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By : Tri Anjaswarni, S.Kp. M.Kep. Disampaikan dalam Kuliah Mata Ajar Mental Health Nursing pada Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas Brawijaya Malang Learning Objectives After studying this chapter the student should be able to : 1. List the developmental tasks of adolescence. 2. Compare the various theiretical views of adolescence 3. Identify the major areas that should be included when assessing adolescents 4. Describe maladaptive responses evident in adolescence 5. Analyze nursing intervenstions useful in working with adolescents 6. Evaluate nursing care provided for adolescents A. Introduction Adolescence is a time of transition an age when the person is not yet an adult but is no longer a child. Difficult periode for adolescence Terjadi berbagai perubahan perilaku terkait dengan perkembangan yang terjadi pada diri remaja Penekanan bidang garap pada masa remaja adalah berfokus pada perkembangan personal (person development).
B. Developmental Stage
Havighurst identified the following tasks that should be accomplished during adolescence : 1. Achieving new and more mature relations with age mates of both sexes 2. Achieving masculine or feminine social roles 3. Accepting physical build and using the body effectively 4. Achieving emotional independence from parents and other adults 5. Preparing for marriage and family life 6. Praparing for career 7. Acquiring a set of values and an ethical system as a guide to behavior and developing an ideology
Theory
Biological Theory
Description
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Emphasis is on physical growth, behavior, and the environment which influence feeling, thoughts and action. Transform the young person physically from a child into a reproductively mature adult. The changes fall into two categories : hormonal & somatic Psychoanalytical Puberty is called the genital stage, in which sexual interest is awakened Theory (Freud) The genitalia mature(sexual exploration and maturation) The release of sex hormones increases. Upset the balance between the ego and id New solutions must be negotiated Psychosocial Theory Adolescents attempt to establish an identity within the social (Modified by : environment Erickson, Sullivan and Emphasize the effect of social factors on developmental processes others) Ego identity or relationship between a persons self perception and how a person appears to athers The stage of Identity V.S Identity diffusion To coordinate self security, self esteem, intimacy, general activity and sexual satisfaction in relationships. Attachment Theory Focuses on the quality of attachments Insecure attachments as risk factor that can result in maladaptive responses to loss or trauma. Cognitive Theory Adolescence is an advanced stage of cognition (cognitive functioning) Formal thought : The ability to reason goes beyond the concrete to more abstract thinking ( concrete objects to symbols or abstractions) This develops continuously from the concrete thinking of childhood to abaout age 2. Cultural Theory View adolescence as a time when a person believe that adult privileges are deserved but are withheld. This stage end when society gives full power and status of an adult. Multidimensional Th Adolescence is seen as adaptation on continuum of development. Less emphasis on age and more on the development level and timing of biological, psychological, & environmental influences.
outcome identifikasi anak remaja (usia belasan tahun) yang berresiko tinggi mempunyai masalah.
School
Truancy Undeachiem ent, Disruptive behavior
Substanc
e Abuse
Regular use Large amounts
Antisocial Behaviors
High-Risk Adolescent
Sexual
Promiscuit y Pregnancy Sexual Abuse Appearanc e Poor hygiene Disregard for dress
Medical
Chronic illness Handicap
Mood Functional
Sleep problems Eating Problems Psychosomati c Depression Anxiety Hostility
tipe perilaku anak remaja yang harus diperhatikan: 1. Body Image 2. Identity 3. Independence 4. Social Role 5. Sexual Behavior
E.Maladaptive Responses
1. Inappropriate Sexual Activity 2. Unwed Motherhood 3. Suicide 4. Runaways 5. Conduct Disorders 6. Violence 7. Drug Use 8. Hypochondriasis 9. Weight Problems 10. Occult Involvement 11. Parental Divorce
F.Nursing Diagnoses
Diagnosis berdasarkan DSM-IV psychiatric illness