THE HUMAN NEEDS THEORY

One of the most famous

pyramid models in history, the famous
human needs theory has been taught
to us and consistently been taught
since our early high school years. This
has been dubbed many several
names, from the human needs theory,
to the hierarchy of needs theory. But
no matter what you call it, it holds the
same concept. This paper, helps us
understand, and dissect the
meanings, technicalities, and practical implication of the human needs theory.

The triangle is a model which simply implies that a person must first
achieve and attain his needs at the bottom of the hierarchy (psychological
basic needs) before moving their way up (self actualization). But let’s dig
deeper.

PROPONENT
Abraham Harold Maslow was
an American psychologist who was
best known for creating “Maslow's
hierarchy of needs”, a theory that
suggested that people have a
number of needs, and as these needs
are met, they are able to go on to
pursue other needs.

Maslow (1943, 1954) stated that

people are motivated to achieve
certain needs and that some needs
take precedence over others. Our
most basic need is for physical
survival, and this will be the first thing
that motivates our behavior. Once
that level is fulfilled the next level up is
what motivates us, and so on.
 He is one of the earliest psychologists to focus attention on happy
individuals and their psychological trajectory. Inspired by the work of the
humanistic psychologist Erich Fromm, Maslow insists that the urge for self-
actualization is deeply entrenched in the human psyche, but only surfaces once
the more basic needs are fulfilled. Once the powerful needs for food, security,
love and self-esteem are satisfied, a deep desire for creative expression and
self-actualization rises to the surface.

THEORY ASSUMPTIONS

Maslow proposed that motivation is the result of a person’s attempt at

fulfilling five basic needs: physiological, safety, social, esteem and self-
actualization. Maslow’s theory is based on the following assumptions:

1. People’s behavior is based on their needs. Maslow believed that

human behavior is based on their needs. Man is a wanting being,
i.e. his wants are growing continuously even when some wants are
satisfied. Satisfaction of such needs influences their behavior. When
one need is satisfied, they will move to strive for other needs. Human
needs are of a varied and diversified nature.
2. A satisfied need does not motivate. People’s needs are in
hierarchical order, starting from basic needs to other higher level
needs. Needs have a definite hierarchy of importance. A satisfied
need can no longer motivate a person to work; only next-higher
level need can motivate him. As soon as needs on a lower level are
fulfilled, those on the next level will emerge and demand
satisfaction. According to Maslow, “Man does not live by bread
 alone”. This conclusion of Maslow is a practical reality and needs to
be given adequate attention while motivating employees.
3. A satisfied need can no longer motivate a person; only next higher
level need can motivate him. A satisfied need does not act as a
motivator. A person moves to the next higher level of the hierarchy
only when the lower need is satisfied. The needs network for most
people is complex, with several affecting the behavior of each
person at any one time.
4. As one need is satisfied, another replaces it. A person moves to the
next higher level of the hierarchy only when the lower need is
satisfied. When one need is satisfied another need emerges to take
its place, so people are always striving to satisfy some need. In
general, lower level needs must be satisfied before higher level
needs are activated sufficiently to drive behavior. This is called
transcendence.

According to Maslow, individuals are motivated by unsatisfied needs. As

each of these needs is significantly satisfied, it drives and forces the next
need to emerge.

Maslow’s Theory focuses on needs as the basis for motivation. This theory is
widely recognized and appreciated. However, some of his propositions are
questioned on his classification of needs and hierarchy of needs. But,
despite such criticism, the theory is still relevant because needs, no matter
how they are classified, are important to understand the behavior. It helps
managers to realize that the need level of employee should be identified to
provide motivation to them.

DEFINITION OF TERMS

1. Need- something that is necessary for an organism to live a healthy life.

2. Hierarchy- A hierarchy is an arrangement of items (objects, names, values,

categories, etc.) in which the items are represented as being "above",
"below", or "at the same level as" one another.
 3. Psychological Needs- Physiological need is a concept that was derived to
explain and cultivate the foundation for motivation. This concept is the
main physical requirement for human survival.

Physiological needs include:

 Homeostasis  Sleep
 Health  Clothes
 Food  Shelter[9]
 Water

4. Social Needs- After physiological and safety needs are fulfilled, the third
level of human needs are seen to be interpersonal and involves feelings of
belongingness.

