HUMAN GROWTH AND DEVELOPMENT - Principles of Health Sciences 1 – 1 - ثاني ثانوي

Link to digital lesson CHAPTER www.ien.edu.sa 7 HUMAN GROWTH AND DEVELOPMENT Science Case Study Investigation You are the nurse practitioner at the pediatric office where Noura and Abdullah take their baby boy, Ali, 18 months old, and his sister Sara, 4 yrs old, for routine health check-ups. The mother is concerned about Ali's inability to stand up on his feet, and he still prefers crawling. She also asks if it is OK for his age that he is not saying any words rather than only making tuneful babbles because his sister was able to say 'mama' at 8 months. At the end of the chapter you will be asked to compare Ali's case with the normal milestones for his age group. Why should Abdullah and Noura know about normal developmental milestones and how it would affect them taking care of their child? I LEARNING OBJECTIVES After completing this chapter, you should be able to: Identify at least two physical, mental, emotional, and social developments that occur during each of the seven main life stages. • Recognize ways that life stages affect an individual's needs. • Create examples for each of Maslow's Hierarchy of Needs. • Name the two main methods people use to meet or satisfy needs. • Create a situation that shows the use of each of the following defense mechanisms: rationalization, projection, displacement, compensation, daydreaming, repression, suppression, denial, and withdrawal. KEY TERMS affection growth puberty defense mechanisms esteem life stages safety needs self-actualization وزارة التعليم Ministry of 108aticCHAPTER 7 2022-1444 GE44.PATHWAYS.G02.S2.HLTH.SB.indb 108 14/10/2022 10:14

INTRODUCTION Human growth and development begins at birth and continues throughout an individual's lifetime. Growth refers to measurable physical changes that occur throughout a person's life, e.g. height, weight and body shape. Development refers to the changes in intellectual, mental, emotional, social, and functional skills that occur over time. Health care providers must be aware of these life stages and individual needs to provide quality health care (Figure 7-1). (A) 7:1 LIFE STAGES Although individuals differ greatly, each per- son passes through life stages of growth and development: Infancy: birth to 1 year. Early childhood: 1-6 years. Late childhood: 6-12 years. ⚫ Adolescence: 12-18 years. . Early adulthood: 19-40 years. . Middle adulthood: 40-65 years. ⚫ Late adulthood: 65 years and older. (B) FIGURE 7-1 An understanding of life stages is important for the health care provider, who may provide care to individuals of all ages, from the very young (A) to the elderly (B). As individuals pass through these life stages, four main types of growth and development occur: physical, mental or cognitive, emotional, and social. Physical refers to body growth and includes height and weight changes, muscle and nerve development, and changes in body organs. Mental or cognitive refers to intellectual development and includes learning how to solve problems, make judgments, and deal with situations. Emotional refers to feelings and includes dealing with love, hate, joy, fear, excitement, and other similar feelings. Social refers to interactions and relationships with other people. Relationships with family, friends, and peers affect our emotional and physical health. وزارة التعليم Ming Education 2022 1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 109 HUMAN GROWTH AND DEVELOPMENT 109 | 14/10/2022 10:14

وزارة التعليم Mine 110 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02.S2.HLTH.SB.indb 110 INFANCY Physical Development The most dramatic and rapid changes in growth and development occur during the first year of life. A newborn baby weighs approximately 2.7-3.6 kg (6-8 lbs) and measures 46-55 cm (18-22 inches) in length (Figure 7-2). By the end of the first year of life, weight has usually tripled to 9.5-11 kg (21-24 lb), and height has increased to approximately 74-76 cm (29-30 inches). At birth, the muscular and nervous systems are very immature and include reflex actions which allow the infant to respond to the environment, like the Moro reflex (startle), the rooting reflex (turning the mouth to the cheek), the sucking reflex (response to a slight touch on the lips) and the grasp reflex (holding an object in the hand) (Figure 7-3). Muscle coordination develops in stages from lifting of the head slightly at birth to walking without assistance, grasping objects with the thumb and fingers, and throwing small objects at the age of 12 months. Most infants have four to eight teeth by the end of the first year of life and have developed good vision with the ability to focus on small objects. Sensory abilities such as smell, taste, and hearing are also more refined. Mental Development Mental development is also rapid during the first year. Newborns respond to discomforts such as pain, cold, or hunger by crying. As their needs are met, they gradually become more aware of their surroundings and begin to recognize individuals associated with their care. As infants respond to stim- uli in the environment, learning activities grow. At birth, they are unable to speak. By 2-4 months, they coo or babble when spoken to, laugh out loud, and FIGURE 7-2 A newborn baby usually weighs approximately 2.7-3.6 kg and mea- sures 46-55 cm in length. 14/10/2022 10:14

