This document discusses several concepts related to human growth and development: - It defines growth as a physical increase in body size through cell multiplication or enlargement, while development refers to ongoing changes in body structure, physiology, psychology, and cognition throughout life. - Several theories of development are summarized, including Freud's psychosexual stages, Erikson's psychosocial stages, Piaget's cognitive development stages, and Kohlberg's stages of moral development. - The document also discusses homeostasis, the body's ability to maintain stable internal conditions through feedback mechanisms like negative feedback regulation of temperature and osmoregulation of fluid balance. Maintaining homeostasis is essential for proper cellular functioning.

1. LIFE PROCESS
HOMEOSTATIC MECHANISM
BIOLOGICAL AND PSYCHOLOGICAL
DYNAMICS IN CAUSATION OF DISEASE
LIFESTYLE DISEASES

3. INTRODUCTION
•From infancy through old age,human beings
encounter new and challenging life changes
•An understanding of how people develop at various
stages of life influences nursing practice
•Clients’ state of wellness and health encompasses
many dimensions like social, spiritual, cultural, sexual
and environmental

5. DEFINITION
 GROWTH: Growth is the physical increase in the
body’s size and appearance caused by
increasing number of new cells(hyperplasia), or
increasing size of cells(hypertrophy)

6. DEVELOPMENT: it is the process of ongoing
change, re-organization and integration that occurs
throughout the life, this process includes changes
in body structure and physiologic function,
psychosocial behaviors, emotional responses and
cognition

7. PRINCIPLES OF GROWTH AND
DEVELOPMENT

8. 1. Growth and development are orderly and
sequential as well as continuous and complex
2. Growth and development follow regular and
predictable trends: cephalocaudal; proximodistal
development
3. Growth and development are both differentiated
and integrated
4. Different aspects of growth and development
occur at different stages and at different rates and
can be modified
5. The pace of growth and development is specific
for each person

9. FACTORS INFLUENCING GROWTH
AND DEVELOPMENT
•ORDINAL POSITION IN THE FAMILY

10. DEVELOPMENTAL THEORIES

12. INTRODUCTION
• Primary concepts:
1. Unconscious mind
2. The id
3. The ego
4. The super ego
5. Stages of development based on sexual
motivation

13. • Freud identified the underlying
stimulus for human behavior as
sexuality, which he called “libido”
• “LIBIDO” is defined as general
pleasure seeking instincts rather than
purely genital gratification

14. COMPONENTS OF FREUD’S THEORY
Unconscious mind: contains memories,
motives, fantasies and fears that are
not accessible to recall but that
directly affect behavior
The ID: part of the psyche concerned
with self-gratification by the easiest
and quickest available means

15. The EGO: conscious part of the psyche; serves
as a mediator between the desires of id and
the constraints of reality; includes one’s
intelligence, memory, problem solving,
separation of reality from fantasy and
incorporation of experiences; develops
throughout life
The SUPER EGO: part of the psyche that
represents one’s conscience and develops from
the ego during the first year of life;
represents the internalization of rules and
values so that socially acceptable behavior is
practiced

16. DEVELOPMENTAL STAGES
• ORAL STAGE(0-18 MONTHS):
infant’s pleasures center on
gratification by using the mouth for
sucking and satisfying hunger
• ANAL STAGE(18 MON-4 YEARS):
toilet training a crucial issue at
this stage

17. • PHALLIC STAGE(3-7YEARS):
child has increased interest in gender
differences(his / her own gender);prefers
parent of opposite gender;”Oedipus complex” in
boys & “Electra complex” in girls; curiosity
about genitals and masturbation increase
• LATENCY STAGE(7-12 YEARS):
marks the transition to adult sexuality;
increasing sex role identification with parent
of same sex prepares the child for adult roles
and relationships
• GENITAL STAGE(12-20 YEARS):
sexual interest expressed in overt
sexual relationships

19. • He identified 8 stages from birth to old
age and death
• Each stage is characterized by a
developmental crisis to be mastered
• Unsuccessful resolution at one stage may
delay progress through the next stage
• But mastery can occur later

20. ERIKSON’S EIGHT STAGES!!
1.TRUST vs MISTRUST(INFANCY):
infant learns to rely on care
givers to meet basic needs of warmth,
food and comfort; mistrust is the result
of inconsistent, inadequate or unsafe
care

