Human Growth and

Development
7:1 Life Stages
 Growth and development begins at birth
and ends at death
 During an entire lifetime, individuals have
needs that must be met
 Health care workers need to be aware of
the various stages and needs of the
individual to provide quality health care
Life Stages
 Infancy: birth to 1 year
 Early childhood: 1-6 years
 Late childhood: 6-12 years
 Adolescence: 12-20 years
 Early adulthood: 20-40 years
 Middle adulthood: 40-65 years
 Late adulthood: 65 years and up
Four main types of Growth and
Development
 Physical: body growth
 Mental: mind development
 Emotional: feelings
 Social: interactions and relationships
with others
 All four types above occur in each stage
Erikson’s Stages of
Psychosocial Development
 Erik Erikson was a psychoanalyst who
identified eight stages of psychosocial
development
 For each stage a basic conflict or need
must be met
 See Table 7-1 in text
Infancy
 Age: birth to 1 year old
 Conflict – Trust vs. Mistrust
 Dramatic and rapid changes
 Physical development– roll over, crawl, walk,
grasp objects
 Mental development—respond to cold, hunger,
and pain by crying. Begin to recognize
surroundings and become aware of
surroundings and people
Infancy
 Emotional development – show anger,
distrust, happiness, excitement, etc.
 Social development – self-centeredness
concept of the newborn to recognition of
others in their environment
 Infants are dependent on others for all needs
Early Childhood
 Age: 1-6 years old
 Conflict:
 Toddler 1 to 3 years - Autonomy vs. shame and doubt
 Preschool 3 to 6 years – Initiative vs. guilt
 Physical development – growth slower than in infancy.
Muscle coordination allows the child to run, climb, move
freely. Can write, draw, use a fork and knife
 Mental development – verbal growth progresses, short
attention span, at end of stage ask questions, recognize
letters, and some words
Early Childhood
 Emotional development – develop self-
awareness and recognize the effect they have
on other people and things. Children feel
impatience and frustration as they try to do
things beyond their abilities. This lead to temper
tantrums (the terrible two’s)
 Social development – at beginning of stage
very self-centered one year old to sociable six
year old. Strong attachment to parents. Needs
are food, shelter, protection, love and security.
Late Childhood
 Age: 6-12 years old
 Conflict – Industry vs. inferiority
 Physical development– slow but steady. Muscle
coordination is well developed and children can engage
in physical activity that require complex motor-sensory
coordination
 Mental development – developing quickly and much of
the child’s life centers around school. Reading and
writing skills are learned, understand abstract concepts
like honesty, loyalty, values and morals
Late Childhood
 Emotional development -- the child achieves greater
independence and a more distinct personality. Fears are
replaced by the ability to cope.
 Social development – changes from activities by
themselves to more group oriented. They are more
ready to accept the opinions of others and learn to
conform to rules, and standards of behavior. Needs are
the same as infancy and early childhood along with the
need for reassurance, parental approval, and peer
acceptance.
Adolescence
 Age: 12-20 years old
 Conflict – Identity vs. Role Confusion
 Physical development – growth spurts, muscle
coordination slows. Development of sexual
organs and secondary sexual characteristics
(puberty). Secretion of sex hormones leads to
the onset of menstruation in girls and the
production of sperm and semen in boys. Body
shape and form changes.
Adolescence
 Mental development – most foundations have
been set. Development primarily involves an
increase in knowledge and sharpening of skills.
Learn to make decisions and accept
responsibility for actions.
 Emotional development – emotional
development is often stormy and in conflict.
Adolescents try to establish their identities and
independence. They respond more and more
to peer group influences.
Adolescence
 Social development – spending less time with family
and more time with peer groups. They attempt to
develop self-identity and independence and seek
security from their peers. Toward the end of this stage
they develop a more mature attitude and develop
patterns of behavior that they associate with adult
behavior.
 Need for reassurance, support and understanding. Problems
that develop in this stage can be traced to conflict and feelings of
inadequacy and insecurity.
