lecture 2

• Lifespan approach


  Includes the sequence of events & experiences in a life from birth until death
• Tenets of lifespan approach

  • Potential for growth & development exits throughout the lifespan
  • Development has many directions, with no specific route or direction
  • Patterns of development vary due to social, historical, cultural & gender variables
  • There are many dimensions to development & each may follow a different trajectory
• Dimensions of development

  • Physical-motor
  • Cognitive-intellectual
  • Personal-social-emotional
• Lifespan approach to nursing practice

  Nurse has an opportunity to provide information, resources, & interventions for patients & families to enhance emotional development, cognitive growth & psychosocial well-being throughout the lifespan
• Benefits of lifespan approach to nursing practice

  • Increase nurse's understanding of the patient & promote individual care
  • Identify disruptions in development
  • Increase awareness of the patient, their perception of their problem, their responses to it
  • Facilitate accurate assessment & communication, enhance empathy & promote the development of interventions that are specific & meaningful for the patient
• Contributions of lifespan approach in practice

  • Communication, particularly development of rapport
  • Establishment of empathy
  • Interviewing
  • Identification of patient concerns & general facilitation of therapeutic communication
  • Risk assessment
  • Identification & implementation of appropriate interventions
  • Appropriate referral
  • Awareness of boundary issues
• Mental health across the lifespan

  Basic elements of mental health are acquired throughout a person's development<|>Mental health, like physical contributes to a person's quality of life<|>It enhances our functioning in all aspects of life-work, relationships & social situations- & also enables us to feel that we are worthwhile & acceptable just as we are<|>Mental health helps us to mediate & manage stress from external events in our lives, to cope with the ups & downs & to be hopeful about the future
• Relationship between mental health & development

  Satisfactory personal development is related to & dependent upon an individual's mental health<|>Mental health problems can result when developmental tasks & challenges are not met due to some disruptions in the internal or external environment
• Internal & external conditions affecting mental health

  • Internal conditions include inherited characteristics & personality characteristics
  • External conditions include parenting, nurturing in childhood, positive & negative life events
• Developmental theories

  Some theorists developed a lifespan approach & devised "stages" to explain how changes occur across the lifespan<|>Stages have different meanings depending on the variable being considered<|>Stage theories may be biological, sociocultural or cognitive-structural<|>Nurses may apply stage theories during assessment to consider individuals/families are assessed holistically & range of issues affecting development may be examined<|>Theories help us understand why some people are might be more vulnerable to mental health problems or at risk for developing mental illness than others
• Sigmund Freud's theory

  Proposed 3 personality structures namely id, ego & superego<|>If the functions are in balance…helps the person resolve the conflicts of different psychosexual stages of personality development<|>Maturation is the desired outcome of the individual successfully moving through the 4 stages from infancy to adolescence
• Relevance of Freud's theory

  • Assists the nurse in understanding patient behaviours that are inconsistent with age or the expected level of development
  • Concepts of regression & fixation are integral to this understanding
  • Fixation refers to behaviours that indicate unmet needs or unresolved conflicts of a particular psychosexual stage
• Freud's psychosexual stages

  Id is the dominant personality structure during infancy…if the infant failed to receive adequate oral gratification frustration could result…if over-attention was given to meeting oral needs the child may continue to have a preoccupation with their mouth as they grow resulting in habits such as heavy smoking in adulthood<|>Any frustration experienced during the anal stage could result in anal fixation…result would be stubbornness, selfishness, laziness
• Eric Erikson's theory

  Predicted successful personality development as an outcome of conflict resolution throughout the 8 stages<|>Relevance of this theory for nurses…assists the nurses with increased interpersonal understanding of the individual's biological, psychological, spiritual & social dimensions<|>Stages highlight the central concerns at different times in their life& identify challenges that may cause risks
• Jean Piaget's theory