21. 2.AUTONOMY vs SHAME & DOUBT(TODDLER 1-3
YRS):
gains independence through
encouragement from parents to feed, dress
and toilet self
if parents over protective or
have high expectations shame and doubt as
well as feelings of inadequacy may
develop in the child

22. 3.INITIATIVE vs GUILT(PRESCHOOL 4-6 YRS):
confidence gained as a toddler,
allows preschooler to take initiative in
learning; explores new experiences
if child faces restrictions,
guilt results and child becomes hesitant
to attempt more challenging skills in
motor or language development

23. 4.INDUSTRY vs INFERIORITY(SCHOOL-AGED):
gains pleasure from finishing
projects and receiving recognition for
accomplishments
if not accepted by peers or cannot
meet parental expectations a feeling of
inferiority and lack of self-worth may
develop

24. 5.IDENTITY vs ROLE CONFUSION(ADOLESCENCE):
adolescent in a transition from
childhood to adulthood; secondary sex
characteristics develop; role confusion
occurs when adolescent unable to
establish identity and a sense of
direction

25. 6.INTIMACY vs ISOLATION(YOUNG ADULTHOOD):
makes commitment to others; fear of
commitments results in isolation and
loneliness
7.GENERATIVITY vs STAGNATION(MIDDLE
ADULTHOOD):
desire to make contributions to
the world; if this task not met stagnation
results and the person becomes self-
absorbed and obsessed with his/ her own
needs
8.EGO CENTRICITY vs DESPAIR(LATER
ADULTHOOD):
reminiscence about life events
provides a sense of fulfillment; if one
believes that one’s life has been a
failure then sense of despair may prevail

26. 3.COGNITIVE DEVELOPMENT ~
JEAN PIAGET

27. INTRODUCTION
• Piaget explained two concepts of
intellectual growth in children:
ASSIMILATION & ACCOMODATION
• ASSIMILATION: process of integrating new
experiences
• ACCOMODATION: alteration of existing thought
processes to manage more complex information

29. AGE PHASE DESCRIPTION
0-24 MONTHS SENSORIMOTOR learns about the world by using their
senses to interact with their
surroundings.
2-7 YEARS PRE-OPERATIONAL children build on object permanence
and continue to develop abstract
mental processes. This means they
can think about things beyond the
physical world, such as things that
happened in the past.
7-11 YEARS CONCRETE
OPERATIONAL
Develops logical thinking
11 YEARS OR
OLDER
FORMAL
OPERATIOANL
Use of abstract thinking, establishes
values and meaning in life

30. 4.MORAL DEVELOPMENT ~
LAWRENCE KOHLBERG

31. LEVEL STAGE DESCRIPTION
 PRE-
CONVENTIONAL
STAGE 1: PUNISHMENT AND OBEDIENCE
ORIENTATION
STAGE 2: INSTRUMENTAL RELATIVIST ORIENTATION:
judge the morality of action.
 CONVENTIONAL STAGE 3: GOOD BOY-GOOD GIRL ORIENTATION
STAGE 4: LAW AND ORDER ORIENTATION
 POST
CONVENTIONAL
STAGE 5: SOCIAL CONTRACT, UTILITARIAN
ORIENTATION
STAGE 6: UNIVERSAL ETHICAL PRINCIPLE
ORIENTATION

33. Homeostasis is the word derived from the 2 Greek Words
‘homeo’ meaning ‘similar,’ and ‘stasis’ meaning ‘stable.’
Homeostasis refers to stability, balance, or equilibrium
within a cell or the body. Homeostasis is an important
characteristic of living things.
Maintaining a stable internal environment which requires
adjustments as conditions change inside and outside the
cell. The maintenance of systems within a cell is called
homeostatic regulation.

34. Homeostasis is regulated by 3 different mechanisms and
they are:
a) Osmoregulation
b) Thermoregulation
c) Chemical Regulation.
These mechanisms are performed in the body by various
systems of the body like Respiratory system, Endocrine
system, Reproductive system, Urinary System, Nervous
system.

35. Feedback Regulation
Hormones regulate the activity of body cells. The
release of hormones into the blood is controlled by a
stimulus.
The response to a stimulus changes the internal
conditions and itself may become a new stimulus
and this self-adjusting mechanism by the internal
system is called is called feedback regulation.
The feedback regulations are of 2 types:
1. Positive feedback regulation.
2. Negative feedback regulation.

