Introduction

Adolescents make up about the same percent of the population in the United States in general and in Puerto Rico, 14.5% and 16.2% respectively.^1,2 However, troubling statistics suggest that the similarity stops there. Teenage births, violence against adolescents, and mental ailments specific to Puerto Rico have prompted concern among nonprofit organizations and government agencies, such as the National Council of La Raza and the Department of Health of Puerto Rico. Mandatory continuing education in adolescent health may help nurses to focus on this segment of the population.

Adolescent health in Puerto Rico has obvious areas for concern. The incidence of teenage pregnancies and births, 49 births for every 1,000 girls age 15 to 17, is still higher than any state in the U.S - although it has declined since 1997.^3,4

The trouble doesn't stop there. Violence in public schools in Puerto Rico has been on the rise. The total number of incidents in 2003 reached 1,600, compared to 821 in 1998.⁵ Nearly 41% of children and adolescents who died between the ages of 10 and 19 died of homicide.6 In the U.S. homicides constitute only 15.5% of deaths among young people ages 15 to 24.⁶

Finally, an epidemiological study of the child and adolescent population in Puerto Rico conducted in 2000 revealed that 140,528 children between the ages of 3 and 17 had characteristics that indicated some type of mental ailment, with impairment ranging from mild to moderate. More than 59,000 of those children and adolescents met the criteria for severe emotional disturbance, according to the Center for Mental Health Services in the U.S.⁷ On a positive note, a survey during the 2002-2003 and 2003-2004 school years of 62,844 students in 503 Puerto Rican public and private schools showed that drug use lags behind that in U.S. schools.8,9 Nevertheless, enough areas of concern persist to warrant the attention of professional nurses.

After studying the information presented here, you will be able to:

• Discuss the parameters of normal pubertal development in terms of sequence and tempo.
• Identify the developmental tasks of adolescents.
• Describe the effects of physical changes on psychosocial development.
• Discuss the cognitive changes that occur during adolescence.
• Describe the nutritional requirements to support adolescent growth.
• Identify the principles of resiliency in promoting healthy development.
• Describe the parameters of consent and confidentiality in adolescence.
• Identify communication techniques that are effective with adolescents.