(A) (B) (C) (D) FIGURE 7-3 Some reflex actions an infant has at birth include (A) rooting, (B) suck- ing, (C) grasp, and (D) Moro. squeal with pleasure. By 6 months of age, infants understand some words and can make basic sounds, such as "mama" and "baba." By 12 months, infants understand many words and use single words in their vocabularies. Emotional Development Emotional development is observed early in life. Newborns show excitement. By 4-6 months of age, distress, delight, anger, disgust, and fear can often be seen. By 12 months of age, elation and affection for family and caregivers is evident. Events and relationships that occur in the first year of life when these emotions are first exhibited can have a strong influence on an individual's emotional behavior during adulthood. Social Development Social development progresses gradually from the self-centeredness concept of the newborn to the recognition of others in the environment. By 4 months وزارة التعليم Minister Education 2022-1444 HUMAN GROWTH AND DEVELOPMENT 111 | GE44.PATHWAYS.G02.S2.HLTH.SB.indb 111 14/10/2022 10:14

وزارة التعليم Mines 112CHAPTER 7 2022 1444 GE44.PATHWAYS.G02.S2.HLTH SB.indb 112 FIGURE 7-4 By 4 months of age, infants recognize their caregivers and stare intently at others. of age, infants recognize their caregivers, smile readily, and stare intently at others (Figure 7-4). By 6 months of age, infants watch the activities of others, show signs of possessiveness, and may become shy or withdraw when in the presence of strangers. By 12 months of age, infants may still be shy with strangers, but they socialize freely with familiar people, and mimic and imitate gestures, facial expressions, and vocal sounds. Needs and Care Infants are dependent on others for all needs. Food, cleanliness, and rest are essential for physical growth. Love and security are essential for emotional and social growth. Stimulation is essential for mental growth. While caring for infants, a health care provider should give the parents or guardians support and reassurance and involve them in the infant's care. Promoting these positive relationships will ensure the appropriate amount of stimulation for infant development in physical and emotional ways. Providing information on nutrition, growth, development, sleep patterns, meeting needs, and creating a healthy environment will promote wellness in the infant. Care must be taken at all times to ensure the infant's safety. Preventing the trans- mission of infection by washing hands thoroughly and observing standard precautions is also essential during care. EARLY CHILDHOOD Physical Development During early childhood, from 1-6 years of age, physical growth is slower than during infancy. By age 6, the average weight is 20.4 kg (45 lb), and the average height is 116 cm (46 inches). Skeletal and muscle development helps the child 14/10/2022 10:14

assume a more adult appearance. The legs and lower body tend to grow more rapidly than do the head, arms, and chest. Muscle coordination allows the child to run, climb, and move freely. As muscles of the fingers develop, the child learns to write, draw, and use a fork and knife. By age 2 or 3, most pri- mary teeth have erupted, and the digestive system is mature enough to handle most adult foods. Between 2 and 4 years of age, most children learn bladder and bowel control. Mental Development Mental development advances rapidly during early childhood. Verbal growth progresses from the use of several words at age 1 to a vocabulary of 1,500-2,500 words at age 6. Two-year-olds have short attention spans but are interested in many different activities (Figure 7-5). They can remember details and begin to understand concepts. Four-year-olds ask fre- quent questions and usually recognize letters and some words. They begin to make decisions based on logic rather than on trial and error. By age 6, children are very verbal and want to learn how to read and write. Memory has developed to the point where the child can make decisions based on both past and present experiences. Emotional Development Emotional development also advances rapidly. At ages 1-2, children begin to develop self-awareness and to recognize the effect they have on other peo- ple and things. Limits are usually established for safety, leading the 1- or 2-year-old to either accept or defy such limits. By age 2, most children begin to gain self-confidence and are enthusiastic about learning new things (Figure 7-6). However, chil- dren can feel impatient and frustrated as they try to do things beyond their abilities. Anger, often in the form of "temper tantrums," occurs when they can- not perform as desired. Children at this age also like routine and become stubborn, angry, or frustrated when changes occur. From ages 4-6, children begin to gain more control over their emotions. They understand the concept of right and wrong, and because they have achieved more independence, they are not frustrated as much by their lack of abil- ity. By age 6, most children also show less anxiety when faced with new experiences because they have learned they can deal with new situations. وزارة التعليم Ministry of EductION 2022-1444 FIGURE 7-5 One- to 2-year-olds are interested in many different activities, but they have short attention spans. FIGURE 7-6 By age 2, most children begin to gain some self-confidence and are enthusiastic about learning new things. HUMAN GROWTH AND DEVELOPMENT 113 | GE44.PATHWAYS.G02.S2.HLTH SB.indb 113 14/10/2022 10:14

