Applied Knowledge in Asthma Care - Essay Example

Erikson and Piaget: Applied Knowledge in Asthma Care Asthma is a chronic condition that needs to be managed well by the patients and those who care for them to prevent unfortunate events as a result of increased health risk status; or at the least, to avoid recurrent admissions to hospitals due to asthmatic attacks. These health care interventions may be applied effortlessly by those who are already cognitively mature. However, there are kinds of patients that health care providers must give special considerations. In this paper, the nursing care of a six-year old newly-diagnosed asthmatic child named Brianna will be considered using the developmental stages suggested by theorists Erik Erikson and Jean Piaget to make appropriate action care plan during her stay and as she leaves the hospital. According to Sadock (2007), Erik Erikson was an American psychoanalyst who was born in Germany and was the one who proposed the theory of psychosocial development. In his theory of eight stages, he emphasized the importance of social interactions and its effects on the psychological and psychosocial growth or decline of an individual. These stages are linked to two possible outcomes: a positive and a negative one. Erikson identified a certain crisis inherent to a specific stage. His stages divide into trust versus mistrust; autonomy versus shame and doubt; initiative versus guilt; industry versus inferiority; identity versus role confusion; intimacy versus isolation; generativity versus stagnation; and integrity versus despair—each of which are attached to a specific age range. The ability of the individual to succeed over these stage-specific tasks then determines the individual’s psychological and psychosocial maturity. Given with her age, it is decisive that Brianna belongs to the psychosocial stage where the conflict between initiatives versus guilt is at its peak. As stated by Rathus (2008), children at this stage learns to take initiatives by themselves to be able to learn from the things that they encounter day by day. Initially, Brianna’s nursing care plan must entail the thought that these children need to act independently (NIH, 1995, p. 25). Thus, they need and want to participate in their care. Nurses should allow this by letting the preschoolers do the manageable parts of the treatment process. When their attention is caught by something, they focus on these things; they do them with eagerness and show utmost interest. However, this focus easily fades as they have short attention span. Initiative-versus-guilt-stage belonging children also learn to imitate and impersonate what the older individuals do around them. They are curious and always want to discover the things of their surroundings (Rathus, 2008, p. 356); they experiment and take idea from the results of their actions and use them as they do things in the future. As an effective care provider, the nurse can take this curiosity as an opportunity to be able to get Brianna’s attention upon educating her and telling her about her condition and the things related to her care. The nurse can also effectively do so by role playing or demonstrating how things are done as these children learn fast by imitating what the elders around them do. If the nurse can make this possible, then Brianna will take interest; this can make her take initiatives in caring for herself even after she is released from the hospital care and without the presence of any health care professionals around. Dreeben (2010) added that the plays the children of this stage participate with are those that can enhance their leadership and following skills (p. 245). The specific developmental crisis of guilt occurs when the child sees the self as not being able to do specific things that he or she thinks he or she should have done. In another case, they also feel guilty if they perceive that the grown-ups are not satisfied with what they have done or are doing. Moreover, these children often times think that whatever misfortune that meets them are an effect of a responsibility not taken or not done well. This results to self-enforced penalties and self-denied pleasures (Nelissen & Zeelenberg, 2009). As an aid to prevent developmental crisis related to Erikson’s theory of psychosocial development and make Brianna free of any unreasonable guilt, on the other hand, the nurse can make her feel more comfortable and reinforce Brianna’s correct actions by praising her and telling her that she has done well. Jean Piaget’s cognitive development theory, nonetheless, is composed of four stages. The Swiss psychologist named these four stages as sensorimotor stage, preoperational stage, concrete operational stage and the formal operational stage. These stages, like Erikson’s, are assigned to certain age ranges. Davies and Janosik (1991) stated that Piaget had formulated these stages “to understand their intellectual and cognitive development” (p. 410). Still, according to Brianna’s age, the child can be classified as being part of the preoperational