7 CLIENT’SRESPONSE TOILLNESS 137
of autonomy may become overly dependent on others.
Failure to develop identity can result in role confu-
sion or an unclear idea about whom one is as a per-
son. Negotiating these developmental tasks affects
how the person will respond to stress and illness.
Lack of success may result in feelings of inferiority,
doubt, lack of confidence, and isolation—all of which
can affect how a person responds to illness.
Genetics and Biologic Factors
Heredity and biologic factors are not under voluntary
control. We cannot change these factors. Research
has identified genetic links to several disorders. For
example, some people are born with a gene associ-
ated with one type of Alzheimer’s disease. Although
specific genetic links have not been identified for sev-
eral mental disorders (e.g., bipolar disorder, major
depression, alcoholism), research has shown that
these disorders tend to appear more frequently in
families. Genetic makeup tremendously influences a
person’s response to illness and perhaps even to treat-
ment. Hence family history and background are es-
sential parts of the nursing assessment.Physical Health and Health Practices
Physical health also can influence how a person re-
sponds to psychosocial stress or illness. The healthier
a person is, the better he or she can cope with stress
or illness. Poor nutritional status, lack of sleep, or a
chronic physical illness may impair a person’s ability
to cope. Unlike genetic factors, how a person lives
and takes care of himself or herself can alter many of
these factors. For this reason, nurses must assess the
client’s physical health even when the client is seek-
ing help for mental health problems.
Personal health practices, such as exercise, can
influence the client’s response to illness. Auchus et
al. (1995) studied the exercise patterns of psychiatric
inpatients and found that walking was a common
form of exercise. Those who walked one to five timesTable 7-2
ADULTGROWTH ANDDEVELOPMENTTASKS
Stage TasksYoung Adult (25 to 45 Years of Age)Middle Adult (45 to 65 Years of Age)Older Adult (65 Years of Age
and Older)Accept self.
Stabilize self-image.
Establish independence from parental home and financial independence.
Establish a career or vocation.
Form an intimate bond with another person.
Build a congenial social and friendship group.
Become an involved citizen.
Establish and maintain a home.
Express love through more than sexual contacts.
Maintain healthy life patterns.
Develop sense of unity with mate.
Help growing and grown children to be responsible adults.
Relinquish central role in lives of grown children.
Accept children’s mates and friends.
Create a comfortable home.
Be proud of accomplishments of self and mate/spouse.
Reverse roles with aging parents.
Achieve mature civic and social responsibility.
Adjust to physical changes of middle age.
Use leisure time creatively.
Cherish old friends and make new ones.
Prepare for retirement.
Recognize the aging process and its limitations.
Adjust to health changes.
Decide where to live out remaining years.
Continue warm relationship with mate/spouse.
Adjust living standards to retirement income.
Maintain maximum level of health.
Care for self physically and emotionally.
Maintain contact with children and relatives.
Maintain interest in people outside the family.
Find meaning in life after retirement.
Adjust to the death of mate/spouse or other loved ones.