Concepts for Nursing Practice 3rd Edition by Jean Foret Giddens

Leigh Small A basic characteristic of all human life is change. Development is a complex process that involves the integration of an expansive variety of gradual changes that occur across multiple domains and result in an individual’s functional abilities. These changes usually increase in complexity according to a dynamic, somewhat predictable sequence that begins at conception and continues over the life span until older age and/or death.1–4 The individual’s state of health, environmental context, and/or life experiences may alter an aspect of an individual’s development, causing it to stagnate or regress to an earlier stage. The ability to provide patient-centered, quality care requires nurses to understand and assess the different aspects of an individual’s development and appropriately adjust the care they provide. It is also important for nurses to recognize when expected developmental progression in any area is not occurring, so that collaborative interventions can be initiated. DEFINITION Development refers to the sequence of physical, psychosocial, and cognitive developmental changes that take place over the human life span.3 Development does not occur as an isolated phenomenon. Rather, it represents the dynamic integration of three aspects of change: growth, differentiation, and maturation. Physical growth is a quantitative change in which an increase in cell number and size results in an increase in overall size or weight of the body or any of its parts. Differentiation is the process by which initially formed cells and structures become specialized. This is both a quantitative and a qualitative change from simple to complex in which broad global function becomes refined and specific. Maturation is the emergence of personal, behavioral, or adultlike physical characteristics or a “ripening.” Maturation enables an individual to function in a fully developed and optimal way. Thus maturation increases adaptability and competence for individuals to adjust to new situations.3 Development, as well as the interrelated processes of growth, differentiation, and adaptation, is significantly impacted by genetics, environmental factors, culture, family values, and personal experiences.3–6 Therefore the overall concept of development, as defined in this context, affects all aspects of every individual and directs all aspects of nursing care. Times during which development is rapidly occurring (i.e., infancy, childhood, and older adulthood) deserve special a