Human Development: A Case Study of Mr Khin

This case study examines the human development of Mr Khin, exploring the biological, psychological, and social factors that impact his health and wellbeing. It predicts his future health outcomes based on his current circumstances.

Running head: CASE REPORT
NURS2003 Case Study
Name of the Student
Student ID
Name of the University
Author Note

1CASE REPORT
Table of Contents
Introduction................................................................................................................................2
Background................................................................................................................................2
Biological Factors......................................................................................................................2
Psychological Factors.................................................................................................................3
Social Factors.............................................................................................................................5
Predictions for Next Five Years.................................................................................................6
Conclusion..................................................................................................................................6
References..................................................................................................................................8
Appendix A..............................................................................................................................11
Appendix B..............................................................................................................................14
Appendix C..............................................................................................................................15

2CASE REPORT
Introduction
The concept of human development encompasses the procedure of enhancing the
opportunities and freedoms of individuals, with the aim of improving the overall health and
wellbeing (Kail & Cavanaugh, 2018). This case study focuses on a person Mr Khin. The
purpose of conducting an interview for collecting details on human development of the
person was associated with the intent of obtaining a sound understanding of the different
internal and environmental factors that govern the health and wellbeing of the person. In
addition, the case study also involved conducting a naturalistic observation that helped in
observing the client in their natural environment.
Background
Mr Khin is a retired personnel and currently stays with his wife, elder daughter, son-
in-law and one grandson. He retired from job 15 years ago. He has another daughter and son
who reside abroad. The daughter who stays with him is currently employed as a registered
nurse at the National University Hospital (NUH). Following his retirement he lives a happy
and satisfied life, as he is able to spend quality time with his family members that could not
be accomplished all through his employment years. He had been employed in a reputed
position at his workplace and received a good amount of salary. There is absence of any
fiscal constraint in the family.
Biological Factors
Human development is regulated by a plethora of biological factors that commonly
include gender, nutrition, and genetics, thus creating an important impact on the course of
development of an individual. An analysis of the case scenario suggests that Mr Khin had a
normal birth without any severe complications and there was no significant history of any
disabilities or genetic disorders. However, his sister suffers from hypertension and diabetes
mellitus, and his brother has gout and hypertension. There is mounting evidence for the fact
that genetic inheritance of traits that are specific for particular diseases often determines the
phenotype in the manner they get expressed in the progeny (Diamond et al., 2014). In
addition, the genotype also acts in the form of a blueprint during growth and development of
children and the aggregation of genes often determines the presence and manifestation of
diseases in the child. Genetic factors are likely to influence the blood pressure and associated
cardiovascular complications in individuals (Zhu, Gu & Xu, 2016). In addition, the risks for

3CASE REPORT
hypertension increase under circumstances when heredity is present in combination with
unhealthy lifestyle habits.
Owing to the identification of several genetic variants in genome-wide association
studies (GWAS), it can be suggested that presence of hypertension in his siblings have also
made Mr Khin likely to get affected by this condition at a later stage in life (Lu et al., 2014).
He is currently under the prescribed medication of multi-vitamins each day, following
breakfast. His weight is roughly 75kg and height is 170cm. On calculating the body mass
index (BMI) of the client from the mass and height, it was found to be 26.0 kg/m2. Owing to
the fact that BMI from 18.5 to 25 is considered normal weight, it can be suggested that Mr
Khin is overweight (Holyhealthyumc.com, 2016). Being overweight is characterised by the
accumulation of fat in the body, thus leading to a range of negative health outcome. Owing to
the fact that overweight increases risks of death, cancer and chronic health complications, Mr
Khin is at an increased likelihood of suffering from health problems that might worsen his
quality of life (Fujioka, 2015). However, he mentions performing good amount of physical
activity and also uses stairs, in place of lift.
Adherence to a healthy diet that comprises of fresh fruits and vegetables also suggest
that adequate efforts are being taken by him in order to enhance his health and wellbeing,
while eliminating the risk factors for chronic health problems (Milte, Thorpe, Crawford, Ball
& McNaughton, 2015). He also avoids consumption of alcohol or sweetened beverage. Time
and again it has been established that increased consumption of sweetened drinks makes
people more susceptible to diabetes, obesity, and cardiovascular problems (Ma et al., 2015).
Despite the influence of smoking and alcohol consumption on tachycardia and tachypnoea,
taking into consideration the fact that he refrained from smoking or drinking habits several
years ago, it is less likely that he will suffer from any major chronic disorders (Brunner et al.,
2017).
Psychological Factors
There is mounting evidence for the fact that human development is governed by a
range of psychological factors that commonly include individual-level functioning that create
a significant influence on the mental state of a person (Ryan & Deci, 2017). In addition,
children are often dependent on the nurturing and care they are subjected to, and this largely
depends on the capability of the caregivers. Absence of personalised care during the initial
stages of life have been found to play a crucial role on the growth, health, cognitive capacity

