Nursing theory


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introduction to Nursing theory, major nursing and non-nursing theories

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Nursing theory

  1. 1. Philosophy of nursing theory
  2. 2. Learning objectives • Define theory, concept, construct, Metaparadigm , proposition and model • Discuss the importance of using nursing theories • Describe concepts of nursing theories • Explain the types of nursing theories • Describe the application of different nursing theories • Criticize/analyze different nursing theories
  3. 3. Sub-topics • Definitions of theory and related terms • Nursing theory • Importance of nursing theories • Development of nursing theories • Major nursing theories • Non-nursing theories used in nursing
  4. 4. Theory • A set of related statements that describes/explains phenomena in a systematic way. • Theory comes from the Greek word, “theoria”, which means a be holding, spectacle or speculation. • Theories are always speculative in nature and are never considered to be true or proven. • They are always subjected to further development and revision or may even be discarded if not supported by empirical evidence
  5. 5. Concept • Concepts are building blocks of a theory. • A concept is a word picture or mental idea of a phenomenon. • They are words or ideas that symbolize some aspect of reality. • A concept may be very concrete such as human heart or very abstract such as love. • Concrete concepts may be specified and defined more easily than abstract concepts.
  6. 6. Construct • Construct is highly abstract phenomenon or concept. • It is the term used to indicate a phenomenon that cannot be directly observed but must be inferred by certain concrete or less abstract indicators of the phenomenon. • Examples of construct include wellness, mental health, self esteem and assertiveness. • Each of these concepts can be identified by the presence of some measurable concepts
  7. 7. Proposition • Proposition is a statement or assertion of the relationship between concepts. • Propositional statements derived from theories or from generalizations based on empirical data. • These statements may indicate the relationship between concepts in several ways and may assert two events tend to vary together.
  8. 8. Proposition . . . • Example, there is a relationship between pulse rate and respiratory rate. • Propositional statements may also assert that one variable causes on other variable. • Example, bacteria causes disease.
  9. 9. Model • Model is a symbolic representation of some phenomenon or phenomena. • It represents some aspect of reality, concrete or abstract. • It may be structural, pictorial, diagrammatic, or mathematical. • Difference between theory and model; theory focuses on statements or explanations of the relationship between phenomena, a model focuses on the structure or composition of phenomena.
  10. 10. Cont’d • Phenomena - It is an idea or fact or event that appears or is perceived. • Paradigm - the network of science, philosophy and theory accepted by a discipline or person. • The prevailing paradigm directs the activities of a discipline. • Metaparadigm - the most global perspective of a discipline, singles out the phenomena with a discipline deals in a unique manner, i.e. person, environment, health, illness, etc.
  11. 11. Nursing theory • Nursing theory is the term given to the body of knowledge that is used to support nursing practice. • In their professional education, nurses will study a range of interconnected subjects which can be applied to the practice setting. • This knowledge may be derived from experiential learning, from formal sources such as nursing research or from nonnursing sources.
  12. 12. Nursing theory • Nursing is many things to many people. • Most universally agreed upon is that Nursing is a science involving people, environment and process fueled by a vision of transcendence in the context of healthcare. • It is interesting to note that 90% of all nursing theories have been generated in the last 25 years. • Many schools encourage students to formulate personal philosophies or mid-range theories of Nursing as part of their curriculum. • Some might argue that this multiplicity of theory is detrimental (harmful) to the practice and undermines common vision.
  13. 13. Nursing theory . . . • Others would say that the nature of the young science is sufficiently far reaching to require such tactics in order to elicit true consensus. • Nursing theory provides the foundation of nursing knowledge and gives direction to nursing practice. • Nursing theory should guide the development and future direction of nursing research.