36. Positive feedback regulation
Positive feedback is less common in biological systems.
Positive feedback acts to speed up the direction of change
Example:
Lactation (milk production) When the baby starts sucking
the nerve messages the mammary glands which cause the
hormone prolactin which is secreted by the pituitary gland.
The prolactin release is directly proportional to the baby
sucking the milk.

37. Negative Feedback regulation:
Thermoregulation
Negative feedback is the most common feedback loop in the
biological system.
To maintain the homeostatic balance the system acts to reverse
the direction of change to maintain the things constant.
Example 1:
When the carbon dioxide level increases in the air which we
breathe, the lungs are signalled to exhale carbon dioxide more
which causes increase in the breathing rate and CO2 level is
balances and then lungs will function normally.

38. Example 2:
When the body temperature increases then automatically the
receptors in the skin and hypothalamus senses the
temperature change and triggers a command from the brain
which makes skin to sweat,
the blood vessels near the skin surface will dilate and that
helps to decrease the body temperature and this is called
thermoregulation and this also comes under negative feedback
loop.

39. Osmoregulation
Osmosis
is the essential process that is carried out in the body for the
proper functioning of cells.
• Water movement in the body is carried out through
Osmosis. Osmosis is carried out by balancing both sides of
the cell membrane, for the proper functioning of
Biochemical process of the cells which is most required.

40. Two conditions which will alter the biochemical process and
results in the death of the cells are:
1. concentration of solutes increases above normal in the
extracellular fluid which causes in the movement of
intracellular fluid to extracellular surface will occur which
will result in the cell shrinkage
2. concentration of solutes decreases in the extracellular
fluid which causes in the movement of extracellular fluid
inside the cells and will result in the swelling of the cell
and ruptures the cell after certain extent.
The maintenance of stable concentration of solutes is most
required for the proper functioning of cells and the organisms and
is maintained through osmosis and diffusion.

41. Chemical Regulation
Control of blood glucose level is an example of negative
feedback.
Blood glucose concentration rises after a meal (the stimulus).
The hormone insulin is released by the pancreas, and it
speeds up the transport of glucose from the blood and into
selected tissues (the response).
Blood glucose concentrations then decrease, which then
decreases the original stimulus. The secretion of insulin into
the blood is then decreased

43. INTRODUCTION
• Primary role of nurse as caregiver are
Promote health
Prevent illness
Restore health
Facilitate coping
 Health is more than just absence of illness
 Health is influenced by a variety of factors
 Nurses knowledge on these factors very
important

44. HEALTH!!!
• “Health is a state of complete physical,
mental and social wellbeing and not
merely absence of disease or infirmity”
~ WHO(1948)

45. CONCEPTS OF HEALTH
• Understanding of health is the basis of all
health care
• Health not perceived the same way by all
members of community
• Gives rise to confusion about the concept of
health
• New concepts bound to emerge on new patterns
of thought

47. • Health is viewed as an “absence of
disease” & if one was free from disease
he is considered to be healthy
• Medical profession viewed man as a
machine, disease as a consequence of the
break down of the machine and one of the
doctor’s task as repair of the machine
• Criticism: it has minimized the role of
environmental, social, psychological and
cultural determinants of health

48. • Although treated many diseases,
inadequate to solve health problems like
accidents, drug abuse, mental illness
etc
• Developments in medical and social
sciences led to the conclusion that the
biomedical concept of health was
inadequate

50. • Deficiencies in biomedical concept gave
rise to other concepts
• Attractive hypothesis put forward by
ecologists
• “health is a dynamic equilibrium
between man and his environment, and
disease a maladjustment of the human
organism to environment”

51. • DUBOS defined health as “health implies the
relative absence of pain and discomfort and
a continuous adaptation and adjustment to
the environment to ensure optimal function”
• Ecological concept raises two issues:
imperfect man & imperfect environment
• History strongly argues that improvement in
human adaptation to natural environment can
lead to longer life expectancies and a
better quality of life in the absence of
modern health care delivery services

52. c.PSYCHOSOCIAL CONCEPT

53. • Health is not only a biomedical
phenomenon
• Is influenced by social, psychological,
cultural, economic and political factors
• Thus health is both biological and
social phenomenon

