Kozier & Erb's
Fundamentals of Nursing
Concepts, Process, and Practice
Eleventh Edition
Chapter 25
Promoting Health in Young
and Middle-Aged Adults
Copyright © Pearson Education Limited 2022. All Rights Reserved
Learning Outcomes (1 of 2)
25.1 Compare and contrast the following generational groups: baby boomers,
Generation X, Generation Y, and the iGeneration.
25.2 Describe the usual physical development occurring during young and middle
adulthood.
25.3 Identify characteristic tasks of psychosocial development during young and middle
adulthood.
25.4 Explain changes in cognitive development throughout adulthood.
Copyright © Pearson Education Limited 2022. All Rights Reserved
Learning Outcomes (2 of 2)
25.5 Describe moral development according to Kohlberg throughout adulthood.
25.6 Describe spiritual development according to Fowler throughout adulthood.
25.7 Identify selected health problems associated with young and middle-aged adults.
25.8 Identify developmental assessment guidelines for young and middle-aged adults.
25.9 List examples of health promotion topics for young and middle adulthood.
Copyright © Pearson Education Limited 2022. All Rights Reserved
Introduction (1 of 4)
• Baby boomers
– Born between 1945 and 1964
– An individualistic outlook
– "Workaholic" orientation
– Respect at work
– Loyal and dedicated
Copyright © Pearson Education Limited 2022. All Rights Reserved
Introduction (2 of 4)
• Generation X
– Born 1965–1978
– Often raised in two-worker households
– Less impressed with corporate values
– More skeptical
– Resist authority
– Enjoy challenges and opportunities to solve problems creatively
Copyright © Pearson Education Limited 2022. All Rights Reserved
Introduction (3 of 4)
• Generation Y
– Millennials
– Born 1979–2000
– Part of an increasingly multicultural America
– Technologically sophisticated
▪Also dependent
– Enjoy public affirmation of efforts
Copyright © Pearson Education Limited 2022. All Rights Reserved
Introduction (4 of 4)
• iGeneration or Generation Z
– Have never been without the internet
– Multitaskers
– Obsessed with safety
– Front lines of a mental health crisis
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults (20 to 40 Years)
• "Adulthood" depends on:
– Social context
– Financial status
▪Dependent/independent
– Living arrangements
– Assuming new roles
– Developing values and attitudes related to roles
• Boomerang kids
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Physical Development
• Prime physical years
• Body systems functioning at peak efficiency, but may engage in high-risk activities
• Weight and muscle mass may change with diet and exercise.
• Physical changes in pregnant and lactating women
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Psychosocial Development
(1 of 2)
• Freud, Erikson, Havighurst, and Newman and Newman
• Establishing intimacy
• Establishing sense of self
• Choice of a lifelong partner and considerations of childbearing
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Psychosocial Development
(2 of 2)
• Stressors of parental divorce
• Occupational choice and education
• Remaining single more common
• Nontraditional lifestyles more acceptable
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Cognitive Development (1 of
2)
• Piaget's formal operations stage is not last stage.
• Postformal thought
– Creativity
– Intuition
– Ability to consider information in relation to other ideas
– Understanding the temporary nature of knowledge
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Cognitive Development (2 of
2)
• Postformal thought
– From abstract thinking to practical considerations
– Problems have more than one cause or answer, and some solutions work better
than others.
– Comprehend and balance arguments
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Moral Development
• May enter postconventional level
– Separate self from others' expectations
– Define morality in terms of personal principles
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Spiritual Development (1 of
2)
• Fowler's stage
– Individuating reflective period (after 18 years)
– Focuses on reality
– Religious teaching from childhood accepted or redefined
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Spiritual Development (2 of
2)
• Fowler's stage
– Spiritual but not necessarily religious
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Health Risks (1 of 3)
• Injury and Violence
– Homicide
– Mass shootings
– Intimate partner violence (IPV)
▪Actual or threatened abuse of a current or former partner
• Suicide
– A leading cause of death in the young adult age group
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Health Risks (2 of 3)
• Hypertension
– Major problem for young African American men
• Substance Abuse
– Including smoking
• Sexually Transmitted Infections (STIs)
– Chlamydia most prevalent
– Keep information confidential
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Health Risks (3 of 3)
• Eating Disorders
– Assess nutritional concerns, diet and exercise patterns
– Proper nutrition during childbearing years in women
• Certain Malignancies
– Testicular, breast, and cervical cancers
– Pap smears for women
Copyright © Pearson Education Limited 2022. All Rights Reserved
Young Adults Health Assessment and
Promotion
• Young adults usually interested in meeting health needs
• Many stresses, changes occur from ages 20 to 40.
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults (40 to 65 Years)
• Stability and consolidation
• Maturity
– Maximal function and state of being fully developed
• Guided by underlying philosophy
• Tolerant of views of others
• Open to new experiences and continued growth
• Self-accepting and insightful
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Physical
Development
• Menopause in women
• Climacteric used to denote change in sexual response in men
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Psychosocial
Development
• Erikson's stage
– Generativity vs. stagnation
▪Self-concern equaling welfare of humankind indicates generativity.
▪Boredom and self-absorption indicates stagnation.
• "Midlife crisis"
– Not universal and more common in males
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Cognitive
Development (1 of 2)
• Little change in cognitive and intellectual abilities
• Reaction time
– Diminishes in later part of the middle years
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Cognitive
Development (2 of 2)
• Maintain memory and problem solving
• Learning continues
– Enhanced by motivation
• Influence of genetic, environmental, and personality factors
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Moral Development
• Kohlberg's levels
– Enter postconventional level
▪Extensive experience of personal moral choice and responsibility
– Few progress to Stage 5 before age 40
▪Social contract orientation
– Rights of others over one's own rights
▪Research demonstrates moral development continues through adulthood.
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Spiritual
Development (1 of 2)
• Fowler
– Not all adults reach the paradoxical–consolidative stage.
– View "truth" from a number of viewpoints
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Spiritual
Development (2 of 2)
• Less dogmatic about religious beliefs
• Religion offers more comfort than previously.
• Often rely on spiritual beliefs to deal with illness, death, and tragedy
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Health Risks (1 of 3)
• Injuries
– Motor vehicle crashes common cause
– Changing physiological factors
• Cancer
– Lung, prostate, and colon (men)
– Lung, breast, and colon (women)
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Health Risks (2 of 3)
• Cardiovascular Disease
– Heart disease, cancer
– Metabolic syndrome increases risk.
• Obesity
– Decreased metabolic, physical activity
– Risk for many chronic diseases
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Health Risks (3 of 3)
• Alcoholism
– May exacerbate health, personal problems
• Mental Health Alterations
– Increased anxiety, depression
Copyright © Pearson Education Limited 2022. All Rights Reserved
Middle-Aged Adults Health Assessment
and Promotion
• Middle-aged adults usually interested in:
– Maintaining health
– Preventing acceleration of aging process
Copyright © Pearson Education Limited 2022. All Rights Reserved
