THEORIES FROM OTHER DISCIPLINES *Every person is capable and has the desire

UTILIZED IN NURSING to move up the hierarchy toward a level of

self-actualization. However, progress is
often disrupted by a failure to meet lower
Maslow’s Human Needs Theory level needs. Life experiences, including
(Hierarchy of Needs) separation and loss of job, may cause an
- Father humanistic psychology and individual to fluctuate between levels of
creator of maslow’s hierarchy hierarchy

*Therefore, not everyone will move through

the hierarchy in a unidirectional manner but
may move back and forth between the
different types of needs.

1. Physiological needs – biological

requirements for human survival
e.g. air, food, drink, shelter, clothing,
warmth, sex, sleep
2. Safety needs - protection from
elements, security, order, law,
stability, freedom from fear
3. Love and belongingness needs -
social needs and involves feelings of
belongingness
- the need for interpersonal
relationships motivate behavior.
e.g. friendship, intimacy, trust and
Is a motivational theory in psychology acceptance, receiving and giving
comprising a five-tier model of human affection and love
needs, depicted as hierarchical levels within Affiliating – being part of a group
a pyramid. (family, friends, work)
4. Esteem needs: Esteem for oneself
From the bottom of the hierarchy upwards, (dignity, achievement, mastery,
the needs are: independence)
1. Physiological Desire for reputation or respect or
2. Safety respect from others (e.g. status,
3. Love and Belonging prestige)
4. Esteem *Most important for children and
5. Self-actualization adolescents and precedes real
self-esteem or dignity
Deficiency needs vs. Growth needs 5. Self-actualization needs – realizing
Deficiency needs arise due to deprivation personal potential, self-fulfillment,
and are said to motivate people when they seeking personal growth and peak
are unmet. The motivation to fill such needs experiences.
will become stronger the longer the duration “to become everything one is
they are denied capable of becoming”

Example: The longer a person goes without

food, the more hungry he will become.

Deficiency needs – first four levels

Growth or Being needs – top level

*Growth needs stems from a desire to grow

as a person. Once these needs have been
reasonably satisfied, one may be able to
reach the highest level : self-actualization
Expanded Hierarchy of Needs Behavior leading to self-actualization:
1. Biological and Physiological needs 1. Experiencing life like a child, with full
2. Safety needs of absorption and concentration
3. Love and belongingness needs 2. Trying new things instead f sticking
4. Esteem needs to safe paths
5. Cognitive needs – knowledge and 3. Listening to your own feelings in
understanding, curiosity, exploration, evaluating experiences instead of
need for meaning and predictability the voice of tradition, authority, or
6. Aesthetic needs – appreciation and the majority
search for beauty, balance, form, 4. Avoiding pretense (game playing)
etc. and being honest
7. Self-actualization needs 5. Being prepared to be unpopular if
8. Transcendence needs – a person is your views do not coincide with
motivated by values which transcend those of the majority
beyond the personal self (e.g. 6. Taking responsibility and working
mystical experiences and certain hard
experiences with nature, aesthetic 7. Trying to identify your defenses and
experiences, sexual experiences, having the courage to give them up.
service to others, the pursuit of
science, religious faith, etc.) Educational applications:
Holistic approach to education and
learning – complete physical, emotional,
Characteristics of self-actualizers: social, and intellectual qualities of an
1. They perceive reality efficiently and individual and how they impact on learning
can tolerate uncertainty - Students need to feel emotionally
2. Accept themselves and others for and physically safe and accepted
what they are within the classroom to progress and
3. Spontaneous in thought and action reach their full potential
4. Problem-centered (not self-centered) - Students must be shown they are
5. Unusual sense of humor valued and respected in the
6. Able to look at life objectively classroom, and the teacher should
7. Highly creative create a supportive environment.
8. Resistant to enculturation, but not Students with a low self-esteem will
purposely unconventional not progress academically at an
9. Concerned for the welfare of optimum rate until their self-esteem
humanity is strengthened.
10. Capable of deep appreciation of e.g. A tired and hungry student will
basic life experience find it difficult to focus on learning

