Introduction
This paper discusses Maslow’s Hierarchy of Needs theory and its applicability to the nursing practice. The purpose of the paper is to investigate pragmatic adequacy, social meaningfulness, and feasibility of the theory in the context of nursing and its compatibility with real practice. For the research, statistical and thematic analysis methods were used. It was found that Maslow’s Hierarchy of Needs theory may have a significant meaning for nursing and proves its applicability to real practice. When successfully applied, the theory may beneficially influence patients’ health and well-being.
Maslow’s Hierarchy of Needs theory was proposed in 1943 by psychologist Abraham Maslow. It can be considered one of the humanistic theories that focus on a person’s growth and self-development and where a person is referred to as a unique individual. Maslow’s hierarchy is often schematically depicted as a pyramid where needs are arranged in the following order from bottom to top: physiological needs, safety, love and belonging, esteem, self-actualization. Physiological needs include basic subsistence needs such as water, food, and sleep. Safety implies security, health, resources, and the absence of fear. Love and belonging include intimate relationships, friendship, the need to get, and give affection. Esteem refers to a person’s status and self-perception, including confidence, independence, and recognition. Self-actualization is the need to realize a person’s potential and to achieve goals. According to Maslow, for the achievement of the top needs, a person must at first satisfy the needs located below (Butts & Rich, 2018). Thus, Maslow’s theory states that people’s level of motivation is based on the fulfillment of their needs.
Main body
Maslow’s theory has been widely used in such spheres as psychology, sociology, education, and healthcare. For instance, it was applied by Lenthe, Jansen, and Kamphuisof (2015) in their study that investigated the influence of socio-economic inequalities in food choice behavior. The study showed that “healthier food choices were made by people who were classified in higher levels of Maslow’s pyramid of needs” (Lenthe et al., 2015, p. 1146). In Bassett’s (2016) research, Maslow’s hierarchy was used to study the needs of prisoners with the focus on the need for belonging. Thus, one may agree that Maslow’s Hierarchy of Needs theory shows itself as applicable to different spheres of scientific, professional, and social life.
The theory states that the fulfillment of human needs influences a person’s motivation and well-being. One of the main theory concepts implies that any person strives for self-actualization to realize his or her full potential. However, on the way of self-actualization, more basic needs require fulfillment at first. These needs must be taken into account in the context of healthcare to affect a patient’s well-being. Identifying patients’ needs has great importance and can help to provide appropriate treatment. In this regard, the theory also addresses the nursing metaparadigm concepts.
The nursing metaparadigm includes four main concepts: person, environment, health, and nursing. The nursing concept that refers to the nurses’ actions and skills can be connected with the need for safety. The researchers Shih et al. (2018) conducted a study on the needs of hemodialysis patients. According to them, “patients were mostly concerned for the care they receive from the medical staff” during the treatment process (Shih et al., 2018, p. 275). These concerns include, for instance, the nurses’ skills to operate hemodialysis machine technology and can refer to the patient’s need to feel safe. In addition, the research shows that patients were also worried about the treatment environment and equipment (Shih et al., 2018). These concerns also may refer to the need for safety and physiological needs that, in this case, can be connected with the concept of an environment that focuses on a patient’s surroundings.
The need for safety, in addition, addresses the concept of health that includes physical and psychological state of patients. The researchers identified such needs of patients as “prevention of complications such as headache and abdominal pain” and an opportunity to communicate with nurses for reducing psychological pressure (Shih et al., 2018, p. 274). The person concept that includes social and spiritual aspects can be addressed by the need of belonging. The researchers found that some patients needed to be accompanied or visited by family members and friends and to be “able to share their feelings with other patients during hemodialysis” (Shih et al., 2018, p. 274). One may conclude that physiological needs, the need for safety, and belonging have a significant meaning for the nursing metaparadigm influencing patients’ physical and psychological well-being.
For achieving appropriate treatment, it is necessary to apply Maslow’s theory to the healthcare environment. Patients should be seen as people with their needs, “choices, preferences, and the possibility of becoming masterful, officious, or, in malignant circumstances, helpless and hopeless” (Butts & Rich, 2018, p. 664). In addition, well-being includes not only feeling good but also psychological and social aspects. According to Butts and Rich (2018), relationships with patients should be “based on authentic behavior, honest dialogue, and genuine therapeutic listening” (p. 497). The understanding of these processes can help to improve patient’s treatment and rehabilitation.
The theory can be applied, for instance, in situations when patients have serious and life-threatening diseases. According to research conducted by Zhou et al. (2019), women with breast cancer expressed the need in a good environment and a respectful treatment setting. Compliance with these needs was “beneficial for developing and maintaining good self‐esteem and mental health among women with breast cancer” (Zhoe et al., 2019, p. 5). The researchers note that many patients have the need for information regarding such aspects as the course of the disease, treatment plan, risk factors, and prognosis (Zhoe et al., 2019). According to them, information needs are crucial for women with breast cancer “because of how painful their diagnosis is” (Zhoe et al., 2019, p. 5). One may suggest that when getting the information, patients also can get support from medical staff.
