Study Guide on Chapter 14: Developmental Considerations and Chronic Illness

Chapter 14: Developmental Considerations and Chronic Illness in the Nursing Care of Adults

Erikson’s Adult Psychosocial Developmental Stages

• Young adulthood (ages 18 to 40)

  • Crisis: Intimacy versus isolation
  • Focus on establishing intimate relationships and personal connections.

• Middle adulthood (ages 40 to 65)

  • Crisis: Generativity versus stagnation
  • Emphasis on nurturing the next generation and contributing to society.

• Late adulthood (ages 65 to death)

  • Crisis: Integrity versus despair
  • Reflection on life and acceptance of one’s contributions and decisions.

Adult Health Concerns

• Health risks related to lifestyle choices:
  • Young adulthood: Common risks include drug use, poor nutrition, excessive sun exposure, tobacco use, and unsafe sex practices.
  • Middle adulthood: Major concerns include alcohol and tobacco use, sedentary lifestyle, obesity, heart disease, and lung disease.
  • Late adulthood: Predominant issues consist of chronic illnesses, dementia, disability, risk of falls, sensory impairments, and increased suicide rates.

Socialization in Older Adults

• Engagement in hobbies
  • Encouragement of participation in leisure activities.
• Continued work beyond retirement age
  • Allows for social interaction and purpose.
• Importance of socialization
  • Fosters mental health and emotional well-being.

Chronic Illness

• Definition:
  • Chronic illness refers to long-lasting or recurrent conditions.
  • Disability resulting from chronic illness can vary.
  • May significantly interfere with activities of daily living (ADLs).
• Chronic Disease Self-Management Program:
  • Effective educational program for managing chronic conditions.
  • Resources can be found at: www.selfmanagementresource.com

Gerontological Influence on Chronic Illness

• Life Span: Understanding the lifespan perspective in health care for chronic conditions.
• Family caregivers:
  • Commonly includes adult children caring for aging parents and spouses.
  • Family units may face increased risk due to caregiving burdens.
• Nursing diagnoses related to aging:
  • Frail elderly syndrome.
• Impact on daily living patterns:
  • Chronic illness may require establishing new routines to cope with health changes.

Chronic Sorrow

• Description:
  • Chronic sorrow is a normal psychological response to experiencing chronic illness.
• Characteristics:
  • It reflects a permanent sadness linked to losses incurred due to chronic health conditions.
• Nursing Diagnosis: Chronic Sorrow.

Spirituality

• Importance in coping with chronic illness:
  • Spirituality aids individuals in finding hope and peace during difficult times.
• Nursing Diagnoses related to spirituality:
  • Impaired Religiosity
  • Readiness for Enhanced Spiritual Well-Being
  • Spiritual Distress.

Powerlessness

• Acknowledgment of factors contributing to feelings of powerlessness:
  • Uncertainty regarding illness progression and an ongoing lack of control over health.
• Nursing Diagnosis: Powerlessness.

Coping Mechanisms

• Positive attitudes are crucial:
  • Maintaining a constructive outlook can greatly influence illness adaptation.
• Nursing Diagnoses related to coping:
  • Ineffective Coping
  • Compromised Family Coping
  • Disabled Family Coping
  • Readiness for Enhanced Family Coping.

Hope

• Realistic perspectives on hope:
  • Hope improves overall quality of life and fosters adaptability in patients facing chronic conditions.
• Nursing Diagnoses involving hope:
  • Hopelessness
  • Readiness for Enhanced Hope.

Sexuality

• Considered a lifelong aspect of identity:
  • Both femininity and masculinity contribute to self-worth across the lifespan.
• Nursing Diagnoses related to sexuality:
  • Disturbed Body Image
  • Ineffective Sexuality Pattern
  • Sexual Dysfunction.

Role Changes

• Impact of chronic illness on life roles:
  • Chronic illness can modify various life roles requiring adaptation by families and patients.
• Nursing Diagnoses related to role changes:
  • Deficient Knowledge
  • Readiness for Enhanced Knowledge
  • Grieving
  • Ineffective Role Performance.

Family and Caregivers

• Understanding the strain on family caregivers:
  • Caregivers may experience significant role strain due to chronic illness demands.
• Approaches to support caregivers:
  • Respite care options available to relieve stress.
  • Role of chronic care coaches in aiding families.
• Nursing Diagnoses for family caregivers:
  • Risk for Caregiver Role Strain
  • Caregiver Role Strain.

Financial Considerations

• Importance of addressing financial resources:
  • Financial strain can complicate chronic illness management and family coping.
• Nursing Diagnoses related to finances:
  • Compromised Family Coping
  • Disabled Family Coping
  • Readiness for Enhanced Family Coping.

Health Promotion

• Essential for all age groups:
  • Health promotion strategies are necessary for maintaining health across the adult lifespan.
  • Empowerment through health education is crucial.
  • Nursing Diagnosis: Deficient Knowledge.

Nursing Care for Chronic Illness

• Core principles of nursing care include:
  • Respect for patient preferences and wishes.
  • Inclusion of families in care plans.
  • Education for patients and families about chronic conditions.
  • Empowering patients and families to take an active role in care management.
  • Ensuring dignity for patients through care practices.

Review Questions

• Question #1: What is a nursing care goal for those in middle adulthood? (Select all that apply.)

  • To identify confusion
  • To promote positive lifestyle choices
  • To empower patients to make healthy changes
  • To provide reminiscence therapy
  • To provide education on vaccinations

• Question #2: To plan care for a patient, which of these does the nurse identify as the developmental task for older adults?

  • Identity versus confusion
  • Intimacy versus isolation
  • Generativity versus stagnation
  • Integrity versus despair