BSNC 1000 - Module 2 Latest Update Graded A

BSNC 1000 - Module 2 Latest Update Graded A Growth - quantitative (an increase in cell number and size results in an increase in overall size or weight of the body and its parts) - indicators: height, weight, teeth, skeletal structures, sexual characteristics Development - qualitative (difficult to measure) - includes growth, maturation and differentiation - a progressive and continuous process of change leading to increased skill and capacity to function (the result of interactions between biological and environmental influences) Scope of growth and development - expected - delayed - advanced Period of risk for growth and development - risk of adverse effects during stage of rapid growth and change: embryonic, infant, toddler, preschool, school age, and adolescent stages Risk factors for growth and development - prenatal factors - birth factors - individual factors - family factors - situational factors - determinants of health - toxic stress - health status Characteristics of developmental changes - continuous and orderly - head to foot (cephalocaudal - e.g., baby's head) - trunk to extremities (proximodistal) - simple to complex, general to specific (e.g., larger muscle before smaller muscles) Factors influencing growth and development - environment in which the person lives - genetics - the interaction between these two Erikson's 8 stages of life - psychosocial model that covers the entire lifespan - each person goes through 8 stages of development - they need to accomplish a particular task before moving on to the next stage (each stage builds upon the successful resolution of the previous developmental conflict) - maturation and ego activity are the primary mechanisms of development Function of (1) ego and (2) maturation - (1): mediates the conflicts between the biological needs and societal norms - (2): establishes the timeline of this mediation Epigenesis - the developmental results of the mechanisms of ego and maturation - successive gradual change Nursing implications of Erikson's theory - the quality of early developmental work is important - the original required trust elements cannot be retrieved (epigenesis) therefore... - the health promotion model is important (children need familial, societal and community support for proper development) Older adult in Canada - persons over the age 65 - generally at this age physical and cognitive impairments begin Chronological age - age as measured in years from date of birth - may have little relation to the reality of aging of an older person Demographics of older adults in Canada - older adult population is growing - women tend to have a longer life expectancy than men Demographics of older adults in BC - highest life expectancy in Canada - large percentage of older adults are immigrants (need to ensure that our healthcare is culturally appropriate) - older adult population is growing Province with the highest older adult population New Brunswick Developmental tasks for older persons - adjusting to decreasing health and physical strength - adjusting to retirement and reduced or fixed income - adjusting to the death of a spouse - accepting one's self as an ageing person - maintaining satisfactory living arrangements - redefining relationships with adult children - finding ways to maintain quality of life Purpose of developmental tasks for older adults - to help them deal with change and loss - e.g., loss of health, SO's, sense of being useful, income, independent living Cohort A group of members who share some common experience (e.g., born in the same decade or country) Biological theories of aging - stochastic theories - nonstochastic theories Nonstochastic (programmed) theories - ageing is programmed at the cellular level (each cell has a natural life expectancy) - as more cells cease to replicate, the signs of aging appear and the person dies at a "predetermined" age Stochastic (error) Theories - ageing is seen as events that occur randomly and over time - ageing is the result of an accumulation of errors in the synthesis of DNA and RNA - with each replication, more errors occur until the cell is no longer able to function - results in the visible signs of ageing (e.g., grey hair) Subcategory of nonstochastic theories - neuroendocrine-immunological theory Subcategories of stochastic theories - wear-and-tear - cross-link - oxidative stress Older adult aggregates - youngest old (65-74) - old (75-84) - oldest-old (85+) Reason for older adult aggregates - different aggregates required for different stages of life - e.g., many 60-70 year olds can care for themselves and be physically active Piaget's Theory of Cognitive Development - consists of sensorimotor period, preoperational period, concrete operations, and formal operations - children acquire knowledge through acting on their environment - they internalize environmental challenges through assimilation and accommodation Assimilation - the process of making sense of new information in comparison to what is already known - e.g., a person evaluates a headache as a usual experience - concept of Piaget's theory of cognitive development Accommodation - the process of adapting ways of thinking to a new experience or new information - e.g., a person evaluates a severe headache as an unusual experience - concept of Piaget's theory of cognitive development Nursing implications of Piaget's theory - assimilation and accommodation represent adaptation to new health challenges - e.g., a person learns to see themselves as a person with a brain tumor who requires