  14. 14. Nursing theory . . . • Barnum (1994) offers this vivid analogy to describe nursing theory: • “A theory is like a map of a territory as opposed to an aerial photograph. The map does not display the full terrain (building, roads, moving, vehicles, or grazing livestock): instead it peaks out these parts that are important for its purpose. If its aim is to guide travelers, the map will highlight the roads; if its purpose is to describe its terrain, it will show its mountains, plains and rivers. But no map or theory reflects all that is contained with in a phenomenon. Such a map will defeat its purpose; giving one a handle on the phenomenon. The handle is created by making the essential parts stand out in relief.”
  15. 15. Importance of nursing theories • used to describe, develop, disseminate, and use present knowledge in nursing. • provide a framework for nurses to systematize their nursing actions: – What to ask, what to observe, what to focus on and what to think about. – They provide a framework to develop new and validate current knowledge. • used to define commonalities of the variables in a stated field of inquiry; – guide nursing research and actions – predict practice outcomes – predict client response.
  16. 16. How do nurses use theory in everyday practice? • Organize patient data • Understand patient data • Analyze patient data • Make decisions about nursing interventions • Plan patient care • Predict outcomes of care • Evaluate patient outcomes
  17. 17. Classification of nursing theories A. Depending On Function • Descriptive-to identify the properties and workings of a discipline • Explanatory-to examine how properties relate and thus affect the discipline • Predictive-to calculate relationships between properties and how they occur • Prescriptive -to identify under which conditions relationships occur
  18. 18. Classification of nursing theories B. Depending on the Generalizability of their principles • Grand theory: provides a conceptual framework under which the key concepts – Leininger’s Theory of Culture Care Diversity and Universality – Newman’s Theory of Health as Expanding Consciousness – Orem’s Self-Care Deficit Nursing Theory – Parse’s Theory of Human Becoming
  19. 19. Classification of nursing theories • Middle range theory: is more precise and only analyses a particular situation with a limited number of variables. • Practice /prescriptive/micro theory: explores one particular situation found in nursing. • It identifies explicit goals and details how these goals will be achieved.
  20. 20. Classification of nursing theories D. Based on the philosophical underpinnings of the theories • Needs theories • Interaction theories • Outcome theories • Humanistic theories
  21. 21. Cont’d 1. “Needs” theories • These theories are based around helping individuals to fulfill their physical and mental needs. • Needs theories have been criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position.
  22. 22. Classification of nursing theories 2.“Interaction” theories • As described by Peplau (1988), these theories revolve around the relationships nurses form with patients. • Such theories have been criticized for largely ignoring the medical model of health and not attending to basic physical needs. 3. “Outcome” theories • Outcome theories portray the nurse as the changing force, who enables individuals to adapt to or cope with ill health.
  23. 23. Classification of nursing theories • Outcome theories have been criticized as too abstract and difficult to implement in practice. 4. “Humanistic” Theories • Humanistic theories developed in response to the psychoanalytic thought that a person’s destiny was determined early in life. • Humanistic theories emphasize a person’s capacity for selfactualization.
  24. 24. Classification of nursing theories • Humanists believe that the person contains within himself the potential for healthy & creative growth. • Carl Rogers developed a person –centered model of psychotherapy that emphasizes the uniqueness of the individual. • The major contribution that Rogers added to nursing practice is the understandings that each client is a unique individual, so, person-centered approach now practice in nursing.
  25. 25. Development of nursing theory • The development of nursing theory has provided direction for the structure of professional nursing practice, education, and research • The introduction of nursing theory historically begins with Florence Nightingale • Conceptual and theoretical nursing models generate knowledge that will: – improve nursing practice – guide nursing approach – facilitate the organization of curricula for all levels of nursing education
  26. 26. Development . . . • From nursing science, conceptual models and nursing theories evolve. • As the profession continues to expand, its own body of knowledge, concepts and theories continue to develop to support nursing practice component.
