HHNP1 Module 10 Student PDF

Module 10 Growth and Development Part 1 Learning Outcomes Identify principles of growth and development Explore major developmental theories that underlie developmental mechanisms Describe the physical growth, cognitive and psycho-social development from infancy to adolescence Synthesize...

Module 10 Growth and Development Part 1 Learning Outcomes Identify principles of growth and development Explore major developmental theories that underlie developmental mechanisms Describe the physical growth, cognitive and psycho-social development from infancy to adolescence Synthesize health risks and health concerns relevant to developmental stages from infancy to adolescence Analyze appropriate nursing interventions and considerations when caring for each age group. Growth and Development Stages of growth and development Human growth and development are continuous, intricate and complex. Growth and development are based on timing and sequence of developmental tasks. People progress through phases of growth and development at a highly individualized rate. Understanding typical growth and development helps nurses to predict, prevent, and detect any changes from patients’ expected patterns. Physical Growth Growth is a quantitative and measurable aspect of an individual’s increase in physical measurements. Indicators include changes in height, weight, teeth, skeletal structures, and sexual characteristics. Influences on growth are not just genetic; growth is also affected by other contextual factors, such as socioeconomic status. Development A progressive and continuous process of change leading to increased skill and capacity to function The result of complex interactions between biological and environmental influences Qualitative in nature, and difficult to measure Has certain predictable characteristics (e.g., simple to complex, general to specific)  The Great Debate NATURE NURTURE Are we products of our genes? Are we products of our environments? Factors Influencing Growth and Development Three major categories of factors influence human growth and development: Genetic or natural factors Heredity, temperament Environmental factors Family, peer group, health environment, nutrition, rest/sleep/exercise, living environment, political and policy environment Interacting factors Life experiences, prenatal health, state of health  Other Influencing Factors Health Environment: Family: genetics, family availability and accessibility Nutrition: availability of dynamics, early attachment, of resources that support Sleep and exercise quality of food sense of security etc. health (healthcare services, associated cost, etc.) Living environment: climate; Political Environment: Prenatal health: maternal developed/developing Municipal, provincial and health, nutrition, substance Life experiences/trauma country; community life; federal policies; political use; use of prenatal services socioeconomic status; air, unrest/war etc. water, housing quality etc. State of health: underlying health conditions  A theory is an organized, often observable, Traditions of logical set of statements about a subject. Developmental Human developmental theories are models intended to account for how and why people Theories develop as they do. Theories help nurses assess and treat a patient's response to illness. Developmental Theories Developmental theories are grouped into five broad traditions of theory development: Organicism, Psychoanalytic and psychosocial, Mechanistic, Contextualism, Dialecticism +++ developmental theories available to use and reference, but for the purpose of this course we will focus on: Piaget Theory of Cognitive Development Erikson’s Theory of psychosocial development Kohlberg’s 6 stages of moral development Developmental Theories and Nursing No single theory successfully describes all aspects of growth and development. Nurses need to consider an individual’s development within the context of families, social relationships, communities, and the larger society. Developmental theories help the nurse use critical thinking skills to consider how and why people respond as they do. Cognitive Developmental Theories Focus is on reasoning and thinking processes, including the changes in how people perform intellectual operations. These operations are related to the ways people learn to understand the world in which they live. Mental processes, including perceiving, reasoning, remembering, and believing, affect certain types of emotional behaviour. Piaget’s Theory of Cognitive Development Addresses the development of children’s intellectual organization and how they think, reason, perceive, and make meaning of the physical world Four stages: Sensorimotor (birth to 2 years of age) Preoperational (2 to 7 years of age) Concrete operations (7 to 11 years of age) Formal operations (11 years to adulthood)  Piaget’s Theory of Cognitive Development Sensorimotor: Infant develops patterns for dealing with the environment. Acquire knowledge through sensory experiences and manipulating objects. Object permanence occurs. Preoperational: Children learn to think with the use of symbols and mental images. Play is the initial method of non-language use of symbols. When language develops, it broadens their ability to communicate. Concrete operational: Children achieve the ability to perform mental operations. Children are able to think about their own actions and that of others. Children can begin to cooperate and share new information about their actions. Formal operational: An individual's thinking moves to abstract and theoretical subjects. Adolescents can organize their thoughts in their minds and have the capacity to reason with other possibilities. Piaget’s Theory of Cognitive Development Nursing implications of cognitive development Support adaptation of the patient to new health challenges by providing information and support. Offer positive feedback when patients successfully adapt to their challenges. Moral Developmental Theories A subset of cognitive theory that describes the development of moral reasoning Moral reasoning is how people think about the rules of ethical or moral conduct, but it does not predict what a person would actually do in a given situation. Moral development is the ability of an individual to distinguish right from wrong and to develop ethical values on which to base his or her actions. Kohlberg’s Theory of Moral Development A child’s moral development does not advance if the child’s cognitive development does not also mature. Levels and stages do not occur at specific ages; people attain different levels of moral development. Preconventional level Conventional level Postconventional level Psychosocial Developmental Theories Theories in the psychoanalytic and psychosocial tradition describe the development of personality, thinking, behaviour, emotions, and mental health. This development is thought to occur with varying degrees of influence from internal biological forces and external societal and cultural forces.  