surgery Freud's psychoanalytic model of personality development - two internal biological forces drive psychological change in a child (sexual (libido) and aggressive energies) - motivation is to achieve pleasure and avoid pain - accounts for 5 psychosexual developmental stages from which personality emerges (id, ego and superego) Nursing implications for Freud's theory - encourage older adults to be independent within safe limits - when activities associated with basic pleasure (e.g., eating, sexual activity and elimination) are altered by illness or disability, knowledgeable and empathetic nursing care is required Kohlberg's theory of moral development - developing children progress through a predictable sequence of stages of moral reasoning (preconventional, conventional, postconventional). - 6 stages at 3 levels Categories of expected development - physical/physiological - motor - social/emotional - cognitive - communication - adaptive Physical/physiological development - the growth and changes in body tissues and organ systems and the resultant changes in body functions and proportions - e.g., cellular proliferation, maturation, differentiation Motor development - the achievement of gross to fine motor skills (refinement) Social/emotional development - development that includes the areas of relationships and feelings - includes self-understanding, self-regulation, moral development, understanding others, and understanding social interactions Cognitive development - the development of thinking, problem-solving, and memory - includes memory capacity, executive functioning, cognitive self-regulation, the processing and use of information, understanding the relationships between self and information Communication development - includes speech and language - requires sensory and motor integration and interactional relationships to develop and refine - includes receptive language (understanding language) and expressive language (expressing emotion/thoughts/ideas) Adaptive development - the acquisition of a range of skills that enable independence at home and in the community - e.g., activities of daily living, complex skill, learned skills, self-care, cooperation Developmental age - a reference to how closely a person's physical and mental development parallels with normal developmental milestones Chronological age 5-12 Developmental age = school age Erickson's stages of development - Trust vs. mistrust (infancy) - Autonomy vs. shame and doubt (toddler) - Initiative vs. guilt (preschool) - Industry vs. inferiority (school age) - Identity vs. role confusion (adolescence) - Intimacy vs. isolation (young adulthood) - Generativity vs. stagnation (middle adulthood) - Ego integrity vs. despair (later adulthood) Integrity versus despair - Erikson's 8th stage of life - old age 65+ - reflect on their life and feel satisfaction or disappointment. - by suffering physical and social losses, such as those through retirement or illness, the person may also suffer loss of status and function. - answers: Has my life been worthwhile Implications of integrity versus despair - nurses can contribute to the valuing of people at all ages and stages in their communities (e.g., promote their involvement in youth mentoring) - helps display value for the skills and experience of older people Wear and tear theory - example of stochastic theory - a view of ageing as a process by which the human body wears out because of the passage of time and exposure to environmental stressors - internal or external stressors increase the number of errors or the speed at which they occur (errors cause a decline in cellular function) - e.g., in the knees of runners Cross link theory - example of stochastic theory - ageing is due to the accumulation of errors caused by the stiffening of proteins in the cell Oxidative stress theory (free radicals) - example of stochastic theory - cell damage accumulates through life as a consequence of free radicals produced by oxidative metabolism - exposure to environmental pollutants (e.g., radiation) increase the production of free radicals and the rate of damage - in youth, naturally occurring vitamins, hormones, enzymes and antioxidants neutralize free radicals but with aging, damage caused by free radicals occurs faster than the rate at which cells repair themselves, and cell death occurs Neuroendocrine theory - example of nonstochastic theory - programmed death of immune cells due to damage caused by the increase of free radicals as aging progresses - T cells lose their ability to self-regulate and begin to attack the body Generativity versus self-absorption and stagnation - adulthood age 40-65- should be able to see beyond their needs and accomplishments and view the needs of society - dissatisfaction with one's achievements often leads to self-absorption and stagnation - answers: What can I offer succeeding generations? Implications of generativity versus self-absorption and stagnation - assist adults in choosing creative ways to foster social development and find a sense of fulfilment (e.g., volunteer at a local school) Genetic factors (affecting growth and development) - hereditary - temperament Environmental factors (affecting growth and development) - family - peer group - health environment - nutrition - rest, sleep, and exercise - living environment - political and policy environment Interacting factors (affecting growth and development) - life experiences - prenatal health - state of health Frued, Erikson, Piaget, Kohlberg (1) psychosexual (2) psychosocial (3) cognitive (4) moral development