Chapter 11: Developmental Theories Flashcards
Understanding normal growth and development helps nurses how?
Helps them predict, prevent and detect deviations from patient’s own expected patterns.
Growth
Encompasses the physical changes that occur from the prenatal period through older adulthood.
Also demonstrates both advancement and deterioration.
Development
Refers to biological, cognitive and socioemotional changes that begin at conception and continue throughout a lifetime.
Development is dynamic and includes progression.
The ability to progress through each developmental stage influences
The overall health of the individual
Success or failure experience within a phase affects what?
The ability to complete subsequent phases.
With repeated developmental failures, what results?
Inadequate sometimes result. However, with repeated successes, health is promoted.
Developmental theories
Provide a framework for examining, describing and appreciating human development.
Understanding the specific task or need of each developmental stage guides
Caregivers in planning appropriate individualized care for patients.
Biophysical Development
How our physical bodies grow and change
Gesell’s Theory of Development
That each child’s pattern of growth is unique and this pattern is directed by gene activity
Cephalocaudal Pattern of Growth
Sequence in which growth is fastest a at the top (head then down)
Proximodistal Pattern of Growth
Starts at the center of the body and moves toward the extremities
What can affect and influence development?
Genes direct the sequence but environmental factors also influence
What factors can affect growth?
Poor nutrition or chronic diseases affect growth rate and result in smaller stature regardless of genetic blueprint.
However, good nutrition will not result in larger stature or growth rate beyond that of your genetic blueprint
Theories of psychoanalytical/psychosocial development describe
human development from the perspectives of personality, thinking and behavior.
Psychoanalytical theory explains development as
Primarily unconscious and influenced by emotion
Psychoanalytical Model of Personality and Development
Individuals go through 5 stages each characterized by sexual pleasure in parts of the body (mouth, anus and genitals)
Adult personality is the result of how an individual resolves conflicts between these sources of pleasure.
Sigmund Freud- Stages of Development include
Stage 1: Oral (birth to 18 months)
Stage 2: Anal (12 to 18 months - 3 years)
Stage 3: Phallic or Oedipal (3-6 years)
Stage 4: Latency (6-12 years)
Stage 5: Genital (Puberty through Adulthood)
Stages of Development: Stage 1-Oral
Initially sucking and oral satisfaction. Vital to life and pleasurable.
Inadequate bonding or chronic illness could affect an infant’s development.
Stages of Development: Stage 2-Anal
Increasingly aware of anal region and its products.
Through toilet-training process the child delays gratification to meet parental and societal expectations.
Stages of Development: Stage 3-Phallic or Oedipal
The boy becomes interested in the penis; the girl becomes aware of the absence of a penis (penis envy)
The child fantasizes about the parent of the opposite sex as his/her first low interest
Stages of Development: Stage 4-Latency
Sexual urges from the earlier Oedipal stage are repressed and channeled into productive activities that are socially acceptable.
Stages of Development: Stage 5-Genital
Final stage. Sexual urges reawaken and are directed to an individual outside the family circle.
Unresolved prior conflicts surface during adolescence.
Once the conflicts are resolved, he/she is then capable of having a mature adult sexual relationship.
Freud Components of Personality
ID
Ego
Superego
ID
Basic Instinctual impulses
Most primitive part of the personality. Drive to achieve pleasure.
Originates in the infant.
Ego
Represents the reality component.
Mediates conflicts between the environment and the forces of the id.
Helps people judge reality accurately, regulate impulses and make good decisions.
Superego
Performs regulating, restraining and prohibiting actions.
Referred to as the conscience
Eriksons Theory of Development
Individuals need to accomplish a particular task before successfully mastering the stage and progressing to the next.
Erikson’s Theory of Development differed from Freud in 2 ways:
- development occurred throughout the lifespan.
2. development focused on psychosocial stages rather than psychosexual stages
Erikson’s Theory of Development
- Trust vs. Mistrust (birth to 1 year)
- Autonomy vs Sense of Shame and Doubt (1-3 years)
- Initiative vs Guilt (3-6 years)
- Industry vs Inferiority (6-11 years)
- Identify vs Role Confusion (Puberty)
- Intimacy vs Isolation (Young Adult)
- Generatively vs. Self-Absorption and Stagnation (Middle Age)
- Integrity vs Despair (Old Age)
Trust vs Mistrust
establishing a basic sense of trust is essential for the development of a healthy personality.
Requires a consistent caregiver to meet needs.
*Trust = Faith and optimism
Autonomy vs Sense of shame and Doubt
Include activities related to relationships, desires and playthings.
Limiting choices and/or enacting harsh punishment leads to feelings of shame and doubt.
*Achieves self-control and willpower.
Initiative vs Guilt
Developing their superego or conscience.
Conflicts often occur between the desire to explore and limits place on his/her behavior
Conflicts sometimes leads to feeling of frustration and guilt especially if caregiver’s responses are too harsh
*Successful resolution of this stage leads to direction, purpose and impulse control.
Industry vs Inferiority
Eager to apply themselves to learning socially productive skills
Thrive on accomplishments and praise
If skills are too difficult, they develop as sense of inadequacy and inferiority
*Must develop feeling of achievement to develop a sense of competency
Hospitalized children need to understand routines and participate as actively as possible (i.e record their own I&O)
Identity vs Role Confusion
Dramatic physiological changes associated with sexual maturation mark this stage.
Preoccupation with appearance and body image.
Acquiring sense of identify is essential.
Separation from family.
*Mastery leads to devotion and fidelity to others.
Nurses help adolescents deal with illness by giving them enough information to make decisions about their treatment plan.