  27. 27. Major nursing theories • • • • • • • • • • • Nightingale's environmental theory Henderson’s Human Needs Theory Orem’s self care theory Roy’s Adaptation Model Roger’s theory of Science of Unitary Human Beings Roper, Logan and Tierney’s activities of daily living theory Faye Abdullah: patient centered approach Newman system’s theory Lidya E. Hall: Care, core and cure King’s theory of goal attainment The prescriptive theory of Nursing
  28. 28. Nightingale's environmental theory • It is one of Nightingale's nursing theories • Incorporated the restoration of the usual health status of the nurse's clients into the delivery of health care • Disease - reparative process • Nurse’s role - manipulating the environment to facilitate this process • Her intent was to describe nursing and provide guidelines for nursing practice and education
  29. 29. Factors present in the patient's environment • Pure or fresh air • Pure water • Ventilation and warming - Building sickness • Sufficient food supplies • Noise • Efficient drainage • Observation of the sick • Cleanliness • Social considerations • Light (especially direct sunlight)
  30. 30. Major concepts defined by Nightingale • Patient – an individual who is responsible, creative, in control of their lives and health, and desiring good health. • Health – a state of wellbeing; using one’s power to the fullest. • Illness - the reaction of the nature against the conditions in which we have placed ourselves. • Environment – is external to the person, but affecting the health of both sick and well persons.
  31. 31. Environmental…. • The environment, one of the chief sources of infection, must include fresh air, fresh water, efficient drainage, cleanliness, and light. • Nursing - a service to people intended to relief pain and suffering. – The goal of nursing is to promote the reparative process by manipulating the environment.
  32. 32. Application • Applies in all situation that nursing care is provided. • Allows clients to change/ adapt in relation to their diseased state. • It is used by managers and leaders to influence the positions about the nursing care today.
  33. 33. Application • The practice of environment configuration according to patient's health or disease condition is still applied today • E.g. in cases as patients infected with Clostridium tetani (suffering from tetanus), who need minimal noise to calm them and a quiet environment to prevent seizure-causing stimulus.
  34. 34. Theory critique • Nightingale’s nursing principles remain relevant today, as ventilation, warmth, quit, diet, and cleanliness are integral parts of nursing care. • She emphasized nurses should wash frequently and maintain the personal hygiene of their patients. • For nightingale, patients are passive and have no say in their care. • did not put the relationship between concepts clearly
  35. 35. Henderson’s Human Needs Theory • Virginia Henderson viewed nursing as an art and a discipline separated from medicine. • She believed that “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he/she would perform unaided if he/she had the necessary strength, will or knowledge.” • Identified 14 components of Basic Nursing Care (basic needs of the patient) :
  36. 36. Henderson’s . . . 1. Breathe normally 2. Eat and drink adequately 3. Eliminate body waste 4. Move and maintain desirable postures 5. Sleep and rest 6. Select suitable clothes dress and undress 7. Maintain body temperature within normal range by adjusting clothing and modifying the environment 8. Keep the body clean and well groomed and protects the integument.
  37. 37. 14 basic needs . . . 9. Avoid changes in the environment and avoid injuring others. 10. Communicate with others expressing emotions, needs, fears, or opinions. 11. Worship according to one’s faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use of the available health facilities.
  38. 38. Major concepts defined by Henderson Patient – individual; requires assistance to achieve health and independence or a peaceful death. • Individual will achieve or maintain health if they have the necessary strength, will or knowledge. Health – is a quality of life basic to human functioning. • Health is equated with independence, while illness is associated with a lack of independence.
  39. 39. Major concepts . . . Environment – all external conditions and influences that affect life and development. Nursing – a unique function of assisting sick or well individuals in a complementary role. • The goal of nursing is to help the individual gain independence as rapidly as possible.
  40. 40. Theory critique • Henderson’s theory closely corresponds to Maslow’s hierarchy of needs • However, she omitted self- actualization from the remit of the nurse. • Henderson viewed the nurses’ role as that of a substitute for the patient, helper to the patient, and a partner with the patient. • She listed 14 basic needs that nurses should assist patients with if the patients are unable to perform them unaided.