FIGURE 7-7 Playing alongside and with other chil- dren allows preschoolers to learn how to interact with others. Needs and Care Social Development Social development expands from a self-centered (egocentric) 1-year-old to a sociable 6-year-old. In the early years, children are usually strongly attached to their parents (or to the individuals who provide their care), and they fear any separation. They begin to enjoy the company of others, but are still very possessive. Playing alongside other children is more common than playing with other children (Figure 7-7). Gradually, children learn to put "self" aside and begin to take more of an interest in others. They learn to trust other people and make more of an effort to please others by becoming more agreeable and social. Friends of their own age are usually important to 6-year-olds. The needs of early childhood still include food, rest, shelter, protection, love, and security. In addition, children need routine, order, and consistency in their daily lives. They must be taught to be responsible and must learn how to conform to rules. This can be accomplished by making reasonable demands based on the child's ability to comply. While caring for toddlers, a health care provider must be sensitive to the child's fears and anxiety when dealing with strangers. Enlisting the help of parents or guardians, using a calm but firm approach, establishing rapport with the child, using play to alleviate fear, providing simple explanations to gain cooperation, allowing the child to participate in care by providing one or two choices, and reassuring the child are all ways to make care easier. Building these positive family relationships allows the child to develop self-control and participate fully in the larger community. After a painful procedure, it is essential to comfort the child. At all times, it is important to maintain a safe environment and prevent the transmission of infection. LATE CHILDHOOD Physical Development The late childhood life stage, which covers the ages of 6-12, is also called preadolescence. Physical development is slow but steady. Weight gain averages 2.3-3.2 kg (4-7 pounds) per year, and height usually increases approximately 5-7.5 cm (2-3 inches) per year. Muscle coordination is well developed, and children can engage in physical activities that require complex motor-sensory coordination. During this age, most of the primary teeth are lost, and perma- nent teeth erupt. The eyes are well developed, and visual acuity is at its best. During ages 10-12, secondary sexual characteristics begin to develop in some children. وزارة التعليم Minis 114 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 114 14/10/2022 10:14

Mental Development Mental development increases rapidly because much of the child's life centers around school. Speech skills develop more completely, and reading and writing skills are learned. Children learn to use information to solve problems, and the memory becomes more complex. They begin to understand more abstract concepts such as loyalty, honesty, val- ues, and morals. Children use more active thinking and become more adept at making judgments. Emotional Development Emotional development continues to help the child fears and gain self-confidence. achieve a greater independence and a more distinct FIGURE 7-8 Role-playing allows a child to control personality. At age 6, children are often frightened and uncertain as they begin school. Reassuring parents and success in school help children gain self-confidence. Role-playing also allows a child to control fears and gain self-confidence (Figure 7-8). Gradually, fears are replaced by the ability to cope. Emotions are slowly brought under control and dealt with in a more effective manner. By ages 10-12, sexual maturation and changes in body functions can lead to periods of depression followed by periods of joy. These emotional changes can cause children to be restless, anxious, and difficult to understand. Social Development Social changes are evident during these years. Seven-year-olds tend to like activities they can do by themselves and do not usually like group activities. However, they want the approval of others, especially their parents and friends. Toward the end of this period, children tend to make friends more easily, and they begin to develop relationships with others. As these relationships develop, a sense of being part of a wider community develops. Needs and Care Needs of children in this age group include the same basic needs of infancy and early childhood, together with the need for reassurance, parental approval, and peer acceptance. Hopefully, family relationships have been built to sup- port the child. Because this age group is prone to accidents and minor infections, health care providers must stress safety and healthy living principles. Information should be provided about nutrition, personal hygiene, sleep patterns, exercise, dental hygiene, preventing infection, and puberty. وزارة التعليم Mingo EducTION 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 115 HUMAN GROWTH AND DEVELOPMENT 115 14/10/2022 10:14

