Peer Relationships
During adolescence, close friendships and first romantic relationships become important factors in the development of a young person’s identity as a future adult. These relationships also influence feelings of acceptance and belonging.
Friendship. Adolescence is a time of forming friendships, with members of both the same and opposite sexes. Social activities are usually with the same select groups of individuals. School cliques are common. Many adolescents also have one or two best friends of the same sex during these years with whom they spend large amounts of time. These friendships are often important emotional preparation for more intimate and romantic relationships with others as the person matures.
Dating. Dating becomes a significant issue during these years (Fig. 11-2). Early teen dates usually consist of large groups of both boys and girls going to the mall or the movies. As adolescents get older, they begin to pair off into couples. Many people experience their first steady relationship during these years. First love brings many complicated feelings. A breakup with a first boyfriend or girlfriend can be extremely difficult for the adolescent to handle emotionally.
Peer Pressure and Risk Taking. To define their identity, exert their independence, and “prove” to peers that they are maturing, adolescents may take significant risks with their health and well-being, school success, and relationships. Such risk-taking behavior includes non-compliance with a medical regimen, school truancy, sexual promiscuity, dangerous activities, such as skydiving or car racing, drinking, and using drugs. Adolescents may not be fully knowledgeable of the possible consequences of their actions, or they may insist that they do not care. They are especially vulnerable to unsafe situations because of natural immaturity and the pressure for acceptance. Many adolescents feel a sense of immortality, assuming that nothing bad can happen to them. They are often competitive, with a desire to set themselves apart from the crowd.
Some adolescents who do not “fit” into a same-age peer group may seek the companionship of young adults who give them access to cars, alcohol, cigarettes, money, and mature relationships. The adolescent may come to depend on the older person’s interest for a sense of security or identity. The young adult may take advantage of the adolescent’s role confusion and social immaturity. The result may be even greater pressure for the adolescent to become involved in substance abuse, sexual promiscuity, and delinquency. Young adult men, for example, father a large number of teenage pregnancies, partly because of the dependent relationship and imbalance of power and maturity between an adolescent girl and a young adult man.
FIGURE 11-2 · A primary developmental task of adolescence is to achieve new and more mature relationships.
Families can help adolescents to overcome peer pressure by modeling safe habits and practices. To the adolescent, active, non-judgmental listening is often more productive than dictating behaviors. The family should promote a safe home environment where adolescents receive appropriate responses for their actions and assistance with finding alternative and satisfying recreation and relationships. Parents and older siblings should give information to adolescents about the hazards of risk taking and positively reinforce appropriate practices. Attempting to make adolescents aware of the consequences of risk taking usually works better than exerting authority or using law enforcement and punitive measures. The goal is to make the individual teenager feel part of the solution. A nurse’s job includes active listening, reinforcing healthy eating habits, and encouraging the adolescent to seek well-informed sources for guidance. When an individual feels judged or pressured, it is not uncommon to reject conclusions and judgments of others.
NCLEX Alert Questions relating to these ages may include nutrition (e.g., overeating, anorexia) or risky behaviors (e.g., driving habits, sexual explorations). Peer pressure issues may be included as part of the scenarios or the options.
Food and Eating Habits
Adolescents have special nutritional needs that are important for optimum health. As a result of multiple activities and less adult supervision over meals, young people may indulge in a diet composed primarily of “junk food” that is high in fat, sugar, and empty calories. The number of overweight adolescents in this country is increasing, as is diabetes mellitus, a chronic disease. Poor dietary habits can also lead to problems as metabolism slows and young adults lead a more sedentary lifestyle. Bad nutritional habits at any age can lead to fatigue, unhealthy appearance, and susceptibility to illness.
Teenage boys normally have huge appetites. Many can eat large amounts of food without seeming to gain weight. Some boys lose or gain weight for a specific purpose. Some boys become concerned with achieving a muscular appearance, consuming protein drinks and spending time at a gym in an effort to “pump up.” Or they may engage in dangerous weight loss practices to achieve a lower-than-normal body weight for sports such as wrestling.
Girls are often very concerned about appearance. They may fret continually that they are fat. Gaining just 2 or 3 pounds can make adolescent girls depressed or discouraged. Anorectic or bulimic patterns of eating may emerge during these years. Anorexia is marked by eating minimal amounts of food; bulimia is characterized by a pattern of binge eating, followed by induced vomiting or the use of laxatives. Be aware that, although most people who suffer from these problems are young women, teenage boys and young men sometimes are afflicted as well. Obesity for both sexes can also be a serious problem.
Areas of Concern
Adolescents develop physically and socially at various rates. As they take on more responsibilities, they may have special concerns that their families will share. As a nurse, you need to be prepared for questions related to these and other areas. In Practice: Educating the Client 11-1 lists tips for providing guidance.
Communicate to families that a solid family life helps teenagers achieve a positive self-image. Young people are usually happiest when family relationships are based on mutual respect and affection. Mutual respect recognizes the adult’s task to discipline the adolescent in an age-appropriate manner and the adolescent’s ability to adjust to changing discipline. The gradual path to independence demands the development of self-discipline. Most teenagers will agree that they desire firm disciplinary measures, imposed fairly according to their age and the nature of their misbehavior. Many experts on child behavior agree that strict “discipline for discipline’s sake” only stirs rebellion and undermines self-respect.
IN PRACTICE : EDUCATING THE CLIENT 11-1
ADOLESCENT CONCERNS ABOUT GROWTH AND DEVELOPMENT
• Development of healthy habits: cleanliness, balanced nutrition, sleep and rest, activity and exercise
• Safety measures with motor vehicles and bikes
• Importance of scholastic and skill achievement
• Importance and development of self-respect
• Selection of peers as friends
• Wise counseling about sex and sexuality
• Responsibilities resulting from sexual activity
• Problems that arise from substance use and abuse (cigarette smoking, alcohol, recreational drugs)
Adults must remember that many fluctuations in adolescent behavior are a normal part of growing up. Adolescents are learning to make decisions and to assume responsibility for those decisions. Home support is invaluable. A home that acts as a base—for friendships and personal activities, family conferences for planning and problem-solving, wholesome companionship within the family, and acknowledged moral and ethical standards—furnishes guidelines for adolescents, who learn to respect and to live with themselves and others.
Adolescents who are loved, accorded a measure of freedom and responsibility, disciplined sensibly and respectfully, and encouraged to grow and to achieve personal identity, usually respond with love and respect for family. They enjoy family life and achieve a healthy, mature adulthood. The future family life of young people, when they raise their own children, will probably be patterned after these positive family experiences.
Key Concept Parents need help in accepting their "child" as an "adult."
KEY POINTS
• Adolescence is a turbulent time, marked by rapid physical growth and frequent emotional upheavals.
• Puberty is the time when a person matures sexually and becomes able to reproduce.
• The developmental tasks of adolescence involve the formation of a self-image, establishment of goals for the future, and building relationships with others.
• Skill development in adolescence helps teenagers to learn more and may influence future career and educational choices.
• Great variation exists in physical and emotional maturity among young people.
• Relationships with family and friends and dating contribute to the adolescent’s self-perceptions and interpersonal skills.
• Solid family communication and relations help adolescents get through difficult challenges.
• Age-appropriate discipline is important for adolescents trying to withstand peer pressure.
• Sex education from trusted adults helps teenagers avoid mistakes based on misinformation.
