Major Influence on the Developing Person

1
Major Influence on the Developing Person
I can make me a man!

• Dr. Patricia E. Freed

Chapters 4, 5, 6, 7
2
Objectives

• Describe major influences on developing persons
• Describe influences at different stages of
  development
• Identify influences that are hazardous/crisis for
  each stage
• Ways to prevent harm

3
Influences on Development

• Life Span Related
• Cohort Related
• Non-normative influences
• Contextual influences
• Sociocultural
• Environmental
• Spiritual/Religious
• Family

Normative
4
Influences

• First, there are normative age-graded influences
  those correlated highly with age, such as
  physical maturation, commencement of education,
  and parents' death.  LIFE SPAN RELATED
• Then, there are normative, history-graded
  influences, that is, historical events that
  influence entire age cohorts-economic
  depressions, epidemics, wars, social movements. 
  COHORT RELATED
• Next, there are a host of non-normative
  influences events that have great impact on
  individual lives but that most people escape,
  such as contracting a rare disease, having a
  child with a genetic abnormality, or winning a
  lottery.  NON NORMATIVE
• Last there are influences which arise from the
  context in which the individual finds himself.
  CONTEXTUAL

5
Contextual Influences
Environmental
Different things influence my development
differently
Spiritual/Religious
Socio-Culture
Family
Person
or and and/or stage of
development At any stage of development - At any
stage of development
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Social Influences

• Social environments shaped by
• Occupations
• Economic resources
• Neighborhoods

Health
Opportunities
Values Beliefs
All developmental dimensions are effected by our
socioeconomic status.
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Socioeconomic LevelsSubcultural Groups

• Social Stratification
• Values and Role expectations
• Status and Power
• Health Status
• Vulnerable populations
• more illness, lower quality of life, premature
  death
• lack of resources and exposure to risk
• Homeless, elderly, children, poor, migrants,
  refugees, immigrants, mentally ill

See SES Website
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Classes

• Upper Upper Class - Old Money
• The Lower Upper Class - Bill Gates
• Overclass Yuppies Children of Privilege
• Upper Middle Class
• Middle Class American Dream
• Lower Middle or Working
• Upper lower class
• The underclass

9
2005 HHS Poverty Guidelines
SOURCE  Federal Register, Vol. 70, No. 33,
February 18, 2005, pp. 8373-8375.
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Cultural Influences

• The culture and subcultures into which we are
  born encompass and direct us for life.
• We learn an identity, values, beliefs, norms,
  habits of life, language, relationships, time,
  space, work, play, right wrong and physical and
  mental health practices.

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Culture Definitions

• Culture
• Manifest culture
• Customs
• Ideal culture
• Regional culture
• Subculture
• Ethnic- ethnicity
• Rural Culture
• Urban Culture
• Socioeconomic level
• Religious culture
• Family culture
• EMIC or ETIC
• Rituals
• Dialect

These Cuban Americanwomen in Miami,
Floridashare a subculturalidentity that is
reinforcedthrough their language,food, and
other traditions
Know these terms!
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Culture

• The sum total of the learned ways of doing,
  feeling and thinking, past and present, of a
  social group within a given period. These ways
  are transmitted from one generation to the next
  and to immigrants who become members of the
  society.
• Cultures have common characteristics.

13
Characteristics

• Culture is adaptive
• Culture is learned
• Culture is cumulative
• Cultures change
• People are not aware of their own culture
• People do not know all of their own culture
• Cultures allow a wide range of behavior
• Cultures dont exist in isolation

See Power Point Show on Study Guide
14
Culture-Bound Illness

• Amok
• Ataqe de nerios
• Susto
• Ghost sickness
• Falling out
• Bulimia

Read about these in your textbook very
interesting!
15
An Example

• Does it happen here?
• Koro Shook Yong
• Malaysians
• Chinese

This is not Pleasant!
Also know as Penile Retraction Syndrome Or Penis
Panic Or Shrinking Penis
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Shook Yong KoroCase Study
H.K.F. a 34 year old Chinese male, was at a
cinema show when he felt the need to urinate. He
went out to the latrine to relieve himself and
he suddenly felt a loss of feeling in the genital
region. The thought occurred to him that he was
going to have a penile retraction. Sure enough,
he noticed that his penis was getting
shorter... He felt cold in the limbs, and was
weak all over, and his legs gave way under him.
So he sat on the floor, all this time holding
onto his penis. About half an hour later, the
attacks abated. He went to see a medical
specialist and was prescribed some
pills. History At 24 years of age, he exposed
himself to a prostitute, and was infected with
gonorrhea, and since then he had remained
abstinent. He heard of shook yong from his
friends prior to the attack and also heard about
some fatalities during intercourse. Treatment
He was vigorously reassured and given some talk
on sexual anatomy. No further attacks occurred.

