Big Picture C

Big Picture in Focus: ULOa. Theories Relevant to Nursing Practice

Week 5-6: Unit Learning Outcomes (ULO): At the end of the unit, you are expected
to:

a. Explain the different views on non-nursing theorist and it’s relevance to

nursing practice.

Essential Knowledge

Abraham Maslow (Maslows Hierarchy of Needs)

Maslow’s Hierarchy of Needs is a theory in psychology proposed by Abraham

Maslow. It explains the human motivation based on the pursuit of different levels of
needs. The theory states that humans are motivated to fulfill their need in a hierarchical
order. There are five main levels to Maslow’s Hierarchy of needs which is the goal is to
to reach the fifth level of hierarchy: Self-actualization.

https://www.verywellmind.com/what-is-maslows-hierarchy-of-needs-4136760
Physiological Needs

The first and the lowest level of Maslow’s Hieararchy of Needs. The most
essential things that a person needs in order to survive such as the need for shelter,
water, food, warmth, rest, and health. At this level, a person’s motivation is from their
instinct to survive.

Safety/Safety & Security Needs

The second level of Maslow’s Hierarchy refers to a person’s need for security,
safety in their life and to their surroundings. The motivation comes from the need for
law, order, and protection from unpredictable and dangerous conditions.

Love and Belongingness Needs

The third level of Hierarchy which means humans are social creatures that
cannot live alone and needs to interact with others. On this level a person thrives for
friendship, intimacy, family, and love. When deprived of these needs, individuals may
experience loneliness or depression.

Self-Esteem Needs

Self-esteem need are related to a persons need to gain recognition and to feel
respected. Once a person has fulffilled their love and belonging needs (third level) they
seek to fulfill their esteem needs.

Self Actualization Needs

The fifth and final level of Maslow’s hierarchy of needs. Self-actualization relates
to the realization of an individual’s full potential. At his point people strive to become the
best that they possibly can be. It can be manifest in different ways such as obtaining
skills, knowledge, seeking happiness and pursuing life dreams

Harry Stack Sullivan (Sullivan’s Stages of Interpersonal Development)

The theory of Sullivan deals with about people’s characteristic interaction

patterns. According to him a individual’s personality is shaped entirely by the
relationship we have with other people, without other people, humans would have no
personality.

Sullivan’s Stages of Development

LEVEL OF
PHASE INTERACTING,COMMUNICATING,
APPREHENDING
INFANCY (Birth-18 mons) Experiences maternal tenderness and
intuits. Maternal Anxiety. Struggles to
achieve feelings of security and to avoid
anxiety (Gratification of Needs)

CHILDHOOD (18 mons-6 yrs) Modifies actions to suit social demands in

sex roles training, peer play, family events.
Uses language and movement to avoid
anxiety (Delayed Gratification)
JUVENILE (6-9) Learns to accept subordinate to authority
figures outside the family. More concept of
self esteem role (Formation of peer group)
PRE ADOLESCENCE (9-12) Capable of participating in genuine love
relationships with others. Develop
consideration and concerns outside the
self.(Developing relationships within same
gender)
EARLY ADOLESCENCE (12-14) Heterosexual contacts enter into personal
relationship. Attempts to integrate sex with
other personal relationship. (Identity)
LATE ADOLESCENCE (14-21) Mastet expression of sexual impulses.
Forms satisfying and responsible
associations. Uses communication skills to
protect self from conflicts with others.
(Forming lasting, intimate relationships

Source: Balita, C.E;Ultimate Learning Guide to Nursing Review 2005;Page 114

Two types of self according to Sullivan:

• The ‘GOOD ME’ versus the ‘BAD ME’ – Is based on social appraisal and the
anxiety that results from negative feedback

• The ‘NOT ME’ – It refers to the unknown, repressed component of the self.
Sullivan's theory explains about anxiety, self system and self-esteem:

• Security operations – Reduces feelings of anxiety or insecurity.

• Self system – Security operations; Consistent pattern of behavior that maintains

people’s interpersonal security by protecting them from anxiety

Ludwig Von Bertalanffy (General Systems Theory)

Systems theory was proposed by Ludwig a Biologist in 1940. The theory

provides approach to understanding, analyzing and thinking about organizations.
System theory views an organization as an organism, a system is made up of separate
components. These parts rely on one another, interrelated, and share a common
purpose and together form a whole.

