給家長的信－從兒科診所過渡至內科診所：如何幫助子女作適切準備 謝詠儀醫生 Public Education Series No. 6 (2013)

貴子女因健康的需要要繼續長期的治療。一般兒科診所提供服務至十九歲的病人，之後，病人便要轉介至內科診所跟進與治療。

對新醫療環境和陌生的醫護人員感到不安和憂慮是可以理解的。譬如，青年病者擔心新遇上的醫護不詳細明瞭他從前病歷，或者不能如兒科醫護般容易溝通，新診所病人數量較多，醫生可能診症時間較短等等。有時，青年病者和家人甚至不想離開兒科診所的跟進。另一方面，兒科的醫護也可能捨不得自年幼已醫治的病人轉往他處。

凡此種種其實對青年病者並非最好的安排，因為他們的醫療需要會因年紀漸長大而非盡由兒科服務所能完善地提供。至今，一般的轉介都缺乏周詳的統籌，致青年病者往往未能安心和順利過渡至內科服務，可能影響他們往後的醫治的成效。有見於此，兒科醫生著手推廣「過渡護理」計劃，好讓青年病者得到最佳的準備與安排，轉至內科服務後繼續獲得稱心和優質的健康保障。

「過渡護理」的目的包括倡導年青病者多項的技巧和能力，如與醫護的溝通、自我護理﹝如約期，服葯﹞、對治療作決定，和申張自己的需要等等。另外，家長也要就子女成長階段作相應調節管教和照顧子女的原則與方法。

為了讓 貴子女循序漸進地學懂對自己的健康和治療責任的承擔，我們有以下的建議。

1. 在 貴子女青春期內醫生會開始與你和 貴子女談論將來會轉往內科服務的計劃。

2. 請多鼓勵 貴子女多與醫護人員直接溝通。

3. 請盡早教導 貴子女處理他/她特別的醫療需要。

4. 協助家務會令他們對家庭有歸屬感和有承擔；成長後，他們亦較易找到工作。

5. 請幫助 貴子女明瞭他/她的健康情況，和治療對目前和將來的健康的重要性。

6. 請鼓勵 貴子女覆診前作好整理和提示將要發問的問題紀錄下來。請著他/她自己預約覆診。

7. 請與 貴子女談論他/她對學業和就業的考慮和選擇。

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Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals.

This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/

When you are pregnant, Dr Tony Lau, Public Education Series No. 5 (2013)

When you are pregnant unexpectedly, be calm and make good choices!

Many teenagers find out they are pregnant unexpectedly. She may be sad, scared, angry, feeling guilty or ashamed. She may cry easily. She may keep the pregnancy secret. These are understandable.

You could make good choices! Please talk to trusted adults about your current situation. Professional people likes doctors, nurses, social workers and teachers could offer clear and correct information for you. Information from peers might be biased such that unsound decision is made resulting in unfavorable or dangerous situation. Your health and baby’s health are paramount.

Pregnancy in teenage girl is associated with risks of nutritional deficiency, mood problems, partner violence, unsatisfactory weight gain or unhealthy risky behaviour. The baby is affected by these situations and may be born prematurely with low birth weight. Young mother faces changing roles. Issues of financial or housing difficulties may arise. In Hong Kong, enhanced service for pregnant teenager is provided by Hospital Authority and other organizations working in partnership. Such services include enhanced antenatal care, education and talks on child care, career planning and counseling.

If you need information on termination of pregnancy, consult a registered doctor for professional advice. Utilization of illegal medical service or substandard medical service outside Hong Kong will result in irreversible damage to your body including infectious diseases, surgical complications or problems of fertility.

The following services are reliable and appropriate for your needs:

1.           Family Planning Association of Hong Kong

Wan Chai. Tel. 25754799;  Mong Kok. Tel 27704994; Tsuen Wan. Tel. 24432773

2.           Mother’s Choice

Tel. 2868 2022

3.           “When Teens Meet Angels” - by Evangelical Lutheran Church of Hong Kong

Tel 51322155

4.           “Caritas Project Hyacinth” - by Caritas Social Service Division

Tel 25802626 or 95513707

5.           Maternal and Child Health Centers (31 clinics in different districts in Hong Kong)

Please talk to professional people. Your confidentiality will be respected!

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Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals.

This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/

Download Seminar Materials - Adolescents with ADHD (being held 2013-05-25)

Over 100 participants, including youth workers, family members of young people, various professionals in Adolescent Health and other stakeholders attended the Seminar being held on May 25.  With permission from speakers, the abstracts of PPT slides are loaded for reference.

