Growth, Development, Sexuality Readings: pg. 751-790 (CH 28) Taking a Life Span Approach - Growth: refers to an increase in physical size and capacity. It includes components such as changes in height and weight, increased size of functioning organs, and the increasing complexity of the brain and nervous system - Development: is the continuous process of increased skill and ability to function - Both growth and development are affected by genetic and environmental factors such as nutrition and medical conditions - Theories of Growth and Development - Sigmund Freud’s theory of psychosexual development (eww) - Erikson’s theory of psychosocial development → the only good one tbh - Emphasis on social interactions - Inner and outer conflicts from birth to old age (8 stages) - Piaget’s theory of cognitive development - 4 stages: sensorimotor, preoperational, concrete operational, and formal operations - Based on the idea of schema Growth and Development Across the Life Span 1. The infant period (birth-1yr) - Physical development: rapid growth of head, brain, mobility, hearing and touch - Psychosocial development: theory of attachment, developing trust and security - Cognitive development: self vs. nonself, hand-eye coordination, vision, thinking - Communication: crying, fussing, smiling, laughing, babbling, 2. The toddler period (1-2yrs) - Physical development: largely motor development, walking, manual dexterity, brain grows, fontanels close, teeth erupt, bladder control - Psychosocial development: independence, autonomy and determination, the 3. 4. 5. 6. 7. word “no”, temper tantrums, strongly attached to parents - Cognitive development: sensorimotor stage of touching, tasting, looking, listening, awareness of cause and effect, conceptual reasoning, egocentrism - Communication: language and speech, self-centered The preschool period - Early childhood (3-5yrs) - Physical development: trunk is more proportional, gross and fine motor skills, organ systems mature, immune system boosted, full visual acuity - Psychosocial development: social play, closer to peers, controlling behaviour, asking “why?”, imagination, curiosity, gender identification forming, early sense of right and wrong and rules - Cognitive development: more intuitive thinking, egocentrism still persists, imagination and symbols understood - Communication: understanding of what is said, telling stories, comprehensible speech The School-Age period - middle and late childhood (6-8 and 8-12) - Physical development: taller and slimmer, growth spurts, onset of puberty, advanced motor activities, adult teeth - Psychosocial development: sense of industry, willing to learn, emotions more stable, friendships very significant, valuable social lessons - Cognitive development: mastered conversation, conceptual thinking, flexibility in thinking, valuing fairness - Communication: speaks close to adults, enjoys word games, actively reading to learn, communication in oral and written terms The adolescent period (13-19yrs) - Physical development: growth spurt and then slower growth, full puberty, - Psychosocial development: personal identity, sexual/romantic feelings, fitting in, more caring and concern in friendships, mature relationships - Cognitive development: complex and sophisticated thought, abstract reasoning, very self-reflected - Communication: complex language and vocabulary, many avenues of communication, own acronyms and phrases The young adulthood period (20-25yrs) - Physical development: physical changes slow down, sexual development completed, internal organs at peak, slows down at higher end of this stage - Psychosocial development: leaves parents, mature relationship nd family, sexual identity, decisions about family + parenting + career, - Cognitive development: knowledge & experience in life, specialized interests - Communication: ability to process thoughts and feelings before expressing them The middle adulthood period (36-65yrs) - Physical development: gradual slowing of physical function, loss of muscle etc., baldness in men, menopause in women, decrease in sexual function - Psychosocial development: generativity, creativity and contributions to society, thoughts on retirement, varies greatly in individuals - Cognitive development: no loss in cognitive abilities, reaction time slows, slightly slower in technology 8. The older adulthood period (65-74yrs) - Physical development: significant decline in functioning, aging, posture, height, low ROM, risk for falls and injury high, loss in senses, organs decreased functioning - Psychosocial development: integrity, life reflection - Cognitive development: changes in sensory function, vision and hearing loss, reduction in memory and mental abilities - Communication: issues with understanding body cues, may lose speaking or vision that impairs communication skills Performing Assessments Across the Life Span - The nurse’s approach needs to be adapted to the developmental needs as well as to the individual preferences of the patient - Be aware of the specific health risks of each age group - Blah blah blah different age groups Supporting Health Across the Life Span - Developmental tasks, nutrition, safety, sleep patterns, immunizations, toilet training, school readiness, prevention of obesity, injury prevention, sexual identity, preventing