Assumptions:

1. All system must be goal directed

2. A system is more than the sum of it’s parts.
3. A system is everchanging and any change in one part affects the whole.
4. Boundaries are implicit and human systems are open and dynamic.

Nursing Models based on Systems Theory

a. Imogene King’s System Interaction Model

b. Betty Neuman’s Health Care Systems Model
c. Dorothy Johnson’s Behavioral System Model

Basic Elements of a System

a. Input – Information that enters the system

b. Output – The end product of a system
c. Feedback – The process through which the output is returned to the system
 Retrieved from: https://nursekey.com/theoretical-foundations-of-nursing-practice/

Kurt Lewin (Change Theory)

Theorized a three-staged model of change. Known as unfreezing, movement,

refreezing. The theory represents a practical mode for understanding the change
process, which it entails that change is needed, before moving towards the new and
finally to the desired solidifying level of behavior.

Three Stages

1. Unfreezing – it is the recognition of the need for change and the dissolution
of previously held patterns of behavior
2. Movement – The actual shift of behavior towards a new healthful pattern
3. Refreezing – A long term solidification of new pattern of behavior.

Erik Erikson (Theory of Psychosocial Development)

Erikson is an ego psychologist. According to Erikson human believes that

personality develops in a series of stages. There are eight stages over a lifespan
showing the development. The main elements behind the theory is to identify of one’s
ego when conflicts arise a person have the opportunity to grow or fail equally.
 STAGES DEVELOPMENTAL TASK STRENGTH
Oral-Sensory (Birth- Trust vs. Mistrust Drive and
1 yr) Hope
Musculo-Anal (1-3 Autonomy vs. Shame and Self Control
yrs) Doubt and will power
Locomotor-Genital Initiative vs. Guilt Direction and
(3-5 yrs) purpose
Latency (6-11 yrs) Industry vs. Inferiority Methods and
confidence
Adolescence (12-18 Identity vs. Role Confusion Devotion and
yrs) Fidelity
Young Adulthood Intimacy vs. Isolation Affiliation and
(19-35 yrs) love
Adulthood (35-50 Generativity vs. Stagnation Production and
yrs) care
Maturity (50+ yrs) Ego Integrity - Despair

Source: Balita, C.E;Ultimate Learning Guide to Nursing Review 2005;Page 114

Lawrence Kohlberg’s (Theory of Moral Reasoning/Development)

L. Kohlbergs proposed the three disctinct levels of moral reasoning. Each level is
based on the degree to which a person conforms to conventional standards of society.
It has two stages, and its stages represents different degrees of complexity of moral
reasoning.

LEVEL 1 PRE-CONVENTIONAL LEVEL

STAGE 1 -Punishment and Obedience Orientation
-Reflexes causes action
“I must follow the rules otherwise I will be punished”
STAGE 2 -Instrumental Relativist Orientation
-Conforms to obtain rewards of favors
“I must follow the rules for the reward and favor it
gives”
LEVEL 2 CONVENTIONAL LEVEL
STAGE 3 -Good-Boy-Nice Girl Orientation
 -Seeks good relations and approval of family group;
Orientation to interpersonal relations of mutuality

“I must follow the rules so I will be accepted”

STAGE 4 -Society-Maintaining Orientation
-Obedience to law and order in society; maintenance of
social order shows respect and authority.
“I must follow rules so there is order in the society”
LEVEL 2 POST CONVENTIONAL LEVEL
STAGE 5 -Social Contract Orientation
-Concerned with individual rights and legal contract;
social contract;utilitarian lawmaking perspective
“I must follow rules as there reasonable laws for it”
STAGE 6 -Universal Ethical Principle Orientation
-Higher law and conscience orientation
-Orientation to internal decisions of conscience but
without clear rationale or universal principles
“I must follow rules because my conscience tells
me”
Source: Balita, C.E;Ultimate Learning Guide to Nursing Review 2005;Page 115

Self-Help: You can also refer to the sources below to help you further
understand the lesson

Cooper, Kim and Gosnell, Kelly. (2019). Foundations of Nursing. Edition 8. St.
Louis, Missouri: Elsevier.

Alligood, M. (2018) Nursing Theorist. Elsevier. Singapore