Another example of settings where the theory can be applied successfully is the procedure of hemodialysis. The research that has already been mentioned in this paper focuses on the patients’ needs during hemodialysis (Shih et al., 2018). There were included physical, mental, and spiritual needs of patients. However, according to researchers, “patients have the most needs in relation to medical staff care” (Shih et al., 2018, p. 277). Such needs may include, for instance, monitoring of hemodialysis machine operation, smooth needle injection and extraction, and others (Shih et al., 2018). The researchers note that “when such needs are not addressed, they may ultimately become a barrier to the treatment process” (Shih et al., 2018, p. 277). Thus, the settings corresponding to the theory concepts should include such aspects as a good environment, respectful and caring attitude, professional skills of nurses.
The main goal of medical staff is to do their best for the health and well-being of patients. The mentioned above studies of hemodialysis and breast cancer show that meeting of patients’ needs can improve their physical and psychological well-being during treatment and rehabilitation processes. Thus, the theory can prove its utility in real-world nursing practice helping to provide appropriate treatment conditions and environments for patients.
The researches also prove the clinical significance of Maslow’s theory. For instance, Mofokeng and Green (2018) conducted a study of the needs of mothers with HIV. According to them, meeting the needs of safety, esteem, and belonging can help HIV patients to reduce stress (Mofokeng & Green, 2018). Medical staff can help meet these needs providing support, information, and a positive, respectful attitude; “otherwise the chances of defaulting are high” (Mofokeng & Green, 2018, p. 47). One may conclude, in practice, Maslow’s theory proves its effectiveness and significance.
The discussing theoretical framework implies that patients’ state, to a large extent, depends on nursing skills and a positive healthcare environment. In this regard, it is possible to agree that the mentioned aspects also refer to the professional requirement that must be followed by nursing staff. However, one may note that for the meeting of some patients’ needs by nurses, the nurses’ needs should be met as well. According to Dempsey (2016), it is important to fulfill the nurses’ work environment needs to achieve a higher level of motivation. These needs include not only physiological ones but also the need for physical and emotional safety. In particular, safe patient mobility, appropriate unit staffing, adequate shifts, and rest breaks (Dempsey, 2016). The research conducted by Liu, Aungsuroch, and Yunibhand (2016) proves that nurses’ job satisfaction is closely related to patients’ satisfaction and quality of care. Thus, considering the applicability of the theory in nursing practice, it is important to pay attention not only to patients’ needs but also to the needs of nursing staff.
On this basis, it should be noted that the feasibility of the theory in practice in many respects depends on the clinic policy and the working environment and conditions. Among aspects that impact nurses’ job satisfaction, researchers identify such factors as compliance with the hospital policy, salary, workload, work demand, organization structure, and some others (Liu et al., 2016). Thus, first of all, the clinic should provide favorable working environment conditions for the satisfaction of the needs of nurses.
It is possible to agree that the compatibility of the theory with real-life nursing practice depends on the medical staff working conditions as well. However, other factors influencing compatibility also may be highlighted. As mentioned earlier, the satisfaction of patients’ needs is related to the professional skills of the medical staff. In this regard, nurses must have the appropriate level of education, training, and practice to meet requirements for their professional skills. In addition, emotional and psychological factors also can be important. For successful fulfillment of patients’ needs, nurses should have a steady mental state that can be affected by such aspects as job motivation, professional commitment, psychological distress, positive or negative affectivity, and others (Liu et al., 2016). Emotional state can be influenced both by the working environment and personal reasons. Thus, compatibility of the theory may depend on working conditions, level of professional skills of nurses, and their psychological state.
Conclusion
One may conclude that Maslow’s Hierarchy of Needs proves its significance and applicability to the nursing practice. Meeting needs of patients through an appropriate environment, positive, respectful attitude, and professional skills can influence treatment and rehabilitation processes, and patient’s well-being. Nurses’ job satisfaction also plays a significant role in the applicability of the theory. Achieving a good working environment for medical staff, a hospital contributes to the patients’ health. Thus, compliance with certain factors makes Maslow Hierarchy of Needs theory applicable and effective in real-life nursing practice.
References
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Shih, C. Y., Huang, C. Y., Huang, M. L., Chen, C. M., Lin, C. C., & Tang, F. I. (2019). The association of sociodemographic factors and needs of haemodialysis patients according to Maslow’s hierarchy of needs. Journal of clinical nursing, 28(1-2), 270-278.
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