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Developmental Theories Growth and Development

Developmental Theories Growth and Development. NRS 101. Why study theory?. Provides a framework Offers logic for observations and explanations How and why people act Important for nurses to combine theory, practice, and research Nurses assess responses to illness and treatments. Theory.

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Developmental Theories Growth and Development

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  1. Developmental TheoriesGrowth and Development NRS 101

  2. Why study theory? • Provides a framework • Offers logic for observations and explanations • How and why people act • Important for nurses to combine theory, practice, and research • Nurses assess responses to illness and treatments

  3. Theory • Organized and logical set of statements about a subject, frameworks to clarify, to make sense of. • Human Development Theory: Models intended to account for how and why people become who they are, tries to explain and predict human behavior.

  4. Growth and Development • Growth: Quantitative changed, measured and compared to norms • Height, weight compared to normal growth charts • Development: Qualitative, progressive, continuous process of change leading to a functional capacity • Child crawls, rolls over, walks

  5. Four Areas of Developmental Theories • Biophysical-How do we grow, change, age • Psychosocial-Personality & behavior • Cognitive-Thinking, intellect • Moral-Knowing right from wrong, ethics

  6. Biophysical Developmental Theories • Gesell’s Theory: Grow according to our own genetic blueprint and pace, growth is directed by gene activity, environmental factors can modify pattern of development • Genetic Theory of Aging: DNA function of cell lifespan, programmed cell death, accounts for longevity in families

  7. Biophysical Developmental Theories • Nongenetic Cellular Theories: Looks at cell rather than DNA, “wear and tear” theory, our bodies just wear out. Free Radical Theory • Physiological Theories of Aging: 1) Breakdown of performance of a single organ 2.) Impairment of physiological control mechanisms

  8. Erik Erikson • Student of Anna Freud • Evolutionary process: Biological, psychological, and social events contribute to readiness for each task/stage • Added 3 adult stages to Sigmund’s model

  9. Erikson’s Stages of Psychosocial Development • Trust vs. Mistrust • Autonomy vs. Shame • Initiative vs. Guilt • Industry vs. Inferiority • Identity vs. Role Confusion • Intimacy vs. Isolation • Generativity vs. Stagnation • Integrity vs. Despair

  10. Jean PiagetCognitive Development Theory • How we think, learn to reason, exercise judgment, have intellectual organization • Observed children • Defined 4 periods that children move through: • Sensorimotor (Birth-2 yrs) • Preoperational (2-7 yrs.) • Concrete (7-11 yrs) • Formal (11 yrs-adult)

  11. Jean PiagetMoral Development • Stages of moral development influenced by environment • Observed boys, ages 5-13 yrs.

  12. Moral Development Theories • How we acquire moral values, are guided by morals, how we treat others based on morals • Jean Piaget-Environmental influences • Lawrence Kohlberg-Cognitive and moral linked, expanded Piaget’s work, defined 3 levels with 6 stages of moral development

  13. Lawrence KohlbergMoral Development Theory • Level 1- Preconventional • Stage 1- Punish and Obey • Stage 2- Instrumental Relativist • Level 2- Conventional • Stage 3- Good boy/Nice girl • Stage 4- Society Maintenance • Level 3- Post-Conventional • Stage 5-Social Contract • Stage 6- Universal Ethics

  14. Analysis • Theories give nurses some answers on why and how people react, respond as they do • Human behavior is complex • No one theory answers all questions • All theories are multi-dimensional, not linear, they are guidelines

  15. Growth and Development • Refer to P&P pg. 173 Table 11-1 for Developmental Age periods • Conception through adolescence • Physical growth and cognitive development • Stages of development per age

  16. Intrauterine Life • 40 weeks, 9 calender months • Nagele’s Rule • 3 Trimesters (every 3 months) • Prematurity- 20-37 weeks gestation pg. 175 Table 10-1 • Tocolysis: Therapeutic interventions to stop labor before 37 weeks (IV’s, meds. Bedrest)

  17. Newborn • Neonatal period to first month of life • P&P pg. 183 Box 11-4 for injury prevention during infancy

  18. Infant • 1 Month to 1 year • Health Risks: Injury prevention, child abuse/maltreatment • Health Concerns: Nutrition, feeding, supplementation, overfeeding, dentition, sleep, immunizations

  19. Toddler • 12-36 months • Health Concerns and Risks: • need for close supervision • curiosity • poisonings • auto safety

  20. Pre-Schooler • 3-5 years • Concerns • fear of dark • fear of animals • fear of thunderstorms • fear of medical procedures

  21. School Age • 6-12 years • Cognitive changed • Concrete operations • Mature language development • Health risks: Accidents, falls, cancer, abduction, infections

  22. Adolescence • Teen years • Ages 13-20 years • Increased growth rate, sexual changes, changes in muscle and fat distribution • Risks for accidents, homicide, suicide, substance abuse, tobacco use, eating disorders, sexual experimentation, pregnancy, STD’s

  23. Young to Middle Adult • 20’s to 40’s • Physical, cognitive, psychosocial changes • Lifestyle, career, marriage, sexuality, childbearing. Infertility • Risk factors for family history of disease, personal hygiene, environmental and occupational factors, family and career stress, health screenings, exercise and nutrition

  24. Middle Adult • 40’s to 60’s • Menopause- Women- disruption of menstruation and ovulation, ovaries no longer produce sex hormones • Climacteric- Men- decrease levels of testosterone, decrease erection/ejaculation; sperm still is produced • Psychosocial Changes: career transition, sexuality, family changes • Health Concerns: Stress, family diseases, forming positive health habits, anxiety, depression

  25. Older Adult • Above 65 years • Health Concerns: Chronic disease/disability, injury, decreased senses and physical strength, retirement, family changes, assisted living, grandchildren, support of other seniors, remaining independent, sexual concerns, death/dying/loss, medications, insurance coverage, memory, aging process, nutrition, hydration, skin care

  26. Older Adult • Gerontology-Geriatrics • Myths and Stereotypes • Theories of Aging:Stochastic (random damage over time), NonStochastic (predetermined by body mechanisms) • Psychosocial Theories: Disengagement, Activity, Continuity

  27. Older Adult • Health services: Active adult communities, retirement communities, home care, adult day care, assisted living long term care, respite care, living with children or grandchildren

  28. Older AdultPhysiological Changes • Skin • Head and Neck • Thorax and Lungs • Heart and vascular system • GI • Reproductive • GU • Musculoskeletal • Neuro

  29. Older AdultCognitive Changes • Delirium • Dementia • Alzheimer’s Disease • Depression

  30. Older AdultPsychosocial Changes • Retirement • Social Isolation • Sexuality • Housing and environment • Death

  31. Older AdultHeath Risks • 90% Of adults over 65 have atleasr one health risk • Heart disease • Cancer • CVA • COPD, Smoking cessation • Nutrition, dental problems • Arthritis • Falls • Polypharmacy

  32. Older AdultPsychosocial Concerns • Therapeutic communication • Touch • Reality orientation • Validation Therapy • Reminiscence • Body Image interventions

  33. Older AdultPsychosocial Concerns • Therapeutic communication • Touch • Reality orientation • Validation Therapy • Reminiscence • Body Image interventions

  34. Older AdultAcute Care Considerations • Risk for dehydration, malnutrition • Risk for delirium • Risk for nosocomial infection • Risk for incontinence • Risk for falls • Risk for skin breakdown

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