Health is one of our most precious possessions. The preservation of health is met through the satisfaction of our basic human needs. Understanding the basic needs of people, therefore, is essential for the practical nurse in planning for and meeting the needs of the patient.
a. Definition of Health.
b. Total Health. Although the absence of disease and illness is, by anyone's definition, essential to good health, it is, by no means, the only factor. Total health includes all of the following aspects as well:
Figure 1-1. The health-illness continuum.
b. As we previously stated, health, just as life itself, is a process of continual change. And we must continually adapt to these changes in our lives in order to maintain good health and well-being. It is our adaptation or response to that change, rather than the change itself, that affects our health. For example, two students just found out about a big test tomorrow, for which they are completely unprepared. One student responds to this stressful situation (stressor) by going home, getting his books out, and starting to study. The other student breaks out into a sweat, and spends most of the evening fretting over this outrage and imagining what will happen to him if he doesn't pass the test. No doubt, this student is doing more damage to his health than is his friend. And, considering the time and energy he is expending on worrying (and not studying), he may experience even more stress when they receive their grades!
c. Adaptation and effective functioning, even in the presence of chronic disease, can be considered a state of wellness. A person may be in perfect physical condition, but feel too tired and "blue" to go to work, while his co-worker, a diabetic, is at work, functioning fully and accomplishing his job. Which of these two people is at a higher level on the health-illness continuum?
Death occurs when adaptation fails completely, and there is irreversible damage to the body.
The individual's state of health is determined by the ability to adapt to changes in the following dimensions:
Regardless of one's definition of health, the individual who practices the following positive health habits on a regular basis is certainly at an advantage.
a. Physical Needs. These are closely related to body functions and are sometimes referred to as primary or physiological drives. Physical needs include:
b. Emotional Needs. Emotional needs are closely interwoven with physical needs and are met in interaction with significant others. They include:
|NOTE: This applies to the patient's perception of the nurse's feelings toward him. For example, if your patient feels that you do not approve of or respect him, he may become very demanding, or he may withdraw and not cooperate with your efforts to make him healthy again.|
c. Social Needs. Social needs grow out of the culture and society of which one is a member. They include:
|NOTE: Remember that all human behavior is aimed toward the satisfaction of basic human needs.|
Psychologist Abraham Maslow defined basic human needs as a hierarchy, a progression from simple physical needs to more complex emotional needs (see figure 1-2).a. Types of Needs.
Figure 1-2. Maslow's hierarchy of needs.
b. Relationship Between Levels of Needs.
c. Relationship Between Levels of Needs.
The categories of Maslow's hierarchy are closely related to the basic human needs discussed in paragraph 1-6. Table 1-1 contains a comparison.
Maslow's Hierarchy of Needs
Basic Human Needs
Food, shelter, water, sleep, oxygen
Food, water, oxygen, elimination, clothing and shelter for body, warmth and protection, activity, or sensory and motor stimulation, including sex, physical exercise, and rest
Affection, identification, companionship
Love, including approval and esteem, importance, including recognition and respect, adequacy, including self-sufficiency and the need to be needed and wanted, productivity, including work an creative pursuits
Self-fulfillment, achieving one's capabilities
Table 1-1. Comparison of basic human needs and Maslow's hierarchy of needs.
Remember that human needs are not constant; they are fluid and changing with first one, then another, taking priority. What may start as a basic need for food can take on social and personal significance. Your care plan as well as your patience are aimed toward the satisfaction of the patient's needs. He has common needs because he is a person; he has individual needs because he is unique; he has special needs because he is sick. The Practical Nurse supplies the help that is required to meet the patient's needs during the stressful periods of hospitalization and recuperation.