11. Establish deep satisfying Use of Maslow’s Hierarchy as a Nurse?

interpersonal relationships with a Prioritizing Patients Needs
few people - e.g. Pain relief before starting
12. Peak experiences physical therapy for a patient
13. Need for privacy recovering from back surgery
14. Democratic attitudes Assist with Care Planning
15. Strong moral/ethical standards - e.g. A care plan for an elderly
woman who lives alone and has
mobility issues would prioritize
impaired mobility (physiological)
ahead of social isolation (love and
belonging)
Consideration of ADLs (activities of daily
living)
- Assisting patients with ADLs
e.g. Assistance to the bathroom – they will
put their basic physiological need of
elimination ahead of their safety and risk
falling; Patient rings the call light
Studying for PNLE 3. Syntaxic - which consists of
● Prioritizing of answers consensually validated symbol activity,
● Choose physiological first especially of a verbal nature
- One which has been agreed upon by
a group of people as having a
Henry (Harry) Stack Sullivan – standard meaning. Words and
“Transactional Analysis” numbers are the best examples of
(Interpersonal Theory) such symbols.
Father of Interpersonal Psychiatry or - Produces logical order among
Interpersonal Psychoanalysis experiences and enables people to
communicate with one another
3 Cognitive Process - The child gradually learns the
1. Prototaxic experience - “may be 'consensually validated' meaning of
regarded as the discrete series of language - in the widest sense of
momentary states of the sensitive language.
organisms - These meanings have been
● Pro = For acquired from group activities,
interpersonal activities, social
- refers to the first kind of experience the experience.
infant has and the order or arrangement in
which it occurs Stages of Development:
- they have no necessary connection among Infancy – extends from birth to the
themselves and possess no meaning for the appearance of articulate speech
experiencing person - the oral zone is the primary zone of
Example: Found in its purest form interaction between the baby and its
during the early months of life and is the environment
necessary precondition for the appearance - nursing provides the baby with its
of the other two modes. interpersonal experience.
Infants: “He has no awareness of himself - from birth to eight months;
as an entity separate from the rest of the gratification of needs
world. In other words, his felt experience is Characteristics:
all of a piece, undifferentiated, without 1. Transition from a prototaxic to a parataxic
definite limits. It is as if his experiences mode of cognition
were 'cosmic” 2. The organization of bad, anxious,
rejecting, frustrating mother and the good,
2. Parataxic mode - of thinking relaxed, accepting, satisfying mother
consists of seeing causal 3. The differentiation of the baby’s own
relationship between events that body so that the baby learns to satisfy its
occur at about the same time but tensions
which are not logically related independently of the mothering one,
● Para = beyond, past for example by thumb sucking
4. The learning of coordinated
Whenever a black cat comes my way I face movements involving hand and eye, hand
disaster and mouth and ear and
Example: voice.
- All superstitions, for instance, are
examples of parataxic thinking. 2. Childhood – learning of language and
- The child cannot yet relate them to the organization of experience in the
one another or make logical syntaxic mode
distinctions among them. - extends from the emergence of
- Not a step by step process. articulate speech to the appearance
Experience is undergone as of the need for playmates.
momentary, unconnected states of - 18 months to 6 years of age or
being. Childhood; Delayed gratification
3. Juvenile era – it extends throughout the Ludwig von Bertalanffy’s “General
most of the school years; Systems Model”
- 6-9 years of age; formation of
peer group
- Includes purpose, content and
- one acquires social subordination
process, breaking down the “whole”
to authority figures outside of family
and analyzing the parts.
- one becomes competitive and
Relationship between the parts of the whole
cooperative
are examined to earn how they work
together
4. Preadolescence – begins to develop the
A system is made up of separate
conception of gender;
components. The parts rely on one another,
- 9-12 years of age; development of
are interrelated, share a common purpose,
relationships of same gender
and together form a whole.
little boy – masculine role
little girl - feminine role
1. Input - is the information that enters
- growth of symbolic ability enables the
the system (information, money,
child to play at being a grown-up or
energy, time, individual effort and
performances dramatizations; to become
raw materials)
concerned with overt and covert activities
2. Throughput - is converting raw
that serve to ward off punishment and
materials or energy from the
anxiety – Sullivan calls this preoccupations
environment into products that are
usable by either the system itself or
5. Early Adolescence – main problem is
the environment. (thinking planning,
the development of a pattern of
decision-making, sorting, sharing
heterosexual activity
information, meting, discussing, etc.)
- 12 to 14 years, develops an identity
3. Output - is the end products of a
- the physiological changes of puberty are
system (software programs,
experienced by the youth as feelings of lust
documents, decisions, rules, money,
- lust dynamism involves primarily the
assistance, cars, clothing, etc.)
genital zone, but other zones such as the
4. Feedback - is the process through
mouth and the hands also participate in
which the output is returned to the
sexual behavior
system (why were mistakes made?,
- there is separation of erotic need from
how many mistakes were made?
the need for intimacy
How many had to be recalled to
- the erotic need takes as its object a
correct errors?)
member of the opposite sex while the need
for intimacy remains fixated upon a member
Von Bertalanffy developed General
of the same sex
Systems Theory which has the following
- if these two needs (erotic and intimacy)
assumptions:
do not separate, the young person displays
1. All systems must be goal directed
a homosexual rather than a heterosexual
2. A system is more than the sum of its
orientation
parts
3. A system is everchanging and any
6. Late Adolescence – prolonged initiation
change in one part affects the whole
into the privileges, duties, satisfactions and
4. Boundaries are implicit and human
responsibilities of social living and
systems are open and dynamic.
citizenship.
- 14 to 21 years of age characterized
Nursing Models based on Systems
by formation of lasting, intimate
Theory:
relationships
1. Imogene King’s Systems Interaction
Interpersonal Theory explains 3 types of
Model
self: good me, bad me, and not me
2. Betty Neuman’s Health Care
“Good me” versus the “Bad me” - based on
Systems Model
social appraisal and the anxiety that results
3. Dorothy Johnson’s Behavioral
from negative feedback
System Model
“Not me” refers to the unknown, repressed
component of the self
 DEVELOPMENTAL THEORIES

