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Basic Human Needs and Maslow's Hierarchy
Basic human needs are essential elements for survival and health, common to all people. Meeting these needs depends on physical and social environments, including the family and community. Holistic nursing care addresses physical, safety, psychosocial, and spiritual needs.
Characteristics of Basic Needs
Lack of fulfillment results in illness.
Fulfillment helps prevent illness or signals health.
Meeting the need restores health.
Takes priority over other desires when unmet.
Unmet needs create a feeling of deficiency; met needs produce satisfaction.
Levels of Maslow's Hierarchy
Physiologic Needs
Highest priority; essential to life maintenance.
Oxygen: Most critical; evaluated via skin color, vital signs, anxiety, restlessness, and mental status.
Water/Fluids: Balance prevents dehydration or edema; monitored via intake/output, skin turgor, and weight.
Food and Elimination: Maintained through digestive and metabolic processes; assessed by weight, muscle mass, and lab values.
Temperature: Normal narrow range around ().
Sexuality, Physical Activity, and Rest: Essential for rejuvenation, physical health, and holistic balance.
Safety and Security Needs
Physical Safety: Protection from harm through hand hygiene, sterile technique, proper equipment use, safe medication administration, and fall prevention.
Emotional Safety: Trusting others and freedom from fear or anxiety; fostered by therapeutic relationships and clear communication.
Love and Belonging Needs
Higher-level need focused on understanding, accepting, giving/receiving love, and group belonging.
Nursing interventions include involving family/friends, establishing trusting relationships, and referring to support groups.
Self-Esteem Needs
Need to feel good about oneself, feel pride, and receive respect/appreciation from others.
Affected by role changes, illness, and body image changes; nursing care focuses on patient perception, respecting values, and goal setting.
Self-Actualization Needs
Highest level; reaching full potential by developing unique capabilities.
Characteristics include self-acceptance, objectivity, creativity, and problem-solving.
Nursing care emphasizes patient strengths, hope, and self-directed goal achievement.
The Family
A family is defined as any group of people who live together and depend on one another for physical, emotional, and financial support. It serves as a buffer between individual needs and societal expectations.
Family Structures
Nuclear Family: Traditionally composed of two parents and children. Contemporary definitions include any two or more people depending on each other emotionally, physically, or financially (including blended families, adoptive families, and childless couples).
Single-Parent Family: Headed by one parent (often female); faces unique financial burdens and role-shift challenges.
Other Structures: Cohabiting adults, binuclear families (joint custody), dyadic nuclear families, and single adults living independently.
Family Functions
Physical: Provides safe environment for growth and recuperation.
Economic: Offers financial support to members.
Reproductive: Raises children.
Affective and Coping: Provides emotional comfort and identity during stress.
Socialization: Teaches values, beliefs, and problem-solving skills.
Family Developmental Stages (Duvall's Theory)
Couple and family with young children: Establish relationship, adjust to infants, ensure child safety.
Family with adolescents and young adults: Maintain open communication, balance freedom with responsibility.
Family with middle-aged adults: Strengthen marital ties, prepare for retirement, maintain generational ties.
Family with older adults: Adjust to retirement, physical decline, loss of spouse, or moving homes.
Family Risk Factors
Lifestyle: Chemical dependency, poor nutrition, lack of knowledge on parenting/marital roles.
Psychosocial: Inadequate income, conflict, lack of childcare.
Environmental: Unsafe living conditions, pollution, work stress.
Developmental: Single adolescent parents, isolated older adults, new babies without support.
Biologic: Genetic predispositions to disease, congenital defects.
The Community
A community is a specific population living in the same geographic area under similar regulations with common values, interests, and needs.
Key Community Influences on Health
Social Support Systems: Networks of family, friends, and local organizations providing emotional and financial assistance.
Community Health Structure: Availability and accessibility of hospitals, clinics, emergency services, and transportation.
Economic Resources: Personal finances, job market, and health insurance coverage (e.g., impact of the Affordable Care Act / PPACA).
Environmental Quality: Sanitation, zoning laws, police/fire safety, and food access.
Community-Based vs. Community Health Nursing
Community Health Nursing: Focuses on public health and entire populations within a community.
Community-Based Nursing: Focuses on managing acute or chronic health needs of individuals and families within community settings (e.g., home care, clinics, school nursing).
Environmental Health and Sustainability
Environmental health encompasses physical, chemical, biological, and psychosocial factors external to a person.
Principles of Environmental Health
Florence Nightingale & Ecojustice: Nursing advocacy extends to protecting the natural environment to promote human health (ANA Code of Ethics Provision 9.4).
Climate Change Impacts: Rising temperatures and extreme weather contribute to heat-related illness, vector-borne diseases, water/food insecurity, and respiratory illness.
UN Sustainable Development Goals (SDGs): Global target to reduce poverty, promote health equity, foster sustainable communities, and protect natural ecosystems.
Culture of Health: Framework emphasizing equitable, accessible healthcare, healthy environments, and cross-sector collaboration.