Growth & Development

PRINCIPLES OF DEVELOPMENT
Continuous process through life
Orderly sequence
Predictable but unique ranges
Systems mature at different rates
More rapid in early periods
Pace/Pattern
Gross to refined skills simple to complex

Proximal to Distal/Simple to Complex

Nature vs Nurture
Genetics
vs
Environment

Humans grow and develop in the

following dimensions
Physical
Cognitive
Psychosocial
Moral
Spiritual

Freud Psychosexual development

Based on sexual
motivation
LIBIDO
energy or life
instinct

PSYCHOSEXUAL THEORY
Freud (1923)
Oral-sensory infancy
Anal muscular toddlerhood
Phallic locomotion
pre-school
Latency school age
Genital puberty to adulthood

Erikson's Stages of Psychosocial

Development
Stage I: Trust vs. mistrust
(Infancy)
Stage II: Autonomy vs. shame and doubt
(Toddler)
Stage III: Initiative vs. guilt
(Preschool years)
Stage IV: Industry vs. inferiority
(School age years)

Eriksons Stages (Cont..)

Stage V: Identity vs. role confusion
Adolescence
Stage VI: Intimacy vs. isolation
Young Adulthood
Stage VII: Generativity vs. stagnation
Middle Adulthood
Stage VIII: Ego Integrity vs. despair
Later Adulthood

Cognitive Development Theory

Piaget (1969)
Cognitive development:
* Brain
* Nervous system
* Experiences
Adaptation - adjust
Assimilation - integration
Accommodation process
new information

COGNITIVE DEVELOPMENTAL
THEORY
Piagets stages of development:
1. Sensory Motor - birth to 2 years
Reflex activities
Exploration

Piaget Stages of Development

2. Pre operational

2-7 years
Pre-conceptual,
Intuitive figures
things out

Piaget Stages of Development

3. Concrete Operations 7-11 years
compliance

Piaget Stages of Development

4. Formal Operations 11- adult

Kohlberg - Moral Development

Pre conventional
birth to age 9
Punishment/
obedience
orientation

Kohlberg cont.
Conventional morality
9-13 years
Post conventional level of
morality 13 years to
death:
* Contractual/legalistic
* Universal ethical

Maslows Theory of
Human Needs (1950)
Physiological
Safety
Belonging/love
Esteem
Self actualization

Self Concept
An individuals conceptualization of himself or
herself
Subjective sense of self
Complex mixture of conscious and unconscious
thoughts, attitudes and perception
Affects ones self esteem and how one feels
about himself or herself

Self Concept
Role

Body Image

Self Esteem

Identity

Stressors Influencing Self Concept

Self Concept and the Nursing

Process
Assessment
Nursing Diagnosis
Planning: Goals and Outcomes
Implementation
Evaluation

Myths and Stereotypes

Ill, disabled, physically unattractive
Financial Status affluent to poor
Undervaluing by society due to
attractiveness, energy & youth
Outdated knowledge and
experience

Developmental Tasks For Older Adults

Adjustment to:
Decreasing health and physical strength
Retirement and reduced or fixed income
Death of a spouse, children, siblings & friends
Accepting self as aging person
Maintaining satisfactory living arrangements
Redefining relationships with adult children and
siblings
Finding ways to maintain quality of life

Focus on Older Adults

Health Care Settings

Hospital
Nursing Home
Ambulatory Care
Home Care

Physiological Changes with Aging

Integumentary
Respiratory
Cardiovascular
Gastrointestinal
Musculoskeletal
Neurological

Sensory eyes, ears,

taste, smell, touch,
proprioception
Genitourinary
Reproductive
Endocrine
Immune

Other Changes Associated with Aging

Functional Changes
Capacity & safe performance of ADLs

Cognitive Changes
Delirium, dementia & depression

Psychosocial Changes
Involves life transitions and loss (Retirement, social
isolation, sexuality, housing and environment and
death)

Health Promotion & Maintenance

Participation in screening
activities
Regular exercise
Weight reduction
Well balanced diet
Moderate alcohol use
Smoking cessation
Regular dental visit
Annual Immunization

Risk Factors for Falls in the Older

Adult
Intrinsic Factors
History of falls
Impaired vision
Conditions affecting
mobility
Cognitive impairment
Alteration in bladder
function
Medication
Slow reaction time

Extrinsic Factors

Environmental hazards
Inappropriate footwear
Unfamiliar environment
Improper use of assistive
devices

Older Adults in Acute Care Settings

Poses increased risk for adverse events such
as:

Delirium
Dehydration
Malnutrition
Health care associated infection
Urinary Incontinence
Falls

Older Adults and Restorative Care

Refers to two types of care:
the continuation of recovery from acute illness or
surgery that begins in the acute care setting
Support of chronic conditions that affect day-to-day
function

Both types of care take place in private homes

and long-term care setting