ADOLESCENCE Physical Development Adolescence, ages 12 to 18, is often a traumatic life stage. Physical changes occur most dramatically in the early period. A sudden "growth spurt" can cause rapid increases in weight and height. A weight gain of up to 11 kg (25 pounds) and a height increase of several centimeters can occur in a period of months. Muscle coordination does not advance as quickly. This can lead to awkwardness or clumsiness in motor coordination. This growth spurt usually occurs anywhere from ages 11 to 13 in girls and ages 13 to 15 in boys. The most obvious physical changes in adolescents relate to the development of the sexual organs and secondary sexual characteristics, frequently called puberty. Secretion of sex hormones leads to the onset of menstruation in girls and the production of seminal fluid in boys. Secondary sexual characteristics in females include growth of pubic hair, development of breasts and wider hips, and distribution of body fat leading to the female shape. The male develops a deeper voice; attains more muscle mass and broader shoulders; and grows pubic, facial, and body hair. Mental Development Since most of the foundations have already been established, mental develop- ment primarily involves an increase in knowledge and a sharpening of skills. Adolescents learn to make decisions and to accept responsibility for their actions. At times, this causes conflict because they are treated as both children and adults, or are told to "grow up" while being reminded that they are "still children." FIGURE 7-9 Adolescents use the peer group as a safety net as they try to establish their identities and independence. Emotional Development Emotional development is often stormy and con- flicted. As adolescents try to establish their iden- tities and independence, they are often uncertain and feel inadequate and insecure. They worry about their appearance, their abilities, and their relationships with others. They frequently respond more and more to peer group influences. At times, this leads to changes in attitude and behavior and conflict with values previously established via fam- ily relationships. Toward the end of adolescence, self-identity has been established. At this point, teenagers feel more comfortable with who they are and turn attention toward what they may become. They gain more control of their feelings and become more mature emotionally. وزارة التعليم Mines 116 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02 S2.HLTH SB.indb 116 14/10/2022 10:14

Social Development Social development usually involves spending less time with family and more time with peer groups. As adolescents attempt to develop self-identity and independence, they seek security in groups of people their own age who have similar problems and conflicts (Figure 7-9). If these peer relationships help develop self-confidence through the approval of others, adolescents become more secure and satisfied. Peer relationships that are considerate and support- ive allow the adolescent to have more confidence in their choices. Toward the end of this life stage, adolescents develop a more mature attitude and begin to develop patterns of behavior that they associate with adult behavior or status. Needs and Care In addition to basic needs, adolescents need reassurance, support, and under- standing. Many problems that develop during this life stage can be traced to the conflict and feelings of inadequacy and insecurity that adolescents expe- rience. Examples include eating disorders and smoking. Even though these types of problems also occur in earlier and later life stages, they are frequently associated with adolescence. Eating disorders often develop from an excessive concern with appearance. Three common eating disorders are anorexia nervosa, bulimia, and bulimar- exia. All three conditions are more common in female than male individuals. Psychological or psychiatric help is usually needed to treat these conditions. Because of the many conflicts adolescents experience, health care provid- ers must be nonjudgmental to establish rapport while providing care. It is essential to listen to the adolescent's concerns, be sensitive to their nonverbal behavior, involve them in decision making, and answer questions as honestly and completely as possible. It is also important to provide education about hygiene, nutrition, developmental changes, and substance abuse. Encouraging and upbeat relationships between peers, family, and friends not only impacts the individuals' physical and emotional health but promotes healthy rela- tionships with the entire community as the adoles- cent moves into adulthood. EARLY ADULTHOOD Physical Development Early adulthood, ages 19-40, is frequently the most productive life stage. Physical development is basi- cally complete, muscles are developed and strong, and motor coordination is at its peak. This is also the prime child-bearing time and usually produces the healthiest babies (Figure 7-10). Both male and female sexual development is at its peak. وزارة التعليم Ministry of Eduction 2022 1444 FIGURE 7-10 Early adulthood is the prime childbear- ing time and usually produces the healthiest babies. HUMAN GROWTH AND DEVELOPMENT 117 | GE44.PATHWAYS.G02.S2.HLTH.SB.indb 117 14/10/2022 10:14