55. • It is a synthesis of all the above
concepts
• Recognizes the strength of social,
economic, political and environmental
influences on health
• It is described as a multidimensional
process involving the well-being of the
whole person in the context of his
environment

56. • Implies that all sectors of society
have an effect on health, like
agriculture, animal husbandry, food,
industry, education, housing, public
works, communications and other
sectors
• Emphasis is on promotion & protection
of health

58. HUMAN
DIMENSION
PHYSICAL
EMOTIONAL
INTELLECTUAL
ENVIRONMENTAL
SOCIOCULTURAL
SPIRITUAL

60. • Genetic make-up
• Age
• Developmental level
• Race
• Gender
are all part of an individual’s
physical dimension and strongly
influence his / her health status and
health practices

62. • How the mind affects body functions
and responds to body conditions also
influence health
• Long term stress affects body systems,
and anxiety affects health habits
• Calm acceptance and relaxation can
actually change body response to
illness
• E.g.: before an exam, a student has
diarrhea!!

64. • Intellectual dimension encompasses
Cognitive abilities
Educational background
Past experiences
These influence a patient’s responses
to teaching about health and his
reaction to nursing care during
illness

66. • Housing
• Sanitation
• Climate
• Pollution(air, food, water)
• E.g.: increased incidence of asthma
and respiratory problems in large
cities with smog

68. • Health practices and beliefs are
strongly influenced by economic level,
lifestyle, family and culture
• Health seeking practices less in low
socio- economic groups
• Stress related habits and illness more
in high- income groups

70. • Spiritual beliefs and values are
important components of a person’s
health and illness behaviors
• E.g.: Roman Catholics require baptism
for both live births and still born
babies

72. DISEASE
• Disease is a pathologic change in the
structure or function of the body or
mind
• Has specific symptoms and boundaries

73. ILLNESS
• Illness is the response of the person to
a disease
• Is an abnormal process in which the
person’s level of functioning is changed
compared with a previous level

74. CONCEPT OF DISEASE CAUSATION
• Upto the time of Louis Pasteur(1895-
1922) various concepts were in vogue
•Super natural theory of disease
•Theory of humors
•Concept of contagion
•Miasmatic theory of disease
•Theory of spontaneous generation
• Discoveries of microbiology marked a
turning point in the concepts

75. Contagion theory
• Propounded by Fracastorius, an Italian
epidemiologist
• Disease spread through minute particles,
transmitted by direct contact, by
fomites,& from a distance
• Advocated the use of personal measures
for arresting the spread of diseases

76. • MIASMATIC THEORY
•Toxic vapors or ‘miasma’ emanated
from decaying animal and vegetable
matter and diffused in the
surrounding area, spreading disease
•E.g.: miasma from marshy places
produced malaria; diphtheria from
sewer gas; yellow fever by decaying
coffee leaves

77. Spontaneous generation theory
• Propounded by Aristotle
• Believed that living organisms emerged
directly from non- living matter

78. • Germ theory of disease
• Gained momentum during 19th and early
20th century
• Emphasis shifted from empirical
causes( bad air) to microbes as the
sole causes of disease
• Modern medicine recognizes that
disease rarely is caused by a single
agent
• Modern medicine has moved away from
strict adherence to germ theory

79. Epidemiological triad

80. Multifactorial causation
• Pettenkofer of Munich was an early
proponent of this concept
• But, “germ theory” overshadowed this
concept
• Later diseases like cancer, coronary
heart disease could not be explained on
the basis of germ theory

81. • Realization began to dawn that the
‘single cause idea’ was not true
• For e.g. TB is not merely due to
tubercle bacilli, but factors like
poverty, overcrowding and malnutrition
also contribute

82. Web of causation
• This model was suggested by MacMohan and
Pugh in their book “Epidemiologic
Principles and Methods”
• This model is ideally suited in the
study of chronic diseases, where the
disease agent is often not known, but is
the outcome of interaction of multiple
factors

83. • This does not imply that the disease
cannot be controlled unless all the
multiple causes or chains of causation
or at least a number of them are
appropriately controlled or removed
• Sometimes removal or elimination of
just only one link or chain may be
sufficient to control disease,
provided that link is sufficiently
important in the pathogenic process