The psychosocial model covered the whole lifespan, not just childhood and adolescence. Erikson’s Development occurs in eight Theory of Eight stages. Stages of Life Each stage builds upon the successful resolution of the previous developmental conflict. Erikson’s Theory of Eight Stages of Life Eight stages of life: Stage 1: Trust versus mistrust (birth to 1 year of age) Stage 2: Autonomy versus sense of shame and doubt (1 to 3 years of age) Stage 3: Initiative versus guilt (3 to 6 years of age) Stage 4: Industry versus inferiority (6 to 11 years of age) Stage 5: Identity versus role confusion (adolescence) Stage 6: Intimacy versus isolation (young adulthood) Stage 7: Generative versus self-absorption and stagnation (middle adulthood) Stage 8: Integrity versus despair (old age) Erikson’s Developmental Theory Stage 1: Trust versus mistrust: Infant's trust is built through consistent, reliable caregiving and the concept of trust is tested when an infant is hospitalized or after the birth of a new sibling. Stage 2: Autonomy versus sense of shame and doubt: Toddler learns to be independence and develops self confidence. Not learning independence creates feelings of shame and self-doubt. This can be accomplished through self-care activities such as walking, feeding, and toileting. Stage 3: Initiative versus guilt: The child learns to initiate activities. Accomplishing this task teaches the child to seek challenges in later life. Children use fantasy and imagination to explore their environment. Conflicts often arise between the desire to explore and the limits placed on their behaviour. Erikson’s Developmental Theory Stage 4: Industry versus inferiority: The child develops a sense of competence in physical, cognitive, and social areas. Not learning new skills may lead to a sense of inadequacy or inferiority. Stage 5: Identity versus role confusion: The task is to try out several roles and form a unique identity. New social demands, opportunities, and conflicts arise in relation to emergent identity and separation from family. Erikson’s Developmental Theory Nursing implications: Theory implies that the quality of early developmental experience is important. Ex. children who live in environments where violence is common and trust has not been attained are at greater risk of experiencing poor intimate relationships. Implies that the original required trust elements cannot be retrieved; at best, a person learns to live with the fear and anger associated with this mistrust. Nurses therefore need to practise within the health promotion model to build the familial, community, and societal supports necessary for supporting vulnerable children to achieve successful transitions at each stage Trauma-informed care  Developmental Age Periods: Prenatal: conception to birth Infancy: birth to approx. 12 to 18 months of age Infancy to Early Childhood: 1 to 6 years of Adolescence age Middle Childhood: 6 to 12 years of age Adolescence: 12 to approx. 19 years of age Selecting a Developmental Framework for Nursing An organized, systematic approach ensures that a care plan will meet the needs of the child and family. A developmental approach helps nurses plan and organize care according to the child’s developmental stage. All care planning should promote culturally safe, ethical, legal, and evidence-informed care Infant Infancy: Period from 1 month to 1 year of age Physical changes Cognitive changes Language Psychosocial changes Separation Play  Health risks Sudden infant death syndrome (SIDS) Accidental injury and falls Bodily damage – burns Aspiration/suffocation Drowning Poisioning Infant Child maltreatment Motor vehicles Health concerns Nutrition Supplementation Infant overfeeding and obesity Dentition. Immunizations Sleep  Toddler Toddlerhood: period from 12 to 36 months of age Physical changes Gross Motor and Fine Motor Skills Cognitive changes Object permanence Preoperational thought Language Development Psychosocial changes Sense of autonomy  Health risks Injury – Falls Bodily damage Poisoning Drowning Toddler Burns Aspiration/suffocation Motor vehicle accidents Health concerns Nutrition Preschooler Preschool period: ages 3 to 5 years Physical changes Gross Motor and Fine Motor Skills Cognitive changes Artificialism Animism Immanent justice Language Development Psychosocial changes Play  Health risks (similar to Toddlers) Falls and injuries Drowning Burns Choking and suffocation Poisioning Preschooler Motor vehicle accidents Bodily damage Health concerns Nutrition Sleep Vision School-Age Child “Middle years”: ages 5 to 12 Physical changes Puberty Fine Motor and Gross Motor skills Cognitive changes Concrete operations Classification Language development Psychosocial changes Moral development Peer relationships Sexuality  Health risks Accidents, injuries Illness, disease Falls School-Age Motor vehicle accidents and “on road” Injuries Substance use and poisioning Child Bodily damage Health concerns Health education Safety Nutrition Adolescence Adolescence: period between 12 and 19 years of age Definition of “adolescent” versus “puberty” Physical changes Sexual maturation Cognitive changes Formal operations Reason abstractly Introspective Language skills Adolescent Psychosocial changes Gender identity Group identity Family identity Vocational identity Moral identity Health identity  Health risks Injuries Mental Health Suicide Substance abuse Adolescent Eating disorders Obesity and physical inactivity Sexual exploration Sexually transmitted infections (STIs) Pregnancy  Health concerns Health education Adolescent Adolescents in Rural Communities Indigenous adolescents Lesbian, Gay, Bisexual, Transgender, Queer and 2 Spirit (LGBTQ2) Building Healthy Habits Early Nutrition Physical activity Sleep Literacy and learning disabilities Oral health Immunizations Digital media and use of screens  The Importance of Play Stress reducer and tension reliever Alleviates anxiety Freedom of expression to act Sense of safety and security Fosters growth and development Allows children to make choices Canadian Society for Exercise Physiology, n.d.; CDC, 2020; Potter et al., 2019 Technology & Learning Technology & Socialization Self-concept and Self-identity Care in Hospital Minimize separation with family Minimize trauma of hospitalization Use of child-life specialist Allow child to retain as much control Allow some flexibility Develop care based on child's development Communicate honestly and openly Family-centred care