4CASE REPORT
and personality development of individuals (Music, 2016). In addition, responsiveness and
sensitivity are major features that contribute to positive development and health outcomes.
Mr Khin obtained educational attainment till a graduate engineering degree and worked till
the age of 47. In addition, he is also able to accurately perform the activities of daily living.
Owing to the fat that the inability or capability of a person to successfully conduct ADL acts
as a noteworthy measurement of the functional status, and presence of disability in elderly
people, it can be suggested that Mr Khin was not suffering from any disability, and
demonstrated good health condition (Dunlop et al., 2015). However, one major change in his
daily functioning can be associated with a reduction in his learning activity and memory,
concomitant with forgetting things that are not paid attention.
Deficits in learning capacity, attention and memory can be accredited to the onset of
dementia, an umbrella term that refers to gradual and long-term reduction in the ability to
remember, think and act (Robinson, Tang & Taylor, 2015). In addition, the condition also
brings about a reduction in motivation and often gives rise to difficulties in language
processing and motivation. Although Mr Khin does not demonstrate any lack of motivation
or low mood, and appears satisfied with his life, when compared to counterparts of same age
who have become a burden to their family members, it can be cited that he has been affected
with early state dementia. He does not have any monetary concerns and also maintains
contact with his colleagues, while meeting them each month. According to Paunio et al.
(2015) depression and retirement are intricately associated and the failure in the reality of life
in living up to promise, after several years of employment often results in the onset of
persistent low mood among the elderly. However, an analysis of the case scenario suggests
that the client was looking forward to eventually being able to pay concentration and
attention on things that he considered pleasurable.
Development of social connections, a sense of purpose and a steady routine were
some common factors that increased his quality of life and wellbeing, and prevented the onset
of any mental disorder. Besides enhancing the wellbeing of a person, social connection also
creates an impact on the immune system, increases the chance of longevity, facilitates easy
recuperation from diseases, and enhances self-confidence, self-esteem, and empathy towards
others (Cacioppo & Cacioppo, 2014). Thus, it is extremely appearing that the health of Mr
Khin is strongly reliant on his surrounding people.