84. NATURAL HISTORY OF DISEASE

85. INTRODUCTION
• ‘NATURAL HISTORY OF DISEASE’ is a key
concept in epidemiology
• It signifies the way in which a disease
evolves over time from the earliest
stage of its pre pathogenesis phase to
its termination as recovery, disability,
or death, in the absence of treatment or
prevention

86. • Each disease has its own unique
natural history, and is different in
individuals

87. 1.PRE- PATHOGENESIS PHASE
• This refers to the period preliminary to
the onset of disease in man
• The disease agent has not yet entered
man, but the factors which favor is
interaction with the human host are
already existing in the environment

88. • This situation is frequently referred
to as “ man in the midst of disease”
or “man exposed to the risk of
disease”
• Potentially we are all in the pre-
pathogenesis phase of many diseases,
both communicable and non-
communicable

89. 2.PATHOGENESIS PHASE
• Begins with the entry of disease agent
in the susceptible human host
• The final outcome of the disease may be
recovery, disability or death
• The pathogenesis phase may be modified
by intervention measures such as
immunization and chemotherapy

90. VARIABLES INFLUENCING HEALTH
STATUS, BELIEFS AND PRACTICES
• HEALTH STATUS: is the state of health of
an individual at a given time
• HEALTH BELIEFS: are concepts about
health that an individual believes true.
Such beliefs may not be grounded on
facts
• HEALTH BEHAVIORS: are actions people
take to understand their health state,
maintain an optimal state of health,
prevent illness and injury and reach
their maximum physical and mental
potential

91. VARIABLES
INTERNAL
BIOLOGIC PSYCHOLOGIC
EXTERNAL
PHYSICAL ENVT,
STANDARDS OF
LIVING, FAMILY &
CULTURAL BELIEFS,
SOCIAL SUPPORT
NETWORKS
COGNITIVE
GENETIC MAKE-
UP, SEX, AGE,
DEVELOPMENTA
L LEVEL
MIND-BODY
INTERACTION,
SELF-
CONCEPT
LIFESTYLE
CHOICES,
SPIRITUAL &
RELIGIOUS
BELIEFS
ENVIRONMENT

93. DEFINITION
• HEALTH PROMOTION:
is the process of enabling people
to increase control over and to improve
their health
• DISEASE PREVENTION:
is a branch of medicine which
focuses on the prevention of disease,
both in individuals and communities

94. FACTORS AFFECTING AN INDIVIDUALS CHOICES OF
HEALTHPROMOTION BEHAVIORS!!

95. Individual
choosing
healthy /
unhealthy
behaviors
Environm
ental
influence
Knowledge
of health
promoting
behaviors
Personal
beliefs,
attitudes
& values
Genetic
influence
Family,
friends &
peer
influence

99. • Is the living conditions, behaviors and
habits that are typical of or chosen by
a person or a group

100. LIFESTYLE DISEASES
• Also called “diseases of longevity” or
“diseases of civilization”
• Increases with industrialization
• Many current day health problems are
associated with lifestyle changes
• Result of inappropriate relationship of
people with their environment

101. SOME STATISTICS!!
• IN 1900, top 3 causes of death in U.S were
pneumonia, TB & diarrhea
• Communicable diseases accounted for 60% deaths
• In 1940’s most deaths due to heart diseases,
cancer and other lifestyle diseases
• By late 1990’s, lifestyle diseases accounted for
more than 60%

102. WHO warned 270 million people are
Susceptible.
Seen commonly in China, India,
Pakistan and Indonesia.
These takes years to develop and then
becomes so much a part of our lives
that it can not be cured.

103. ESTIMATED BURDEN OF LIFE
STYLE DISEASES IN INDIA
By 2020 chronic diseases are expected
to claim 7.63 million compared to
3.78 Million in 1990.
By 2020,30 million people are
projected to have diabetes
by 2025, estimated hypertension is
213.5 million compared to 118.2
million in 2000(raising 80%).

104. CAUSES OF LIFESTYLE DISEASES

110. TOP 10 LIFESTYLE DISEASES!!

111. • Alzheimer’s disease
• Arteriosclerosis
• Cancer
• Chronic liver disease / Cirrhosis
• Chronic obstructive pulmonary disease
• Diabetes
• Heart disease
• Nephritis / CRF
• stroke