Doing physical examinations
It is only necessary to do a physical examination in some contexts. If a young person comes to you for condoms and cannot spend time with you, it is enough to briefly discuss sexual behaviour with them and then give them what they want. Sometimes, you may need to do a physical examination in order to diagnose the problem the young person has and to help them. Some parts of the physical examination can cause embarrassment. For example, vaginal examination for a vaginal discharge may cause embarrassment in a young woman. Therefore avoid doing vaginal examination unless there is a strong indication of need for this. For example, for a young woman in labour you should do a vaginal examination to assess the progress of labour. You should not do a pelvic examination of a virgin.
As part of the physical examination, check the following:
- Pulse rate
- Presence of anaemia
- Presence of undernutrition
- Presence of swelling or tenderness in the abdomen.
How to make the physical examination less stressful a young person
- Respect the young person's sensitivity about privacy.
- Explain what you are doing before you begin each step of the examination.
- Protect their physical privacy as much as possible. Allow them to keep their clothes on except for what must be removed. Make sure to cover the parts of the body that are exposed. Never leave any part of the body exposed when not being examined.
- Reassure the client that any results of the examination will remain confidential.
- A good rapport and relationship between you and the young person is essential. Try to establish trust.
- Provide reassurance throughout the examination.
- Give constant feedback in a non-judgemental manner, 'I see you have a small sore here, does it hurt?'
Based on what you get from the history taking and physical examination, you should counsel and provide services for each specific problem the young person has. For STIs, HIV/AIDS, unsafe abortions, contraception, emergency contraception, sexual abuse and substance abuse refer to the respective sessions on how to respond to the specific needs of the young person. For pregnancy, childbirth and postpartum-related needs, you will learn how you should provide care in the next session.