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FAMILY HEALTH CARE: CHILD & ADOLESCENT NURSING

PURPOSE The purpose of this report is to study the peculiarities of the nursing care needed by children and adolescents. Special psychological and physiological characteristics of the age groups under consideration have been emphasized. Stress caused by health problems by children and adolescents can be significantly reduced by the proper nursing care provided.

INTRODUCTION Social and emotional well-being is very important both for children and adolescents. However, children of different age groups have specific needs, which may significantly differ from the needs which younger or older children have. Thus, it is sensible to take into account developmental theories when discussing the nursing care needs of children and adolescents. One of the most competent developmental theorists, Erik Erikson, divided the whole period of the childhood into several stages: 18 months to 3 years (the so called early childhood), 3 to 5 years (play age), and 6 to 12 years (school age) (E. Erikson, 1950). For children timely vaccination and regular medical examinations are of major importance. Forming and maintaining healthy lifestyle habits is the primary task both for parents and caregivers. Taking into account their psychological characteristics, it is possible to say that adolescents are closer to being adults than to being children. However, they still remain vulnerable (Healey, 2007).

2 DEFINITIONS Adolescence Transitional age of physical and psychological development of a human generally occurring between puberty and legal adulthood (E. Erikson, 1950).

Behavior The range of actions made by organisms in conjunction with their environment, which includes other organisms and systems around as well as the physical environment (Institute of Education Sciences, 2010).

Childhood The age span ranging from birth to adolescence (E. Erikson, 1950). In many theories of development childhood is divided into early childhood, play age, school age, and adolescence.

Disability A physical or mental handicap, especially one that prevents a person from living a full, normal life (Institute of Medicine, 2009).

Emotional well-being The ability to understand the value of emotions and use them for selfdevelopment and achieving personal goals. Everyday emotional well-being also involves identifying, building upon, and operating from an individuals strengths rather than focusing on problems and/or weaknesses (Institute of Education Sciences, 2010).

Health care The prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions (Institute of Medicine, 2009).

Health problems A state in which an individual is unable to perform his everyday functions normally, without assistance or pain (Institute of Medicine, 2009).

Nursing care The practice in which a nurse assists an individual in the performance of those activities contributing to health or its recovery that the individual would perform unaided if he had the necessary strength, will or knowledge (Institute of Medicine, 2009).

Social well-being A complex concept which involves a persons relationship with others and how that person communicates, interacts, and socializes with other people. It can also relate to how people make friends and whether they have a sense of belonging (Institute of Education Sciences, 2010).

4 BACKGROUND Both social and emotional well-being is important for a harmonious multilateral development of a child. Social well-being is a core aspect of a persons development. Our capacities and needs connected with others (social needs), and awareness and management of our inner feelings and experiences (emotional needs), are determining features of our quality of life. All children and adolescents require care and attention to these areas of development. However, children and teenagers often are at higher risk for experiencing lower levels of social-emotional well-being. Especially this can be related to the children and adolescents with disabilities. They are more likely to be bullied and harassed, have a limited number of friends, and engage in fewer extracurricular activities than their peers.

DISCUSSION School environment can influence children and adolescents rather negatively, for it focuses rather on the childs failures than on his talents and capacities. In the most cases children and teenagers do not get the help they need until there is a crisis, and one has the potential for high level of social and emotional distress. Children and adolescents with health problems are at higher risks socially and emotionally, which, however, does not mean that such situation is inevitable. Many disabled children and adolescents experience rather positive outcome in this area. However, family and larger community should take an active part in attending to the social and emotional needs of such children and teenagers along with considering ways to provide stronger encouragement and support on their behalf.

5 The number of communities taking part in the insurance of social and emotional well-being of children and adolescents with special needs. For instance, such children have greater access to the so called inclusive experiences. This, in particular, means that teenagers with health problems nowadays have greater access to the same educational, recreational, and other environments as their peers without health problems. By becoming more included in the social life of the community they get better options for building social relationship and making friends. Increased social activity is also associated with higher expectations for learning and social interaction (Healey, 2007). As a result of increasing opportunities for taking active part in the social life of the community its attitude towards disability and health problems is changing in a positive way. Children and teenagers with disabilities are not treated as potentially useless any more. Individuals with health problems are now more likely to be valued for their abilities and contributions instead of just being noticed for their needs. The growing efforts of the young people to take control of their lives and create positive changes both reflects and impacts social and emotional well-being. At the school level, students are developing more self-advocacy. In addition, the practice of joining together for self-advocacy activities in the communities becomes widely spread among the young people with disabilities nowadays. These trends demonstrate a rather positive tendency. However, the need for extensive implementation of the system changing practices aimed at supporting young people with disabilities is constantly increasing.

