Developmental TheoriesDevelopmental TheoriesGrowth and DevelopmentGrowth and Development

NRS 101NRS 101

Why study theory?Why study theory?

Provides a frameworkProvides a frameworkOffers logic for observations and Offers logic for observations and explanationsexplanationsHow and why people actHow and why people actImportant for nurses to combine theory, Important for nurses to combine theory, practice, and researchpractice, and researchNurses assess responses to illness and Nurses assess responses to illness and treatmentstreatments

TheoryTheory

Organized and logical set of statements Organized and logical set of statements about a subject, frameworks to clarify, to about a subject, frameworks to clarify, to make sense of.make sense of.Human Development Theory: Models Human Development Theory: Models intended to account for how and why intended to account for how and why people become who they are, tries to people become who they are, tries to explain and predict human behavior.explain and predict human behavior.

Growth and DevelopmentGrowth and Development

Growth: Quantitative changed, measured Growth: Quantitative changed, measured and compared to normsand compared to norms Height, weight compared to normal Height, weight compared to normal growth chartsgrowth chartsDevelopment: Qualitative, progressive, Development: Qualitative, progressive, continuous process of change leading to a continuous process of change leading to a functional capacityfunctional capacityChild crawls, rolls over, walksChild crawls, rolls over, walks

Four Areas of Developmental Four Areas of Developmental TheoriesTheories

Biophysical-How do we grow, change, age Biophysical-How do we grow, change, age

Psychosocial-Personality & behaviorPsychosocial-Personality & behavior

Cognitive-Thinking, intellectCognitive-Thinking, intellect

Moral-Knowing right from wrong, ethicsMoral-Knowing right from wrong, ethics

Biophysical Developmental Biophysical Developmental TheoriesTheories

Gesell’s Theory: Grow according to our Gesell’s Theory: Grow according to our own genetic blueprint and pace, growth is own genetic blueprint and pace, growth is directed by gene activity, environmental directed by gene activity, environmental factors can modify pattern of developmentfactors can modify pattern of developmentGenetic Theory of Aging: DNA function of Genetic Theory of Aging: DNA function of cell lifespan, programmed cell death, cell lifespan, programmed cell death, accounts for longevity in familiesaccounts for longevity in families

Biophysical Developmental Biophysical Developmental TheoriesTheories

Nongenetic Cellular Theories: Looks at Nongenetic Cellular Theories: Looks at cell rather than DNA, “wear and tear” cell rather than DNA, “wear and tear” theory, our bodies just wear out. Free theory, our bodies just wear out. Free Radical TheoryRadical TheoryPhysiological Theories of Aging: 1) Physiological Theories of Aging: 1) Breakdown of performance of a single Breakdown of performance of a single organ 2.) Impairment of physiological organ 2.) Impairment of physiological control mechanismscontrol mechanisms

Erik EriksonErik Erikson

Student of Anna FreudStudent of Anna FreudEvolutionary process: Biological, Evolutionary process: Biological, psychological, and social events contribute psychological, and social events contribute to readiness for each task/stageto readiness for each task/stageAdded 3 adult stages to Sigmund’s modelAdded 3 adult stages to Sigmund’s model

Erikson’s Stages of Psychosocial Erikson’s Stages of Psychosocial DevelopmentDevelopment

Trust vs. MistrustTrust vs. MistrustAutonomy vs. ShameAutonomy vs. ShameInitiative vs. GuiltInitiative vs. GuiltIndustry vs. InferiorityIndustry vs. InferiorityIdentity vs. Role ConfusionIdentity vs. Role ConfusionIntimacy vs. IsolationIntimacy vs. IsolationGenerativity vs. StagnationGenerativity vs. StagnationIntegrity vs. DespairIntegrity vs. Despair

Jean PiagetJean PiagetCognitive Development TheoryCognitive Development Theory

How we think, learn to reason, exercise How we think, learn to reason, exercise judgment, have intellectual organizationjudgment, have intellectual organizationObserved childrenObserved childrenDefined 4 periods that children move through:Defined 4 periods that children move through:Sensorimotor (Birth-2 yrs)Sensorimotor (Birth-2 yrs)Preoperational (2-7 yrs.)Preoperational (2-7 yrs.)Concrete (7-11 yrs)Concrete (7-11 yrs)Formal (11 yrs-adult)Formal (11 yrs-adult)

Jean PiagetJean PiagetMoral DevelopmentMoral Development

Stages of moral development influenced Stages of moral development influenced by environmentby environmentObserved boys, ages 5-13 yrs.Observed boys, ages 5-13 yrs.

