infant
birth to 1 year
toddler
1-3 years
preschool
3-5 or 6 years
school age
6-10 or 12 years
preadolescent
10-12 or 13 years
adolescent
13-19 years
early or young adult
20-40 years
middle adult
40-64 years
late adult
65+ years
young old Vs. old old
greater than 85 years
assessment of cognitive and physical development changes
growth gross motor fine motor neurological language
major developmental influences in healthcare
Erik Erikson- societal influences
piaget- cognitive changes
erikson’s theory
well known theory of development.
believed that personality develops in a series of predetermined stages and his theory describes the impact of social experience across the whole lifespan
erikson’s stages of development
birth to year 1
trust V. mistrust
whether or not to trust the caregiver
erikson’s stages of development
1-3 years
autonomy V. doubt
children develop self-sufficiency by ctrl activities such as eating, toileting, and talking
erikson’s stages of development
3-6 years
initiative V. guilt
children begin to take more control over their environment
eriksons stages of development
7-11
industry V. inferiority
children develop a sense of competence by mastering new skills
eriksons stages of development
adolescence
identity V. role confusion
development of a sense of self
eriksons stages of development
young adulthood
intimacy V. isolation
young adults seek out romantic love and companionship
eriksons stages of development
middle age
generativity V. stagnation
nurture others and contribute to society
eriksons stages of development
older adults
integrity V. despair
reflection on life, looking back with fulfillment or bitterness
piaget said there are
4 stages in cognitive development of children
piaget: sensory motor stage
children from birth to about 2 years
piaget: pre-operational stage
children aged 2-7
piaget: concrete operational stage
children aged 7-11 or 12
piaget: formal operations stage
occurs in adolescents from age of 11 to 16 or more
assessment of developmental prevention needs
safety- no throw rugs for elders, babyproof home, helmets, seatbelts
health and wellness
instruments for measuring developmental changes
birth dates
scale
tape measure
growth charts
global and holistic measures for developmental changes
Denver Developmental screening test
bright futures
ages and stages
DDST
a test for screening cognitive and behavioral problems in preschool children
admin by pediatrician or other health/social service proff
tasks in DDST
grouped into 4 catagories
social contact, fine motor skill, language, gross motor skill
smiles spontaneously (90% of 3mo olds)
knocks 2 building blocks together (90% of 13mo olds)
speaks 3 words other than mom or dad (90% of 21mo olds)
hops on one leg (90% of 5 yo)
bright futures
prevention and health promotion for infants, children, adolescents, and their families
bright futures materials
amt of content can be overwhelming
health supervision guidelines, pocket guide, PDA, health promo info sheets
practice guides on oral health, mental health, and physical activity
powerpoint pres and handouts
BF tool and resource kit
BF activity book
performing preventive services
Nutrition 3rd Ed
ages and stages questionnaire
developmental and social-emotional screening for children from one month to 5.5 years
highly reliable and valid
looks at strengths, trouble spots,
educates parents about developmental milestones
incorporates parents’ expert knowledge about their children
areas screened in ASQ
communication gross motor fine motor problem solving personal social parents/caregivers complete the questionnaire, and prof score them
developmental stages, tools, kits, milestones and charts are______
guides
they are not set in stone
What is culture
the system of share beliefs, values, customs, behaviors, and artifacts that the members of society use to cope with their world and with one another, and that are transmitted from generation to generation through learning
what is cultural competence
treating every patient with equal respect and dignity regardless of culture, race, or ethnicity
american cultural beliefs, values, and customs
individualistic, freedom, power distance, equality
things are earned, patriotism
thanksgiving, politics
in 2030 it is projected that _____% of the us will be non white
40
racial and ethnic healthcare disparity
unequal
quality
quantity
access- people go to the ER with or without access and they will be treated, this perceived lack of access keeps people out
patient factors relating to healthcare disparity
language barriers low health literacy lack of trust in the medical system different health care beliefs financial barriers
healthcare provider factors relating to health care disparity
conscious/unconscious biases
ineffective communication
inability to build trust
time limitations
how can we reduce racial and ethnic disparity
interpreters
patient education materials (3rd-5th grade level)
identify available health care services, referrals
integrate, accommodate, and aid assimilation; say it differently
non judgmental attitudes
listen; know what they think and what they actually need
general survey- assessment
begins when pt walks in the door
use all senses
appearance, gait, clothing, height, demeanor, overall wellness
ALWAYS begin with inspection
what to observe?
physical appearance- age, gender, LOC, skin color, facial features
body structure-stature, nutrition, symmetry, posture, position
mobility- gait, ROM
vitals- o2 sat, temp, pulse, respirations, bp
doppler to find pulse
see assessment of older adult and infant
back of chapter 9