Pharmacological intervention for Adolescents with ADHD [Dowload]
Dr Chun-pan TANG, Consultant Psychiatrist, Kwai Chung Hospital

Psychological intervention for Adolescents with ADHD [Dowload]
Dr Cheryl SO, Clinical Psychologist, Kwai Chung Hospital

處理長期病患 潘恩賜職業治療師 Public Education Series No. 4 (2013)

「我是一位長期病患者」，這句話說起來何其沉重！傳統上，我們總執著地要把疾病根治，不能完全痊癒的，有時甚至被消極地稱之為「絕症」！事實上，現今社會醫學昌明，從前衝擊生命的可怕疾病，現在很多都已被人類一一征服過來，只要控制得宜，很多病人都能與其他人一樣活得長壽，活得精彩！
如何與一些比較困難的疾病共存？首要的條件當然是認識疾病的本質。精明的朋友都會掌握有用的資料，包括：

1. 病症的成因

• 包括在病理上的基本認識，醫生如何檢查及診斷病症等

2. 病徵及可能引發的併發症

• 更早覺察一些早期病徵，以便及早處理及控制病情

3. 治療方法及相關身體反應

• 藥物作用及副作用，避免將病徵混淆
• 各種復康療程，包括如何在家中配合的訓練與活動，復康療程一般包括物理治療、職業治療、言語治療和其他治療

4. 社區及其他政府支援

• 除了各項政府資助外，在社區內還有很多設施讓大家都能享受一個無障礙的生活。最近香港職業治療學會印製了一份名為「去街guide」的小冊子，內容就是環繞為輪椅使用者而設的交通工具指南。

5. 照顧者的如何參與支援

• 坊間有很多為慢性病者而設計的講座及資源中心，有時亦會特別探討照顧者的需要，令照顧者更有信心與病者併肩作戰

6. 本地的支援組織

• 在香港有很多慢性疾病的支援組織，讓公眾人士和病者本身更容易取得有用的資訊，很多病者亦發現與其他病者一起分享與慢性疾病生活的心得，一方面會掌握更多生活上適應的技巧；另一方面，這些個人分享對於其他同路人亦有大的支持！

7. 如何妥善照顧自己

• 包括不同情況的處理和日常起居飲食、工作和學習上的平衡，對各種興趣的參與等。

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作為一位醒目的慢性疾病病人，我們還要懂得辨別各類資料的真確性和可信性；對自己的身體狀況及護理有相當了解，保持正面的態度去面對疾病帶給我們日常生活的挑戰。青少年的慢性病患者，都有一份頑強的鬥志，能接受疾病的衝擊，並把它變成動力，向世界展示我們如何超越所謂的「不可能」！

Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals. 
This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/

How to talk to my daughter with Anorexia Nervosa, Dr Anita Tsang, Public Education Series No. 3 (2013)

Many parents are totally at a loss of what to do when they start to suspect their daughter of suffering from anorexia nervosa  This has never come to their mind as they might have only noticed her eating “healthy “ food and thinking that many teens just want to keep fit. It is not until that she is eating much less and others are commenting that she is losing weight then they become aware that there is a problem. They may think that all will get back to normal by asking her to eat more. Soon they will find out that this not only does not work but in fact make things worse. There are constant conflicts over food. Parents become more frustrated and she is getting thinner. This is because she is suffering from a disease with many complex factors contributing to it.  It is not just about “eating” or “not eating”.

The difficulty in dealing with the situation lies with the paradox that on one hand you need to deal with her eating, yet on the other hand, you cannot just talk about food and weight.  You need to understand her feelings and emotions behind.  Here are a few tips for you.

1. Listen to her. Don’t lecture about food.

• When she talks to you about eating issues, listen to her. Don’t lecture about food. Ask her why she can’t eat, just listen. Don’t correct. She wants someone to understand the struggle she is going through. Just listen. Nod your head or say “uh-huh”. Don’t preach.

2. Avoid placing blame, shame or guilt on her actions or attitudes. 

• Don’t use “you” statements like “You just have to eat” or “You are acting irresponsibly”.
• Use “ I” statements like “ I am concerned about you because you are not eating your lunch.”

3. Avoid power struggles over eating. 

• Do not force them to eat. Do not beg them to eat. Do not criticize their eating habits.  Often anorexic girls are struggling with control in their lives. Do not demand them to change for your sake.  Avoid emotional blackmail. This may make things worse.
• There will be arguments over food and eating. Don’t let them continue.  Respond calmly and firmly. Re-state your expectation. Express your concern. Tell her “we can talk about this later” without any anger.

4. Do not comment on how she looks or how you/others look.

• She is already very obsessed about weight and appearance issues.  Any further comments on these issues will only reinforce her on their importance. 
• Do not say "You are not fat". Instead try to help her to explore what are her fears about being fat and what she wants to achieve by being thin. 

5. Don’t act like a “food police”.

• Many anorexic girls complain that their parents always spy on them to see what they are doing and how much they have eaten. They feel like being put under a microscope. The feeling of loss of personal space suffocates them. They need someone to support them to go through the struggle, not a policeman/calorie counter over the dining table. 

6. Take care of yourself.

• Do not deal with this on your own. Seek help from professionals - the doctors, school teachers, social workers, and counselors. Bring in circle of support – your spouse, your family, your friends or parent support groups. 

Seeking help early will help you to better support your daughter in overcoming the disease and becoming healthy again.