Eating Disorders
 Often develop from an excessive concern
for appearance
 Anorexia nervosa
 Bulimia
 More common in females
 Usually, psychological or psychiatric help
is needed to treat these conditions
Substance Abuse
 Use of alcohol or drugs with the
development of a physical and/or mental
dependence on the chemical
 Can occur at any life stage, but frequently
begins in adolescence
 Can lead to physical and mental disorders
and diseases
 Treatment towards total rehabilitation
Reasons Chemicals Used
 Trying to relieve stress or anxiety
 Peer pressure
 Escape from emotional or psychological
problems
 Experimentation
 Seeking ―instant gratification‖
 Hereditary traits or cultural influences
Suicide
 One of the leading causes of death
in adolescents
 Permanent solution to temporary problem
 Impulsive nature of adolescents
 Most give warning signs
 Call for attention
Reasons for Suicide
 Depression
 Grief over a loss or love affair
 Failure in school
 Inability to meet expectations
 Influence of suicidal friends or parents
 Lack of self-esteem
Increased Risk of Suicide
 Family history of suicide
 A major loss or disappointment
 Previous suicide attempts
 Recent suicide of friends, family, or role
models (heroes or idols)
Early Adulthood
 Age: 20-40 years old
 Conflict Intimacy vs. Isolation
 Physical development – basically complete.
Muscles are developed, strong and motor
coordination is at its peak.
 Mental development – young adults seek
additional education, choose careers and
independence.
Early Adulthood
 Emotional development – Young adults
are subjected to many emotional stresses
related to career, marriage, family, etc.
 Social development – moving away from
peer group, and adults tend to associate
with others who have similar ambitions.
Most find a mate and begin a family.
Middle Adulthood

 Age: 40-65 years of age

 Conflict – Generosity vs. Stagnation
 Physical development – Hair grey’s and thins,
skin wrinkles, muscle tone decreases, hearing
loss, visual acuity losses, weight gain. 
 Mental development – can continue to
increase. Confident decision makers and
excellent at analyzing situations.
Middle Adulthood
 Emotional development – can be a
period of contentment and satisfaction.
 Social development -- Family
relationships can decline as children begin
lives of their own and parents die. Divorce
rates are high. Friendships are with
people with similar interests and lifestyles.
Late Adulthood
 Age: 65 years of age and up
 Conflict – Ego integrity vs. despair
 Physical development – on the decline.
Skin becomes dry and wrinkles, ―age
spots‖ appear. Hair thins, muscles lose
tone and strength. Memory loss can occur
and reasoning ability can diminish.
Late Adulthood
 Mental development – varies. People who
remain mentally active and are willing to learn
new things tend to show fewer signs of
decreased mental ability
 Emotional development – Emotional stability
also varies.
 Social development – retirement can lead to
loss of self esteem, lost identity. Death of
spouse and friends cause changes in social
relationships.
7:2 Death and Dying
 Death is ―the final stage of growth‖
 Experienced by everyone and
no one escapes
 Young people tend to ignore its existence
 Usually it is the elderly, who have lost
others, who begin to think about their
own death
7:2 Death and Dying
 Death is ―the final stage of growth‖
 Experienced by everyone and
no one escapes
 Young people tend to ignore its existence
 Usually it is the elderly, who have lost
others, who begin to think about their
own death
Research
 Dr. Elizabeth Kübler-Ross was the leading
expert in the field of death and dying
 Results of her research
 Most medical personnel now believe patient
should be informed of approaching death
 Patient should be left with some hope and
know they will not be left alone
 Staff need to know extent of information
known by patient
Research
(continued)
 Dr. Kübler-Ross identified 5 stages of
grieving
 Dying patients and their families/friends may
experience these stages
 Stages may not occur in order
 Some patients may not progress through
them all, others may experience several
stages at once
Stages of Death and Dying
 Denial – refuses to believe
 Anger – when no longer able to deny
 Bargaining – accepts death, but wants
more time
 Depression – realizes death will
come soon
 Acceptance – understands and accepts
the fact they are going to die
Caring for the Dying Patient
 Very challenging, but rewarding work
 Supportive care
 Health care worker must have
self-awareness
 Common to want to avoid feelings by
avoiding dying patient
Hospice Care
 Palliative care only
 Often in patient’s home
 Philosophy: allow patient to die with dignity
and comfort
 Personal care
 Volunteers
 After death contact and services
Right to Die
 Health care workers must understand
this issue
 Ethical issues must be addressed
 Allowing patients to die can cause conflict
 Specific actions to end life cannot be taken
 Laws allowing ―right to die‖
Summary
 Death is a part of life
 Health care workers will deal with death
and dying patients
 Must understand death and dying process
and think about needs of dying patients
 Then health care workers will be able
to provide the special care these
individuals need
7:3 Human Needs
 Needs: lack of
something that is
required or desired
 Needs exist from birth
to death
 Needs influence our
behavior
 Needs have a priority
status
 Maslow’s hierarchy of
needs
Maslow’s hierarchy of needs
Meeting Needs
 Motivation to act when needs felt
 Sense of satisfaction when needs met
 Sense of frustration when needs not met
 Several needs can be felt at the same time
 Different needs can have different levels
of intensity
Methods for Satisfying
Needs
 Direct methods – meeting a need and
obtaining satisfaction.