Social Belonging needs include:

 Friendships
 Intimacy
 Family

5. Self-esteem- Esteem needs are ego needs or status needs. People develop
a concern with getting recognition, status, importance, and respect from
others. Most humans have a need to feel respected; this includes the need
to have self-esteem and self-respect. Esteem presents the typical human
desire to be accepted and valued by others.
6. Self-Actualization- This level of need refers to the realization of one's full
potential. Maslow describes this as the desire to accomplish everything that
one can, to become the most that one can be

Self-actualization can include:[3]

 Mate Acquisition  Utilizing & Developing Talents
 Parenting  Pursuing goals
 Utilizing & Developing Abilities

7. Transcendence- Transcendence refers to the very highest and most

inclusive or holistic levels of human consciousness, behaving and relating,
as ends rather than means, to oneself, to significant others, to human
beings in general, to other species, to nature, and to the cosmos.
 NURSING THEORIES DRAWN

Need theory by Virginia Henderson

The need theory promotes patients’ independence and put an emphasis on the
basic human needs to expedite patients’ health status improvement after
hospitalization. The need theory is explained more using nursing activities that are
based on 14 components of human needs. (Vera, 2014)

Physiological Components

 1. Breathe normally
 2. Eat and drink adequately
 3. Eliminate body wastes
 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 environment
 8. Keep the body clean and well groomed and protect the integument
 9. Avoid dangers in the environment and avoid injuring others

Psychological Aspects of Communicating and Learning

 10. Communicate with others in expressing emotions, needs, fears, or

opinions.
  14. Learn, discover, or satisfy the curiosity that leads to normal
development and health and use the available health facilities.

Spiritual and Moral

 11. Worship according to one’s faith

Sociologically Oriented to Occupation and Recreation

 12. Work in such a way that there is sense of accomplishment

 13. Play or participate in various forms of recreation

How do the two theories work together?

 Both theories focus on the importance of human needs. There are close
similarities between the two theories. "Henderson’s 14 components can be
applied or compared to Abraham Maslow’s Hierarchy of Needs" (Gonzalo,
2011).

 According to a theoretical foundations of nursing article, “The prioritization

of the 14 Activities was not clearly explained whether the first one is
prerequisite to the other. But still, it is remarkable that Henderson was able
to specify and characterize some of the needs of individuals based on
Abraham Maslow’s hierarchy of needs” (Gonzalo, 2011).
  This is where Maslow’s theory comes into play supporting Henderson’s
theory due to the fact that Maslow’s hierarchy of needs have been
prioritized.

IMPORTANCE TO NURSING PROFESSION

Physiological Needs and Safety, the basic levels of Maslow’s Hierarchy,
are often the focus of patient care.

The generalized principle of Maslow’s Hierarchy of Needs allows for its

application in a variety of settings, as has been demonstrated in scientific
fields and healthcare settings to help foster a culture of change. Nursing
continues to be a leading field that has adopted Maslow’s ideas in determining
care plans and acknowledging patient concerns.

This theory has enriched the caring profession in nursing offering novel ways of
understanding people and the world. Such is the case with perspectives
provided by Maslow, which offer a powerful conceptual framework enabling us
to understand and tailor optimal interventions to promote better care.

Level 1: Physiological needs

Nurses must have a decent work environment. To begin with, they need
sufficient breaks to eat, go to the bathroom, and catch their breaths. Nurses
also need communication tools that enable them to connect and collaborate
more efficiently.
Using effective communication tools can simplify and streamline clinical
workflows. Equipping nurses with technologies that enhance care delivery helps
them reclaim time they would otherwise waste on inefficient approaches to
communicating with physicians, locating people and resources, getting critical
test results, and more.
Addressing physiological aspects in a healthcare environment will enable nurses
to reclaim time for basic human needs like rest and meals. As a result, they will
have more energy for patient care.

Level 2: Safety Needs

We all have a basic need to feel safe. If this need is not met, nothing else works.
Hospitals and other healthcare environments should equip nurses with tools that
enable them to call for immediate help when their physical safety is at risk. For
example, a wearable, hands-free communication badge can be used to
contact security when someone is threatening a nurse or anyone else on a floor.
Hospitals should also create processes or protocols that make bullying
unacceptable, and allow nurses to resist bullying without fear of retaliation.

