Vulnerable populations are defined as the disadvantaged sub-segment of the community(Shivayogi, 2013). Vulnerable populations require the utmost care and specific considerations (Shivayogi, 2013). Vulnerable populations include children, adolescents, pregnant women, fetuses, human in vitro fertilization, prisoners, employees, military persons and students in hierarchical organizations, terminally ill, comatose, physically and intellectually challenged individuals, institutionalized, elderly individuals, visual or hearing impaired, ethnic minorities, refugees, international research, economically and educationally disabled and healthy volunteers (Shivayogi, 2013). The adolescents group as a whole face many challenges and have many reasons why they are labeled a vulnerable population. For this paper, examined will be female adolescents, women’s health issues faced by female adolescents, psychosocial issues impacting female adolescents, and importance of providing culturally competent care to this group.
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The adolescent age group is made of individuals who are 10-17 years of age. In the United States this group make up 13% of the population, which equates to approximately 42 million people (“HHS.gov,” 2018). Out of the 13% of adolescents in the United States, 49% of adolescents are females (“HHS.gov,” 2018). The female adolescent population was chosen for this paper, as adolescence is a period where people are the most vulnerable (“JIMSA, 2012). This population is at risk for premature death, illness, and injury (“WHO,” 2018). Female adolescents are most vulnerable due to the overall growth and development, physical, reproductive and psychological changes exposing the female adolescents to many health risks (“JIMSA,” 2012).
As a female adolescent there are numerous areas that impact women’s health. Two of the major categories in adolescents that caregivers are concerned with are sexual and reproductive issues and mental health and social issues (Youngkin, Davis, Schadewald, & Juve, 2013). For the female adolescent they are entering into puberty, getting their menses, and engaging in sexual activity. With the introduction of their menses and sexual activity, sexual and reproductive health becomes an important issue that needs to be address with this vulnerable population.
Sexual and reproductive issues that impact female adolescents include sexual behaviors, contraceptive use, sexually transmitted infections, pregnancy, births, and abortions, and menstrual disorders. During adolescents many become sexually active. About half of adolescents report engaging in sexual activity (Youngkin et al., 2013). Due to adolescents engaging in sexually activity, contraceptive use becomes an important conversation.
Contraceptive use is reported by 79% of female adolescents 15 to 19 years of age the first time they engage in sex (Youngkin et al., 2013). 84% of adolescents report using a contraception method most of the time they engage in sex (Youngkin et al., 2013). Adolescents use contraceptive methods to protect them from pregnancy and sexually transmitted diseases. 21% of sexually active adolescents report using condom in addition to a hormonal method of contraception (Youngkin et al., 2013).
26% of female adolescents 14 to 19 years of age have at least one of the following sexually transmitted infections: human papillomavirus, Chlamydia, herpes, trichomoniasis (Youngkin et al., 2013). This population makes up approximately half of all new cases of sexually transmitted infections (Youngkin et al., 2013).
In addition, female adolescents have a to be concerned about pregnancy, births, and abortions. Yearly 740,000 adolescents become pregnant (Youngkin et al., 2013). Approximately 30% of the female adolescent population will become pregnant before the age of 20 (Youngkin et al., 2013).
Menstrual disorders impact female adolescents as well. 75% of female adolescents experience some type of menstrual problems(Youngkin et al., 2013). These problems include variation in menstrual length, dysmenorrhea, dysfunctional uterine bleeding, and amenorrhea (Youngkin et al., 2013). Dysmenorrhea is the leading cause of missed days from school (Youngkin et al., 2013). 14% of female adolescents missed school because of cramps (Youngkin et al., 2013).
The above women’s health issues can have adverse impacts on an adolescents life. Dysmenorrhea causes missed days for school. Adolescent pregnancy can have adverse impacts on both the adolescent and their child (Youngkin et al., 2013). Adolescents who become pregnant are at risk for a dropping out of high school or decreases the changes that they will attend college (Youngkin et al., 2013). With the sexual and reproductive health issues having such a potential to cause significant impacts to the adolescents, health care workers need to be ensure to address these issues with their patients. In addition, there are numerous national and local initiatives to help decrease the changes of female adolescents encountering these issues. In addition, to women health issues such sexual and reproductive issues that impact female adolescents there are numerous psychosocial issues.
