Nursing and Lifespan Health Case Study

Task Information: You are to read the case study provided and write an essay with the following elements that will explore the developmental stage of the Cameron Family as a whole and as individual members. The purpose of this assessment is to deepen your understanding of the different phases of change in people’s lives, and critically reflect on how various theorists and society view these phases of change throughout the lifespan. I received a Distinction for this case study.

Please note my writings are published for educational purposes only, all of my works have been submitted to Turnitin so please do not copy and paste or you will be flagged for plagiarism. My reference list is included at the bottom.

The purpose of this essay is to identify and understand the stages or lifecycles that both individuals and families experience throughout their life. To better understand how the different phases in a person’s life can affect their health outcomes, it is important to recognise at what stage they are at or entering into and identify the health concerns linked to that stage. It is also important to identify and understand what developmental tasks someone is undertaking, expected to experience or needs assistance with during each phase of their life. Erik Erickson believed that people progress through eight distinct stages of life, his theory was based around the psychosocial model and placed more weight upon the adult years of life, while Sigmund Freud’s theory of psychosexual stages consisted of five stages and gave more weight to pre puberty years. Freud believed that sexual energy and the existence of libido formed the unconscious basis of how an individual’s personality developed throughout their life. This essay will first discuss the Cameron family members’ stages of life as individuals, comparing each stage between Erikson and Freud. Then it will identify the developmental stage the Cameron family as a whole fall within. Discussion will then centre around the developmental tasks for the family as detailed by Evelyn Duvall’s theoretical model of family development, followed by the health concerns specific to the family and the implications to nursing practice. Finally, the family’s resilience factors will be considered to determine how they will deal with life in this stage of their lifecycle.

Michael and Jane are both in Erikson’s Stage 6 (Intimacy vs Isolation) (Sacco, 2013). From 19 – 40 years, gaining a confidence in one’s own identity during the previous adolescent years provides the basis for mature intimate relationships to develop during this stage (Beyers & Seiffge-Krenke, 2010). Erikson believed that being able to commit to another without fearing loss of ego is a fundamental task for young adults (Beyers & Seiffge-Krenke, 2010). Freud believed that in this stage of life, the Genital Stage, the reappearance of sexual feelings gradually matured from self-involved pleasure seeking behaviours to socialized adults oriented in reality and ready to procreate (Phillip, 2010).

Nathan at age 10 years is in Erikson’s Stage 4 (Industry vs Inferiority) (Sacco, 2013). In this stage (6 – 11 years) the main goal is to become self-motivated, enthusiastic and learn to work productively. Successfully attaining an industrious attitude results in feeling competent in one’s skills (Greene, Graham & Morano, 2010). Freud also believed that this stage sees children working towards competency and proving themselves, their sexuality entering into a latent phase as the child focuses more on learning how to behave socially (Phillip, 2010).

Millie at age 5 years is in Erikson’s Stage 3 (Initiative vs Guilt) (Sacco, 2013). Erikson’s third stage of development encompasses the preschool years (ages 3 – 5), alleging that it is in this stage that children begin to explore their environment through play (Greene, Graham & Morano, 2010). This play enables them to begin to discover themselves and what their purpose is through different activities (Greene, Graham & Morano, 2010). Freud believes that in this stage of a child’s development (Phallic Stage) the primary focus is genitalia, the development of sexual feelings with pleasurable play and understanding the difference between male and female (Phillip, 2010).

Melanie at age 18 months is entering into Erikson’s Stage 2 (Autonomy vs Shame) (Sacco, 2013). In this stage, toddlers are beginning to assert that they can do things on their own with little help, bringing a sense of controlling the self when successfully completed or feeling shame upon failure (Greene, Graham & Morano, 2010). Freud calls this the Anal Stage and believes that the approach to toilet training and a child’s first experience of regulating their own body influences how some personality traits are formed (Phillip, 2010).

Family developmental theory is derived from the typical attributes of family life, identifying stages of life cycles and providing a framework around which families can be assessed, understood and aided by health care workers (Friedman, Bowden & Jones, 2003). This identification helps to provide support for growth as a family and promote better health (Friedman, Bowden & Jones, 2003). Evelyn Duvall’s (1957) widely cited theory of family development proposes that families progress through eight distinct phases of development, or lifecycles. Each stage includes specific developmental tasks and health care concerns and is identified by the age of the eldest child if children are present.

