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Growth and Development of Adolescents
Transcript of Growth and Development of Adolescents
- there are 2 types of eating disorders most common in adolescents: anorexia nervosa and bulimia nervosa
- Anorexia Nervosa is a physical and Psychological Disorder. An intense fear of gaining weight and refusal to maintain body weight at the normal minimum for one's age and height.
- Bulimia Nervosa involves binge eating and behaviours to prevent weight gain, including self-induced vomiting, misuse of laxatives and other medications, and excessive exercise (Potter and Perry 359).
- Rationale For Inclusion: Adolescents are typically heavily influenced by the media, and the excessively thin beauty ideals that are presented. Since it is adolescents that are the most susceptible to media influence, they are the age group at the highest risk of developing an eating disorder in an attempt to keep up with society’s “ideal” body image. (Striegel-Moore). Erikson - Adolescence is a time when clinicians encourage a shift in health responsibility from parent to child.
- The need for compassion, concern, respect, privacy, and independance is extremely important at this time.
- Active Listening, Open ended Questions, and honesty can greatly ease the interview and assessment process (Arnold and Boggs 360).
- Establishing Trust in the nurse client relationship is essential. Individuals in the adolescent age group tend to be in the beginnings of establishing identity and being independant, as they are in the stage prior to adulthood.
Adolescents have a good understanding of body image and integrity, and possible threats to life.
Can sometimes have difficulty adhering to long term goals.
They use concrete rather than abstract thinking (Arnold and Boggs 356).
These Individuals are often concerned greatly with privacy (Potter and Perry 359).
For these reasons, the following strategies can be implemented in order to effectively communicate as a nurse. Communication Strategies Sexual Experimentation Substance Abuse -the most commonly used and abused substance by adolescents is alcohol, and specifically binge drinking.
- Because this is their first time using substances, adolescents tend to experiment.
- 80% of adolescents are women, 20% are men
- The use of alcohol can make a adolescent feel more mature, especially if they feel they have been treated like a child by adults. (Potter and Perry 359).
- Used for several reasons associated with the age group, including peer pressure, alleviation of stress, modelling a family members behaviour, or the belief that it will improve their level of social performance and give a sense of well-being (Beman) -In assessing someone with an eating disorder, a nurse should look at past/present diet history, food records, eating habits, attitudes, health beliefs, and socioeconomic and psychosocial factors. (Potter and Perry 359). Ensure Discussions with Adolescents are Private and Confidential Piaget Piaget Gesell Freud Psychosocial Cognitive - Between childhood and adulthood (12 to 19 years of age)
- Starts with puberty
- Puberty – point at which reproduction is possible- Primary sexual characteristics develop (maturations of reproductive organs)- Secondary sexual characteristics develop (development of female breasts and pubic hair)- Three sub phases: early adolescence (12-14), middle adolescence (14-17), and late adolescence (17-19)- Increased growth rate of skeleton, muscle, and viscera, sex- specific changes (hip and shoulder width), alterations in distribution of muscle and fat, development of the reproductive system- Hormonal fluctuations – hypothalamus produces gonadotropin-releasing hormones.
- Ovarian cells begin to produce estrogen and testicular cells produce testosterone
(Potter & Perry, 359-370) Psychological
• Become more social
• Behavioural patterns become
• Mood swings
• Intense daydreaming
• Anger is outwardly expressed
• Person becomes more introspective
• Tendency to withdraw when upset
• Emotions fluctuate in time and range
• Feelings of inadequacy may be present
• Increased constancy with emotions for older adolescents and anger is more apt to be concealed
(Edelman & Mandel)
• Increase ability for limited abstract thought
• Uncertainty when confronted with new values
• Often compare themselves to their peers
• Capacity for abstract thinking develops
• Intellectual powers increase
• Concerns with philosophic, political, and social problems arise
• Person can perceive and act on long-range operations
• Can view problems comprehensively
• Intellectual and functional identity is established
(Potter & Perry) •Erikson’s Theory of Eight Stages of Life – identity vs. role confusion (12 – 18 years)
tasks of adolescence is to try out several roles and form and unique identity.
Implications – assist hospitalized adolescents with dealing with their illness by giving them enough information to allow them to make decisions about their own treatment plan. • Piaget’s Theory of Cognitive Development – sensorimotor, preoperational, concrete operational, and formal, adolescents are in the formal stage, they can be included in decision making about his/her own healthcare that is based on his/her ability to think abstractly. Theory addresses the development of children’s intellectual organization and how they think, reason, perceive, and make meaning of the physical world. •According to Piaget, changes that occur within the mind and the widening social environment of adolescents result in the highest level of intellectual development, known as formal operations • Gesell’s theory of maturational development – pattern of growth and development is directed by the activity of genes, environmental factors can support, change, and modify but not generate the progressions of development, pattern of maturation follows a fixed developmental sequence, biological body determines behavioural development, •Freud’s Five Stages of Psychosexual Development – stage 5 genital (puberty through adulthood) time of turbulence when earlier sexual urges reawaken and are directed to individuals outside of the family. Unresolved prior conflicts surface during adolescence and once conflicts are resolved, individual is than capable of having a mature sexual relationship – implications educate parents to encourage youth to be independent and make his/her own decisions.