Intimacy vs Isolation
*Deepened capacity to love others and care for them
If unable to establish companionship and intimacy, isolation results thus leading to feelings of rejection and disappointment
Generativity vs Self-Absorption and Stagnation
Adult focuses on supporting future generations.
Expanding one’s personal and social involvement is critical.
Achieve success by contributing to future generations through: parenthood, teaching and community involvement
Integrity vs Despair
View lives with a sense of satisfaction or as failures.
*Retrospective: interpret their lives as meaningful or feel regret.
Some adults suffer loss of status and function.
Search for the meaning of life.
*Conquering this stage leads to strength of wisdom.
Nurses in the position to help people feel valued, appreciated, and needed.
Three basic classes of temperament
- The Easy Child
- The Difficult Child
- The Slow-to-Warm-up Child
The Easy Child
Even tempered.
Regular and predictable.
Open and adaptable to change. Typically positive.
The Difficult Child
Highly active, irritable and irregular in habits. Negative withdrawal toward others. Requires more structured environment. Adapts slowly to new routines. Usually intense and primarily negative.
The slow-to-warm-up child
Reacts negatively and with mild intensity to new stimuli.
Adapts slowly with repeated contact.
Passive resistance to changes in routine.
Stage-Crisis Theory
Havighurst’s 3 primary sources for developmental tasks.
Successful resolution of each task must be accomplished for progression to the next.
3 Primary sources for developmental tasks include
- Tasks that surface because of physical maturation.
- Tasks that evolve from personal values.
- Tasks that are the result of pressures from society.
Life Span Approach
Views the individual’s’ personal circumstances (health/family), how the person views and adjusts to changes and the current social and historical context in which the individual is living.
Individuals may compensate for shortcoming using new approaches (i.e w/ age or disability)
Cognitive Theories
stress how people learn to think and make sense of their world
Theory of Cognitive Development (Piaget)
- Sensorimotor (Birth to 2 years)
- Preoperational (2-7 years)
- Concrete Operations (7-11 years)
- Formal Operations (11 to Adulthood)
Sensorimotor
child learns about himself and environment and learns aspects of the environment exist even though they cannot always be seen (object permanence)
Preoperational
Learn to think with symbols and mental images.
Believe inanimate objects have life-like thoughts and feelings “animism”.
Thinking influenced greatly by fantasy and magical thinking. Play pivotal.
Concrete Operations
Can form mental operations.
Can describe a process without actually doing it and see it in reverse order.
Can appreciate their perspective as opposed to others perspective.
Formal Operations
Egocentric though: self-consciousness: their actions and their appearance are constantly being scrutinized. Risk-taking behaviors.
With maturity, thinking moves to abstract and theoretical subjects. Reason with respect to possibilities.
This stage marked the end of cognitive development.
Research supports that adult do not always
arrive at one answer to a problem but may accept several possible solutions
Adults incorporate what when making decisions?
emotions, logic, practicality, and flexibility
On the basis of these observations, a 5th stage of cognitive development has been termed
“Post-formal thought”
Post-formal thought
adults demonstrate ability to recognize answers vary from situation to situation and that solutions need to be sensible
Moral Development
changes in a person’s thoughts, emotions and behaviors that influence beliefs about what is right or wrong.
encompasses both interpersonal and intrapersonal dimensions.
Lawrence Kohlberg’s Theory of Moral Development
Expands on Piaget’s cognitive theory
Encompasses 6 stages of moral development under three levels
Three Levels of Kohlberg’s Theory of Moral Development
Level I: Preconventional Reasoning (Stages 1&2)
Level II: Conventional Reasoning (Stages 3&4)
Level III: Postconventional Reasoning (Stages 5&6)
Level I: Preconventional Reasoning
Premoral level in which there is limited cognitive thinking and thinking is primarily egocentric.
Likes and pleasures.
Stage 1 of Kohlberg’s Theory of Moral Development
Punishment and Obedience Orientation:
child’s response to a moral dilemma is in terms of absolute obedience to authority and rules.
punishment is viewed as proof of being wrong.
Stage 2 of Kohlberg’s Theory of Moral Development
Instrumental Relativist Orientation:
child recognizes there is more than one right view (teacher vs parent)
punishment is viewed not as proof of being wrong but as something to be avoided
Level II: Conventional Reasoning
Wanting to fulfill the expectations of the family, group or nation and develop a loyalty to and actively maintain support.
“What’s in it for me?” “How will it affect my relationships with others?”
Stage 3 of Kohlberg’s Theory of Moral Development
Being good is important and defined as having good motives, showing concern for others, and keeping mutual relationships through trust, loyalty, respect and gratitude.
Stage 4 of Kohlberg’s Theory of Moral Developement
Moral decisions take into account societal perspectives.
“Right” behavior is doing one’s duty, showing respect for authority, and maintaining the social order.
Level III: Postconventional Reasoning
The person finds a balance between basic human rights and obligations and societal rules and regulations.
Define personal moral values and principles.
Stage 5 of Kohlberg’s Theory of Moral Development
An individual follows the societal law but recognizes the possibility of changing the law to improve society.
Believes that all rational people would agree on basic rights such as liberty and life.
The U.S. Constitution is based on this morality.
Stage 6 of Kohlberg’s Theory of Moral Development
Defines “right” by the decision of conscience in accord with self-chosen ethical principles (principle of justice for example).
What distinguishes Stage 5 from Stage 6?
Civil disobedience distinguishes Stage 5 from Stage 6.
In stage 6 a person may not follow the law if they feel it is unjust.
Nursing Diagnoses: Developmental Issues
- Risk for delayed development
- Delayed growth and development
- Risk for disproportionate growth