6 RECOMMENDATIONS The strategy of prevention applies well to addressing the social and emotional needs of children and adolescents with health problems. A well-coordinated, sustained focus on prevention practices in schools, youth communities, and homes should be built on the progress that has already been achieved. The prevention practices should include social and emotional competencies teaching, creation of multidisciplinary supports, advocacy for necessary resources, and linking people and environments. Becoming more prevention-oriented in schools and youth organizations means to support the development of social-emotional competencies that contribute to learning (Durlak, Weissberg, Dymnicki, Taylor & Schellinger, 2011). This also includes creating systems that encourage student engagement, safety, and a positive climate. The unmet social and emotional needs of children and adolescents can remain unnoticed for a long time. Thus, there is a need for additional support, training, and resources developed to help young people and their families get qualified and timely assistance. This effort of schools and youth organizations should be supported by health care systems and social services. Young people need more resources and training both in schools and youth organizations directed toward social and emotional well-being. There is a need to train front line providers, who would first see and connect with children and youth (Law, King, Kertoy, Hurley et al., 2006). While children and youth with health problems typically do not have the opportunity for as many, or as varied, social relationships as their peers without disabilities, they often lack the so called social capital to protect themselves from

7 poor social and emotional outcomes. Such experiences need to be viewed as interconnected and addressed holistically.

CONCLUSION To be able to guarantee the social and emotional well-being of the children and adolescents with health problems, and reduce the risk for them to be harassed or neglected, the society should continue to develop initiatives that link people, environment, and prevention practices and help to generalize the positive experience in the overcoming the negative attitude to the disabled youth. The efforts aimed at overcoming the disregard and prejudice have to be based on respect for others and an appreciation of diversity, engage youth lacking social and emotional well-being, create social networks and capacities, and bring together healthy youth and teenagers with health problems in a way that would give each individual an opportunity to use his or her talents and capacities. Working together, families, health care professionals, and children and adolescents with health problems themselves can create the proper context for healthy and successful social-emotional development.

8 References Abery, B.H., Mithaus, B.E., Wehmeyer, M.L. & Stancliffe, R.J. (2003). Theory in self-determination. Springfield, IL: Charles C. Thomas Publishing.

Australian Government Department of Health and Ageing (March 2004). Supporting parents and families: the mental health and well-being of children and young people. Commonwealth of Australia: National mental health strategy.

Durlak, J.A., Weissberg, R.P., Dymnicki, A.B., Taylor, R.D. & Schellinger, K.R. (January/February 2011). The impact of enhancing students social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82(1), pp. 405-432.

Erikson, Erik (1950). Childhood and society.

Hawbaker, B.W. (2007). Student-led IEP meetings: Planning and implementation strategies. TEACHING Exceptional Children Plus, 3(5).

Healey, Justin (2007). Teen Health.

Institute of Education Sciences, US Department of Education (2010). The condition of education 2010: Children and youth with disabilities. Washington, D.C.

9 Institute of Medicine (2009). Preventing mental, emotional, and behavioral disorders among young people:Progress and possibilities. Washington DC: National Academies Press. 19, pp. 517-534.

Law, M., King, G., Kertoy, M., Hurley, P. et al. (2006). Patterns of participation in recreation and leisure activities among children with complex physical disabilities. Developmental Medicine and Child Neurology, 48, pp. 337-342.

Mental health and well-being in adolescence: an overview. [Online] (updated 02 Sep. 2010) Available at: http://raisingchildren.net.au/articles/mental_health_teenagers.html/context/106 7 [Accessed 09 Sep. 2012].

National Survey of Children with Special Health Care Needs. [Online] (updated 10 Apr. 2012) Available at: http://www.cdc.gov/nchs/slaits/cshcn.htm [Accessed 10 Sep. 2012].

Orygen YOUTH Health. Why Youth Mental Health? [Online] Available at: http://oyh.org.au/why-youth-mental-health [Accessed 10 Sep. 2012].

Parents and carers. [Online] Available at: http://www.headspace.org.au/parents-andcarers [Accessed 09 Sep. 2012].

10 Tips for parents: adolescents. [Online] (updated Aug. 2010) Available at: http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-ttipsadol [Accessed 10 Sep. 2012].

Tips for parents: kids 5-11. [Online] (updated Aug. 2010) Available at: http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-ttips5 [Accessed 10 Sep. 2012].