وزارة التعليم Minst 118 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 118 Mental Development Mental development usually continues throughout this stage. Many young adults pursue additional education to establish and progress in their chosen careers. Frequently, formal education continues for many years. Emotional Development Emotional development usually involves preserving the stability established during previous stages. Young adults are subjected to many emotional stresses related to career, marriage, family, and other similar situations. If emotional structure is strong, most young adults can cope with these worries. They find satisfaction in their achievements, take responsibility for their actions, and learn to accept criticism and to profit from mistakes. Social Development Social development frequently involves moving away from the peer group. Instead, young adults tend to associate with others who have similar ambi- tions and interests, regardless of age. Needs and Care Needs of early adulthood include the same basic needs as other age groups. In addition, young adults need independence, social acceptance, self-confidence, and reassurance. MIDDLE ADULTHOOD Physical Development Middle adulthood, ages 40-65, is frequently called middle age. Physical changes begin to occur during these years. The hair tends to gray and thin, the skin begins to wrinkle, muscle tone tends to decrease, hearing loss starts, visual acuity declines, and weight gain occurs. Women experience menopause, or the end of menstruation, along with decreased hormone production that causes physical and emotional changes. Men also experience a slowing of hormone production. This can lead to physical and psychological changes, a period fre- quently referred to as the male climacteric. Mental Development Mental ability can continue to increase during middle age, a fact that has been proved by the many individuals in this life stage who seek formal education. Middle adulthood is a period when individuals have acquired an understand- ing of life and have learned to cope with many different stresses. This allows them to be more confident in making decisions and to excel at analyzing situations. 14/10/2022 10:14

Emotional Development Emotionally, middle age can be a period of con- tentment and satisfaction, or it can be a time of cri- sis. The emotional foundation of previous life stages and the situations that occur during middle age determine emotional status during this period. Job stability, financial success, the end of child rearing, and good health can all contribute to emotional satisfaction (Figure 7-11). Stress-created by loss of job, fear of aging, loss of youth and vitality, ill- ness, marital problems, problems with children, or aging parents-can contribute to emotional feel- ings of depression, insecurity, anxiety, and even anger. Therefore, emotional status varies in this age group and is largely determined by events that occur during this period. Social Development FIGURE 7-11 Job stability and enjoyment during middle adulthood contribute to emotional satisfaction. Social relationships also depend on many factors. Relationships between husband and wife can become stronger as they have more time together and opportunities to enjoy success. Needs and Care Needs of middle adulthood include the same basic needs as other age groups. In addition, these individuals need self-satisfaction, a sense of accomplish- ment, autonomy, and supportive social relationships. Peer and friend relation- ships continue to be important as these adults establish a healthy role in their community. Health care providers must encourage middle-aged adults to identify risk factors to their health status and to make changes to promote wellness. Increasing exercise, improving nutrition, avoiding obesity, quitting smoking, and other similar actions can improve health status and increase longevity. LATE ADULTHOOD Physical Development Late adulthood, age 65 and older, has many different terms associated with it. These include "elderly," "senior citizen," "golden ager," and "retired citizen." Physical development is on the decline. All body systems are usually affected. The skin becomes dry, wrinkled, and thinner. Brown or yellow spots (frequently called "age spots") appear. The hair becomes thin and frequently loses its luster or shine. Bones become brittle and porous and are more likely to fracture or break. Cartilage between the vertebrae thins and can lead to a stooping posture. Muscles lose tone and strength, which can lead to fatigue and ::poor coordination. A decline in the function of the nervous system leads to وزارة التعليم Minique Education 2022-1444 HUMAN GROWTH AND DEVELOPMENT 119 | GE44.PATHWAYS.G02 S2.HLTH SB.indb 119 14/10/2022 10:14