stage. Specifically, she belongs to the group with an “intuitive thought processes” (Weber & Kelley, 2009, p. 712). Having an intuitive thinking means that the child knows that something exists but cannot distinguish and cannot give a reason why it does. As Daniels (2004) spoke of it, the preoperational stage is the stage when children like Brianna have concrete thought processes. That is, children think of something as it is and cannot relate it with anything else. Because children of this age are not actually logically able to analyze things that come across their awareness, preschoolers like Brianna must be given the answer why there is a need of wearing the mask in direct and simple words. This can be done by saying that the purpose of any medicine or the facial mask is “to help with your cough or to help you breath” (NIH, 1995, p. 25). The nurses must also realize that it is indeed important that they receive explanations about the things that are being done on or around them. They too have to be informed why things happen and be reinforced of the fact that being sick is not the result of their doing. Moreover, a child like Brianna can already appreciate herself as a “separate entity with increased ability to communicate and socialize with others” (Daniels, 2004). This can basically be founded by these children’s focus on their selves or what is called “egocentricity” (Fisher & Lerner, 2005, p. 832). Although they are already able to mingle with others, they have this incapability of thinking things the way others do. It is advisable that the nurses and the parents allow the children like Brianna to see the truth about what she is going through by making them socialize with those children who are in the same position as they are. Despite their egocentric thoughts, these steps can allow Brianna and the others see that they are not along in going through the same phases they are currently suffering with. As provided by the Sparks and Taylor’s Nursing Diagnosis Reference Manual, this can “decrease the children’s feelings of isolation and sense of being different from others” (Ralph & Taylor, 2005, p. 296). Additionally, as curiosity shoots up, they frequently ask questions starting with “why.” Because of this, the children at this age are already more knowledgeable that makes them able to look forward to things on specific date or time by telling them how to count the days in the calendar. Brianna must also be taught of the timing of her medication by way of showing the calendar or the clock. As for having an easily distracted attention, the care providers must make sure that they give these children the most important information during their attentive times. This can be one way of making certain that the child gets the significant facts about his or her condition and the process of their care. If it is possible, it may be helpful to provide answers to her every question. Nurses and other medical providers should make sure that the children put under their care must receive the appropriate and effective tending that they need. Insightful as they should be, it is righteous that they must consider several important points that can assist them in doing so. In caring for an asthmatic patient like Brianna, caregivers and even parents must also realize the value of learning how children like her think, behave and manage themselves around things. Medical care must not only be the focus. Instead, focusing into their cognitive, psychological and psychosocial developmental stages is equally important since these will not only enable the nurses and other health care providers to provide medical care but also the psychological and the child’s needs in other aspects. References Daniels, R. (2004). Nursing fundamentals: caring & clinical decision making. Clifton Park, NY: Thomson Learning. Davies, J.L., & Janosik, E. H. (1991). Mental health and psychiatric nursing: a caring approach. Sudbury, MA: Jones & Bartlett Learning. Dreeben, O. (2010). Patient education in rehabilitation. Sudbury, MA: Jones & Bartlett Learning. Fisher, C. B, & Lerner R. M. (2005). Piaget, Jean. In Encyclopedia of applied developmental science (Vol. 2, p. 832). Thousands Oaks, CA: Sage Publications. National Institutes of Health. (1995, October). Nurses: partners in asthma care. Retrieved from http://www.nhlbi.nih.gov/health/prof/lung/asthma/nurs_gde.pdf Nelissen, R.M., & Zeelenberg, M. (2009, February) When guilt evokes self-punishment: evidence for the existence of a Dobby Effect [Abstract]. Emotion, 9 (11): 118-22. Ralph, S. S., & Taylor, C. M. (2005). Sparks and Taylor’s nursing diagnosis reference manual (6th ed.). Ambler, PA: Lippincott Williams & Wilkins. Rathus, S. A. (2008). Childhood and adolescence: voyages in development (3rd Ed.). Belmont, CA: Thomas Wadsworth. Sadock, B. (2007). Kaplan & Sadock’s sypnosis of psychiatry: behavioral sciences/clinical psychiatry (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Weber, J. R., & Kelley, J. (2009). Health assessment in nursing (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Read More