[Download PDF of this article / 下載本文 pdf]

Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals.

This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/

進食失調 張志雄醫生 Public Education Series No. 2 (2013)

進食失調是指病者對體重過份注意引致進食行為出現問題，繼而嚴重影響身體的症狀。它一般可分為厭食和暴食兩大類,而本文會談談厭食症之診斷、病徵及家人需留意之處。厭食症的發病者多為十多二十歲的青春期女性，現時在香港沒有很準確的患病統計數字。一般患者在不同情況下被診斷出厭食症：如婦科醫生為停經女性看病，又或家庭醫生診斷其他疾病時發現。也有學校社工在輔導學習或社交問題時發現體重暴跌，甚至在政府學童保健身體檢查時發現而作轉介，又或因體弱昏倒、情緒出現問題而需要入院等等。

診斷
該病可在短暫時間如幾週內，由病發發展至很嚴重情況，亦可導致死亡。因此，及早診斷和接受治療是很重要的。醫生會根據病徵來斷症，患者如有體重下降低於性別及年齡所預期中位數之百份之十五，自我形象扭曲，拒絕增加體重，及女性停經三次或以上，都可被斷定為厭食症。

病徵
生理：身體缺乏多種營養，出現疲勞怕冷；肌肉消瘦致易跌倒受傷、貧血、膚色蒼白，手掌呈淺橙色、指甲呈暗紫等。嘔吐患者牙齒受胃液而損毀，扣喉者手指背面出現厚皮，其亦會出現體內電解質失調而影響心率。
身體缺乏足夠能量，新陳代謝減慢，血壓下降，心跳減慢，脈搏微弱，體溫偏底，便秘，思想遲緩，皮膚出現幼毛，頭髮乾燥缺乏光彩及容易脫落。荷爾蒙失調導致不規律的月經或完全停經，骨骼鈣質流失而轉變成往後不能修補的骨質疏鬆；青少年生理成長受影響亦會引致延遲發育。
心理、行為、社交：患者常有不少怪異的進食行為，例如過度仔細處理食物，嚴謹計量每種食物的熱量等等。其對食物有極度的選擇性，偏向某些食物，而對某些食物如肉類等會有嘔心感。也有病者在進食前出現焦慮、猶豫不決、進食時間冗長、不喜歡與人一起進食、進食再不是一件樂事；或進食後扣喉把食物吐出，因怕肥而過度做運動；患者情緒起伏較大、易哭、或自殘；強迫症、焦慮症、抑鬱症亦可能會同時出現，學業和社交會大受影響。

家人
進食失調給家庭帶來很大的困擾。家長必須保持冷靜，否則便弄巧反拙。厭食只是一個病徵，背後可能隱藏了很多誘因，如自我期望過高，自尊心不足，對自我形象或何謂標準體重的曲解，又或因家庭、學業帶來的壓力、朋友排斥等非當局者可清晰了解的因素。所以，最重要是尋求專業人仕的幫助，慢慢把這些問題逐一解決。同時，家人必須給予患者支持，持正面態度關愛他們，透過專業界人員的協助，一起渡過治療的過程。家人如有困擾，亦應尋求專業人仕幫助。

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Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals.
This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/

運動與青少年 劉秀麗護士 Public Education Series No. 1 (2013)

青少年人正值青春和發育期, 適當的運動十分重要。

運動的好處
運動的好處很多,這包括促進身體健康, 加強心肺功能,防止高血壓, 强壯肌肉, 增加關節柔軟度, 促進新陳代謝及身體抵抗力, 增加能量消耗以預防肥胖, 加強體格、肌肉及骨格的發展, 改善體形及姿態, 舒展身心, 舒減精神壓力。 群體運動更能建立友誼和團隊合作, 增強自信心及意志, 培養積極人生觀。

持之以恆 注意安全
運動種類繁多, 青少年可按照自己的興趣和能力, 選擇適合自己的運動。在適宜的天氣和環境下作運動很重要, 如過熱的天氣作室外運動易致中暑。運動的裝備同樣重要,衣服以吸汗和不影響運動為主, 運動鞋要舒適及配合運動的需要, 如跑鞋配合跑步使用。運動前要有充份的熱身和舒展筋絡, 運動量宜慢慢增加,運動時應常補充水份。運動的方法要正確, 運動時若有不適應停下休息,有身體不適不應勉強繼續。運動最重要是抱正面的態度,持之以恆,不要存好勝心,量力而為,注意安全,運動後要有充份的休息。
若不幸於運動時遇到受傷或意外, 應保持冷靜, 作適當的急救法後, 盡早求醫。急救法: 如扭傷時, 冰敷後以繃帶包紮受傷部位; 懷疑骨折時, 切勿移動骨折部位, 應以硬物承托骨折部位, 並以繃帶或布類作固定, 然後送院。
總括而言, 運動有益身心, 只要我們有正確的運動知識和態度, 運動便變成我們的樂趣。

[Download PDF of this article / 下載本文 pdf]

Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals.
This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/