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Social Factors
Time and again it has been emphasised that there are numerous social determinants
that create an influence on health at manifold levels throughout the course of life of an
individual. In addition, these determinants or factors encompass the conditions in which
people take birth, work, grow, live, and subsequently age in the community (Braveman &
Gottlieb, 2014). Unequal distribution of such social factors have been found to create a
significant damaging experience, and are often considered as a combination of
underprivileged social policies, and prejudicial economic provisions (Marmot & Allen,
2014). Following conduction of the interview, and the naturalistic observation of the client, it
was identified that Mr Khin’s family comprised of his wife, two daughters, one son, one son-
in-law and one grandson. While his son and one daughter were presently employed overseas,
his other daughter was an employed registered nurse at the paediatric ward of National
University Hospital (NUH). It has often been found that socioeconomic status (SES) acts in
the form of a significant sociological and economic measure of the work experience of an
individual, in relation to the position based on earners' education, household income, and
occupation.
Research evidences have confirmed the fact that low income and poor educational
attainment are strong predictors of an array of mental and physical health problems, together
with respiratory distress, coronary disease, arthritis, and schizophrenia (Williams, Priest &
Anderson, 2016). Furthermore, attaining education in families that belong to higher
socioeconomic section of the society, is stereotypically emphasised as much more significant,
both in the local community, as well as within household (Martens et al., 2014). In contrast,
poor SES in a family is often characterised by considering shelter, food, and safety as
priorities, thus forcing education to take a backseat (Nandi, Glymour & Subramanian, 2014).
Hence, the fact that Mr Khin and his family members were well educated, and in possession
of good and respectable employment positions, provides a clear indication of their high SES.
This played a significant role in lowering their risks from suffering from poor health
outcomes.
He suggested having regular contact with his sister and brother, and often paid them
weekly visits. This is directly associated with the factor of social support which acts in the
form of actuality and perception that a person is being care for, has necessary assistance from
other family members and is a part of a social network (Holt-Lunstad & Uchino, 2015). In
addition, he also demonstrates appreciation and thankfulness towards all family members

6CASE REPORT
who play an active role in supporting and helping each other. When one of the family
members has difficulty or stress, the whole family tries to solve the problem and provides
moral supports. There is mounting evidence for the fact that elderly individuals having
associations with social network are often found to show elevated self-esteem, with a reduced
likelihood of having any decline in their health status (De Choudhury & De, 2014).
Furthermore, social support is also identified to function simultaneously as a problem-based
(getting tangible evidence that aids resolve a problem) and emotion-based coping tactic (used
to control emotional rejoinders that originate due to stressful events (Wang, 2016). Thus,
owing to the fact that Mr Khin is integrated in a positive relationship in his social network
that comprises of his immediate family members and siblings, he demonstrates a positive
health and wellbeing, with an enhanced quality of life.
Predictions for Next Five Years
Taking into consideration the current biological, social, environmental and
psychological factors that are prevailing, in relation to Mr Khin, it is predicted that over the
next five years, he is less likely anticipated to suffer from any major health abnormalities.
Owing to the fact that he belongs to a high SES of the society and receives allowance after
his retirement, besides obtaining financial help from the children, he will not face any major
difficulties in gaining access to primary and community based healthcare resources. Although
poor educational attainment and low economic background acts as an impediment in gaining
access to amenities that are responsible for care delivery to the patients, Mr Khin and his
family members have high education, thereby reducing his chance of reporting poor health
outcomes, due to insufficient access.
Furthermore, his engagement and cordial relationship with neighbours and siblings
will create a significant positive impact on his health, and reduce his susceptibility to several
diseases like anxiety, depression, cardiovascular complications, and cancer. He might also
develop hypertension owing to its hereditary nature. It should also be taken into consideration
that he performs physical activity and adheres to a good diet. Thus, there is a reduced
likelihood of any chronic health disorder, provided he is able to effectively manage his BMI.
However, if left undiagnosed and untreated, the presenting complaints of forgetfulness and
difficulty in attention might aggravate, thus leading to the onset of dementia, which in turn
would create a significant impact on his health, and increase burden for his family members.

7CASE REPORT
Conclusion
To conclude, the case study involved Mr Khin who did not manifest any major
deterioration in his health and wellbeing. Although conducting a naturalistic observation and
interview facilitated gaining an insight into major aspects of his life that might have shaped
the current scenario, there were few limitations. The interview based data collection process
was time-consuming. In addition, controlling outside variables during naturalistic observation
was difficult, and it generated a vast amount of subjective data.