FIGURE 7-12 Elderly individuals who remain men- tally active show fewer signs of decreased mental ability. hearing loss, decreased visual acuity, and decreased tolerance for temperatures that are too hot or too cold. Memory loss can occur, and reasoning ability can diminish. The heart is less efficient, and circu- lation decreases. The kidney and bladder are less efficient. Breathing capacity decreases and causes shortness of breath. However, it is important to note that these changes usually occur slowly over a long period. Many individuals, because of better health and living conditions, do not show physical changes of aging until their 70s and even 80s. Mental Development Mental abilities vary among individuals. Elderly people who remain mentally active and are will- ing to learn new things tend to show fewer signs of decreased mental ability (Figure 7-12). Although some 90-year-olds remain alert and well oriented, other elderly individuals show decreased mental capacities at much earlier ages. Short-term memory is usually first to decline. Many elderly individuals can clearly remember events that occurred 20 years ago but do not remember yesterday's events. Diseases such as Alzheimer's disease can lead to irreversible loss of memory, deterioration of intellectual functions, speech and gait disturbances, and disorientation. Arteriosclerosis, a thickening and hardening of the walls of the arteries, can also decrease the blood supply to the brain and cause a decrease in mental abilities. Emotional Development Emotional stability also varies among individuals in this age group. Some elderly people cope well with the stresses presented by aging and remain happy and able to enjoy life. Others become lonely, frustrated, withdrawn, and depressed. Emotional adjustment is necessary throughout this cycle. Retirement, death of a spouse and friends, physical disabilities, financial problems, loss of independence, and knowledge that life must end can all cause emotional distress. The adjustments that the individual makes during this life stage are similar to those made throughout life. Social Development Social adjustment also occurs during late adulthood. Retirement can lead to a loss of self-esteem, especially if work is strongly associated with self worth. Less contact with team members and a more limited circle of friends usually occur. Many elderly adults engage in other activities and continue to make new social contacts. Others limit their social relationships. Death of a spouse and friends and moving to a new environment can also cause changes in social relationships. Development of new social contacts is important at this time. وزارة التعليم Minist 120 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02 S2.HLTH SB.indb 120 14/10/2022 10:14

Needs and Care Needs of this life stage are the same as those of all other life stages. In addition to basic needs, the elderly need a sense of belonging, self-esteem, financial security, social acceptance, and love. While caring for older adults, health care providers must use a nonjudg- mental, supportive approach. Encourage them to talk; allow them as much independence as possible; recognize achievements they have accomplished; provide required health care information as illnesses occur; help them adjust and adapt to physical and mental changes; allow them to express fears and regrets, but remind them of positive accomplishments; and help them find support systems and social networks. checkpoint 1. What are the seven (7) main life stages? 2. Identify two (2) physical, mental, emotional, and social developments that occur during each of the life stages. 7:2 HUMAN NEEDS Needs are frequently defined as "a lack of something that is required or desired." From the moment of birth, every human being has needs. Needs motivate the individual to behave or act so that these needs will be met, if at all possible. Certain needs have priority over other needs. For example, at times a need for food may take priority over a need for social approval, or the approval of others. If individuals have been without food for a period of time, they will direct most of their actions toward obtaining food. Even though they want social approval and the respect of others, they may steal for food, knowing that stealing may cause a loss of social approval or respect. MASLOW'S HIERARCHY OF NEEDS Abraham Maslow, a noted psychologist, developed a hierarchy of needs (Figure 7-13). According to Maslow, the lower needs should be met before an individual can strive to meet higher needs. Only when satisfaction has been obtained at one level is an individual motivated toward meeting needs at a higher level. The levels of needs include physiological needs, safety, affection, esteem, and self-actualization. وزارة التعليم Ministry of Education 2022 1444 GE44.PATHWAYS.G02.S2.HLTH SB.indb 121 HUMAN GROWTH AND DEVELOPMENT 121 | 14/10/2022 10:14

وزارة التعليم Minst 122 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 122 Self-Actualization Obtain full potential. confident, self-secure Esteem Self-respect, have approval of others Love and affection Feel sense of belonging. can give and receive friendship and love Safety and security Free from fear and anxiety, feel secure in the environment Physiological needs Food, water, oxygen, elimination of waste, protection from temperature extremes, sleep FIGURE 7-13 Maslow's Hierarchy of Needs: The lower needs should be met before the individual can try to meet higher needs. Physiological Needs Physiological needs are often called "physical," "biological," or "basic" needs. These needs are required by every human being to sustain life. They include food, water, oxygen, elimination of waste materials, sleep, and protection from extreme temperatures. These needs must be met for life to continue. If any of these needs goes unmet, death will occur. Even among these needs, a priority exists. For example, because lack of oxygen will cause death in a matter of minutes, the need for oxygen has priority over the need for food. A patient with severe lung disease who is gasping for every breath will not be concerned with food intake. This individual's main concern will be to obtain enough oxygen to live through the next minute. Safety Safety becomes important when physiological needs have been met. Safety needs include the need to be free from anxiety and fear, and the need to feel secure in the environment. The need for order and routine is another example of an individual's effort to remain safe and secure. Individuals often prefer the familiar over the unknown. New environments, a change in routine, marital problems, job loss, injury, disease, and other similar events can threaten an individual's safety. 14/10/2022 10:14

