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Course: Fundamentals of Nursing

Topic: Human Development

The Nurses International Community

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COPYRIGHT

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Module Goals

Learners will be able to:

Describe the theories related to human development
Explain how these theories impact nursing care

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What is Human Development?

Lally & Valentine-French, 2019

Human development is the ways that people change, or stay the same across their lifespan - from birth until death.
This includes physical, psychosocial, cognitive, and language related processes.

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Theories Related to Human Development

Franklin & Prows, 2017;

Lally & Valentine-French, 2019

There are many theories related to human development. The following are some of the most important contemporary theories of development:

Psychosocial Theory
Learning Theory (Behaviorism)
Social Learning Theory
Cognitive Theory
Moral Development Theory

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Psychosocial Theory

Lally & Valentine-French, 2019

Developed by theorist Erik Eriksen.
Comprised of eight developmental (psychosocial) stages that cover the entire lifespan.
According to Eriksen, each stage has challenges and goals that must be faced and dealt with in a positive way for successful development.

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Note. Reprinted from Lifespan Development: A Psychological Perspective (2nd ed., 19), by M. Lally & S. Valentine-French, 2019, Creative Commons Attribution-Noncommercial-Share Alike 3.0.

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Critical Thinking Question

A nurse is taking care of an infant that is 6 months old. According to Eriksen’s Psychosocial Stages of Development, what stage of development is the infant in? What are some things the nurse can do to provide developmentally appropriate nursing care to an infant at this stage?

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According to Eriksen’s Psychosocial Stages of Development, a 6 month old infant is in the stage of Trust versus Mistrust
The infant is learning to develop trust during this stage of their life and uses all of his/her senses (vision, hearing, taste, smell, touch) to do so. As such, the nurse should use sensory based strategies while providing nursing care that help the infant to feel safe and trust the nurse and caregiver. Some examples include:
Have the same nurse(s) care for the infant throughout their stay if possible to build trust and decrease stranger anxiety
Providing gentle physical contact with the infant such as holding, swaddling, and patting
Speak in a soft voice and use a calm approach
Provide a favorite toy, blanket etc. to promote trust
Examine the infant while the caregiver is holding him/her
Offer the infant something soothing, such as a pacifier or having the mother breastfeed, after a procedure
Reduce excessive stimuli

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Learning Theory (Behaviorism)

Brau et al., 2018
Lally & Valentine-French, 2019

Prominent behaviorist theorists include John Watson and B.F. Skinner¹.
Focus is on analyzing how changes in the environment affect behavior².
Learning enhanced through conditioning by using positive reinforcement (rewards) for desired behaviors and negative reinforcement for undesirable behaviors¹.

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Social Learning Theory

Lally & Valentine-French, 2019

Developed by Albert Bandura.
Learning occurs by watching others, not just through conditioning with positive and negative reinforcements.
Children often learn behaviors through imitation.
We are not just a product of our environment but also influence our environment.

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Cognitive Learning Theories

Lally & Valentine-French, 2019

Jean Piaget is the most influential of the cognitive theorists.
Focus on how mental processes change

over time.

Piaget theorized that children progress

through four stages of cognitive

development and that children of different ages interpret the world differently.

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Note. Reprinted from Lifespan Development: A Psychological Perspective (2nd ed., 21), by M. Lally & S. Valentine-French, 2019, Creative Commons Attribution-Noncommercial-Share Alike 3.0.

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Terms

Object permanence - The knowledge that an object exists even though it is no longer visible
Conservation - Realize that physical factors (such as, volume, weight, and number) remain the same even though outward appearances are changed
Abstract logic - The ability to understand complex subjects through analysis and evaluation

Sensorimotor - During this stage children are very curious and learn to problem solve through trial and error. They progress from reflex activity to imitative behavior and begin to use language towards the end of the stage.

Preoperational - At the start of this stage, children are egocentric, meaning, they are unable to imagine themselves in another person’s place or see things from another person’s point of view. Their thinking at this stage is concrete and tangible; they can’t reason beyond what they can actually see, hear, or otherwise experience. Through imaginative play, asking questions, and interactions with others, they begin to make associations between ideas.

Concrete Operational - Able to classify, sort, and organize facts about the world in order to solve problems, however, they are still unable to deal with abstract problems and solve things in a concrete, systematic way based on what they perceive. Their thinking is now less self-centered and they can think about things from another person’s point of view.