17
Another Koro Story

• By Vaughan Mon Sep 16th, 2002 at 105653 AM EST
  
• A woman in Nigeria narrowly escaped a recent
  lynching from an enraged crowd after a market
  trader claimed she had stolen his penis. This is
  an example of Koro, (as it is most commonly known
  in the West), a belief that the genitals have
  been stolen, or in other parts of the world, that
  they are fatally shrinking into the body.
• Bizarre as it sounds, the belief in Koro is
  several thousand years old and occurs
  internationally.

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An article

• Earleywine, M. (2001). Cannabis-induced Koro in
  Americans. Addiction, 96(11), 1663-6.

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Cultural Adaptation

• Cultural Shock
• Assessment Tools

Did you say Catural Adaptation?
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4 phases of Culture Shock

• Honeymoon phase
• Disenchanted phase
• Beginning resolution phase
• Effective function phase

Im new Here.
Brink and Saunders
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Assessment Tools

• Values
• Beliefs
• Customs
• Social Structure
• Preferences

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Core Values

• Human Nature
• Person- Nature
• Time
• Activity
• Relational

Textbook Table 5-2
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ValuesTraditional Emerging

• Romantic notions love, marriage family, self
  sacrifice
• Rugged Individual but cooperative
• Adheres to social customs, rules, expected
  behavior, etiquette
• Puritanical- Cleanliness
• Authoritarian outlook, values respects leaders
• Books media to develop social conscience

• Self satisfaction, changing relationships,
  childlessness
• Do your own thing-more freedom of choice
• More informal, Less social concern and
  sensitivity for others
• More sensual, obsession with sex, less concern
  about cleanliness
• Democratic outlook, questions leadership, shows
  apathy and disrespect.
• Mass media information systems for personal
  entertainment and education

Textbook Table 5-4
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Childrearing and Family ValuesPoverty

• Misbehavior important in terms of outcome
• Lack belief in long-term goals
• Communication family more physical
• Parents may be poorly equipped to meet needs of
  children
• Mother is primary care giver authoritarian
  milieu
• Discipline harsh, inconsistent, ridicule
• Aggressive behavior may be encouraged/restrained
  dependent on consequences to parents
• Doesnt teach impulse control

Lareau, A. (2002). Invisible Inequality Social
Class and Childrearing. Sociological Review. 67,
747-756.
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Environmental Influences

• Ecology is the science studying the interactions
  of organisms with their environment and with one
  another.
• It comes from the
• Greek words
• oikos (habitat)
• and logos (science).

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Health Threats

• Environmental Pollution is the release of harmful
  environmental contaminants, or the substances so
  released. Generally the process needs to result
  from human activity to be regarded as pollution.
  Even relatively benign products of human activity
  are liable to be regarded as pollution, if they
  precipitate negative effects later on.

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Environmental Pollution

• Air
• Water
• Soil
• Food
• Light
• Noise
• Surface (Solid waste disposal)
• Hazardous Wastes
• Occupational hazards

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Fact

• Following the Chernoble disaster there was
  widesrpead radiation exposure in areas of
  Belarus, The Russian Federation, the Ukraine
  resulting in long term health effects. 1800
  adults exposed to radioactive iodine, as children
  have developed thyroid cancer.

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Global Warming Health

• Global Climate Change (heat, flooding,
  hurricanes, drought)
• Poor, Elderly, Sick Young Children
• Air Quality
• Shelter
• Waste Removal
• Diseases (insects)
• Tainted Food and Water

US Environmental Protection Agency Report 2008
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Lead Poisoning

• Minimum of 400,000 children with too much lead in
  their blood.
• 25 of Houses (24 million homes)
• Get a Test Kit at the National Safety Council Web
  site http//www.nsc.org/library/facts/lead.htm
• Matel Recall Toys made in China
  http//www.mattel.com/safety/us/

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CDC Recommendations

• Testing at Ages 1 and 2
• Testing at Age 3-6 if
• never been tested,
• receive public assistance or WIC or supplemental
  food services,
• live or frequently visit house built before 1950
• or l978 and recently remodeled,
• if they have a brother or sister or playmate with
  lead poisoning
• Level gt10 ug/dl concern in children begin
  treatment
• Level gt20 ug/dl lead poisoning

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PreventionHow can families reduce the risk of
exposure to lead?

• Avoid exposure to sources of lead.
• Do not allow children to chew or mouth painted
  surfaces that may have been painted with
  lead-based paint.
• If you have a water lead problem, run or flush
  water that has been standing overnight before
  drinking or cooking with it.
• Some types of paints and pigments that are used
  as make-up or hair coloring contain lead. Keep
  these kinds of products away from children
• If your home contains lead-based paint or you
  live in an area contaminated with lead, wash
  children's hands and faces often to remove lead
  dusts and soil, and regularly clean the house of
  dust and tracked in soil.
• Clean all exposed surfaces, rinse with clean
  water, replace mop heads, use vigorous wiping
  right to left (not back and forth).

