“Adolescence is the period of blooming; if uncared you cannot expect tasty fruits” - Unknown

Adolescence is a period of transition between childhood and adulthood, a time of rapid physical, cognitive, social and emotional maturing as the boy prepares for manhood and the girl prepares for womanhood. Adolescence, which literally means “to grow into maturity” is generally regarded as the psychological, social and maturational process initiated by pubertal changes (Whaley and Wong 1997). As the adolescents grow, their problems also increase due to failure in understanding the anatomical, developmental and psychological changes expected during adolescence.

Psychologically adolescence is such a vulnerable stage that boys or girls of this age are easily carried away by perceptions generated by

· Ignorance of parents, elders and society

· Misleading friends and peers

· Half informed or ill informed friends

· Many wrongful messages depicted through internet, TV programs, films and even advertisements.

· Publications carrying partially or fully false information.(Tutor vista.com)

The word ‘adolescence’ comes from the Latin word ‘adolescere’ which means ‘to grow’. So the essence of the word adolescence is growth and it is in this sense that adolescence represents a period of intensive growth and change in nearly all aspects of a child’s physical, mental, social and emotional life. Adolescence has been described by Stanley Hall as ‘the period of storm and stress of human life. Transition from one period to another always is associated with some problems. Adolescence is not an exception and it is also associated with some problems. (Keeny. G, Cassata.L (2004).

DEFENITION

Adolescence is defined by the UNICEF as “the sequence of events by which the individual is transformed into a young adult by a series of biological changes”. It is during this period that secondary sex characteristics develop. Arbitrarily, adolescence is divided into three phases: early, middle and late adolescence refers to age 10 to 13, middle adolescence to 14 to 16 years and late adolescence to 17 to 20 years.(Gupte, Sahani, 2006)

BASIC NEEDS OF ADOLESCENTS

Physiological needs:

Need for activity

Activity of one kind or another is an integral part of the adolescent behavior. The physical changes of puberty, the greater muscular power and the surplus of energy, all contribute towards strengthening the need for activity. This surging need must be controlled and guided into the proper channels such as, dancing, swimming, playing football or other types of games and sports.

Need for sexual satisfaction –

Sex development is a fundamental fact of adolescence. The sex instinct which had been lying dormant during childhood is reawakened. In the adolescence stage the young adolescent repeats 3 stages of sexual development –

a) Auto – eroticism: the adolescent takes interest in his own body and he/she handles his own sex organs.
b) Homo-sexuality: during the early period of adolescence boys love to mix with boys and girls with girls.
c) Hetero – sexuality: this type of sexuality is found at the later stage of adolescence. The boys and girls are attracted towards the opposite sex.

Psychological needs:

Need for freedom

The young adolescents also need freedom in their life. They do not like to maintain a strict routine life. They do not like disciplined life which is imposed on them by their parents. They love freedom regarding taking decisions related to their life.

Need for social life

They want the company of their equals. They love to live with their peers, which has a direct influence in their life. They want to talk, discuss and come to some. The young adolescent wants to be something among his friends and in the total social set up. They want the approval of their actions and recognitions in any form by their parents, class fellows, teachers and the community at large.

The security need

The adolescent depends on his parents for the satisfaction of these needs. He wants their affection and attention. He wants some ideals which may help him in the conduct of his life. He wants inspiration from a hero, whom he worships, and who can guide him. This need can be fulfilled if the adolescent is given opportunity of studying the biography of great men like Gandhi, Nehru, Tagore, Vivekananda, Lakshmibai, Sarojini Naidu etc. He will, derive strength and inspiration from them, imbibes ideals, formulates his life goal and strengthens his will and character.

The adventure need

Thirst for adventure is strong at this age. The adolescent wants to do something so that he is remembered by all. The answer is exploring something which others do not know. Sometimes he is misunderstood and sometimes misdirected. In the absence of proper direction it takes the form of aimless wandering, vagabonding, unsocial acts like strikes and demonstrations. Even the sexual acts mean a thrill and adventure for them. But properly directed adventure can be very much helpful for the adolescent’s social, mental, emotional and physical development.

Need for self dependence or need for a vocation

Boys and girls of high school age begin to think seriously about their future. Boys are usually more seriously concerned about an occupation than girls. Boys, typically, want glamorous and exciting jobs, regardless of the ability required. But the girls, on the other hand normally show a preference for occupations with greater security and less demand on their time. By late adolescence, the adolescents are concerned about what they would like to do and what they are capable of doing. Older adolescents have a growing realization of how much it costs to live and they also know what young people, just out of school, can expect to earn. As a result of this greater realism, they approach the choice of their careers with a more practical and more realistic attitude than they would when they were young.

(Krishnakantha. H.(2009).

Importance of Adolecence

It is a significant period because it is a period of…

Rapid physical development:

It is a period of vital physical as well as physiological changes and developments. At this stage, all the external and internal body parts and organs achieve their full form and maturity.

