Developmental Theories Growth and Development

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Developmental TheoriesGrowth and Development

• NRS 101

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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

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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.

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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

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Four Areas of Developmental Theories

• Biophysical-How do we grow, change, age
• Psychosocial-Personality behavior
• Cognitive-Thinking, intellect
• Moral-Knowing right from wrong, ethics

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Biophysical Developmental Theories

• Gesells 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

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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

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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 Sigmunds model

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Eriksons 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

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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)

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Jean PiagetMoral Development

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

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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 Piagets work, defined 3 levels with 6
  stages of moral development

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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

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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

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Growth and Development

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

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Intrauterine Life

• 40 weeks, 9 calender months
• Nageles 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 (IVs, meds. Bedrest)

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Newborn

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

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Infant

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

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Toddler

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

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Pre-Schooler

• 3-5 years
• Concerns
• fear of dark
• fear of animals
• fear of thunderstorms
• fear of medical procedures

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School Age

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

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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, STDs

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Young to Middle Adult

• 20s to 40s
• 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

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Middle Adult

• 40s to 60s
• 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

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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

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Older Adult

• Gerontology-Geriatrics
• Myths and Stereotypes
• Theories of AgingStochastic (random damage over
  time), NonStochastic (predetermined by body
  mechanisms)
• Psychosocial Theories Disengagement, Activity,
  Continuity

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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

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Older AdultPhysiological Changes

• Skin
• Head and Neck
• Thorax and Lungs
• Heart and vascular system
• GI
• Reproductive
• GU
• Musculoskeletal
• Neuro

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Older AdultCognitive Changes

• Delirium
• Dementia
• Alzheimers Disease
• Depression

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Older AdultPsychosocial Changes

• Retirement
• Social Isolation
• Sexuality
• Housing and environment
• Death

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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

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Older AdultPsychosocial Concerns

• Therapeutic communication
• Touch
• Reality orientation
• Validation Therapy
• Reminiscence
• Body Image interventions

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Older AdultPsychosocial Concerns

• Therapeutic communication
• Touch
• Reality orientation
• Validation Therapy
• Reminiscence
• Body Image interventions

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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