Moral Development TheoriesMoral Development Theories

How we acquire moral values, are guided How we acquire moral values, are guided by morals, how we treat others based on by morals, how we treat others based on moralsmoralsJean Piaget-Environmental influencesJean Piaget-Environmental influencesLawrence Kohlberg-Cognitive and moral Lawrence Kohlberg-Cognitive and moral linked, expanded Piaget’s work, defined 3 linked, expanded Piaget’s work, defined 3 levels with 6 stages of moral developmentlevels with 6 stages of moral development

Lawrence KohlbergLawrence KohlbergMoral Development TheoryMoral Development Theory

Level 1- PreconventionalLevel 1- Preconventional Stage 1- Punish and ObeyStage 1- Punish and Obey Stage 2- Instrumental RelativistStage 2- Instrumental RelativistLevel 2- Conventional Level 2- Conventional Stage 3- Good boy/Nice girlStage 3- Good boy/Nice girl Stage 4- Society MaintenanceStage 4- Society MaintenanceLevel 3- Post-ConventionalLevel 3- Post-Conventional Stage 5-Social ContractStage 5-Social Contract Stage 6- Universal EthicsStage 6- Universal Ethics

AnalysisAnalysis

Theories give nurses some answers on Theories give nurses some answers on why and how people react, respond as why and how people react, respond as they dothey doHuman behavior is complexHuman behavior is complexNo one theory answers all questionsNo one theory answers all questionsAll theories are multi-dimensional, not All theories are multi-dimensional, not linear, they are guidelineslinear, they are guidelines

Growth and DevelopmentGrowth and Development

Refer to P&P pg. 173 Table 11-1 for Refer to P&P pg. 173 Table 11-1 for Developmental Age periods Developmental Age periods Conception through adolescenceConception through adolescencePhysical growth and cognitive Physical growth and cognitive developmentdevelopmentStages of development per ageStages of development per age

Intrauterine LifeIntrauterine Life

40 weeks, 9 calender months40 weeks, 9 calender monthsNagele’s RuleNagele’s Rule3 Trimesters (every 3 months)3 Trimesters (every 3 months)Prematurity- 20-37 weeks gestation pg. Prematurity- 20-37 weeks gestation pg. 175 Table 10-1175 Table 10-1Tocolysis: Therapeutic interventions to Tocolysis: Therapeutic interventions to stop labor before 37 weeks (IV’s, meds. stop labor before 37 weeks (IV’s, meds. Bedrest)Bedrest)

NewbornNewborn

Neonatal period to first month of lifeNeonatal period to first month of lifeP&P pg. 183 Box 11-4 for injury prevention P&P pg. 183 Box 11-4 for injury prevention during infancyduring infancy

InfantInfant

1 Month to 1 year1 Month to 1 yearHealth Risks: Injury prevention, child Health Risks: Injury prevention, child abuse/maltreatmentabuse/maltreatmentHealth Concerns: Nutrition, feeding, Health Concerns: Nutrition, feeding, supplementation, overfeeding, dentition, supplementation, overfeeding, dentition, sleep, immunizationssleep, immunizations

ToddlerToddler

12-36 months12-36 monthsHealth Concerns and Risks:Health Concerns and Risks: need for close supervisionneed for close supervision curiositycuriosity poisoningspoisonings auto safetyauto safety

Pre-SchoolerPre-Schooler

3-5 years3-5 yearsConcernsConcerns fear of darkfear of dark fear of animalsfear of animals fear of thunderstorms fear of thunderstorms fear of medical proceduresfear of medical procedures

School AgeSchool Age

6-12 years6-12 yearsCognitive changedCognitive changedConcrete operationsConcrete operationsMature language developmentMature language developmentHealth risks: Accidents, falls, cancer, Health risks: Accidents, falls, cancer, abduction, infectionsabduction, infections

AdolescenceAdolescence

Teen yearsTeen yearsAges 13-20 yearsAges 13-20 yearsIncreased growth rate, sexual changes, Increased growth rate, sexual changes, changes in muscle and fat distributionchanges in muscle and fat distributionRisks for accidents, homicide, suicide, Risks for accidents, homicide, suicide, substance abuse, tobacco use, eating substance abuse, tobacco use, eating disorders, sexual experimentation, disorders, sexual experimentation, pregnancy, STD’spregnancy, STD’s