Rapid mental development:

During the early adolescence period, rapid mental development occurs. These give rise to the need for later mental adjustments and the necessity for establishing new attitudes, values and interests. The adolescent is mentally alert at this stage. He not only develops not only his intellectual power but also his capacity to critical thinking.

Rapid social development:

It is a period of social development and adjustment. In this stage, the child enters a new field of social responsibilities. The adolescents become socially conscious, self-assertive, and loyal towards their group, they develop co-operation and friendship and become responsible.

Stage of emotional development:

Traditionally adolescence has been thought of as a period of heightened emotionality resulting from glandular and other changes. The heightening is characterised by high degree of instability. The adolescents also develop dependency and sometime independency. They also develop some special feelings like-pride, humility, curiosity, guilt, hero-worshipping etc. All these emotions must be properly guided and they should be provided knowledge to control their emotions at this stage.

Adolecents Today

It was shocking to know that the incidence of having sexual contact was 30.08% for boys and 17.18%for girls among school going adolescents from class IX to XII in an Indian city. 6.31% boys and 1.31% girls reported having had experienced sexual intercourse. Friends constituted the main sexual partners for both boys and girls. Sexual abuse had been reported by both girls and boys. Adolescent school students are involved in sexual activity, but having lack of adequate knowledge in this regard. (Ramadugu. S. et.al, Pune Maharashtra, 2011)

Shashikumar, R., Das R. C and. Prabhu H.R.A (2012) conducted a cross sectional study of factors associated with adolescent sexual activity. It revealed that significantly large number of boys and girls are unaware of role of alcohol on sexual activity and that pregnancy can be caused by single intercourse. This was probably the first such comparative study from India. They suggested that mechanisms need to be evaluated to help adolescents understand their sexual attitudes and situations that are likely to provoke sexual activity. Therefore, not only more detailed and longitudinal studies are needed to understand these relations in a better perspective but also a well planned educational program for adolescents is a need of the hour.

Concerns and issues of adolescents

Role of parents and teachers

For a proper and all round development of the adolescent boys and girls, parents and teachers have a great role to play. Some suggestions have been discussed below -

For Proper Physical Development –

· Provision should be made for compulsory physical exercise at morning and evening.

· Monthly health check-up by the school doctor must be done.

· Scope for some manual work for every adolescent must be provided at home and at school.

· Provision of various types of indoor as well as outdoor games and sports for all students in school.

· Provision for dance classes for girls at school.

· Provision for martial art at school for both boys and girls.

· Provision of extracurricular activities such as Guides, Scouts, NCC and Youth Red Cross should be encouraged.

For Proper Mental Development –

· Home and school atmosphere must be loving and secured.

· The school must have a good library, a school debating society and in every class, a discussion group.

· Various types of clubs, like - music club, art and craft club, may be organized to enable adolescents to develop their creative abilities.

· The guidance services available at school should provide both educational and vocational guidance to their students.

· The teacher should keep an eye on every adolescent and try to fulfill his individual needs. The tutorial system must be adopted when necessary.

· Excursions to places of historical and geographical importance may be organized.

· Activity for the adolescent should be planned in such a way that the imaginations of the young adolescents are directed in the right channels and towards creative efforts.

· The adolescents are generally interested in experimentation and self-examinations of objects. Hence, it is suggested that importance should be given on using new dynamic methods of teaching.

· Different assignments should be given to the students on the basis of their intelligence and the abilities.

· Yoga and meditation must be included in the school curriculum

· Parents should give quality time to their children

· Parents should understand that meeting their material needs is not adequate to meet the emotional needs.

For Proper Social Development –

· Many informal functions may be organized in the school. These would enable the adolescents to come closer to each other and understand the interests and aspirations of each-other. These functions must cater to the needs of all types of adolescents.

· Excursions and field trips may be organized. These lead to informal conversations and close contact between the members of the group.

· Group games, debates, seminars, conference may be organized. These will help the adolescents to participate in social activities.

· The teacher should try to find out the socio - economic conditions, social interests of every adolescent and organize various activities accordingly.

· In the social field, every adolescent has to enter particular vocation in his later life. As such the school authorities should impart him knowledge about various vocations prevalent in society. He should also provided knowledge about some new vocations.

· The adolescents should be initiated into the standards of adult behaviour. Thus he will be trained for better future living.

· Parents should take them for picnics and tours and they should provide adequate recreation for them

· Parents should accept them to participate in group activity such as choir and camps

· Parents should provide them only needed amount of pocket of money. Extra money given to them extra freedom for wrong doings

· They should be entrusted with jobs of responsibility at home and at school as they grow-up. Self-government may be introduced in school to develop a feeling of responsibility among the adolescents.

For Proper Emotional Development –

· Parents and teachers must be able to redirect the emotions of the adolescents in a proper manner. The adolescent must be able to control his emotions and also to repress those emotions which are not socially acceptable.

· Most of the adolescents accept problems of life in a negative way. They are afraid of facing difficult situations in life. Parents and teachers should encourage the adolescents and point out some of their plus points. They may also suggest means and methods of achieving success. This will restore the self-confidence of the adolescents.

