Young Adult Life Stage

Young Adult Life Stage
Fall 2018
Jacey Mitchell
Copyright © 2018, Elsevier Inc. All Rights Reserved.

Biology and Genetics
 18-35 years
 Health-promotion needs
 Developing behaviors to promote healthy lifestyle
 Decreasing incidence of accidents, injuries, violence
 Young adulthood at a glance
 Healthiest period, optimal muscle strength (age 25-30), manual
dexterity peaks
 Gender differences
 Full growth
• Women: Age 17; men age 21
 Longevity: Women > men
 Health care seeking: Women > men
2Copyright © 2018, Elsevier Inc. All Rights Reserved.

Biology and Genetics (Cont.)
 Greater complexity of thinking; more organized
emotional/cognitive development
 Self-help resources very popular with young
adults
 Maternal mortality rate primarily pertains to
young adults—health indicator of a nation’s
health resources

Gordon’s Functional Health
Patterns
 Health perception–health management pattern
 Nutritional-metabolic pattern
 Elimination pattern
 Activity-exercise pattern
 Sleep-rest pattern
 Cognitive-perceptual pattern
 Self-perception–self-concept pattern
 Roles-relationships pattern
 Sexuality-reproductive pattern
 Coping–stress tolerance pattern
 Values-beliefs pattern

Health Perception–Health
Management Pattern
 Behavioral health history
 Risk factors for unintentional injuries
 Preventive care
 Maximize health status, detect problems early
 Age 18: full health appraisal
 Repeat history/physical every 2 years
 Screenings: testicular examination, PAP smear
 Experts now recommend against SBE
 Over age 25: focus on coronary risk factors
• Cholesterol, diabetes, smoking, hypertension, metabolic
syndrome

Health Perception–
Health Management Pattern (Cont.)
 Decision-making and risk taking
 Risk-taking behavior
 Leading causes of death: unintentional injuries,
homicide, suicide
 Communicable disease
 Threats: changes travel, social, sexual behaviors
 Drug resistance; new strains emerging
 Disease examples
• Immunizations: rubella, HPV (women), hepatitis B
• TB, HIV, Lyme disease

Health Management for Young
Adults
 Prevention is key for young adults
 Modifying CHD risk factors for those >25 years
 Hypertension screening and management
 Education to focus on healthy lifestyle choices
 ID metabolic syndrome—precursor to DM
 Obesity, high lipids, hypertension
 Risk taking remains problematic for young adults
—accidents leading cause of death
 Of concern: meningitis, hepatitis B, TB, HPV

Nutritional-Metabolic Pattern
 Obesity: epidemic proportions
 Basal metabolic rate declines
 More intake than energy requirement = weight gain
 Obesity rates vary by ethnicity
 Factors : increasing portion size, “eating out,” sedentary
lifestyles
 Teaching: increased activity, low fat, more
fruits/vegetables, limit portions
 Assessment: BMI, waist circumference, BP, cholesterol
 Nutritional needs/common deficiencies
 Iron, folic acid, calcium

Elimination Pattern
 Eating disorders
 May persist
 Common complaints
 Constipation
 Hemorrhoids
 Occasional diarrhea
 Teaching
 Report changes in elimination patterns
 Adequate fluids, eating fruit/vegetables

Activity-Exercise Pattern
 Exercise recommendations
 Aerobic exercise of moderate intensity for 30 minutes, 5 days
per week
 Barriers: lack of time, access to facilities, safe environments
 Sun/radiation exposure
 Avoid excessive UV: use of sun blocks, sun-protective clothing,
avoid tanning, sunbathing
 Sports
 Recreational activity history guides education
 Helmets for bicycles, motorcycles
 Protective equipment for sports

Sleep-Rest Pattern
 Subject to fatigue
 Work
 Stress
 Inactivity
 Recommendations
 Change activity or stressors
 Try out new tasks or physical activities

Cognitive-Perceptual Pattern
 Piaget: formal operations
 Analysis of all combinations of possibilities and constructs
hypotheses; more perceptive/insightful
 Intellectual growth
 Recall performance and memory: peaks in 20s
 Erikson: intimacy vs isolation
 Increased sense of competency/self-esteem
 Learns to develop reciprocal intimate relationships (requires
mutual trust)
 Postconventional moral reasoning
 Define rights and morality in terms of self-chosen principles