Kurt Lewin’s “Change Theory”

Areas of Developmental Theory
Father of Social Psychology

Biophysical development – attempts to

Behaviour (in this model) is “a dynamic
describe the way our physical bodies grow
balance of forces working in opposing
and change
directions”
i.e. Giselles Theory of Development – each
child pattern of development is unique
3 major concepts:
1. Driving forces – push in a direction
Psychoanalytic/Psychosocial
that causes change to occur; cause
Development - attempts to describe the
a shift in the equilibrium towards
development of the human personality,
change
behavior and emotions.
2. Restraining forces – counter the
1. Sigmund Freud’s Psychoanalytic
driving forces; hinders change
Model of Personality
because they push in opposite
2. Erik Erikson’s Theory of
direction
Psychosocial Development
3. Equilibrium - a state of being
where driving forces equal
Cognitive Development - Jean Piaget’s
restraining forces, and no change
Theory of Cognitive Development
occurs.
Moral Development – Lawrence
- it can be raised or lowered by
Kohlberg’s Theory on Moral Development
changes that occur between the
driving and restraining forces

3 Stages: Sigmund Freud’s

1. Unfreezing – finding a method of making Psychoanalytic Model of
it possible for people to let go of an old Personality Development
pattern that was somehow Stage 1 Oral (birth to 18 months)
counterproductive. ● Initially, sucking and oral satisfaction
Methods: ● Later, infant begins to realize that
1. Increase the driving forces that the mother/parent is separate from
direct behavior away from the self
existing situation or status quo. ● Disruption in the availability could
2. Decrease the restraining forces that have an impact on the infant’s
negatively affect the movement from development
the existing equilibrium.
3. Finding a combination of the first Stage 2 Anal (12 to 18 months to 3
methods. years)
2. Change Stage - which is also called ● Focus of pleasure is the anal zone
“moving to a new level” or “movement” ● Through the toilet – training process,
Involves a process of change in thoughts, the child is asked to delay
feeling, behavior or all three, that is in some gratification in order to meet parental
way more liberating or more productive and societal expectations
3. Refreezing Stage - is establishing the
change as the new habit, so that it now
becomes the “standard operating
procedure”
- Without this stage, it can be easy
for the patient to return to old habits
Stage 3 Phallic or Oediphal (3-6 years) Erik Erikson’s Theory of
Genital organs become the focus of Psychosocial Development
pleasure Described the impact of social experience
● Boy becomes interested in the penis across the lifespan
● Girl becomes aware of the absence
of the penis known as penis envy ● Social interaction and relationships
Exploration and imagination played a role in the development
The child fantasizes about the parent of the and growth of human beings
opposite sex as his/her first love interest In each stage people experience a conflict
Oedipal complex for the Boy that serves as a turning point in
Electra complex for the Girl development
By the end of this stage, child attempts to
reduce his conflict by identifying with the Stage 1 – Infancy (Birth – 18 months)
parent of the same sex in a way to win ● Basic Conflict: Trust vs. Mistrust
recognition and acceptance ● Important Events: Feeding
● Outcome: Children develop a sense
