Adolescent Growth and Development PDF

Growth and Development 1402301 “Health Promotion of the Adolescent and Family” Dr. Rawnaq Almahadeen Mutah University Faculty of Nursing Learning objectives ** At the end of this lecture, the student will be able: Discuss biologic...

Growth and Development 1402301 “Health Promotion of the Adolescent and Family” Dr. Rawnaq Almahadeen Mutah University Faculty of Nursing Learning objectives ** At the end of this lecture, the student will be able: Discuss biologic development Identify personality and cognitive development State the development of social development and body image Describe the optimal health during adolescent including nutrition, sleep & rest, dental health, mental health, and safety promotion and injury prevention  Puberty Puberty refers to the maturational, hormonal, and growth process that occurs when the reproductive organs begin to function and the secondary sex characteristics develop. This process is sometimes divided into three stages: prepubescence, the period of about 2 years immediately before puberty when the child is developing preliminary physical changes that herald sexual maturity; puberty, the point at which sexual maturity is achieved, marked by the first menstrual flow in girls but by less obvious indications in boys; and postpubescence, a 1- to 2-year period after puberty during which skeletal growth is completed and reproductive functions become fairly well established.  The “Ages” of Adolescence Adolescence, which literally means “to grow into maturity,” is generally regarded as the psychological, social, and maturational process initiated by the pubertal changes. Late (18-20 years of Middle age) (15-17 years of Early age) (11-14 years of It involves three age) subphases The term teenage years is used synonymously with adolescence  Biological development The physical changes of puberty are primarily the result of hormonal activity and are controlled by the anterior pituitary gland in response to a stimulus from the hypothalamus. The obvious physical changes are noted in increased physical growth and in the appearance and development of secondary sex characteristics; are the changes that occur throughout the body as a result of hormonal changes (e.g., voice alterations, development of facial and pubertal hair, fat deposits) but that play no direct part in reproduction Biological changes occur during puberty including:- I. Sexual maturation II. Increases in height and weight III. Completion of skeletal growth accompanied by a marked increase in skeletal mass, and changes in body composition  Sexual Maturation (Girl) Breast changes The first signs of puberty among females are the development of breast buds (Thelarche 8-13 years ). Rapid increase in height and weight Growth of pubic hair (Adrenarche 2-6 month after thelarche) Appearance of axillary hair The onset of menstruation (Menarche) occurs 2 years after the appearance of the first pubescent changes  Sexual Maturation (Boy) Testicular enlargement and change in scrotal coloring are the first signs of puberty among males Usually occurring between (9 – 14) years of age The development of pubic hair is also observed Axillary hair development, facial hair extend to cover anterior neck Spermarche, or the onset of sperm production, occurs at approximately age 14 years  Other Physiologic Changes A number of physiologic functions are altered in response to some of the pubertal changes. The size and strength of the heart, blood volume, and systolic blood pressure increase, whereas the heart rate decrease. Growth spurt began earlier in girl , between age 9.5-14,5 , but in boys between 10.5-16 Average height gain in boys 10-30 cm and weight 7-30 kg Average height gain in girls 5-20 cm and weight 7-25kg Personality, Cognitive & Moral Development Theories Freud-Psychosexual stage (Genital stage) Erikson-Psychosocial stage (Identity versus role confusion) Piaget-Cognitive stage (Formal operational) Kohlberg- Moral judgment stage (Post-conventional stage)  Psychosocial Development Erikson (Identity vs. role confusion ) The task of identity formation is to develop a stable, coherent picture of oneself that includes integrating one's past and present experiences with a sense of where one is headed in the future. Adolescence begins with the onset of puberty and extends to relative physical and emotional stability at or near graduation from high school. During this time, adolescents are faced with the crisis of group identity versus alienation. In the period that follows, individuals strive to attain autonomy from the family and develop a sense of personal identity as opposed to role diffusion. A sense of group identity appears to be essential to the development of a personal identity. Young adolescents must resolve questions concerning relationships with a peer group before they are able to resolve questions about who they are in relation to family and society.  Psychosocial Development Erikson (Identity vs. role confusion ) The process of evolving a personal identity is time consuming and stressful with periods of confusion, depression, and discouragement. Experts emphasize that adolescents still need monitoring and input from parents during their search for identity; total abandonment during this phase is undesirable and may leave the adolescent feeling alone, and adrift, resulting in the development of psychopathology. However, as the pieces gradually shift and settle into place, a positive identity emerges. Role diffusion results when the individual is unable to formulate a satisfactory identity from the multiplicity of aspirations, roles, and identifications.  Cognitive Development (Piaget) Formal Operational Thought This stage, the period of formal operations, is Piaget's fourth and last stage. Adolescents are no longer restricted to the real and actual, which was typical of the period of concrete thought; now they are also concerned with the possible. They think beyond the present. At this time, their thoughts can be influenced by logical principles rather than just their own perceptions and experiences. They become increasingly capable of scientific reasoning and formal logic. Adolescents are capable of mentally manipulating more than two categories of variables at the same time. For example, they can consider the relationship between speed, distance, and time in planning a trip.  