  41. 41. Theory critique • These basic needs compose Henderson’s component of nursing care, which mainly focuses on nursing is an art. • Henderson’s 14 basic needs are the basis for activities of daily living theory. • Henderson’s theory is useful in nursing as the nurse can use the fourteen basic needs as a basis for their nursing assessment.
  42. 42. Orem’s self care deficit theory • Dorothea Orem first published her concepts of nursing in sustaining in 1959, refining them in 1980 and 1985. • Originally, she designed her theory for nursing school curricula to help students differentiate among nursing actions. • She worked on three theories, self care deficits, theory of self care and theory of nursing systems. • This theory focuses on identifying the patients self-care needs and nursing actions designed to meet the patient’s needs.
  43. 43. Orem’s …. • Orem contends that the term “care” describes nursing in a most general way. • Nursing is distinguished from other human services and other forms of care by the way in which it focuses on human beings. • Nursing is commonly viewed as a human health service.
  44. 44. Orem’s General Theory of Nursing Three Interrelated Theories: 1. Theory of Self-Care = why and how people care for themselves 2. Theory of Self-Care Deficit = why people can be helped through nursing 3. Theory of Nursing Systems = describes and explains relationships that must be made and maintained for nursing to be produced
  45. 45. Self-Care Theory • Based on the concepts of: – Self-care – Self-care agency – Self-care requisites – Therapeutic self-care demand
  46. 46. Self Care Theory Concepts Self Care • The performance of activities that individuals initiate and perform on their behalf to maintain life, health, and wellbeing.
  47. 47. Self Care Theory Concepts Self-Care Agency • The individual’s ability to perform self-care activities • Consists of TWO agents: – Self-care Agent - person who provides the self-care – Dependent Care Agent - person other than the individual who provides the care (such as a parent)
  48. 48. Self Care Theory Concepts Self-Care Requisites • Reasons for which self-care is done; these express the intended or desired results • Consists of THREE categories: – Universal - requisites/needs that are common to all individuals (e.g. air, water, food, elimination, rest, activity, etc.) – Developmental - needs resulting from maturation or develop due to a condition or event (e.g. adjustment to new job, puberty) – Health Deviation - needs resulting from illness, injury & disease or its treatment (e.g. learning to walk with crutches after a leg fracture)
  49. 49. Self Care Theory Concepts Therapeutic Self-Care Demand • The totality of “care measures” necessary at specific times or over a duration of time for meeting an individual’s self-care requisites by using appropriate methods and related sets and actions.” Care measures Care measures Therapeutic Self Care Demand
  50. 50. Self-Care Deficit Nursing Theory “The condition that validates the existence of a requirement for nursing in an adult is the health associated absence of the ability to maintain continuously the amount and quality of therapeutic self-care in sustaining life and health, in recovering from disease or injury, or in coping with their effects.”
  51. 51. Self-Care Deficit Nursing Theory  Is the central focus of Orem’s grand theory of nursing  Nursing is required when adults (parent/guardian) are incapable of or limited in their ability to provide continuous effective self-care.  Describes and explains how people can be helped through nursing  Nursing meets these self-care needs through five methods of help.