The Cameron family consists of five family members in the immediate household, father and mother aged 31 and 30 years, and three children aged 10 years, 5 years and 18 months. As the eldest child is within the school age years, the Cameron family falls within Duvall’s Stage IV of two-parent nuclear lifecycle: families with school aged-children (Friedman, Bowden & Jones, 2003). This stage in the family lifecycle is often a busy one as children enter school, form friendships and begin to include extracurricular activities such as sports and dance, while parents also strive to maintain their own interests outside of children’s activities (Friedman, Bowden & Jones, 2003). There are three main developmental tasks in this stage. First, the socialisation of children, including the promotion of school achievements and encouraging healthy peer relations. Secondly, maintaining satisfaction within the marital relationship; and thirdly, meeting the physical health needs of the family members (Friedman, Bowden & Jones, 2003).

Developing social skills from an early age plays an important part in establishing successful relationships and fulfilling the social responsibilities that are expected throughout life (Arslan, Durmuşoğlu-Saltali & Yilmaz, 2011). Preschool years provide a significant opportunity to influence emotional development and aid in the evolution of a healthy personality (Arslan, Durmuşoğlu-Saltali & Yilmaz, 2011). These years can also be critical in identifying behavioural issues and addressing them so that they do not present serious problems as the child gets older (Arslan, Durmuşoğlu-Saltali & Yilmaz, 2011).

Extracurricular activities have been widely shown to improve social development and promote the ability to make healthy social relationships such as those between child and coach, making new friends and participating in team activities (Eime, Young, Harvey, Charity & Payne, 2013). All three of the Cameron children have had the opportunity for early peer socialisation through day care and preschool followed by extracurricular activities and seem to be well adjusted in this task development. Since the family’s move, the Cameron family have also expanded their social activities to include more community involvement.

During this stage in family life, parents who have developed or maintained their own interests outside of their children’s activities will find the growing independence of their children easier to cope with (Friedman, Bowden & Jones, 2003). Marital satisfaction within a couple in the child rearing years can be negatively affected by such issues as finances, the breakdown of household chores and disagreements on how to raise the children (Dillon & Beechler, 2010). Successful marriages most often require compromise from both parties (Dillon & Beechler, 2010). Dillon & Beechler (2010) also maintain that living apart from extended family, as the Camerons now do since moving, places more stress on the family and the marital relationship as they no longer have the same access to assistance with urgent childcare arrangements or parenting advice as they did before the move.

Among the health concerns linked to this stage in family developmental theory by Friedman, Bowden & Jones (2003) are several that are relevant to the Cameron family. These include health challenges to the children, dental health, communicable diseases, potential behaviour problems and good health practices (Friedman, Bowden & Jones, 2003). There is no indication present in the case study of substance abuse issues, child abuse, neglect or chronic conditions. As the Cameron children are aged between 18 months and 10 years, the main concerns to their health in this stage are the common childhood wellness checks including vision, hearing and speech, maintaining the recommended immunisation schedule and dental health.

The NSW Immunisation Schedule recommends children to be vaccinated as close as possible to the scheduled milestones in order to accord them the best protection (NSW Government Health, 2019). Melanie at 18 months old is at one of the ages scheduled for an immunisation. Immunisation can be provided by your GP, community health clinics, through school based programs, in some workplaces and some other medical services (Australian Department Government of Health, 2018). Though the importance of vaccinating is generally highly stressed, attitudes towards vaccines can vary for parents considering whether or not to vaccinate their children (Leask, Quinn, Macartney, Trent, Massey, Carr & Turahui, 2008). Health care professionals need to be able to confidently respond to parental concerns regarding the safety of vaccines as it is common for parents to seek advice from those in the health care profession first (Leask, Quinn, Macartney, Trent, Massey, Carr & Turahui, 2008).

During the first 4-5 years, a regular schedule of child health checks is recommended to monitor children’s growth progress and determine whether that progress is within the normal range as early detection can be very important to determining treatment if needed (NSW Government Health, 2018). These checks commonly include hearing, vision, weight, length and head circumference (NSW Government Health, 2018). It can also be helpful to discuss any behaviour concerns parents have with the health care professionals during these sessions (NSW Government Health, 2018).

Studies have shown that while tooth decay in children is common in Australian children, oral education from an early age can considerably lessen the instances of tooth caries (Australian Institute of Health and Welfare, 2012). The Australian Government offers a free dental health benefits scheme for all children between 2 – 17 years of age, utilising this scheme for regular dental maintenance and education on oral health will provide children with access to quality dental treatment from professionals (NSW Government Health, 2019). Additionally, promoting healthy behaviours regarding food choices and nutrition, exercise and sleep patterns has been shown to benefit long term health outcomes (World Health Organization, 2017). The World Health Organisation also recommends health care workers should council families and caregivers regarding nutrition and physical activity (World Health Organization, 2017).

Some of the factors that can promote resilience include emotional bonds with family members, healthy communication, feeling a sense of belonging, closeness, teamwork and connectedness (Meredith, Sherbourne, Gaillot, Hansell, Ritschard, Parker & Wrenn, 2011). The Cameron family have an active social life, regularly attending wider community events and participating in sports. Michael and Jane communicate well with each other, and extended family are still able to provide emotional support. The family has adapted well to the move and appear to be quite resilient to future challenges.

