Developmental Theories Growth and Development

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)

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

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

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

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

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

25. 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

27. 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

28. 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

29. 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

30. 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

31. 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

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

33. Older AdultCognitive Changes Delirium Dementia Alzheimer�s Disease Depression

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

35. 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

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

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

38. 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