Psychosocial issues that impact female adolescents include depression, sexual violence, and substance use and abuse (Youngkin et al., 2013). Approximately 11% of adolescents have depression before age of 18 years of age (Youngkin et al., 2013). Approximately 17% of female adolescents have contemplated suicide, while 8% have actually attempted suicide (Youngkin et al., 2013). Adolescence brings on an increase risk of depression due to engagement of sexual activity, having multiple sex partners, having sexual partners with a sexually transmitted infection, and inconsistent condom use to name a few (Youngkin et al., 2013). In addition, to depression, other psychosocial issues that a female adolescent may encounter is sexual violence.
Approximately 60% of females who have been a victim of sexual violence noted being assaulted before the age of 18 (Youngkin et al., 2013). 11% of adolescent females report being forced to engage in sex (Youngkin et al., 2013). In addition, to the risk of sexual violence, adolescents are at risk for substance use and abuse.
Substance use and abuse such as tobacco, alcohol, marijuana, and other drugs use during the adolescent years are very common (Youngkin et al., 2013). 25% of students reported having five or more alcoholic drinks in a row during the last 30 days (Youngkin et al., 2013). 36% of students reports using marijuana (Youngkin et al., 2013).
Psychosocial issues put adolescents at great risk. Depression could lead to suicide or death. Effects of sexual violence could be long lasting such as causing the adolescents to have post-traumatic stress disorder. Substance abuse or use increases risk taking. There are numerous federal and local programs which aim to help adolescents deal with these issues. As health care workers encounter adolescents, they have to be sure to screen for these issues and provide culturally competent care for these patients.
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Health care workers have to provide culturally competent care to reach the adolescent patients. Cultural and ethical identity is learned from an adolescents parents, family, or care givers. Culture is further influenced by peers (Chiocca, 2015). Culturally competent issues sensitive to the adolescent population include those learned ideas from their families such as for the African American culture there is a strong emphasis on extended family and sickness is viewed as punishment (Chiocca, 2015). Social media plays a significant role of the culture of adolescents. Marketing and peers influence the use of drugs, tobacco, and alcohol. Location and economic status influence the adolescent’s culture. Adolescents who are brought up in an urban are at greater risks for mental health problems, substance use, obesity, and physical inactivity (Patton et al., 2016). Other cultural issues that may impact adolescents who live in an urban setting include increase risks of sexual exploitation, unsafe employment, and human trafficking (Patton et al., 2016).
As a nurse practitioner employing culturally and ethically competent care methods is key for adolescents. Creating a private and trusting environment is important when caring for the adolescent. This helps them build a trusting relationship and feel comfortable with the health care provider. The nurse practitioner should speak directly to the adolescent when caring for them (Chiocca, 2015). Health care providers should listen attentively and be non-judgemental. Provide the adolescent with appropriate care and education as it relates to what the adolescent is experiencing.
Female adolescents are identified as a vulnerable population. They are at risk for several women’s health issues and psychosocial issues. It is important as a health care provider when seeing this population, to screen these patients appropriately to help identify and counsel on these issues. In this paper, examined were the female adolescents, women’s health issues faced by female adolescents, psychosocial issues impacting female adolescents, and importance of providing culturally competent care to this group.
- Adolescents: health risks and solutions. (2018). Retrieved December 16, 2018, from https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions
- Chiocca, E. M. (2015). Advanced Pediatric Assessment (2 ed.). New York, NY: Springer Publishing Company, LLC.
- Health Concerns amongst Adolescent Girls. (2012). JIMSA, 25(2), 67. Retrieved from http://medind.nic.in/jav/t12/i2/javt12i2p67.pdf
- Patton, G. C., Swayer, S., Santelli, J. S., Ross, D. A., Afifi, R., Allen, N., … Viner, R. (2016, May 9, 2016). Our future: a Lancet commission on adolescent health and wellbeing. Lancet, 387(10036), 2423-2478. http://dx.doi.org/10.1016/S0140-6736(16)00579-1
- Shivayogi, P. (2013, January 4). Vulnerable population and methods for their safeguard. Perspectives in clinical research, 4(1), 53-57. http://dx.doi.org/10.4103/2229-3485.106389
- The Changing Face of America’s Adolescents. (2018). Retrieved December 15, 2018, from https://www.hhs.gov/ash/oah/facts-and-stats/changing-face-of-americas-adolescents/index.html
- Youngkin, E. Q., Davis, M. S., Schadewald, D. M., & Juve, C. (2013). Women’s Health A Primary Care Clinical Guide (4th ed.). Upper Saddle River, NJ: Pearson Education, Inc.
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