Ch 22 Health promotion in young and middle-aged adults

Young Adults (Post adolescence to age 40)

Increasingly move away from families, establish career goals, select a life partner, and begin a family
Criteria for actual adulthood varies and must be taken into account with individual client's and families

Physical Development in the Young Adult

Usually complete physical growth by age 20
Active and experience severe illnesses less frequently
Often postpone healthcare when experiencing physical illnesses

Psychosocial Development in the Young Adult

Emotional health of the young adult is related to the individual's ability to address and resolve personal and social tasks
Caught between prolonging adolescence and accepting and assuming adult responsibilities
Basic developmental task is establishing in

Freud's Genital Stage

The young adult is in the genital stage in which energy is directed toward attaining a mature sexual relationship

Erikson's stage of development for young adults

Intimacy vs isolation

Havighurst's psychosocial development for the young adult

selecting a mate, learning to live with a partner, starting a family, rearing children, managing a home, getting started in an occupation, taking on civic responsibility, finding a congenial social group.

Cognitive Development in the Young Adult

Critical thinking habits increase steadily
Major task->identifying an occupational direction
Able to think abstractly and employ logic

Postformal thought

includes creativity, intuition, and the ability to consider information in relationship to other ideas; able to comprehend and balance arguments created by both logic and emotion

Moral Development in the Young Adult

Kohlberg-> Conventional level progressing to Post- conventional level
Young adults identify with established rule and authority and then move on to more individual moral values and principles

Principle Reasoning

Able to separate self from the expectations and rules of others and to define morality in terms of personal principles. Judging according to one's own principles.

Spiritual Development in the Young Adult

Fowler->the young adult enters a period of individual self reflection and further constructs their own idea of spirituality and reality (individuating-reflective period)
Values are accepted or redefined

Health Risks in Young Adulthood

Injuries
Suicide
Substance abuse
Hypertension
Sexually transmitted infections
Eating Disorders
Violence
Abuse
Malignancies

Leading cause of death in young adults

Suicide

Most prevalent STD

Chlamydia

Testicular Cancer

the most common neoplasm in men ages 15-35

Breast Cancer

the 2nd leading cause of cancer death in women, exceeded only by lung cancer

Early breast cancer activities

-Breast self exam as an option for women starting in their 20s
-Women in their 20s and 30s should have a clinical breast exam every 3 years. after 40, annually
-Women at high risk should get an MRI and mammogram every year

High risk factors for cervical cancer

sexual activity at an early age, Multiple sex partners, history of syphilis, herpes genitalis, or Trichomonas vaginitis

Middle-Aged Adults

Begins around age 40 and lasts to age 65
Stability and consolidation
Personal and career experiences have often already been experienced
Often are referred to as the "sandwich generation" because helping children and dealing with aging parents

Physical Development in the Middle-Aged Adult

Major physiological changes occur between 40-65 years of age
Changes begin in young adulthood and proceed and become more noticeable in the middle-aged adult
Most visual changes include graying of hair, weakening of skin, and thickening of waist
decline i

Physical Changes in Middle-aged adult

-Muscle bulk decreases by age 60; decrease in height by 1" due to thinning of intervertebral discs; Ca loss from bone common in postmenopausal women
-Blood vessels lose elasticity and thicken
-Presbyopia by late 40s; Presbycusis particularly in men; taste

Menopause

occurs when a woman hasn't had a period for 12 months; usually occurs sometime between 40-55, average is 47

Psychosocial Development in Middle-Aged Adult

-in the generativity vs stagnation phase of Erikson's stages of development.
Involves expected and unexpected events
Nurse will Want to assess sexuality, relationships, marriage and family, and care of the aging parent

Generativity

The concern for establishing and guiding the next generation. Generative individuals are able to feel a sense of comfort in their lifestyle and receive gratification from charitable endeavors

Havighurst's developmental tasks for the middle-aged adult

1.Achieving adult civic and social responsibility.
2.Establishing and maintaining an economic standard of living
3.Assisting teenage children to become responsible and happy adults
4. Developing adult leisure time activities
5. Relating oneself to one's s

Cognitive Development in the Middle-Aged Adult

Continue to learn and often have enhanced learning due to increased motivation
Should not have significant decline in cognitive function unless there is illness or trauma

Moral Development in the Middle-Aged Adult

Continues throughout adulthood
Still moving from a focus of rules, laws, and authority governing behavior to believing in the rights of others and equality justice and due process
-According to Kohlberg, the adult can move beyond the conventional level to

Spiritual Development in the Middle-Aged Adult

According to Fowler begin to see the truth from many different view points (Paradoxical-consolidative stage)
Often this group of people derive much comfort from spiritual beliefs especially when dealing with illness, death, and tragedy

Health Risks for the Middle- Aged Adult

Risk for developing a health problem is greater than in young adulthood
Injuries
Cancer (Leading cause of death in middle age)
Cardiovascular disease
Obesity
Alcoholism
Mental health alteration

Metabolic Syndrome

cluster of risk factors that increase the risk for cardiovascular disease: obesity with excessive abdominal fat, HT, high lipid levels, and insulin resistance