Overview of Erikson’s Developmental Stages

Question:

Discuss About The Principles Practice Psychiatric Nursing Book?

The aim of the assignment is to outline the stages of a developmental psychology theory in relation to cystic fibrosis (CF). In relation to this theory the paper, discuss where a child (aged 12) with cystic fibrosis may fit developmentally and why. The assignment highlights the cognitive, psychological, social, emotional, and physical implications of living with this chronic disease. The difference in the lifespan development between the health person and people with CF is highlighted in the assignment. Lastly, the importance of understanding the human development for health professionals is explained.

According to Erikson’s developmental stages of human across lifespan include (McLeod, 2013)-

• Infancy stage- 0-1 year
• Toddlerhood- 1-3 year
• Preschool- 3-6 year
• Elementary school- 6-puberty
• Adolescence- teen to early 20s
• Young adulthood- 20-40 year
• Middle adulthood- 40-60 year
• Late adulthood- 60+

Before discussing the developmental stages of CF children, each stage is discussed in general. According to Ericson, in the infancy stage, parents care a child and the child will develop optimism. A child at this age learns concepts and body movements through sensory data such as touch, smell, etc. A child at this age develops trust by secured attachment with mother. If this secured attachment is lost, a child develops mistrust and worthlessness. In the toddler stage, a child tends to build self esteem and autonomy. They take initiative to perform activities of daily life independently such as dressing eating or toilet training. Children experience shame when they lack self-reliance (Berk, 2017). In the preschool stage, children according to Ericson tend to copy the adult behaviour and the most significant relationship is with the basic family. In the school-aged children, development occurs by learning new skills and concepts. At this stage social development occurs.  Children develop significant relationships with peers and neighbour or else it will lead to problems with competence and self-esteem. In the adolescent stage, a person tends to find his or her own identity, develop sense of morality.  If unsuccessful at this age, a child may develop role confusion. In the adult stage, people become capable of establishing satisfying relationship, and deep intimacy.  At the middle adulthood stage a person, tend to focus more on career and work. They are more generative and from late adulthood to death stage, a person acquires integrity or sense of despair (Cherry, 2015).     

Children with cystic fibrosis will have development stages but they may develop in a manner different from the children without the disease. It is the recessive genetic disorder of mucous and sweat glands in the body caused by the defective cystic fibrosis transmembrane regulator gene ().  Ericson’s developmental stages refer to body, mind and culture, and the theory mentions that each stage has a goal. However, children with cystic fibrosis have to overcome many obstacles unlike the normal infants. These infants confronted with CF are less likely to develop strategies required to deal with problems in real life (Cherry, 2015).

Developmental Stages of Children with Cystic Fibrosis

Overcoming obstacles at early stage becomes difficult for the children with CF. In the infant stage, the child may develop mistrust instead of trust as the parents are less aware of the disease like CF and care to be given to the child. Children with CF at toddler stage may develop mistrust issues. During early school age and middle school age, CF children will dependent on the parents and other people for care. They are responsible at this age to learn the basics of CF care. Hence, they demonstrate the delayed cognitive development on terms of language acquisition. Instead of play and other learning opportunities they get the environment of medication. Therefore, they fail to be autonomous and develop the feeling of shame. Instead of learning self-care habits, the children engage with parents to be guided towards self-care. This continues from the age of 6 years until 12 years. In this phase, CF child fails to take initiative for life and may feel guilty and incompetent unlike the normal children. At this age they may feel inferior to others (Ernst et al., 2010).

From the age of 13-15, the CF children partner with parents for owing some aspects of self care. The develop curiosity regarding the support person. At the adolescents stage, the children with CF face identity struggle. CF children depend on the family members for daily activities and to cope with their illness. Therefore, CF children experience role confusion as they fail to accomplish the personal identity. At the age of 16-18, the children with CF can lead their own care and owe maximum aspects of self-care. From early adulthood onwards, CF patients tend to take ownership of care and primarily responsible for their self-care. At the young adulthood stage, CF children struggle to establish satisfying intimate relationship with others. CF patients are preoccupied enough, to have time for others (Baltes & Schaie, 2013).

In this paper, CF is focused on child with age 12 years. Instead of establishing social relationship with peers and neighbors, they experience isolation due to stigmatization and discrimination (Mickley et al., 2013). They do not feel equal to their colleagues and learn the deviations from normality. They may feel inferior as they frequently take medication for cough, expectorant and may feel inferior for being shorter than others. They may appear normal but the visible manifestations of CF make them vulnerable.  They thus feel different from peers.  School life appears to be obstacle, however, they still have the scope of learning skills to integrate into health environment. Eventually the child may learn the disease related experiences such as clubbing of fingers, barrel chest and others. Therefore, children may recur to normalisation as the problem-solving strategy when searching for self-care. They attain greater knowledge for treatment adherence and medication. Children with CF at this age mainly focus on self-care to avoid exacerbation. This hampers their potential to establish intimate relationships with others in the society. However, there is a greater need for children with this illness to have family and social support (Linnemann et al., 2016).