health risks, sexual health, activity levels, family planning, developmental considerations, health patterns, menopause, change and loss, fall prevention Week 5A Lecture: ❖ 6 Principles of Growth and Development ➢ 1. Continuous and uneven ➢ 2. Interactions between genetics and environment ➢ 3. Head-down and body-outwards ➢ 4. Simple to complex and general to specific ➢ 5. Sequence is predictable, but timing and duration vary ➢ 6. Sensitive periods ■ Children (learning), college-age (careers), and old adulthood (life reflection) ❖ Organicism: development is a result of biologically-driven behaviour and the person's adaptation to the environment. Biophysical (describe and explain how the physical body grows and changes) and cognitive–moral theories of development are included in this tradition. ❖ Psychoanalytic and Psychosocial: describe the development of personality, thinking, behaviour, and emotions. This development is thought to occur with varying degrees of influence from internal biological forces and external societal and cultural forces. ❖ Psychosexual development (Freud) ➢ Sexual desires ➢ Body zones: oral, anal, phallic, or oedipal, latency, genital ➢ Id, Ego, and Superego ❖ Cognitive Development (Piaget) ➢ Schema or cognitive maps ➢ 4 stages: sensorimotor, pre-operational, concrete operational, formal operations ❖ Psychosocial development (Erikson) ➢ 8 stages from birth to old age: Trust vs. Mistrust, Autonomy vs. Shame and Doubt, Initiative vs Guilt, Industry vs Inferiority, Identity vs Role confusion, Intimacy vs Isolation, Generativity vs Stagnation, Integrity vs Despair ➢ Lifelong experiences ❖ Moral development (Kohlberg) ➢ Not age specific (begins around age 4) ➢ 3 levels with 2 stages in each: Preconventional, Conventional, and Postconventional ➢ Advances as cognitive development matures ❖ Moral development (Gilligan) ➢ Women relationship-oriented: 3 stages based on an ethic of caring ■ Changes in self not cognitive development ➢ Preconventional: individual survival (self-oriented) ➢ Conventional: self-sacrifice (other-oriented) ➢ Post-conventional: universal-oriented Week 5B Lecture: ❖ “How do concepts of cognitive, psychosexual and psychosocial development connect to each other?” ❖ 5 C’s: Competence, compassion, corresponding, curious, conscious ❖ Erikson’s stages of psychosocial development ➢ Stage 1: Trust vs. Mistrust (Infancy from birth to 18 months) ➢ Stage 2: Autonomy vs. Shame and Doubt (Toddler years from 18 months to three years) ➢ Stage 3: Initiative vs. Guilt (Preschool years from three to five) ➢ Stage 4: Industry vs. Inferiority (Middle school years from six to 11) ➢ Stage 5: Identity vs. Role Confusion (Teen years from 12 to 18) ➢ Stage 6: Intimacy vs. Isolation (Young adult years from 18 to 40) ➢ Stage 7: Generativity vs. Stagnation (Middle age from 40 to 65) ➢ Stage 8: Integrity vs. Despair (Older adulthood from 65 to death) ❖ Freud’s stages of psychosexual development ➢ Oral Stage: erogenous zone is mouth (birth to 1 year) ➢ Anal Stage: erogenous zone is bowel and bladder control (1-3 years) ➢ Phallic Stage: erogenous zone is genitals (3-6 years) ➢ Latent Period: erogenous zone is inactivated sexual feelings (6 to puberty) ➢ Genital Stage: erogenous zone is maturing sexual interests (puberty to death) ❖ Piaget’s Stages of Cognitive Development ➢ Sensorimotor stage: Birth to 2 years ➢ Preoperational stage: Ages 2 to 7 ➢ Concrete operational stage: Ages 7 to 11 ➢ Formal operational stage: Ages 12 and up ❖ Kohlberg’s Levels of Moral Development ➢ Level 1 Preconventional ■ Stage 1: obedience and punishment ■ Stage 2: Individualism and exchange ➢ Level 2 Conventional ■ Stage 3: Developing good interpersonal relationships ■ Stage 4: Maintaining social order ➢ Level 3 Post-conventional ■ Stage 5: Social contract and individual rights ■ Stage 6: Universal principles ❖ “How would you alter care for the different age groups while keeping their stages of development into consideration?” ➢ Allowing young children to talk and answer some questions and state their opinions about their care → give them a level of autonomy while still focusing on the parent ➢ Teenagers are highly individualistic and private and are still establishing their identity so allow them to speak and speak privately when answering personal questions about sexual nature etc. ■ Teenagers start to develop their group identity, gender identity, family identity, vocational identity, moral identity, and health identity ❖ 3 F’s: interpersonal, intrapersonal, and context Quick Quiz Questions: 1. The nurse is caring for a 5-year-old who is hospitalized for stabilization of asthma. In order to render age-specific care, which action should the nurse take? a. b. c. d. Explain the link between asthma and allergens. Respond immediately to the child’s every need. Focus mainly on winning the child’s trust. Exercise patience around continual questions. 2. The nurse in a family practice clinic is seeing a 14-year-old adolescent male regarding a possible sexually transmitted infection. What must the nurse remember about boys at this age, as she talks to the adolescent? a. b. c. d. They follow group norms – what peers do. They think of the risks before having unprotected sex. They will have been infected by a steady partner. They prefer to have at least one parent with them.