(Erikson) -Peer pressure, physiological and emotional changes, and societal expectations can contribute to sexual relations/experimentation in adolescents.
-STIs: incidence increasing in adolescents.
-Adolescent pregnancy occurs across socioeconomic classes, in public and private schools, among all ethnic and religious backgrounds, and in all parts of the country (Potter and Perry 359). http://kellimarshall.net/criticaltvcomedy/wp-content/uploads/2012/09/psychosexual.gif http://cdn.dipity.com/uploads/events/8ffc82390e09ca7990b5bb437d6dd76a_1M.png http://projects.coe.uga.edu/epltt/images/b/b8/Piaget_1.jpg http://upload.wikimedia.org/wikipedia/en/thumb/6/67/Jean_Piaget_in_Ann_Arbor.png/190px-Jean_Piaget_in_Ann_Arbor.png http://noticias.universia.net.mx/mx/images/entrevistas%20y%20personalidades/e/er/eri/erik-erikson.jpg http://projects.coe.uga.edu/epltt/images/b/b8/Piaget_1.jpg http://www.apa.org/pubs/books/images/4318098-150.gif http://womenshealth.gov/publications/our-publications/fact-sheet/images/anorexiafaqdia06.jpg http://www.hbo.com/addiction/img/primarylanding/primary_adolescent.jpg - the adolescent should be reassured about the confidentiality of your discussion
- However, limits of confidentiality should also be set (for example, if the child suggests that they are planning on resorting to self harm) (Arnold and Boggs 356).
- An adolescent is entitled to a confidential conversation (for example, an adolescent is entitled to proper counselling for the sensitive subject of teen pregnancy in order to receive the best possible care) (Potter and Perry 359). Allow for a Sense of Independance - It is very important to avoid a judgemental approach with adolescents, as they are just beginning to gain a sense of independence and self-identity.
- One should be able to participate in decision making
- Avoid using an authoritative approach
- ACTIVE LISTENING Language/Verbalization -Adolescents must first feel comfortable and respected as individuals, especially to reveal intimate information about their risk-taking behaviors (Potter and Perry 359).
- Talk about treatments with long-term gain, not just immediate gratification. (As this age group could typically choose the latter)
- explore alternatives: give choices!
- Use Humour or Street Slang, if appropriate (Arnold and Boggs 356).
- Look for: non verbal cues that may express confusion, escpecially with abstract ideas (Arnold and Boggs). In Physical and Cognitive Assessment - Physical Assessment should always occur in a private setting
- Questions that demand Privacy: Substance Abuse, Sexual Activity
- To determine teens ability to make long term plans: ask the teen to name 3 things they expect to have in 5 years
- look out for warning signs such as self harm http://1.bp.blogspot.com/-fjMmifg5Hl8/Tc9h2IX5aMI/AAAAAAAAABY/kC06-RzQ_zg/s1600/no_jzone_copy.jpg http://static.ddmcdn.com/gif/teen-checkup-pelvic-exam-1.jpg Other Communication Methods and Resources - primary health care activities, particularly health education, can promote healthy development. Can be directed at adolescents, parent, or both.
-high school seminars for students
-group education programs for parents, in a school, clinic, private office, or community centre can help parents to understand adolescent development. (Potter and Perry 359).
- Speakers and organizations can also be used to help in the educational process of adolescents, as they can be influenced by young speakers and big organizations seen in the media. References American Psychological Association (2010). Publication manual of the American Psychological Association. (6th ed.). Washington, DC: American Psychological Association.
Arnold, E., & Boggs, K. U. (2011). Interpersonal relationships: Professional communication skills
for nurses. (6th ed.). St. Louis, MO: Saunders.
Beman, D. S. (1995). Risk factors leading to adolescent substance abuse.Adolescence, 30, 201-201.
Donatelle, R. J. & Thompson, A. M. (2011). Health: the basics. (5th ed.). Toronto, ON: Pearson.
Edelman, C., & Mandle, C. (2010). Health promotion throughout the lifespan. (7th ed.). Toronto,
Erickson EH: Childhood and society, New York, 1963, Norton. References Continued Griswold KS, Aronoff H, Kernan JB, Kahn LS: Adolescent substance use and abuse: recognition
and management, Am Fam Physician 77(3): 331-336, 2008.
Potter, P. A., Perry, A. G., Ross-Kerr, J. C. & Wood, M. J. (2010). Canadian fundamentals of nursing. (revised 4th ed.) Toronto, ON: Mosby. Gardner R: Therapeutic communication with children, ed 2, New York, 1986, Science Books. Striegelmoore, R. H. (1997). Risk factors for eating disorders. Annals of the New York Academy of Sciences, 817(1), 98-109. http://www.cheo.on.ca/Uploads/Nurse%20and%20teen2.JPG