Love and Affection The need for love and affection, a warm and tender feeling for another person, occupies the third level of Maslow's Hierarchy of Needs. When an individ- ual feels safe and secure, and after all physiological needs have been met, the individual next strives for social acceptance, friendship, and to be loved. The need to belong, to relate to others, and to win approval of others motivates an individual's actions at this point. The individual may now attend a social function that was avoided when safety was more of a priority. Individuals who feel safe and secure are more willing to accept and adapt to change and are more willing to face unknown situations. The need for love and affection is satisfied when friends are made, social contacts are established, acceptance by others is received, and the individual is able to both give and receive affection and love (Figure 7-14). Esteem FIGURE 7-14 Individuals of all ages need love and affection. Maslow's fourth level includes the need for esteem. Esteem includes feeling important and worthwhile. When others show respect, approval, and appreci- ation, an individual begins to feel esteem and gains self-respect. The self-con- cept-or beliefs, values, and feelings people have about themselves—becomes positive. Individuals will engage in activities that bring achievement, success, and recognition in an effort to maintain their need for esteem. Failure in an activity can cause a loss of confidence and lack of esteem. When esteem needs are met, individuals gain confidence in themselves and begin to direct their actions toward becoming what they want to be. Self-Actualization Self-actualization, frequently called self-realization, is the final need in Maslow's hierarchy. All other needs must be met, at least in part, before self-ac- tualization can occur. Self-actualization means that people have obtained their full potentials, or that they are what they want to be. People at this level are autonomous, confident, and willing to express their beliefs and stick to them. They feel so strongly about themselves that they are willing to reach out to others to provide assistance and support. MEETING NEEDS When needs are felt, individuals are motivated (stimulated) to act. If the action is successful and the need is met, satisfaction, or a feeling of pleasure or fulfill- ment, occurs. If the need is not met, tension, or frustration, an uncomfortable inner sensation or feeling, occurs. Several needs can be felt at the same time, so individuals must decide which needs are stronger. For example, if individuals وزارة التعليم Minister Education 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 123 HUMAN GROWTH AND DEVELOPMENT 123 14/10/2022 10:14

وزارة التعليم Minst 124 CHAPTER 7 2022 1444 GE44.PATHWAYS.G02.S2.HLTH.SB.indb 124 need both food and sleep, they must decide which need is most important, because an individual cannot eat and sleep at the same time. METHODS OF SATISFYING HUMAN NEEDS Needs can be satisfied by direct or indirect methods. Direct methods work at meeting the need and obtaining satisfaction. Indirect methods work at reducing the need or relieving the tension and frustration created by the unmet need. Direct Methods Direct methods include: . Hard work. ⚫ Realistic goals. . ⚫ Situation evaluation. Cooperation with others. All these methods are directed toward meeting the need. Students who con- stantly fail tests but who want to pass a course have a need for success. They can work harder by listening more in class, asking questions on points they do not understand. They can set realistic goals that will allow them to find success. By working on one aspect of the course at a time, by planning to study a little each night rather than studying only the night before a test, they can establish goals they can achieve. They can evaluate the situation to determine why they are failing and to try to find other ways to pass the course. They can cooperate with others. By asking the teacher to provide extra assistance, or by having a tutor provide extra help, they may learn the material, pass the tests, and achieve satisfaction by meeting their need. Indirect Methods Indirect methods of dealing with needs usually reduce the need and help relieve the tension created by the unmet need. The need is still present, but its intensity decreases. Defense mechanisms, unconscious acts that help a per- son deal with an unpleasant situation or socially unacceptable behavior, are the main indirect methods used. Some use of defense mechanisms is helpful because it allows individuals to cope with certain situations. However, defense mechanisms can be unhealthy if they are used all the time and individuals substitute them for more effective ways of dealing with situations. Examples of defense mechanisms include: ⚫ Rationalization: This involves using a reasonable excuse or acceptable explanation for behavior to avoid the real reason or true motivation. ⚫ Projection: This involves placing the blame for one's own actions or inadequacies on someone else or on circumstances rather than accepting responsibility for the actions. 14/10/2022 10:14

