Erikson Psychosocial
8 stages, each with a crisis to resolve: 1) Trust vs Mistrust (0-1): consistent care, feeding, responsiveness. 2) Autonomy vs Shame/Doubt (1-3): toilet training, choices, "I do it." 3) Initiative vs Guilt (3-6): exploration, planning, leadership. 4) Industry vs Inferiority (6-12): school, competence, achievement. 5) Identity vs Role Confusion (12-18): who am I, values, career. 6) Intimacy vs Isolation (18-40): relationships, commitment. 7) Generativity vs Stagnation (40-65): contributing, mentoring, career. 8) Integrity vs Despair (65+): life review, acceptance, wisdom.
Piaget Cognitive
4 stages: 1) Sensorimotor (0-2): object permanence, cause and effect, trial and error. 2) Preoperational (2-7): symbolic thinking, egocentrism, magical thinking, animism. 3) Concrete Operational (7-11): logical thinking, conservation, reversibility, classification, less egocentric. 4) Formal Operational (11+): abstract thinking, hypothetical reasoning, future planning, moral reasoning. Nursing application: communicate at the cognitive level — concrete for school-age, abstract for adolescent.
Other Theories
Kohlberg Moral: preconventional (obedience, punishment, 0-9), conventional (rules, social order, 9-20), postconventional (social contract, universal ethics, 20+). Freud Psychosexual: oral, anal, phallic, latency, genital. Havighurst Developmental Tasks: age-specific tasks (learning to walk, read, work, retire). Fowler Faith Development: stages of religious/spiritual development. Bandura Social Learning: observational learning, modeling. Vygotsky Zone of Proximal Development: learning with guidance. Application: understand patient developmental stage, communicate appropriately, support developmental tasks, identify developmental delays.
Important Notes
- Erikson: each stage has a crisis to resolve — successful resolution builds strength; unsuccessful leads to difficulty in later stages.
- Piaget: formal operational (abstract thinking) begins around age 11 — explain medical concepts at the cognitive level appropriate to the patient age.
- Kohlberg moral development: preconventional (punishment), conventional (rules), postconventional (principles) — guides how patients make ethical decisions.
Clinical Tips
- Erikson trust vs mistrust (0-1): consistent, responsive caregiving builds trust — inconsistent care leads to difficulty trusting throughout life.
- Piaget concrete operational (7-11): can understand cause and effect but needs concrete examples — use props and demonstrations for teaching.
- Vygotsky zone of proximal development: learning occurs best with guidance slightly above current ability — scaffold learning for patients and families.
Summary
Developmental theories (Erikson psychosocial, Piaget cognitive, Kohlberg moral) guide nursing communication, patient education, and developmental assessment across the lifespan.