Formal Operational - Characterized by flexibility and adaptability. Can draw logical conclusions from observations.

(Franklin & Prows, 2017)

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Moral Development Theory

Developed by Kohlberg to explain how children develop moral reasoning.
Based on cognitive developmental theory.
Kohlberg’s Moral Development Theory consists of three levels: preconventional level, conventional level, and postconventional (autonomous or principled) level.
The three levels are present during different times of Piaget’s stages of cognitive development.

Franklin & Prows, 2017

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Levels of Moral Development

Preconventional Level (preoperational stage of development)

Children determine whether an action is good or bad based on its consequences.
Do not understand the moral principles that support those consequences.

Conventional Level (concrete operations stage of development)

Children concerned with conformity and loyalty so behavior that pleases others and is met with approval is considered good .

Postconventional Level (formal operations stage of development)

Correct behavior defined by individual rights and standards that have been agreed on by entire society.

Franklin & Prows, 2017

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Critical Thinking Question

How can understanding human development theories help nurses provide better care to patients?

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Patients at different stages of development have different levels of understanding and respond differently to nursing care, so it is important for nurses to understand how humans develop across the lifespan so they can provide good care to every patient. For example, a nurse who knows that a 3 year old child is developing a sense of autonomy and free will might ask the child to “help” with a physical exam or procedure by holding things, leading to greater cooperation and a less stressful exam for the child. The nurse would approach a teenager in a very different manner. For example, the nurse who understands human development would know that privacy and body image are usually very important for teenagers, so might ask family to step out during a physical exam and preemptively address concerns about how an intervention might affect the teen’s body. For example, explaining to a teenager who is going to have surgery what the scar from the incision site will look like after it’s healed.

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Impact of Human Development Theories on Nursing Care

Burke, 2021

It is important for nurses to understand human development theories so that they can:

Determine whether patients are meeting developmental milestones (especially important in pediatrics).
Plan nursing care that is developmentally appropriate
Provide education to patients and families about expected age-related changes.

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Impact of Human Development Theories on Nursing Care

Green, 1991

Plan the correct level of stimulation to facilitate progress rather than regression in the accomplishment of developmental tasks.
Understand a person’s response to illness.
Help nurses to recognize deviations from normal.
Understand the specific task or need of each developmental stage in order to plan appropriate individualized care for patients.

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Cultural Considerations

Culture is a universal requirement for psychological development.
Because every culture is different (variations in language, customs, roles and responsibilities etc.), people from different cultures may have different developmental trajectories.
Children from different cultures receive different information from their environments that lead to differences in their beliefs and behaviors.

Huang, 2018; Packer & Cole, 2020

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References:

Brau, B., Fox, N., & Robinson, E. (2018). Behaviorism. In R. Kimmons & S. Caskurlu (Eds.), The Students’ Guide to Learning Design and Research. EdTech Books. https://edtechbooks.org/studentguide/behaviorism

Burke, A. (2021, March 6). Developmental stages and transitions: NCLEX-RN. Registered Nursing.org. https://www.registerednursing.org/nclex/developmental-stages-transitions/

Franklin, Q., & Prows, C.A. (2017). Developmental and genetic influences on child health promotion. In M.J. Hockenberry, D. Wilson, & C.C. Rodgers (Eds.), Wong’s essentials of pediatric nursing (10th ed.)(pp. 114-151). Elsevier.

Green, A. (1991). Application of Jean Piaget's theory of human development for nursing children in an adult intensive therapy unit. Intensive Care Nursing, 7(4), 236-239. https://doi.org/10.1016/0266-612X(91)90049-W

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References:

Huang, C.Y. (2018). How culture influences childhood development. Bournemouth University. https://www.bournemouth.ac.uk/news/2018-07-31/how-culture-influences-children-s-development

Lally, M., & Valentine-French, S. (2019). Lifespan development: A psychological perspective (2nd ed.). http://dept.clcillinois.edu/psy/LifespanDevelopment.pdf

Packer, M.J., & Cole, M. (2020). Culture and human development. Oxford research encyclopedia of psychology. Oxford University Press. https://doi.org/10.1093/acrefore/9780190236557.013.581

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