⚫ Displacement: This involves transferring feelings about one person to someone else. Displacement usually occurs because individuals cannot direct the feelings toward the person who is responsible. ⚫ Compensation: This involves the substitution of one goal for another goal to achieve success. If a substitute goal meets needs, this can be a healthy defense mechanism. ⚫ Daydreaming: This is a dreamlike thought process that occurs when a person is awake. Daydreaming provides a means of escape when a person is not satisfied with reality. Repression: This involves the transfer of unacceptable or painful ideas, feelings, and thoughts into the unconscious mind. An individual is not aware that this is occurring. When feelings or emotions become too pain- ful or frightening for the mind to deal with, repression allows the individ- ual to continue functioning and to "forget" the fear or feeling. Repressed feelings do not vanish, however. They can resurface in dreams or affect behavior. ⚫ Suppression: This is similar to repression, but the individual is aware of the unacceptable feelings or thoughts and refuses to deal with them. The individual may substitute work, a hobby, or a project to avoid the situation. ⚫ Regression: This involves retreating to a previous developmental level that provided more safety and security than the current level an individual is experiencing. Denial: This involves disbelief of an event or idea that is too frightening or shocking for a person to cope with. Often, an individual is not aware that denial is occurring. ⚫ Withdrawal: There are two main ways with- drawal can occur: individuals can either cease to communicate or remove themselves physi- cally from a situation. Withdrawal is sometimes a satisfactory means of avoiding conflict or an unhappy situation. At times, however, interper- sonal conflict cannot be avoided (Figure 7-15). In these cases, an open and honest communica- tion with the individual may lead to improved understanding in the relationship. checkpoint FIGURE 7-15 At times interpersonal conflict cannot be avoided What are the two (2) main methods people use to meet or satisfy needs? وزارة التعليم Minister Eduction 2022-1444 GE44.PATHWAYS.G02 S2.HLTH SB.indb 125 HUMAN GROWTH AND DEVELOPMENT 125 14/10/2022 10:14

Case Study Investigation Conclusion What are the normal milestones that should be achieved by Ali's age group? What is the importance of early detection of growth and developmental delay? Today's Research Tomorrow's Health Care A Microchip to Cure Diabetic Retinopathy? Diabetes mellitus is a chronic disease caused by a decreased secretion of or abnormal response to insulin, a hormone that is needed by body cells to absorb glucose (sugar) from the blood. According to the General Authority for Statistics in Saudi Arabia, approximately 3.3 million or 10.1 percent of the people in the Kingdom have diabetes. A common complication of diabetes is diabetic retinopathy, a disorder of the retina, or nerve- sensitive layer of the eye that provides vision. Diabetic retinopathy affects approximately 36 percent of people with diabetes and is the leading cause of blindness among working-age people. Treatment for diabetic retinopathy has its limitations. Laser therapy is used, but it can cause diminished peripheral (side) and night vision and cause laser burns that damage the eyes. A cancer drug, docetaxel, is effective, but the high dosages required to produce the desired effect cause toxic damage to other tissues in the body. Now a team of researchers in Canada has created a microelectromechanical system, commonly called a "MEMS," that can be implanted behind the eyes to release docetaxel on command using an external magnet. The team made the device from a reservoir loaded with docetaxel, sealed in place with an elastic magnetic membrane. By applying a magnetic field, the team was able to trigger the release of a specific amount of docetaxel into the back of the eye, similar to a squirt bottle. Many other researchers are trying to develop MEMS to treat specific diseases. Some researchers are evaluating MEMS that secrete blood-clotting factors for individuals with hemophilia. Others are trying to develop MEMS that will carry dopamine to treat Parkinson's disease. Think of a future in which tiny capsules floating or implanted in the body will cure chronic diseases and allow individuals to live long and healthy lives. وزارة التعليم Minst 126 CHAPTER 7 2022-1444 GE44.PATHWAYS.G02.S2.HLTH.SB.indb 126 14/10/2022 10:14