Stage 4 Latency (6-12 years) of trust when caregivers provide
Sexual urges are repressed and channeled reliability, care and affection. A lack
into productive activities that are socially of this will lead to mistrust.
acceptable ● Virtue: Hope
Within the educational and social worlds of
the child, there is much to learn and
accomplish Stage 2: Early Childhood (2-3 years old)
This is where the child places energy and ● Basic Conflict: Autonomy vs.
effort. Shame and Doubt
● Important Events: Toilet Training
Stage 5 Genital (Puberty through ● Outcome:
Adulthood) - Children need to develop a sense
Time of turbulence when earlier sexual of personal control over physical
urges awaken and are directed to an skills and a sense of independence.
individual outside the family circle - Potty training in plays an important
Unresolved prior conflicts surface during role in helping children developing
adolescence this sense of autonomy
Once conflicts are resolved, the individual is - Children who struggle and who are
then capable of having a mature adult ashamed for their accidents may be
sexual relationship left without a sense of personal
control
Success during this stage leads to
feelings of autonomy, failure results
in feelings of shame and doubt
● Virtue: Will

Stage 3 – Preschool (3 to 5 years)

● Basic Conflict: Initiative vs. Guilt
● Important Events: Exploration
● Outcome:
- Children need to begin asserting
control and power over the
environment
- Success in this stage leads to a
sense of purpose
- Children who try to exert too much
power experience disapproval
● Virtue: Purpose
Stage 4 – School Age (6-11 years) Stage 8: Maturity (65 years to Death)
● Basic Conflict: Industry vs. ● Basic Conflict: Ego Integrity vs.
Inferiority Despair
● Important Events: School ● Important Events: Reflection on life
● Outcome: ● Outcome: Older adults need to look
- Children need to cope with new back in life and feel a sense of
social and academic demands. fulfillment.
- Success leads to a sense of - Success at this stage leads to
competence, while failure results in feelings of wisdom, while failure
feelings of nferiority results in regret, bitterness, and
● Virtue: Competence despair.
- Those who look back on life they
Stage 5 – Adolescence (12 to 18 years) feel was well-lived, will feel satisfied
● Basic Conflict: Identity vs. Role and ready to face the end of their
Confusion lives with a sense of peace
● Important Events: Social - Those who feel regret will instead
Relationships fell fearful that their lives will end
● Outcome: without accomplishing the things
- Teen needs to develop a sense of they feel should have.
self and personality. ● Virtue: Wisdom
- Success leads to an ability to stay
true to yourself, while failure leads to
role confusion and a weak sense of
self
● Virtue: Fidelity

Stage 6: Young Adulthood (19 to 40

years)
● Basic Conflict: Intimacy vs.
Isolation
● Important Events: Relationships Jean Piaget’s Theory of Cognitive
● Outcome:
Development
- Young adults need to form intimate,
Reasoning and thinking processes,
loving relationships with other
including the changes in how people come
people
to perform intellectual operations
- Success leads to strong
These operations are related to the ways
relationships, while failure results in
people learn to understand the world in
loneliness and isolation
which they live.
● Virtue: Love

Period 1 Sensorimotor (Birth to 2 years)