  52. 52. Five Methods of Nursing Help 1. Acting or doing for another 2. Guiding and directing 3. Providing physical or psychological support 4. Providing and maintaining an environment that supports personal development 5. Teaching
  53. 53. Theory of Nursing Systems • This describes: – How the patient’s self care needs will be met by the nurse , the patient, or both – Nursing responsibilities. – Roles of the nurse and patient – Rationales for the nurse-patient relationship – Types of actions needed to meet the patient’s demands • Designed by the nurse • Based on the assessment of patient’s ability to perform self-care activities
  54. 54. Three Classifications of Nursing Systems 1. Wholly Compensatory: a patient’s self-care agency is so limited that s/he depends on others for well-being. a. Unable to engage in any form of action (e.g. coma) b. Aware and who may be able to make observations or judgments, and decisions about self-care but cannot/should not perform actions requiring ambulation and manipulative movements (e.g. patients with vertebral fractures) a. Unable to attend to themselves and make reasonable judgments about self-care but who can be ambulatory and able to perform some self-care with guidance (e.g. severely mentally incompetent)
  55. 55. Wholly Compensatory Nursing System Accomplishes patient’s therapeutic self-care Nurse Action Compensates for patient’s inability to engage in self-care Supports and protects patient Patient action limited
  56. 56. Three Classifications of Nursing Systems 2. Partly Compensatory: A patient can meet some self-care requisites but needs a nurse to help meet others; either the nurse or the patient have the major role in the performance of selfcare  E.g. a patient with recent abdominal surgery
  57. 57. Partly Compensatory Nursing System Performs some self-care measures for patient Nurse action Compensates for self-care limitations of patient Assists patient as required Regulates self-care agency Patient Action Performs some self-care agency Accepts care and assistance from nurse
  58. 58. Three Classifications of Nursing Systems 3. Supportive-educative: a patient can meet self-care requisites but needs help in decision-making, behavior control, or knowledge acquisition; the nurse’s role is to promote the patient as a self-care agent (teacher/consultant)
  59. 59. Supportive-Educative Nursing System Accomplishes selfcare Patient action Regulates the exercise and development of self-care agency Nurse action
  60. 60. Major concepts defined by Orem (general) • Patient - is an individual unable to continuously maintain selfcare in sustaining life and health, in recovering from disease or injury, or in coping with their effects. • Health – ability to meet self care demands that contribute to the maintenance and promotion of structural integrity, functioning and development. • Illness – occurs when an individual is incapable of maintaining self-care as a result of health related limitations.
  61. 61. Concepts …. • Environment – Any setting in which a patient has un-meet self care needs. • Nursing – A service of deliberately selected and performed actions to assist individuals to maintain self care, including structural integrity, functioning, and development.
  62. 62. Theory critique • Orem’s theory is useful for comprehensive assessment and analysis of individuals. • The theory is very useful for nurses working with chronically ill patients in the hospital or other settings. • It is also used in health maintenance and illness prevention. • The term self-care is used by so many premises which may create confusion. • Individual’s emotional needs are neglected.
  63. 63. Roy’s Adaptation Model • Developed by Dr. callista Roy. • wrote and spoke on the need to define the goal of nursing as a way of focusing the development of knowledge for practice. • Dr. Roy had read a little about the concept of adaptation and was impressed with the resiliency of children she had cared for in paediatrics.
  64. 64. Roy’s Adaptation Model • She focused the individual as a bio-psychosocial adaptive system • Described nursing as a humanistic (values others’ opinions and viewpoints) discipline that places emphasis on persons coping abilities. • According to Roy, the individual and environment are sources of stimuli that require modification for adaptation.
  65. 65. Roy’s Adaptation Model • When the demands of environmental stimuli are too great, or the person’s adaptive mechanisms are too low, the person’s behavioural response are ineffective for coping. • Effective adaptive responses promote the integrity of the individual by conserving energy and promoting the survival, growth and reproduction, and mastery of human system, which seeks equilibrium.
  66. 66. Major concepts defined by Roy • Patient – a person or family with unusual stressors or ineffective coping mechanisms. • Health- a step and process of being and becoming adapted and whole. • Illness- a lack of integration • Environment – all conditions, circumstances, and influences surrounding and affecting the development and behaviour of persons or families. • Nursing – promotion of patients’ effective coping and progress toward adaptation.
  67. 67. Theory critique • Roy’s theory is useful in guiding the nurse in nursing observation and interviewing skills to make an individualized assessment of each person • Serves as a guide in planning and carrying out nursing care action. • Some concepts remain ambiguous e.g. how does adaptation takes place. • Also the theory only includes assessment and interventions and not the full nursing process.
