Detecting and addressing adolescent issues and concerns: Evaluating the efficacy of a primary care previsit questionnaire

Warren Lewin; Bärbel Knäuper; Michelle Roseman; Perry Adler; Michael Malus

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Table 1

Coded data from adolescent charts

ISSUES OR DIAGNOSES

ACTIONS TAKEN

Medical diagnosis
Medical symptoms without diagnosis
Psychological diagnosis
Psychological symptoms without diagnosis
Mix of psychological and medical symptoms without diagnosis^*
Mix of psychological and medical symptoms with diagnosis^*
Depression
Family issue
Behavioural or school issue
Pain
Pregnancy
Sexual health issue (oral contraception, STI screening)^*
Eating disorder

Medical test administered or ordered
Blood workup
Psychological test administered
Education or resources given^*
Counseling or reassurance given
Return-to-clinic for psychosocial issue
Return-to-clinic for medical issue
Non-suicide pact
Medical note written^*
Prescription or pill given
Referral to psychology
Referral to psychiatry
Referral to medical specialist
Referral to other health care professional

PVQ–previsit questionnaire, STI–sexually transmitted infection.
↵* These codes are included in the analyses comparing the number of issues or diagnoses and the number of actions taken between the pre-PVQ and post-PVQ groups but are not included in Table 2 because it was not possible, based on the information in the charts, to differentiate the data into either a medical or psychosocial category.

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Table 2

Variables created from coded chart data

ISSUES OR DIAGNOSES				ACTIONS TAKEN
PSYCHOSOCIAL DIAGNOSES	PSYCHOSOCIAL SYMPTOMS WITHOUT DIAGNOSES	MEDICAL DIAGNOSES	MEDICAL SYMPTOMS WITHOUT DIAGNOSES	PSYCHOSOCIAL ACTIONS	MEDICAL ACTIONS
Psychological diagnosis Eating disorder Depression	Psychological symptoms without diagnosis Behavioural or school issue Family issue	Medical diagnosis Pain Pregnancy	Medical symptoms without diagnosis	Psychological test administered Referral to psychology Referral to psychiatry Non-suicide pact Return to clinic for psychosocial reason	Medical test administered Blood workup Prescription or pill given Referral to medical specialist Referral to other health care professional Return to clinic for medical reason

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Table 3

Reasons for visits: Up to 3 reasons per adolescent were extracted from hotline intake sheets; differences between the groups are not significant at P < .05, with the exception of sexual health concerns, P = .05.

	NO. OF VISITS
REASON	PRE-PVQ GROUP	POST-PVQ GROUP
Psychological problem (not depression or eating issue)	13	16
Medical problem	12	15
Behavioural or school problem	9	15
Check-up or needs doctor	19	19
Oral contraception, pregnancy, morning-after pill	14	9
Pain	6	4
Depression or suicide	17	24
Eating disorder or eating issues	5	5
Family issues	5	7
Sexual health concerns	10	1
Other	3	4