a regional pediatric hospital I and from an urban pediatric primary care clinic. Participants: Twenty-four teens participated. They were predominantly female (92%), African American (62.5%), and 50% had a chronic condition. Their mean age was 16.9 years. Data Analysis: Descriptive statistics were generated from the quantitative instrument. Items were ranked from most to least preferable. Qualitative data analysis was conducted by means of template analysis. The template was modified during repeated review of transcripts until themes unfolded. Results: Four central themes were identified including forming a relationship, supporting self-determination, assuring confidentiality and provider attributes. In determining the quality of their care, teens rated respect and trust as the most important aspect of provider interactions. Participants preferred to be given a choice about their level of autonomy in a health care setting. They reported that when judging quality of care, provider attributes were more important than physical aspects of the clinic environment. Conclusion: When seeking to establish positive interactions with adolescents, providers should focus on enhancing autonomy, maintaining confidentiality, being respectful and honest, and establishing trusting, ongoing relationships. Ultimately, by improving the quality of patient-provider interactions, providers may improve adolescent's health outcomes by facilitating increased and continued utilization of primary and preventive health care.

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