Social development The social environment provides opportunities, barriers, role models, and support for individuals' development and health. Systems within the social environment, including family, peers, schools, community (including the Internet-based community), and the larger society, all contribute uniquely to an adolescent's development and health. Families The process of achieving independence often involves confusion and uncertainty as both parent and adolescent learn to play new roles and work toward establishing the ultimate relationship. As teenagers assert their rights for grown-up privileges, they frequently create tensions within the home. They resist parental control, and conflicts can arise from almost any situation or any subject. Favorite topics of dispute include Internet use, the need for a personal cell phone, manners, dress, chores and duties, homework, disrespectful behavior, friendships, money, automobiles, alcohol and other substance abuse, and time schedules.  Social development Peer Groups For the majority of teenagers, peers assume a more significant role in adolescence than they did during childhood. The peer group serves as a strong support to adolescents, individually and collectively, providing them with a sense of belonging and a feeling of strength and power. The peer group forms the transitional world between dependence and autonomy. The peer group has an intense influence on adolescents' self- evaluation and behavior. Peers serve as credible sources of information, role models of new social behaviors, sources of social reinforcement, and bridges to alternative lifestyles. To gain acceptance by a group, younger adolescents tend to conform completely in such things as mode of dress, hairstyle, taste in music, and vocabulary. Peers can also be a positive force in health promotion by encouraging healthy behaviors, serving as role models, and promoting positive health norms.  Development of body image Sudden growth in early adolescent create feeling of confusion for adolescent Hormone effect on sebaceous gland produce acne, which create problem for adolescent All teenager regardless of gender, concern with question “ Am I Normal “? Compare their body with body of peer and image in the media Response to puberty different from girl to boy Promoting optimal health during adolescent Nutrition Puberty marks the beginning of accelerated physical growth, which can double some adolescents’ nutritional requirements. At the same time, growing independence, the need for peer acceptance, concern with physical appearance, and an active lifestyle may affect eating habits, food choices, nutrient intake, and nutritional status. Increase nutrition requirement during adolescent closely related to increase body mass, muscle, height and weight Caloric and protein increase with this stage, increase need for calcium, iron, zinc Diet rich in fruits and vegetables, whole grains, and fat-free and low-fat dairy products Reduce the intake of sugar-sweetened beverages and salt intake Eat more fish, especially oily fish Promoting optimal health during adolescent Effective health promotion for adolescents should incorporate a developmentally appropriate, multifaceted approach and incorporate adolescents' perspectives on what health means. One strategy for health promotion used by nurses and other professionals in health care settings is the one-on-one health screening. Ensure confidentiality and privacy; interview adolescent without parents. Explain the limits of confidentiality (e.g., legal duty to report physical or sexual abuse or to get others involved if patient is suicidal). Show concern for adolescent's perspective, saying: “First, I'd like to talk about your main concerns” and “I'd like to know what you think is happening.” Promoting optimal health during adolescent Offer a nonthreatening explanation for the questions you ask, such as: “I'm going to ask a number of questions to help me better understand your health.” Maintain objectivity; avoid assumptions, judgments, and lectures. Ask open-ended questions when possible; move to more directive questions if necessary. Begin with less sensitive issues and proceed to more sensitive ones. Use language that both the adolescent and you understand. Restate to adolescents what he or she has said, along with feelings that may be associated with their descriptions. Promoting optimal health during adolescent Nutrition Overeating or undereating during adolescence presents special problems. Snacks, usually selected on the basis of accessibility rather than nutritional merit, become increasingly a part of the habitual eating pattern during adolescence. Excess intake of calories, sugar, fat, cholesterol, and sodium is common among adolescents and is found in all income and racial or ethnic groups and both genders. Inadequate intake of certain vitamins (folic acid, vitamin B6, vitamin A) and minerals (iron, calcium, zinc) is also evident, particularly among girls and teenagers of low socioeconomic status. In combination with other factors, these dietary patterns could result in increased risk for obesity and chronic diseases, such as heart disease, osteoporosis, and some types of cancer later in life.  Sleep & rest Although adolescents should generally get around 9 hours of sleep each night, early morning school scheduling, extracurricular activities, homework, employment, and desired social time with peers or on the Internet can make it difficult for them to get sufficient sleep. Rapid physical growth , tendency toward overexertion and increase activity ,contribute to fatigue Increase need for sleep during growth spurt Health teaching and health promotion should include information to promote sufficient sleep.  Dental Health Dental care aspect of preventive care , should not be neglected during adolescent Regular dental supervision and fluoride supplement essential for health maintain, and prevent dental caries Toothbrush :- Soft nylon, bristle  Mental health Areas of Stress in Adolescence Body image Sexuality conflicts Academic pressures Competitive pressures Relationships with parents Relationships with siblings Relationships with peers Finances Decisions about present and future roles Career planning  Safety Promotion & Injury Prevention Physical injury greatest single cause of death among adolescent Most vulnerable age 15- 24 years old Three source of injury during adolescent ;- vehicle injury, sport injury, firearm Motor vehicle crashes are one of the most common causes of unintentional injury and death for adolescents. Many factors contribute to the higher rate of crashes among teen drivers, including the lack of driving experience and maturity, driving too fast, using alcohol, and using cell phones to talk or text. Injury Prevention Education