Sexual Health History taking in Paediatric ED

Sexual Health History taking in Paediatric ED

Posted on By Claire MeagerIn GeneralLeave a comment

Key contacts

 Dr Claire Meager. ST7 Paediatric registrar, Chelsea & Westminster Hospital. claire.meager@nhs.net

Dr Charles Stewart. Consultant Emergency Paediatrician, Chelsea & Westminster Hospital. charles.stewart@chelwest.nhs.uk

Introduction

—Sexual history is an important part of your ED history, especially with female teenage patients presenting with abdominal pain.

Discussing sexuality and taking a sexual history may cause feelings of discomfort for the provider and patient alike. 1

An audit conducted at Chelsea & Westminster Paediatric ED revealed a need for the development of a tool, to aid clinicians in sexual history taking in teenagers. As a result we are developing a simple proforma covering the essential topics to be covered in sexual health taking in teenagers: lifestyle questions, sexual activity, type of sex, partners, risk assessment and menstrual history. This is a tool that could be completed whilst in the waiting room in ED and then discussed with the doctor during the consultation.

SMART objectives

1.Are we taking sexual/ gynaecological histories from teenage girls (age 13-15yrs) presenting to the Emergency Department with abdominal pain?

2.If sexually active are we asking the appropriate questions regarding sexual health?

3.Are we seeing teenagers on their own?

4.Does gender / grade of doctor affect history taking?

Progress made: What have you learned from doing this?

There is a need for a user friendly tool in Paediatric ED to aid sexual history taking in teenage patients. This needs to be relevant to the context of the emergency department, allowing for busy departments and limited time, yet comprehensive, safe and comfortable for both patient and clinician.

What’s your take home message?

As Paediatricians and acute care clinicians in the ED, we need to be mindful that we are asking the correct questions when it comes to sexual health in our teenage patients, so we can advise and also provide appropriate safeguarding for vulnerable patients.

Resources?

  1. Shafii T, Burstein GR. The adolescent sexual health visit. Obstet Gynecol Clin North Am.2009 Mar;36(1):99-117. doi: 10.1016/j.ogc.2009.01.001.
  2. The National Survey of Sexual Attitudes and Lifestyles (NATSAL) 2012 Based on interviews with > 15000 UK participants

  3. Alexander, S.C., et al., Physicians Use of Inclusive Sexual Orientation Language During Teenage Annual Visits. LGBT Health, 2014. 1(4): p. 283-291.

  4. Department of Health (2000) NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Directions 2000. General Medical Council (2007). 0-18 years: guidance for all doctors.

  5. Health & social care information centre
  6. Sex education forum (2015). National survey on sexual attitudes and lifestyle.