8CASE REPORT
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(2017). Alcohol consumption, sinus tachycardia, and cardiac arrhythmias at the
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De Choudhury, M., & De, S. (2014, May). Mental health discourse on reddit: Self-disclosure,
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Wagner, A. K. (2014). IL‐1β associations with posttraumatic epilepsy development:
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Dunlop, D. D., Song, J., Arntson, E. K., Semanik, P. A., Lee, J., Chang, R. W., & Hootman,
J. M. (2015). Sedentary time in US older adults associated with disability in activities
of daily living independent of physical activity. Journal of Physical Activity and
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Fujioka, K. (2015). Current and emerging medications for overweight or obesity in people
with comorbidities. Diabetes, Obesity and Metabolism, 17(11), 1021-1032.
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Appendix A
1500-1501 Mr khin opened the door and said “Hello, come in” and pointed me to the
shoe shelf to place my shoe.
1502 Mr Khin pointed me to the sofa in the living room and told me sit and
make myself comfortable.
1503 Mr Khin sat on a chair just opposite me and asked me I want cold or hot
drink. I replied “anything, ok for me”.
1504 Mr Khin excused himself and left to the kitchen.
1505 Mr Khin asked his wife to prepare two cups of orange juice.
1506 A kid’s crying sound come out from one of the rooms.
1507 Mr khin quickly come out from the kitchen and went into the room.
1508-1510 Mr Khin was still inside the room and sang songs to stop kid’s crying.
1511-1515 The kid stopped crying and heard Mr khin murmuring sound to the baby.
1516 Mr khin came out from the room with a kid aged of 1 year old.
1517 Mr Khin sat on a chair oppsite me and let the kid sat on his thigh.
1518 Mr Khin’s wife brought two cups of orange juice from the kitchen and
placed them on a table just infront of us.
1519 Mr Khin passed the kid to his wife.
1520 He introuced the kid to me “He is my one and only grandson, Liam, his
elder daughter’s son”.
1521-23 Mr Khin said “the weather is very hot today. The climate changed so fast,
morning the sun is so shiny and hot, evening rains, take care of yourself not
to get flu”.
1524 The door was knocked.
1525 Mr Khin opened the door and asked “anything I can help”.
1526-1528 A man who was holding some pamphlets and files was standing in front of

12CASE REPORT
the door and said “he is from pest control, just wants to do mosquito
check”.
1529 Mr Khin said “Oh no problem, come in”.
1530-1535 Mr Khin followed him and show him around the house.
1536-1538 Before the man leaves, Mr Khin asked him “Do u wanna have a cup of
water or juice?” The man repiled him “Oh it’s ok, thanks”. And the man
leaves the house.
1539 Mr Khin closed the door.
1540 Mr Khin sat on the chair again.
1541 Mr Khin switched on the TV and searched for channel and chose a
channel.
1542 Mr Khin said “Normally, day time, I just take a nap together with my
grandson, or watch a random channels and do meditation at 4-5pm for 1
hour”.
1543 His grandson slowly walked to Mr Khin and passed a small guitar for
playing.
1544 Mr Khin asked his grandson “Why Liam? No sound ah?”
1545-1547 Mr Khin tried to fixed it, checked the batteries, pressed on and off buttom
and pressed the random buttoms. Music sound comes out”
1548-1550 Mr Khin smiled and told his grandson “Yay, ang kon, is awesome right?”
and he passed the small guitar to his grandson. Mr Khin laughed and said “
at least my wife and I are not getting bored since Liam was born. Most of
our time pass by with him.”
1551 The telephone rang.
1552 Mr Khin picked up the call.
1553-1556 Mr Khin talked to his friend over the phone about some oversea bussiness.
1557 Mr Khin said his friend “I’ll call you back tonight again, I need to discuss

13CASE REPORT
with my family.”
1558 Mr Khin put down the call and sat back on the chair.
1559 He said “ My friend called me for some oversea work. He is my best friend
since young, until now we are still close”.
1600 Mr Khin said “When you are getting older, you don’t want a lot of friends,
just a few and your family is enough.”
Summary
 Talking to wife: 5%
 Talking to stranger: 20%
 Spending time with grandson: 30%
 Talking over the phone: 5%
 Others: 40%

