Foundations of Health- Growth and development

What impacts growth and development?

Gender, culture, sexuality

Genomics vs Epigenetics

Genomics- Study of genes and how they can be altered during growth and development

Epigenetics- factors outside of genes that change cellular functions (ex. generational trauma)

Epigenetic examples

Intergenerational trauma, poverty, stress

Physical Growth

-Quantitative and measurable

-Influenced by genetics among other things

Development

-Progressive and continuous

-Increasing capacity and skills to function

-Qualitative and difficult to measure

-Moves from simple/general to more complex/specific

Screening

-Helpful to determine G&D areas of issue for early intervention

-Screening with immunization is good health practice

Erikson’s Theory of Psychosocial Development

-8 stages through the life span

-Each stage = a resolution of a conflict

-Recognizes environment but focus is on individual mastering the conflict

-Conflicts are predominant at stages but exist at all times and may emerge over again in life

-Consider nursing implications for the person that is struggling with the successful resolution of a stage

8 stages of life

Infancy, early childhood, preschool, school age, adolescence, young adulthood, middle adulthood, maturity

Infancy (birth to 18 months)

-Trust vs mistrust

-Teach with anticipatory guidance

-Focus is on parents, the baby needs security!

“Is my world safe?”

Children develop a sense of trust when caregivers provide reliable care and affection. A lack of this will lead to mistrust.

Early childhood (2-3 years old)

Autonomy vs shame and doubt

Teach with empathetic guidance

Learning about independence and self confidence

“Can I do things myself or do I always need others?”

Children need to develop a sense of personal control over physical skills and independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt.

Preschool (3-5)

Initiative vs guilt

Teach about cooperation and control, help them learn about independence

“Am I good or bad?”

Children need to begin asserting control and power over the environment. Success leads to sense of purpose. Children who try to exert too much power get disapproval, resulting in guilt.

School age (6-11)

Industry vs inferiority

-Allow for opportunities, helping them learn about interests and challenges

“How can I be good?”

Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure leads to a sense of inferiority.

Adolescence (12-18)

Identity vs role confusion

“Who am I and where am I going?”

Teens need to develop a sense of self. Success leads to an ability to stay true to yourself, while failure leads to a weak sense of self.

Young adulthood (19-40)

-Intimacy vs isolation

-Learn to be a part of society, develop close relationships and learn their own identity.

-Need social support networks

“Can I give myself to another?” “Am I loved and wanted?”

Adults need to form loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation

Middle adulthood (40-65)

-Generativity vs stagnation

-Expanding within society and supporting the future

-Nurses can support social interactions

“Will I provide something of real value?”

Adults need to create or nurture things that will outlast them, often by having children or creating a positive change. Success leads to feeling accomplishment, while failure leads to shallow involvement in the world.

Maturity (65+)

-Ego integrity vs despair

Nursing can practice without ageism, showing respect, value, and involvement.

“Have I lived a full life?”

Older adults need to look back and feel fulfillment. Success leads to feelings of wisdom, while failure leads to regret, bitterness, and despair.

Piaget’s theory of Cognitive development

4 periods of time experienced by all cultures.

Spontaneous process where individual plays active role in development

Sensorimotor (0-2 years)

The infant explores the world through sensory and motor contact. Object permanence and separation anxiety develop.

Preoperational (2-6 years)

The child uses words and images to represent objects but does not reason logically. The child is able to pretend. The child is egocentric.

Concrete operational (7-12 years)

The child can think logically about concrete objects and can add and subtract. The child also understands conservation

Formal operational (12+ years)

The adolescent can reason abstractly and think in hypothetical terms

4 stages of cognitive development (Piaget)

Sensorimotor > preoperational > concrete operational > formal operational

Kohlberg’s Moral Development Theory

3 levels, 6 stages

Premoral- No understanding/respect for rules

Conventional- Will follow rules

Autonomous- mutual respect for rules

Who makes health care decisions

-Parents can make decisions for those under 19, however minors can make decisions if it is in their best interest and they are making an informed decision. (mature-minor consent)

-Substitute decision makers can make decisions for patients unable to (ex. dementia, TBI)

Health definition

Health- looks at physical, mental, social wellness

looks at aspiration, needs, and ability to change and cope

Health risks and risk factors

May be internal or external (environment), increases susceptability to disease

Ex. Falls, poor eating/obesity, air pollution, marketing to youth (ex. fast food)

Risk assessments

Deciding whether an action will cause more harm than good

ex. surgery, medication, letting someone sleep or waking them up

Attitudes

A settled opinion or way of thinking or feeling towards a person, object or idea

Transtheoretical model of change

pre-contemplation- no plans to take action

contemplation-acknowledge need for change

Preparation-intends to take action immediately

Action

Maintenance- strives to prevent relapse

Termination- Change is made, problem eliminated

Behavior change techniques

-Visualizing, self-talk, positive reinforcement, self assessment, self help groups