  68. 68. Neumann’s health care system model • Developed by Betty Neumann • This is a complex system theory, with a focus on stress reaction and stress reduction. • This comprehensive theory depicts the patient as the core of a circle (genetics, organ strength or weakness, normal temperature range) with several protective layers.
  69. 69. Neumann’s health care system model • The patient is continuously exposed to internal and external stressors: – loss, change, grief, sensory deprivation, and cultural change • which requires line of defence (nutrition, rest, hydration, oxygen, financial circumstances, employment, and lifestyle) and reactions (role expectations, and copping patterns). • Nursing interventions can occur before or after stressors and at three levels of prevention: primary, secondary, and tertiary.
  70. 70. Major concepts defined by Neumann • Patient- is an open system seeking balance and harmony, composite of physiological, psychological, socio-cultural, and developmental variables and viewed as a whole. • It may refer individuals, families, and communities. • Health- A dynamic equilibrium of the normal line of defence.
  71. 71. Neumann’s health care system model • Illness- illness is due to reaction to stressors with lines of resistance (immune and inflammatory response systems). • Environment- comprises internal and external stressors and resistance factors. • Nursing – reduction of stressors through prevention activities at three levels.
  72. 72. Critique • Neumann’s theory is applicable to all phases of nursing process. • It can be applied across all clinical areas and is especially useful for individuals and families. • It uses a holistic approach because each system or subsystem cannot be isolated; rather, the influence of each system on the whole must be considered. • The three levels of prevention are useful guides for planning interventions.
  73. 73. Theory critique • Particularly useful to nurses working in the community setting, but can also be used in the hospital or clinical environment. • It specially shows how to use the nursing process in both settings. • However, it is wellness oriented, and she uses the terms health and wellness interchangeably as if they mean the same thing. • Also, it is prevention rather than treatment oriented.
  74. 74. Roper, Logan and Tierney’s activities of daily living theory • Roper, Logan and Tierney describe nursing s’ aim as meeting the needs of society. • They depict 12 basic activities of daily living and describe five sources of potential or actual problems.
  75. 75. Basic activities of living • Maintaining a safe environment • Working and playing • Breathing • sleeping • Communication • Expressing sexuality • Moving • Dying • Eating and Drinking • Eliminating • Personal cleansing and dressing • Maintaining body temperature
  76. 76. The five sources of problems 1. Disability 2. Pathologic and degenerative tissue change 3. Accident 4. Infection 5. Environmental changes in the physical, psychological and social sector of the client’s life.
  77. 77. Major concepts defined by Roper, Logan and Tierney • Patient- any individual needing help to perform activities of daily livings. • Health- can only be defined in relation to the individual and his expectations, and in relation to his optimal level of functioning in everyday living. • Environment - houses, factories, and offices, sports grounds and playgrounds and rounds are all environments. • There is also the broader view of environment e.g. climate and geographical location.
  78. 78. Concepts . . . • Nursing – helping patients to prevent, solve, alleviate or cope with problems (actual or potential) with activities of daily livings and exists to meet the needs of society.
  79. 79. Theory critique • Concepts, especially metaparadigm concepts, are not well defined. • The theory follows the biomedical model. • The focus of the theory is on nursing as a helping art.
  80. 80. Non – nursing theories used in nursing • Like nursing theories, there are also non-nursing theories which are used in nursing practice. • Among non-nursing theories used in nursing: – General system theory – Maslow’s hierarchy of human needs – Change theory
  81. 81. General system theory • Provides another approach for studying individuals in their environment and is used by many disciplines. • General system theory includes content, purpose and process, breaking down the “whole” and analyzing the parts. • The relationships between the parts of the whole are examined to learn how they work together.
  82. 82. General system theory . . . . Von Bertalanffy (1969 - 1976) developed general system theory which assumes the following: • All systems must be goal directed. • A system is more than the sum of its parts. • A system is ever-changing, and any change in one parts affects the whole. • Bounders are implicit, and human systems are open and dynamic.