Self-Perception–Self-Concept
Pattern
 Western culture: adulthood
 Achieve financial and residential independence
 Life stage conflict: Explore and experiment vs firm commitments
 Employment tied to self-esteem
 Employment issues
 Pay differentials by gender
 Variance in benefits, occupational hazards
 Stress of employment
 Childbearing choices; child care issues
 Increased job burden with decreased job security

Roles-Relationships Pattern
 Young adult friendships more enduring than
earlier relationships
 Formation of intimate relationships
 Decisions about life/career directions
 Formation of family units
 Multiple decisions related to childbearing,
finances, roles/relationships
 Self and family development

Roles-Relationships Pattern (Cont.)
 Separation/divorce
 Affects children, families of couple
 Reevaluation of basic values, strengths, personality
 Depression common—supportive counseling/services
 Violence
 80% of violence is individual acts (homicide, suicide)
 Homicide: second leading cause of death age 15-24
 Associated: guns, alcohol, drug abuse, crimes
 Intimate partner violence
• Crosses all demographic boundaries
• Underreported; women report higher lifetime violence
• Appropriate assessment, detection, treatment needed

Sexuality-Reproductive Pattern
 Infertility
 Affects10%-15% of US couples; increased incidence >25 years
 Assistive reproductive technologies (stressful, costly)
 Sterilization: choice increases with age
 Male issues: orchitis, epididymitis, varicoceles, hydroceles
 Unintended pregnancy (half of all pregnancies)
 Teen birth rate down 30% in the past decade
 Half of unplanned pregnancies are caused by contraceptive
failure
 Nurse’s role: help choose most appropriate method

Sexuality-Reproductive Pattern
(Cont.)
 Prenatal care
 Insufficient for high-risk and minority women
 STDs
 Leading cause of infection (high-risk age group)
 Screening for chlamydia recommended
 Multiple STDs increases risk of HIV
 HIV challenges
 Treatment/prevention needs of chronically ill
 Effective strategies to prevent new infections/improve case
finding
 Counsel on risk-reduction behaviors
 Education of individuals and general public

Coping–Stress Tolerance Pattern
 Stress
 Assess for stress-related complaints
 Assess for signs of achievement stress
 Listen, offer support; referrals as needed
 Suicide and depression
 Suicide: leading cause of death
 Cause: unable to cope with stressful circumstances or
events
 More women attempt suicide; more men succeed
 Assess for depression and suicidal ideation

Values-Belief Pattern
 Health promotion
 Altering value/belief patterns that encourage poor
health practices
 Parenting
 Ensuring healthy offspring
 Genetic testing and prenatal diagnosis decisions
• Decision-making of potential risk of transmission
• Values and decision-making related to genetic impairment

Environmental Processes
 Ethnicity, race, culture
 Nonmajority ethnicity/culture
 Health effects from prejudice, discrimination, educational/work
decisions, residential setting
 Accidents
 Highest cause of death in young adults
 Motor vehicle accident prevention important: seat belts, use of
alcohol, aggressive driving
 Pollution
 Noise: increases risk of hearing loss (e.g., recreational
exposure)
 Air: automobile exhaust; industrial exposures

Environmental Processes (Cont.)
 Occupational hazards/stressors
 Young adults work in hazardous jobs
 Vocational training needed to avoid hazards
 Periodic assessment, counseling for risks
 Chemical agents
 Drug use—injury, disability, violence, social problems
 Alcohol use—accidents, future chronic conditions;
binge drinking
 Tobacco use—leading cause preventable death
• Synergistic effect with asbestos, dust, radiation exposures

Environmental Processes (Cont.)
 Cancer—environmental carcinogens
 Work exposure
• Hazardous chemicals
• Latex: long-term immune system disease
 Unhealthy practices
• Multiple sexual partners, exposure to HPV: risk of cervical
cancer
• Smoking: lung cancer, cervical cancer

Determinants of Health: Social
Factors and Environment
 Social factors and environment
 Neighborhood resources—sets standards for individual health
 Challenges: transportation, medical home, health coverage
 Culture and ethnicity
 Health care based on Western belief system
 Identification needed of culturally influenced health behaviors
and culturally acceptable interventions
 Legislation
 Major political constituency
 Have time/energy to affect issues related to common good

Determinants of Health: Social
Factors and Environment (Cont.)
 Economics
 Satisfying careers; adequate economic returns
 Changes in employment choices, types of jobs, work styles,
potential for job security
 Homelessness
 More families homeless
 Poverty, poor education, lack skills, domestic violence,
substandard health care
 Dual careers
 May amplify relationship strain, domestic violence
 Increased life complexity: child day care, caring for parents,
varied living arrangements

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