Young to Middle AdultYoung to Middle Adult

20’s to 40’s20’s to 40’sPhysical, cognitive, psychosocial changesPhysical, cognitive, psychosocial changesLifestyle, career, marriage, sexuality, Lifestyle, career, marriage, sexuality, childbearing. Infertilitychildbearing. InfertilityRisk factors for family history of disease, Risk factors for family history of disease, personal hygiene, environmental and personal hygiene, environmental and occupational factors, family and career occupational factors, family and career stress, health screenings, exercise and stress, health screenings, exercise and nutritionnutrition

Middle AdultMiddle Adult40’s to 60’s40’s to 60’sMenopause- Women- disruption of menstruation Menopause- Women- disruption of menstruation and ovulation, ovaries no longer produce sex and ovulation, ovaries no longer produce sex hormoneshormonesClimacteric- Men- decrease levels of Climacteric- Men- decrease levels of testosterone, decrease erection/ejaculation; testosterone, decrease erection/ejaculation; sperm still is producedsperm still is producedPsychosocial Changes: career transition, Psychosocial Changes: career transition, sexuality, family changessexuality, family changesHealth Concerns: Stress, family diseases, Health Concerns: Stress, family diseases, forming positive health habits, anxiety, forming positive health habits, anxiety, depressiondepression

Older AdultOlder Adult

Above 65 yearsAbove 65 yearsHealth Concerns: Chronic disease/disability, Health Concerns: Chronic disease/disability, injury, decreased senses and physical strength, injury, decreased senses and physical strength, retirement, family changes, assisted living, retirement, family changes, assisted living, grandchildren, support of other seniors, grandchildren, support of other seniors, remaining independent, sexual concerns, remaining independent, sexual concerns, death/dying/loss, medications, insurance death/dying/loss, medications, insurance coverage, memory, aging process, nutrition, coverage, memory, aging process, nutrition, hydration, skin carehydration, skin care

Older AdultOlder Adult

Gerontology-GeriatricsGerontology-GeriatricsMyths and StereotypesMyths and StereotypesTheories of Aging:Stochastic (random Theories of Aging:Stochastic (random damage over time), NonStochastic damage over time), NonStochastic (predetermined by body mechanisms)(predetermined by body mechanisms)Psychosocial Theories: Disengagement, Psychosocial Theories: Disengagement, Activity, ContinuityActivity, Continuity

Older AdultOlder Adult

Health services: Active adult communities, Health services: Active adult communities, retirement communities, home care, adult retirement communities, home care, adult day care, assisted living long term care, day care, assisted living long term care, respite care, living with children or respite care, living with children or grandchildrengrandchildren

Older AdultOlder AdultPhysiological ChangesPhysiological Changes

SkinSkinHead and NeckHead and NeckThorax and LungsThorax and LungsHeart and vascular systemHeart and vascular systemGI GI ReproductiveReproductiveGUGUMusculoskeletalMusculoskeletalNeuroNeuro

Older AdultOlder AdultCognitive ChangesCognitive Changes

DeliriumDelirium

DementiaDementia

Alzheimer’s DiseaseAlzheimer’s Disease

DepressionDepression

Older AdultOlder AdultPsychosocial ChangesPsychosocial Changes

RetirementRetirementSocial IsolationSocial IsolationSexualitySexualityHousing and environmentHousing and environmentDeathDeath

Older AdultOlder AdultHeath RisksHeath Risks

90% Of adults over 65 have atleasr one health 90% Of adults over 65 have atleasr one health riskriskHeart diseaseHeart diseaseCancer Cancer CVACVACOPD, Smoking cessationCOPD, Smoking cessationNutrition, dental problemsNutrition, dental problemsArthritisArthritisFalls Falls PolypharmacyPolypharmacy

Older AdultOlder AdultPsychosocial ConcernsPsychosocial Concerns

Therapeutic communicationTherapeutic communicationTouchTouchReality orientationReality orientationValidation TherapyValidation TherapyReminiscenceReminiscenceBody Image interventionsBody Image interventions

Older AdultOlder AdultPsychosocial ConcernsPsychosocial Concerns

Therapeutic communicationTherapeutic communicationTouchTouchReality orientationReality orientationValidation TherapyValidation TherapyReminiscenceReminiscenceBody Image interventionsBody Image interventions

Older AdultOlder AdultAcute Care ConsiderationsAcute Care Considerations

Risk for dehydration, malnutritionRisk for dehydration, malnutritionRisk for deliriumRisk for deliriumRisk for nosocomial infectionRisk for nosocomial infectionRisk for incontinenceRisk for incontinenceRisk for fallsRisk for fallsRisk for skin breakdownRisk for skin breakdown