Theories Relevant to Nursing Practice (Maslow, Sullivan, Bertanlaffy, Lewin)

Human Needs Theory

made by Abraham Maslow that categorizes needs into five levels

Physiological Needs, Safety and Security Needs, Love and Belonging Needs, Self-Esteem Needs, Self-Actualization Needs

Five Levels of Hierarchy of Needs (Chronological Order)

Physiological Needs

Biological Requirements for survival

Physiological Needs

Clinical Relevance (Airway maintenance, oxygenation, fluid and electrolyte balance, nutrition, temperature regulation, elimination, sleep, and physical comfort/acute pain management)

Safety & Security Needs

Physical and psychological stability

Safety & Security Needs

Clinical relevance (Fall prevention, medication safety, environmental risk reduction, infection control, and providing clear explanations to alleviate procedural anxiety)

Love & Belonging Needs

Social connection, emotional intimacy, and group acceptance

Love & Belonging Needs

Clinical Relevance (Facilitating family visitation, demonstrating empathetic listening, building a therapeutic relationship, mitigating isolation during hospitalization)

Self-Esteem Needs

Personal worth, Independence, respect, and dignity

Self-Esteem Needs

Clinical Relevance (Maintaining patient privacy, encouraging independence in activities of daily living (ADLs), involving patients in care planning, and providing positive reinforcement

Self-Actualization Needs (Apex)

Reaching full potential and self-fulfillment

Self-Actualization Needs (Apex)

Clinical Relevance (Supporting long-term goal setting, help patients navigate health transitions, and addressing spiritual and palliative goals at end-of-life

Interpersonal Theory - developed by Harry Stack Sullivan where he believed in the existence of relationships, but not of individuals

Interpersonal Theory - One’s personality involved more than individual characteristics, particularly how one interacted with others

Infancy, Childhood, Juvenile, Preadolescence, Adolescence

Sullivan’s Five Life Stages

Infancy

Birth to onset of language

Infancy

Primary need for contact and tenderness

Infancy

Primary zones are oral and anal

Infancy

If needs are met, they have sense of well-being; unmet needs leads to dread and anxiety

Prototaxic mode

dominated; brief, unconnected experiences that have no relation to one another

Childhood

Language to 5 years

Childhood

Parents are viewed as source of praise and acceptance

Childhood

Primary zone is anal

Childhood

Gratification leads to self-esteem

Childhood

Moderate anxiety leads to uncertainty and insecurity; severe anxiety results in self-defeating patterns of behavior

Childhood

Shift to parataxic mode

Parataxic mode

experiences are connected in sequence to each other

Juvenile

5-8 years old

Juvenile

Shift to the syntaxic mode

Syntaxic mode

thinking about self and others based on analysis of experiences in a variety of situations

Juvenile

opportunities for approval and acceptance of others

Juvenile

learn to negotiate own needs

Juvenile

Severe anxiety may result in need to control or restrictive, prejudicial attitudes

Preadolescence

8-12 years old

Preadolescence

Move to genuine intimacy with friend of the same sex

Preadolescence

Move away from family as source of satisfaction in relationships

Preadolescence

Major shift to syntaxic mode (the person begins to perceive himself/herself and can analyze experiences in a variety of settings)

Preadolescence

Capacity for attachment, love, and collaboration emerges or fails to develop

Adolescence

Puberty to adulthood

Adolescence

Need for special sharing relationship to the opposite sex

Adolescence

New opportunities for social experimentation

Adolescence

If the self-esteem is intact, areas of concern expand

Adolescence

Lust

Adolescence

Maturity may be defined as predominance of the syntaxic mode

General Systems Theory

First conceptualized by Austrian biologist Ludwig von Bertalanffy

General Systems Theory

Content-free and applicable to many fields of study

General Systems Theory

May be applied to both living and non-living structures and organized

General Systems Theory

Systems = organized wholes comprised of component parts that interact in a distinct way over time

General Systems Theory

All systems are composed of subsystems or parts that are in dynamic interaction with the rest of the system

General Systems Theory

Every system functions as a whole with properties not evident in the isolated functioning of its parts

General Systems Theory

The parts or subsystems are also systems in themselves, so there is a nested system of interacting structures

General Systems Theory

Systems respond to or interact with the environment in varying degrees. Therefore, systems vary in their capacity to be relatively “closed” or “open”

Equilibrium

The state of stability despite external disturbances

Child, Family Context, Network of Intimates, Neighbourhood and School, Society at Large

The Family as a System

Kurt Lewin

Universally recognized as the founder of modern social psychology

Kurt Lewin

Pioneered the use of theory, using experimentation to test hypotheses

Kurt Lewin

theorized a 3-stage model

Unfreezing-Change-Refreeze model

3-stage model

Driving Forces, Restraining Forces, Equilibrium

Dynamics of Change

Driving Forces

Factors that incentivize, support, or push for transformation

Restraining Forces

Obstacles, resistance, or institutional habits that hinder change and maintain current practice

Equilibrium

occurs when the sum of Driving Forces equals the sum of Restraining Forces, resulting in a stable, unchanging state (the status quo)

Unfreezing

1st stage of Change Theory

Unfreezing

Becoming motivated to change

Unfreezing

Gap between “what is believed” and “what needs to be believed”. Larger gap = ignoring of new information

Unfreezing

The occurrence of anxieties may lead to defensiveness and resistance

Denial, Scapegoating & “Passing the buck”, Maneuvering and Bargaining

3 stages in response to learning anxiety

Change

2nd stage of Change Theory

Change

change what needs to be changed (unfrozen and moving to a new state)

Change

Proactive and clear communication is CRUCIAL

Change

Imitation of role models and personalized solutions may help in making the change

Refreezing

3rd stage of Change Theory

Refreezing

Making the change permanent