The evidence researched for this essay clearly shows that family development theories and individual developmental stages provide significant insight into how to improve health outcomes at different ages and stages of life. Identifying particular health concerns and investigating their implications on nursing practice aids health workers to provide the quality health care that each individual requires. Understanding the “larger picture” that is the family development stage and developmental tasks within, as well as family history, widens the understanding of resilience factors and how health concerns are dealt with. This essay has discussed Evelyn Duvall’s theoretical model of family development which details the development tasks and health concerns for families in different stages of life. Life stage theories of Erik Erikson and Sigmund Freud have been explored to gain knowledge into each family member’s individual stage of life and observe the core phases of each stage. The benefits of vaccinations to protect against preventable diseases, teaching and maintaining dental health and performing regular child health checks have been examined and considered for relevance to the Cameron family. The family’s resilience factors were analysed to determine how they have adapted to moving locations and how they are likely to deal with future challenges as they arise. In closing, identifying the specific family development stage as well as individual stages and the health care concerns connected to them enables health care professionals to tailor health care provision more precisely to individual needs, thereby providing the best quality care available.

References:
Arslan, E., Durmuşoğlu-Saltali, N., & Yilmaz, H. (2011). Social skills and emotional and behavioral traits of preschool children. Social Behavior and Personality: an international journal, 39, 1281-1287. http://dx.doi.org/10.2224/sbp.2011.39.9.1281
Australian Department Government of Health. (2018). Where can I get immunised? Retrieved from https://www.health.gov.au/health-topics/immunisation/about-immunisation/where-can-i-get-immunised
Australian Institute of Health and Welfare. (2012). Child Dental Health Survey Australia 2007: 30-year trends in child oral health. Canberra: AIHW. DOI: http://hdl.handle.net/2440/113144
Beyers, W., & Seiffge-Krenke, I. (2010). Does identity precede intimacy? Testing Erikson’s theory on romantic development in emerging adults of the 21st century. Journal of adolescent research, 25, 387-415. DOI: 10.1177/0743558410361370
Dillon, L. M., & Beechler, M. P. (2010). Marital satisfaction and the impact of children in collectivist cultures: A meta-analysis. Journal of Evolutionary Psychology, 8, 7-22. DOI: 10.1556/JEP.8.2010.1.3
Eime, R. M., Young, J. A., Harvey, J. T., Charity, M. J., & Payne, W. R. (2013). A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport. International journal of behavioral nutrition and physical activity, 10, 98. DOI: 10.1186/1479-5868-10-98
Friedman, M. M., Bowden, V. R. & Jones, E. (2003). Family nursing: research, theory & practice (5th ed., pp. 103-145). Upper Saddle River NJ: Prentice Hall.
Greene, R., Graham, S., & Morano, C. (2010). Erikson’s Healthy Personality, Societal Institutions, and Holocaust Survivors. Journal of Human Behavior in the Social Environment., 20, 489–506. https://doi.org/10.1080/10911350903275069
Leask, J., Quinn, H. E., Macartney, K., Trent, M., Massey, P., Carr, C., & Turahui, J. (2008). Immunisation attitudes, knowledge and practices of health professionals in regional NSW. Australian and New Zealand journal of public health, 32, 224-229. doi: 10.1111/j.1753-6405.2008.00220.x
Meredith, L. S., Sherbourne, C. D., Gaillot, S. J., Hansell, L., Ritschard, H. V., Parker, A. M., & Wrenn, G. (2011). Promoting psychological resilience in the US military. Rand health quarterly, 1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945176/
NSW Government Health. (2018). Child and family health: Frequently asked questions. Retrieved from https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/Pages/child-family-health-FAQs.aspx
NSW Government Health. (2019). Child Dental Benefits Schedule (CDBS). Retrieved from https://www.health.nsw.gov.au/oralhealth/Pages/child-dental-benefits-schedule.aspx
NSW Government Health. (2019). Key facts about immunisation. Retrieved from https://www.health.nsw.gov.au/immunisation/app/Pages/key-facts.aspx
Philip, T. (2010). Psychosexual Development: Freudian Concept. Introduction to Social Work, Indira Gandhi National Open University. Retrieved from https://pdfs.semanticscholar.org/c517/fce869c806850aa79d5df4c3bc157038b963.pdf
Sacco, R. G. (2013). Re-envisaging the eight developmental stages of Erik Erikson: the Fibonacci life-chart method (FLCM). Journal of Educational and Developmental Psychology, 3, 140-146. http://dx.doi.org/10.5539/jedp.v3n1p140
World Health Organization. (2017). Guideline: assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition. World Health Organization.

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