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Environmental Pollution

• http//www.sierraclub.org/factoryfarms/
• http//www.themeatrix.com/
• Example
• Factory Farming

The Meatrix was a 2005 Webby Award winner, and
has enjoyed a tremendous amount of success on
the independent film festival circuit. In
November 2004, the film won Best Documentary
Short at the Fourteenth Annual Environment Media
Association Awards (EMAs) in Los Angeles. It
also has received awards from the Annecy
International Animated Film Festival, the Gynwood
Foundation, and Media Rights Media That Matters
Film Festival.
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• During the past 15 years the number of hog farms
  in the United States dropped from 600,000 to
  157,000, yet the number of hogs remains almost
  the same.
• In 1999, the U.S. Department of Agriculture
  reported that 2 percent of the hog farms in the
  country produce over 46 percent of the total
  number of hogs.

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Factory Farming

• McFARMS GO HOG WILD
• By Laura Orlando
• This article appeared in the July/August 1998
  Dollars and Sense magazine.
• "One man can take care of two thousand pigs in
  one barn. Twenty pigs to a stall . A hundred
  stalls. I can pay him 25,000 and take home at
  least 20 on my investment, which is hovering at
  around 650,000 including the pigs." Jerry
  Sorokowski spat on the ground and dreamed of
  money." Multiply those barns and you multiply
  your money," he continued, "factory farms are
  here to stay."

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• "The odor's usually worse in the mornings around
  630--that's the time I get up and go out to get
  the newspaper and it'll hit you in your face some
  mornings when you walk out. And that's how I
  start my day--just angry that I walk out my door
  and smell this mess and have no control over it.
  And another time it's really bad is usually
  around 730 or 8 at night--it's just awful then
  it's like a cloud rolling in."

Testimonial
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Threats to Public HealthSwine Farms

• Source Hogfarm Lagoons (spills, seepage,
  overflowing, excessive amounts) swine
  mortalities disposal processes
• Pollution Soil, Air and Water
• Contaminates Nitrogen, phosphorous, heavy
  metals, virus, fecal coliform bacteria, toxins,
  hydrogen sulfide, cryptosporidium, Pfiesteria
  piscicida
• Effects on Human Development
  Methemoglobinemia (blue-baby syndrome)
• Increased risk of
  spontaneous abortion
• Human Health Risks Short term memory loss
  or brain damage or other cognitive impairments
• Bronchitis, Coughing (as much as 2 miles
  away)
• Skin
  irritations, Sore eyes
• Contributes to spread of antibiotic
  resistance disease
• More than 40 diseases associated with manure
• Flu-like symptoms-death
• Tension, depression, anger and fatigue  
• Evidence Base
• Two studies have looked generally at the medical
  conditions of residents living near swine factory
  farms. One survey of residents living in the
  vicinity of a 2,500-sow facility found much
  higher reports of respiratory problems than those
  recorded in neighborhoods of farms where no
  livestock was raised (CDC,1998)

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Guilty or Not?
Pfiesteria-like organisms- some Toxic
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CryptosporidiumCryptosporidiosisParasitic
Diarrhea

• People who are most likely to become infected
  with Cryptosporidium include
• Children who attend day care centers, including
  diaper-aged children
• Child care workers
• Parents of infected children
• International travelers
• Backpackers, hikers, and campers who drink
  unfiltered, untreated water
• Swimmers who swallow water while swimming in
  swimming pools, lakes, rivers, ponds, and streams
  
• People who drink from shallow, unprotected wells
• People who swallow water from contaminated
  sources
• Contaminated water includes water that has not
  been boiled or filtered. Several community-wide
  outbreaks of cryptosporidiosis have been linked
  to drinking municipal water or recreational water
  contaminated with Cryptosporidium.

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Spiritual Influences

• Spiritual
• Religious

http//www.jyh.dk/indengl.htm
The Self is the ultimate unity of the personality
symbolized by the circle, The cross, and the
mandala - Carl Jung
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Religion

• Belief system about Divine or Supreme force that
  commands worship obedience
• Comprehensive philosophy or code that guides
  behavior
• Set of practices related to beliefs
• Affiliation with organized body of worshipers
• Group of people with established practice related
  to spiritual beliefs

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All Religions

• World view, way of perceiving reality, meaning of
  life, existence
• Authority, source of power
• Scriptures or sacred words
• Ethical code
• Group identity for adherents
• Aspirations or expectations
• Ideas about what follows death

Great Chart Table 7-1, p.185
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Religious Influences