  83. 83. General ….. • Examples of nursing theories that have used the systems approach to client care: • Roy's adaptation model (1980) • Hall’s philosophy of nursing (1964) • Newman’s health care system model (1972) • Johnson's behavioural model (1968) • Parse’s theory for Nursing (1981)
  84. 84. Human needs theory • Maslow’s hierarchy of humans needs is any physiological or psychological factors necessary for a healthy existence. • The most prominent theorist to focus on human needs has been Abram Maslow (1970).
  85. 85. Human needs theory • It states that all humans are born with instinctive needs. • These needs grouped into 5 categories; are arranged in the order of importance from those essential for physical survival to those necessary to develop a person’s fullest potential. • provides a framework for recognizing and prioritizing basic human needs. • This hierarchy is constructed as a pyramid.
  86. 86. Human needs theory • It is often depicted as a pyramid consisting of five levels: – the four lower levels are grouped together as being associated with Physiological needs/deficiency needs – while the top level is termed growth needs/Being needs associated with psychological needs.
  87. 87. Human needs theory • Deficiency needs must be met first. • Once these are met, seeking to satisfy growth needs drives personal growth. • The higher needs in this hierarchy only come into focus when the lower needs in the pyramid are satisfied. • Once an individual has moved upwards to the next level, needs in the lower level will no longer be prioritized.
  88. 88. Deficiency and being needs • The deficiency needs are: physiologic, safety and security, love and belonging, and esteem needs. • B-needs = self actualization and transcendence ( be greater, better) needs
  89. 89. 1. Physiological needs • These are the basic human needs for such things as air, food, warmth, water, excretion, sexual and other bodily needs. • If some needs are not fulfilled, a person's physiological needs take the highest priority. • Physiological needs can control thoughts and behaviors. – can cause people to feel sickness, pain, and discomfort.
  90. 90. 2. Safety needs • With their physical needs relatively satisfied, the individual's safety needs take over and dominate their behavior. • manifest themselves in such things as a preference for job security, grievance procedures for protecting the individual from unilateral authority, savings accounts . . . .
  91. 91. Safety and Security needs • Personal security from crime • Financial security • Health and well-being • Safety net against accidents/illness and the adverse impacts
  92. 92. 3. Social needs/belongingness • After physiological and safety needs are fulfilled, the third layer of human needs is social. • This psychological aspect of Maslow's hierarchy involves emotionally-based relationships in general, such as: • friendship • intimacy • having a supportive and communicative family
  93. 93. Social needs . . . • Humans need to feel a sense of belonging and acceptance. • They need to love and be loved (sexually and non-sexually) by others. • In the absence of these elements, many people become susceptible to loneliness, social anxiety, and Clinical depression.
  94. 94. 4. Esteem needs • All humans have a need to be respected, to have self-esteem, self-respect, and to respect others. • People need to engage themselves to gain recognition and have an activity that give the person a sense of contribution, to feel accepted and self-valued. • Imbalances at this level can result in low self-esteem or inferiority complexes.
  95. 95. 5. Self-actualization • Self-actualization and transcendence are "being" or "growth" needs (also termed "B-needs") • they are enduring motivations or drivers of behavior.
  96. 96. Change theory • People grow and change throughout their lives. • Change happens daily. • This changes and growth affects human kinds. • Change is continuous. • Reactions to changes are grounded in the basic human needs for self-esteem, safety, and security. • Change may be planned or unplanned. • Kurt Lewin (1962) developed the theory of change.
  97. 97. Change theory . . . • Lewin identified three states of change: unfreezing, movement, and refreezing. • Unfreezing – is the recognition of the need for change and the dissolution of previously held patterns of behaviour. • Movement – is the shift of behaviour towards a new and more healthful pattern. • Refreezing – is the long term solidification of the new pattern of behaviour.