Cognitive, Psychological, Social, Emotional, and Physical Implications of Living with Cystic Fibrosis

Instead of showing more concern for body image, looks, clothes, schoolwork and experiences of different kind of emotions, the CF children concern about physio, taking medications, and nutrition. Mealtime behavior is the other major health-related concern for children with CF. CF children are at greater risk of a dietary malabsorption and chronic lung infection. CF chid will focus less on schoolwork due to high absenteeism pertaining to medication and fatigue (Ernst et al., 2010). At the age when other people learn about logical thinking and systemic manipulations, CF children have to worry about illness and curability. They tend to diminish the emphasis on illness. By keeping the illness secret, they fail to develop intimate friendships. Instead of improved cognitive, emotional and social skills, they develop psychological distress in these children. Anxiety and depression is the common problem encountered by them. Eventually the adolescence phase becomes more difficult for the child of 12 years with CF. While other children gain significant independence, CF child may be highly dependent on parents with increasing hospitalisation due to pulmonary exacerbations. There is a high chance of low self-esteem, strain and reduction in physical activity (VanDevanter et al., 2016).

Understanding human development is essential for the health care professionals as they can coproduce a quality care along with the patients and families. By having an understanding of human development, the care providers can win the tryst of the family  members. They can better resolve the queries of the care users. The physician or the nurse can initiate the intervention for the decision if they are aware of the child’s readiness to engage mentally and emotionally. It will promote the psychiatric nursing (Stuart, 2014). Care can be coproduced if the child is demonstrating the curiosity and the search for insight. By identifying to what extent a child is deviating from the normal developmental milestones, the nurses can help the child with CF to reframe challenges into opportunities for improvement. Learning physio and treatment adherence in child can be enhanced if they are aware of the cognitive and social capabilities of child with CF. Care delivered can be more patient centric by knowing about the age related changes across the lifespan. Human development psychology helps to understand in what the stage the next patient is. Accordingly, they can adjust the compassion. Further, the health professional can move forward in career by attending the classes like lifespan development psychology. In addition to the therapeutic attention, the health care professionals can also address the patients personally with sympathy. They will help to design care for individual situation (Fraser & Rosina, 2017).  It will help the health professionals to better engage with the patents in decision-making. They can encourage honest communication and family support. Understanding the lifespan development will help in comprehensive treatment plan and instituting palliative care treatment plan. It is possible that CF child can have optimistic life despite CF and accomplish meaningful goals. Psychological adjustment can be achieved in these children by stimulating hopefulness and acceptance. In this situation, health care professionals play vital role in life of CF children.

Conclusion

The process inherent in psychosocial development is complicated by CF. A 12 year old child with CF focus more on treatment. Understanding human development can assist the health professionals to support the patients with CF. They can help the child to achieve meaningful goals despite CF.

References

Baltes, P. B., & Schaie, K. W. (Eds.). (2013). Life-span developmental psychology: Personality and socialization. Elsevier.

Berk, L. E. (2017). Exploring lifespan development. Pearson.

Cherry, K. (2015). Erikson’s psychosocial stages summary chart. About. com. Accessed July, 25.

Ernst, M. M., Johnson, M. C., & Stark, L. J. (2010). Developmental and psychosocial issues in cystic fibrosis. Child and adolescent psychiatric clinics of North America, 19(2), 263-283.

Fraser, J., & Rosina, R. (2017). Psychosocial development and response to illness. Paediatric Nursing in Australia: Principles for Practice, 55.

Linnemann, R. W., O’Malley, P. J., Friedman, D., Georgiopoulos, A. M., Buxton, D., Altstein, L. L., … & Moskowitz, S. M. (2016). Development and evaluation of a palliative care curriculum for cystic fibrosis healthcare providers. Journal of Cystic Fibrosis, 15(1), 90-95.

McLeod, S. (2013). Erik Erikson. Retrieved August, 9, 2013.

Mickley, K. L., Burkhart, P. V., & Sigler, A. N. (2013). Promoting normal development and self-efficacy in school-age children managing chronic conditions. Nursing Clinics, 48(2), 319-328.

Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health Sciences.

VanDevanter, D. R., Kahle, J. S., O’Sullivan, A. K., Sikirica, S., & Hodgkins, P. S. (2016). Cystic fibrosis in young children: a review of disease manifestation, progression, and response to early treatment. Journal of Cystic Fibrosis, 15(2), 147-157