Stage 7: Middle Adulthood (40-65 years)
Infant develops action pattern for dealing
● Basic Conflict: Generativity vs.
with the environment. This includes hitting,
Stagnation
looking, grasping or kicking
● Important Events: Work and
As infant learns that sucking achieves a
Parenthood
pleasing result, she/he generalizes the
● Outcome:
action to suck fingers, blanket or clothing.
- Adults need to create or nurture
Successful achievement leads to greater
things that will outlast them, often by
exploration.
having childrenor creating a positive
Toward the end of this stage, infant are able
change that benefits other people.
to make primitive mental images as they
- Success leads to feelings of
acquire object permanence. Before this,
usefulness and accomplishment,
they do not realize that objects out of sight
while failure results in shallow
exist.
involvement in the world
Example:
● Virtue: Care
a 6 month old is shown a toy before it is
hidden – he/she will not search for it
At 18 months, the child can understand
that even if it cannot be seen, it still
exists and will search for it.
Period 2 Preoperational (2 to 7 years) Lawrence Kohlberg’s Theory of
Children learn to think with the use of Moral Development
symbols and mental images Focuses on the description of moral
Still egocentric, the child sees objects and reasoning
persons from only one point view, the child’s Moral reasoning is how people think about
own the rules of ethical and moral conduct but
Play is the initial method of non-language does not predict what a person would
use of symbols actually do in a given situation
This is the time for parallel play Moral development is the ability of an
Later, language develops and broadens individual to distinguish right from wrong
possibilities for thinking abut the past or the and to develop ethical values on which to
future. Children can now communicate base his/her actions
about events with others
Level 1 Pre-Conventional
Period 3 Concrete Operational (7 to 11 - a child has not yet adopted or internalized
years) society’s conventions regarding what is right
Achieve the ability to perform mental or wrong, but instead focuses largely on
operations. external consequences that certain actions
Example: child can now think about an may bring
action that before was performed physically Stage 1 Obedience and Punishment
Child can count and at the same time Orientation
understand what each number represents ● Focuses on the child’s desire to
Can describe a process without actually obey rules and avoid being punished
performing it ● Example: an action is perceived as
Children can mentally reverse the direction morally wrong because the
of their thoughts (Reversibility) perpetrator is punished
Can classify objects according to their Stage 2 Instrumental Orientation
quantitative dimensions (Seriation) ● Expresses the “what’s in it for me?”
Has the ability to see objects or quantities position, in which right behavior is
as remaining the same despite as change in defined by whatever the individual
their physical appearance (Conservation) believes to be in their best interest
● “I’ll scratch your back, and I’ll scratch
Period 4 Formal Operations (11 years to yours” mentality
adulthood) ● Example: Child is asked to do
Thinking moves to abstract and theoretical chores, an incentive will be given by
subjects giving him an allowance
Thinking can venture into such objects as
achieving world peace, finding justice and Level 2 Conventional
seeking meaning in life ● a child sense of morality is tied to
Adolescents can organize their thoughts in personal and societal relationships
their minds. They have the capacity to ● Children continue to accept the rules
reason with respect to possibilities of authority figures, but this is now
New cognitive powers allow the adolescents due to their belief that this is
to do more far-reaching problem solving, necessary to ensure positive
including their futures and that of others relationships and societal order
Their thinking matures and the depth of ● Adherence to rules and conventions
understanding increases with experience is somewhat rigid during this stages
Stage 3 Good Boy, Nice Girl Orientation
● Children want the approval of others
and act in ways to avoid disapproval
● Emphasis is placed on good
behavior and people being “nice” to
others
Stage 4 Law and Order Orientation
● Child blindly accepts rules and
convention because of their
importance in maintaining a
functioning society
 ● Rules are seen as being the same
for everyone, and obeying rules by
doing what one is supposed to do is
seen as valuable and important

Level 3 Post-Conventional
● This level is marked by a growing
realization that individuals are
separate entities from society and
that individuals may disobey rules
inconsistent with their own principles
● They live by their own ethical
principles, principles that typically
include such basic human rights as
life, liberty and justice

Stage 5 Social-Contract Orientation

● The world is viewed as holding
different opinions, rights and values
● Those that do not promote the
general welfare should be changed
when necessary to meet the
greatest good for the greatest
number of people
● Democratic government is
theoretically based on this stage

Stage 6 Universal-Ethical-Principal
Orientation
● Highest stage of functioning
● Some individuals will never reach
this level
● The appropriate action is determined
by one’s elf-chosen ethical principles
of conscience
● These principles are abstract and
universal in application