 Hard work
 Set realistic goals
 Evaluate situation
 Cooperate with others
Methods for Satisfying Needs
 Indirect methods of satisfying a need usually
reduce the need and help relieve tension if need
is unmet. The need is still there but its intensity
decreases.
 Rationalization
 Projection
 Displacement
 Compensation
 Daydreaming
 Repression
 Suppression
 Denial
 Withdrawal
 What is the difference between direct and
indirect methods of satisfying human
needs?
Defense Mechanisms
 Rationalization is putting something into a different
light or offering a different explanation for one’s
perceptions or behaviors in the face of a changing
reality.
 a woman who starts dating a man she really, really likes and
thinks the world of is suddenly dumped by the man for no
reason. She reframes the situation in her mind with, ―I
suspected he was a loser all along.‖
 Projection is the placing a person’s undesired
thoughts, feelings or impulses onto another person
who does not have those thoughts, feelings or
impulses.
 a spouse may be angry at their significant other for not
listening, when in fact it is the angry spouse who does not
listen.
Defense Mechanisms
 Displacement is the redirecting of thoughts feelings
and impulses directed at one person or object, but
taken out upon another person or object. People often
use displacement when they cannot express their
feelings in a safe manner to the person they are
directed at.
 The classic example is the man who gets angry at his boss,
but can’t express his anger to his boss for fear of being fired.
He instead comes home and kicks the dog or starts an
argument with his wife. The man is redirecting his anger from
his boss to his dog or wife.
Defense Mechanisms
 Compensation is a process of psychologically
counterbalancing perceived weaknesses by
emphasizing strength in other arenas. By
emphasizing and focusing on one’s strengths, a
person is recognizing they cannot be strong at all
things and in all areas in their lives.
 When a person says, ―I may not know how to cook, but I can
sure do the dishes!,‖ they’re trying to compensate for their
lack of cooking skills by emphasizing their cleaning skills
instead.
 Daydreaming is a dream like thought process when
the person is awake.
 Daydreaming can be good or bad, it can lead to reaching our
goals. Can be bad if person has the thoughts but don’t take
any action.

Defense Mechanisms
 Repression is the unconscious blocking of
unacceptable thoughts, feelings and impulses.
―Repressed memories‖ are memories that have been
unconsciously blocked from access or view.
 Terrified of heights but don’t know why
 Suppression like repression but the individual is
aware of why they have unacceptable thoughts,
feelings or impulses and refuses to deal with them.
Form of avoidance.
 Avoid the doctor because you are afraid of what you will
hear.
Defense Mechanisms
 Denial is the refusal to accept reality or fact, acting as
if a painful event, thought or feeling did not exist.
 a person who is a functioning alcoholic will often simply deny
they have a drinking problem, pointing to how well they
function in their job and relationships.
 Withdrawal is removing your self either physically or
emotionally from an unwanted situation
 Withdrawal is a healthy defense mechanism when you avoid
an conflict or an unhappy situation.
Summary
 Be aware of own needs and
patient’s needs
 More efficient and quality care can
be provided when know needs and
understand motivations
 Better understanding of our behavior
and that of others
7.4 Effective Communication
 Health care workers must be able to relate
to patients, family, coworkers, and others
 Understanding communication skills
assists in this process
 Communication is the exchange of
information, thoughts, ideas, and feelings
Communication types
 Verbal: spoken words
 Written
 Nonverbal: facial expressions, body
language, and touch
Communication Elements
 Sender– the individual who creates a
message to convey information or an idea
to another person
 Message– the information, idea, or
thought
 Receiver– an individual who receives the
message from the sender
Elements of effective
communication
 The message must be clear
 The sender must deliver the message in a
clear and concise manner
 The receiver must be able to hear and
receive the message
 Avoid interruptions and distractions
Listening
 Essential for communication
 Attempt to HEAR what the other is really
saying
 Good listening skills techniques (see list
page 208)
 Observe speaker closely
 Reflect statements made by the speaker
back to them
Barriers to communication
 Common barriers
 Physical disabilities
 Psychological attitudes and prejudice
 Cultural diversity
Good communication
 Good communication skills allow
development of good interpersonal
relationships
 Health care worker also relates more
effectively with coworkers and other
individuals