• Dietary Laws
• Ideas about illness
• Ideas about health
• Cleanliness
• Family relationships and behavior
• Sexuality
• Death

The beliefs and behavioral imperatives in turn
effect human development.
44
Religion InfluenceAttitudes and Behavior

• Cleanliness
• Money
• Work
• Political behavior
• Family
• Childrearing
• Right and Wrong

45
Spirituality

• Quality beyond association with a religion
• Involves inspiration and reverence for something
  beyond self, a sense of awe
• Meaning and purpose in life
• Harmony in relationships with the universe
• Strives for answer about the infinite
• Hamilton Jackson (l998)

46

• Stages of spiritual development
• Traditional
• Christian - Fowler's six stages of faith
• Buddhist - Ten ox-herding pictures
• Hindu - Seven chakras
• Sufi - Seven levels of self

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Undisciplined
Discipline Begins
In Harness
Faced Round
Tamed
Laissez Faire
All Forgotten
The Solitary Moon
Both Vanished
Unimpeded
The Ten Ox Herding Pictures- Buddhist Stages of
Spiritual Development
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Stages of Spiritual Development

• Psychological
• Egocentric
• Sociocentric
• Worldcentric
• Transpersonal

Ken Wilber
Integral Theory of Consciousness Transpersonal
psychology/philosophy Brief History of Everything

49
Holism

• A nurse does not only seek to alleviate physical
  pain or render physical care - she ministers to
  the whole person.
• The existence of suffering, whether physical,
  mental or spiritual is the proper concern of the
  nurse".
• Travelbee, J.(1971). Interpersonal relations in
  nursing, 159

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Spiritual Assessment(Questions 7-2)

• Respect client as a person with
  spiritual/religious needs who has a right to have
  them met.
• Use knowledge and experience as a beginning-
  Validate!
• Your goal is not to be a spiritual expert but to
  help facilitate spiritual care!
• Do not overwhelm and do not antagonize!
• Do not preach or reconstruct.

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9 Behaviors- Call for Help!

• Withdrawn, sullen or depressed
• Restless, irritable, complaining
• Restless, excitable, garrulous
• Shows undue anxiety about self
• Take turn to worse, critical, terminal
• Shows interest and asks for clergy
• Inquires
• Has few visitors, card, flowers
• Has had (faces) a particularly traumatic or
  threatening experience

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Spiritual DistressNursing Diagnosis Actual or
Potential

• Person is experiences a disturbance in the belief
  system that is his or her source of strength.
• Evidence
• Expressing anger at God
• Discouragement, despair
• Feeling spiritually empty, ambivalent
• Hopelessness

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Spiritual Nursing Care

• Interventions Tailored to unique personal coping
  mechanisms reported to have helped in the past in
  partnership with patient. Be careful about
  participating in worship or ritual because of
  potential role boundary confusion.
• Cultural Knowledge Knowledge of customs,
  ceremonies, cleanliness/hygiene rules, and food
  laws will be of practical value.
• Contraindicated
• When psychotic or delusional
• When clear they do not want to participate
• When minors or parents are unaware that their
  children are participating in activity contrary
  to their denomination and faith (legal
  repercussions).
• Ethical Issues
• Overstepping your own practice (you are not
  clergy)
• Limits of research
• Avoid your own value imposition
• Must be voluntary and specifically asked for
  participation
• Church-state separation (avoid in civic settings-
  governmental role)
• Importance of documentation

From Mohr, WK (2006). Spiritual issues in
psychiatric care. Perspectives in Psychiatric
Care 42(3), 174-182.
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Pastoral Care

• Ministry of care and counseling provided by
  pastors, chaplains and other religious leaders to
  members of their church, congregation or persons
  within a faith-based institution.
• This ministry can range anywhere from home
  visitation to formal counseling provided by
  pastors who are licensed to offer counseling
  services.
• Members of the Interdisciplinary HC team.
• This is also frequently referred to as Spiritual
  Care.

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Group ActivityDescribe a Family Disaster
PlanWhat should be in a Disaster kit?
Directions Contents
56
Group ActivityDescribe a Family Disaster
PlanWhat should be in a Disaster kit?
Plan where to seek shelter and safety for family
and pets. How to contact each other if separated
(help numbers on cell phones) List of diagnoses,
identification bracelet, medications, emergency
numbers Tote kit with Supplies 3-7 days supply
of Rx flashlight, portable radio
batteries, extra pair of prescription glasses
sunglasses, hearing aids, bottled
water, games or activities for children, copies
of important family documents/pictures adhesive
bandages, tissues, essential hygiene products
UPDATE THE KIT What about Pets?

Page 102 Text
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Dont Forget

• Friday
• Dr. Westhus
• Principles of
• Development
• Be sure you
  Signed the Role!