14CASE REPORT
Appendix B
I was sitting on the sofa opposite seats from him while watching TV show and chit chatting.
He is very friendly and easy going person. He was worried that I would be too shy to talk to
him. He talked to me as his niece and joked around with me.
He told me that he was very satisfied with his current situation and family type. Currently, he
was staying with his wife, elder daughter, son-in-law and one grandson. Another daughter
and son were in overseas. He was retired 15 years ago. He was so proud of himself as there
was no bad memory about him in his work life and every one from his work respected him.
Moreover, as it was his passionate job, satisfactory salary and position, he has no regret about
his work. After his retirement, he was not used to stay at home whole day. But now, he was
happy as he could spend more time with family. When he was working, he left to work at
about 8am in the morning and came back home at 6pm in the evening. He had not much time
to spend with family. He had no financial worry as he was still getting retirement allownace
and financial support from his children.
He answered my questions patiently. Firstly, every morning, he walks around the neighbour
and does some light exercise. He said one lucky thing is he has no medical history such as
hypertension, diabetes mellitus and high cholestrol. He was very proud for it as well. His
mother and father was passed away since he was 20 years old in an accident. He has 3
siblings, one sister and one brother. He is the youngest. When his parents passed away, his
brother and sister supported him to study in colleage. Hence, he did not have to worry about
his education and living. He is satisfied that 3 of the siblings are still alive and healthy. He
taught me to live positively in any life situation. Life is up and down.

15CASE REPORT
Appendix C
Salient Biological Factors
Mr Khin was born as normal child birth with no complications. Nil family history of genetics
disorders or disablities. His sister has hypertension and diabtetes mellitus and his brother has
hypertension and gout. However, he does not have serious health problem or chronic illness
so far. He goes for annual medical check up in Raffles hospital. Currently he is taking multi
vitamins tablets one tablet per day in the morning after his breakfast. His weight is roughly
75kg and height is 170cm. He used to exercise every morning such as walking several blocks
and stretching the body exercises for about 1 hour. Most of the time he uses stairs instead of
using the lift as his house is at 3rd floor lift landing HDB falt and he walks from his house to
MRT station. Mr Khin ranks his physical activity as very good. He does not like to eat heavy
meal. He usually eats soup, more vegetables and meat. He likes to eat more vegetables and
fruit every day. He avoids sweet drinks and used to drink alcohol occasionally. He stops
drinking alcohol 12 years ago. He has history of smoking 1 packet per day when he was aged
of 15 to 20 years old. He has no issue with sleep pattern, seldom insomnia. He usually sleeps
from 10 pm to 5:30am.
Salient Psychological Factors
He studied until engeering college and worked until at his age of 47. He notices that his
memory and learning activity is getting slow and tends to forget if he does not concentrate.
He is satisfied himself that he can do most of the ADLs independently and is releived at least
he is burdoned to his family since he is still healthy and independent while his friends and
other elderly at same age with him are depending on their family due to chronic illness and
other health problems. He does not need to worry about financial issue since he has own
retirement allowance and good family support. He speaks Myanmar, Mandrin and English.
His job before his retirement was not much stressful and good team work in the work place,
thus, he had good working experience. Until now, he has contact with his colleagues and
meets up with them at least one time per month. He is satisfied with his previous work
experience and current life.

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Salient Social Factors
His family includes himself, his wife, two daughters, one son, one son-in-law and one
grandson. One son and one duaghter are currently in overseas for working. The daughter
currently living together with him is working in National University Hospital (NUH) as a
registered nurse in pediatric ward. He still has contact with his brother and sister and often
visits to them once a week. He is gratified his life especially his family as all the family
members are helping and supporting each other. When one of the family members has
difficulty or stress, the whole family tries to solve the problem and provides moral supports.
He used to go travels with his family once or twice a year. He has good relationship with his
neighbours and they share each other food. He spends most of the time at home with his wife
and grandson.