· It should be brought into the notice of the adolescent that life is a mixture of failure and success and he must build a power of resistance to face failure in life.

· The adolescent has to face a large number of problems at this, stage, As such, proper guidance and counseling should be provided by parents, teachers and school Guidance Counselor.

· Parents and teachers should treat the adolescent well. They should give him freedom of action within limit. The adolescent should be kept busy with various activities.

· The teacher should try to develop maturity of thinking within the child. The adolescent boys and girls must be allowed to discuss their emotional problems with their parents and teachers. And they must be provided enough scope to take part in different activities in school.

· The teacher should try to find out those students who are emotionally disturbed. They should try to solve their problems personally.

· The parents as well as the teachers should not discriminate among the adolescent boys and girls. The teacher must be known for his impartiality. Then only will he be able to enjoy the confidence of his students.

For Proper Sexual Development –

· More social contracts between boys and girls. Freedom with proper guidance must be provided to the young adolescents to make friends with the opposite sex.

· Proper sex education on a scientific basis should be provided by the teachers.

· Parents and teachers should impart the right information about sex to the adolescent boys and girls.

· Information about HIV and other sex related diseases should be provided on a scientific manner by the parents and teachers to the young adolescents. If necessary, teachers and parents must take help of counselors.

SIGNIFICANT ROLE OF NURSES AND MIDWIFES

To meet the core competencies of adolescent health nursesand midwifes must

· Use an asset framework when assessing adolescents

· Create respectful, trusting relationships adolescents and families when developing health care plans.

· Identify the needs of adolescents for safety, privacy, confidentiality, information and support.

· Develop innovative primary health care strategies within the community to promote adolescent health and to prevent disease

· Advocate for legislation and that promote adolescent health and strengthening families through community involvement.

· Incorporate evidence-based practice to guide the care of adolescents

· Educate them about their transition ,their issues and handling them positively.(Maynard.J,Desousa.M.2004)

Underlying assumptions for teaching andevaluating the adolescent health competencies,

· Nursing and midwifery care recognizes adolescents as normal phase of human growth and development.

· The nurse and midwife will synthesize knowledge relevant to adolescents from all domains to assess, plan implement and evaluate care.

· Nursing and midwifery care is based on primary health maintenance, treatment of ill health and rehabilitation.

· Adolescent health care exists within the context of health over the life span.

· Nursing and midwifery care facilitates participatory decision making in planning and implementing health care.

· Adolescent health care occurs within the context of family and community health development.

NURSES NEED TO

· Talk through the changes associated with puberty and sexuality.

· Give them an opportunity to discuss their feelings about transition and their concerns.

· Discuss about the issues such as smoking, alcohol, drugs and the possible impact on their health and wellbeing.

· Maintains a personal health record book to keep track of appointments, health information’s and medications.

· Discuss adolescent sexual health according to their stage of transition.

· Discuss fertility, safe sex, importance of sex after marriage and avoiding premarital sex.

· Create an awareness about the resources available.

CONCLUSION:

A happy upbringing – with opportunities to learn, play and feel safe–is still a distant prospect for many. Instead, millions of teenagers face hazardous employment, early pregnancy and participation in armed conflict. Burdened with adult roles and deprived of their right as children, adolescents are exposed to protection abuses. Denying this age group their childhood heightens their risk of exploitation in labour, social isolation associated with early marriage, and mortality r morbidity for adolescent girls from pregnancy-and childbirth -related complications. The enormous challenge of protecting adolescents at this vital time in their lives should not be underestimated – and we nurses have a crucial part to play in meeting it.

As the 2015 deadline for the Millennium Development Goals draws near, every effort must be made to ensure the equal well-being of children worldwide. Their hopes and dreams are still very much alive. It is up to us to enable adolescents to reach their full potential. Let us work together with them to make life a positive adventure.

REFERENCE:

Books:

· Gupte and Sahani A.K. (2009). “The text book of Pediatrics”, (11^th edition), New Delhi: JAYPEE brothers and medical publishers (P) Ltd.

· Whaley and Wong (1993) Essentials of Pediatric nursing (5^th edition) Missoure; Moshy

Journals:

· Keeny G, Cassata – L.(2004) WHO University of Illinois, Chicago

· Maynard J, De Sousa Marcella, Nerdham. J (2004) Adolescent Transition Care, Journal of Adolescent Care, Royal College of Nursing London.

· Krishna Kanta Handigni State open University 2009, Adolescent Health and development in Nursing and Mid Wife education.

· Ramadugu S.et al (2011) Indian Journal of Psychiatry. January 20(1):49:55

· Shashikumar R et al (2012) Indian Journal of Psychiatry. April to June

ONLINE

· www.pubmed.com

· www.yahoo.com

· www.google.com

· www.who.org

Received on 19.05.2014 Modified on 03.06.2014

Int. J. Adv. Nur. Management 2(2): April- June, 2014; Page 112-117