  Proposed a theory consisting of 4 broad stages<|>Cognitive-developmental theory<|>Relevance of Piaget's theory…assists the nurse to understand that children require stimulation & an experience of the external world to learn ways of relating to the environment<|>Awareness by the nurse that the ability to think abstractly or conceptually is necessary for problem solving can assist the nurse with the facilitation of decision making with particular patients
• Mental health in childhood

  Early years of development are the most important in building the foundation of future development<|>Most important stages…development of a positive sense of self & the ability to trust others<|>Mental health is evident when the child maintains relationships with others…engaging in learning & play…understanding the concepts of right & wrong…developing psychologically
• Mental health in adolescence

  Main tasks of adolescence are the: successful transition to secondary schooling, learning skills for later life, self reliance & confidence in decision making, developing close relationships within & between genders, formation of personal identity, development of a sense of meaning & purpose in life…major task of identity formation
• Mental health in adulthood

  Adulthood may be seen as a series of changes that occur after adolescence until the final stages of life<|>Throughout adulthood there are changes to cognitive, social, psychological & physical development<|>By early childhood many of the brain's functions have stabilized
• Mental health in early adulthood

  A mutual & satisfying relationship with another person in which individual identity is sustained is evidence of successful resolution at this stage<|>This stage requires "sacrifices or compromises"…as a result of a commitment to another person<|>Intimacy versus Isolation is the task at this stage<|>People at this stage struggle with issues of identity & adjusting to increased responsibility as they attempt to establish a career
• Mental health in middle adulthood

  According to Erikson, middle years are the most productive in terms of family, occupational & social contributions<|>This stage is characterized by the individual as having generous tendencies & energies directed at contributing to a better world<|>"Generativity" relates to guiding & supporting the next generation, also contributes to the enrichment of society
• Examples of generativity

  • Mentoring & guiding younger individuals through their personal & professional development
  • Sharing knowledge & wisdom with younger generations
  • Engaging in volunteer work to help well-being of others
  • Pursuing a profession or career that makes a positive difference
  • Creating art, literature or music that inspires & uplifts others, leaving a creative legacy
• Other generative acts

  • Look after the grandchildren when their parents are not available
  • Teach the younger generations how to get along with others & handle difficult situations
  • Volunteer & serve in the community
  • Take the initiative to support & comfort young people in distress
  • Share life experiences both good & bad, with the next generation
  • Pass on skills & talents to the next generation
• Examples of stagnation

  • Feeling stuck in a monotonous routine without personal growth
  • Lacking a sense of purpose & direction
  • Avoiding responsibilities & commitments
  • Failing to develop meaningful relationships or invest in personal or professional development
  • Being self-centred, focusing solely on individual desires & gratification
  • Neglecting the needs of others & the broader community
  • Resisting change & being unwilling to adapt to new challenges or opportunities for growth
  • Experiencing a sense of regret or dissatisfaction with life's choices & accomplishments
  • Feeling unfulfilled & lacking a sense of meaning in life
• Overcoming stagnation

  Actively seek out new experiences & challenges that push you out of your comfort zone<|>Contribute to your community, mentor others, or engage in meaningful work<|>Identify your personal passions, interests & goals to foster personal growth<|>Surround yourself with supportive & positive individuals to provide emotional nourishment, inspiration & new experiences
• Mental health in older adulthood

  Development in older adults focuses on positive outcomes that relate to the final stages of life<|>Integrity versus despair is the developmental task at hand<|>Integrity includes: Feeling positive about one's ability to look back on their life with a sense of accomplishment & fulfillment, has the following characteristics: Acceptance, sense of wholeness, lack of regret, feeling at peace, feelings of wisdom & acceptance
• Despair


  Despair according to Erikson refers to looking back on life with feelings of regret, shame, or disappointment<|>Characteristics include: Bitterness & regret, Ruminating over mistakes, Feeling that life was wasted, Feeling unproductive, Depression & hopelessness
• How to decrease despair

  Reach out to others: focus on building social support<|>Discuss your feelings with friends & families that can help<|>Look for new connections by participating in community groups or organizations<|>Focus on the positive: think about the memories & events that brought you feelings of pride & happiness<|>Explore new experiences