Theoretical Foundations: Kohlberg, Maslow, Erickson, and Piaget

Kohlberg's Theory of Moral Development

  • Focuses on thinking, reasoning, and decision-making across the lifespan.
  • Three main stages:
    • Preconventional (Children less than 5 years old):
      • Decisions are made to gain rewards or avoid consequences.
      • Example: Sticker charts are effective because children are motivated by rewards.
    • Conventional (6-12 years old):
      • Individuals begin to consider how their actions affect others.
      • Decision-making is influenced by the impact on other people.
    • Postconventional (13 years and older):
      • Involves more abstract thinking in the decision-making process.
      • Individuals start to see the world in a more complex way.

Maslow's Hierarchy of Needs

  • Presents a hierarchy of needs that humans must meet, ranging from basic physiological needs to self-actualization.
  • Needs must be met at the lower levels before one can move on to higher-level needs.
  • Levels of the hierarchy:
    • Physiological needs: food, water, shelter
    • Love and belonging
    • Self-actualization: Pursuing inner talents and feeling fulfilled.
  • Relevance to Nursing:
    • Important for prioritizing patient care.
    • Basic needs must be addressed before psychosocial concerns.
    • Example: A patient in severe pain or worried about their next meal cannot focus on self-actualization.

Erickson's Stages of Human Development

  • Each stage of development involves a psychosocial crisis.
  • It is important to familiarize yourself with these stages because they come up in basically every nursing class.
  • Key stages:
    • Infant (Trust vs. Mistrust):
      • Learning to trust that needs will be met by caregivers.
      • Crisis: Learning to trust that when I have a need, somebody responds to it.
    • School Age (Industry vs. Inferiority):
      • Children focus on activities such as crafts, school, and peer interactions.
      • Hospitalization can disrupt this stage by removing them from their learning environment and peers.
      • Intervention: Provide crafts or ensure they receive homework from school.
    • Adulthood (40-65 years - Generativity vs. Stagnation):
      • Individuals reflect on their accomplishments and contributions to society.
      • Crisis: Transitioning to a new phase of life as children leave home and retirement approaches.
      • Positive resolution: Embracing new roles, such as being a grandparent or enjoying retirement.
      • Negative resolution: Emotionally struggling with aging and change.

Piaget's Theory of Cognitive Development

  • Describes how children explore and learn about the world, focusing on perception and cognition.
  • Children's perception of the world changes significantly until about age 11.
  • Stages:
    • Sensorimotor (0-2 years):
      • Children explore the world through their senses and movement. They touch everything, crawl, or put things in their mouths.
      • Key concept: Object permanence - the understanding that objects continue to exist even when out of sight. Infants initially lack this understanding.
      • Risk: Higher risk for infection and injuries due to exploring the environment by putting things into their mouth.
    • Preoperational (2-7 years):
      • Magical Thinking: The belief that magic is real and can influence events.
      • Animism: Attributing life-like qualities to inanimate objects.
    • Concrete Operational (7-11 years):
      • Conservatism: Understanding that the amount of a substance remains the same even when its appearance changes (e.g., liquid poured into a different container).
    • Formal Operational (11 years and older):
      • Development of abstract thinking that continues into adulthood.