Level 3: Belonging needs

Nurses should also feel empowered at work, and know their feelings and ideas
matter. They are the foundation of excellent patient care. Hospital leaders
should seek out nurses’ perspectives and expert advice on processes, policies
and goals.
Nurses should also be fully involved in co-designing, implementing, and
deploying new technology solutions as they are often the ones using them. IT
vendors must make sure their solutions fit their customers’ clinical workflows and
preferences. Getting nurses’ input and buy-in on the latest innovation before
implementing it will improve adoption and go a long way toward achieving the
intended objective.

Level 4: Esteem needs

Nurses went to school to take care of patients; and when patient satisfaction
and outcomes are good, nurses feel a sense of accomplishment. By creating an
environment where care team members can spend more time with patients,
rather than running around looking for people, phone numbers or supplies,
nurses don’t feel as tired or frustrated. In turn, patients have a better care
experience.
Mobile technology is available for purposeful rounding that captures patient
feedback about their healthcare experience in real-time, which can help
hospitals identify and recognize nurses who provide extraordinary care. This
same tool can also be used for staff rounds, which fosters a culture of
communication to improve employee engagement, trusted relationships, and
well-being.

Level 5: Self-actualization—climate of respect

Having established a solid foundation, nurse leaders can be creative in
establishing an environment where they feel energized by their work.
For example, nurse leaders can give frontline nurses some control over their
schedules. Rather than require everyone to work 12-hour shifts, they can try to
meet staff members’ individual needs. For example, a nurse who wants to go
back to school to earn a higher degree may want to work on weekends, and a
nurse who needs to spend more time with her family may want to work only
during the week. When hospitals create a work environment that builds trust and
allows nurses to have input into determining how to solve problems, they feel
more supported – and this fuels resiliency.

Hospitals can also make nurses feel supported and respected by giving them
the tools they need to communicate effectively with colleagues. In a
collaborative, secure and empowering environment, nurses can easily and
confidently provide excellent patient care. And when they are able to do that
consistently, they will feel self-actualized.

REAL LIFE APPLICATIONS

Nurses can apply Maslow's theory to their practice of patient care. Each
person's needs must be met individually in order for them to feel satisfied, cared
for and cooperative.

Identify the level of care required for the patient. Nurses working in a clinical
setting will not need to attend to the need for food and water, but do need to
protect the safety and privacy for their patients. Confirming what setting the
patient will receive care can help you to understand which patient needs must
be met first.

Evaluate patient communication to determine what needs are not being met.
Body language that includes slouching can reflect a need for respect while
crossed arms can denote a need for safety. Grumpy tones and harsh words can
also reflect a need for care and concern.

Adjust your behavior towards your patients to show acknowledgement of those

needs. Express concern to grumpy patients. Be transparent about procedures
and processes to insecure patients. Speak intelligently and respectfully to
patients whose behavior indicates a desire for respect. Understand that patients
may feel like they are at the mercy of their health and at the medical staff to
restore them.

Allow yourself to form a bond with patients. Patients in extended care programs,
such as residents in nursing homes, will benefit from bonding with their
caretakers. Laugh, joke and enjoy their individual personalities. Express real
concern over their lamentations and enjoy when they share happy news of their
lives. They do so to bond with you, so embrace it.

EXAMPLES:

1. PHYSIOLOGICAL NEEDS: They include basic concerns by family members if

sometimes patients are unaware of their condition. This is mostly extended and
well taken care of by hospitals. It may include providing support for failing
organs, pain and symptom management, taking care of nutrition etc.

2. SAFETY NEEDS: Concerns about emotional well-being in the context of

frequent nightmares and delusions as well as with whether the ICU team can
prevent their conditions from worsening. This can be taken care of by
preventing errors, delirium management and monitoring, taking care of hospital
acquired infections etc.

3. SOCIAL NEEDS (LOVE/BELONGING): Concerns about how much support they

will receive if their critical illness persists (e.g. will people continue to visit or will
they forget about me) and well as whether they will “fit in” to old communities
now that they have “newly acquired” disabilities that may limit them. Hospitals
should allow open visitation of family and friends and post ICU support should be
given by nurses.

4. ESTEEM NEEDS: Concerns about whether they can reach recovery-related

goals – e.g. return to vigorous activities or to work as soon as they had hope.
Can be fulfilled by recognition of dignity/value in each patient, optimizing pre-
illness cognition and physical function through rehabilitation.

5. SELF ACTUALISATION: Concerns about ability to reconcile pre-morbid identity

with “new normal” and to embrace a potentially new identity. For re-
establishing this need, incorporation of spiritual values into patient acre,
acceptance of new limitations, reconciliation of new identity etc. can be of
some help.