THEORETICAL FOUNDATION OF NURSING

BSN - 1D | SEM 1 2022

Lesson 1: Maslow Hierarchy Of Needs – Abraham Maslow SELF-ACTUALIZATION NEEDS (LEVEL 5)

- Desire for personal achievement or mission of his life.
MOTIVATION - Self-actualized persons have frequent occurrence of peak
experiences, which are energized moments of profound
- Derived from Latin words movere which means "to move." happiness and harmony. According to Maslow, only a small
- Is the result of processes, internal or external to the individual, that percentage of the population reaches the level of self-actualization
arouse enthusiasm and persistence to pursue a certain course of
action.
CRITICISM
ABRAHAM MASLOW - Researchers have proved that there is lack of hierarchical
structure of needs as suggested by Maslow.
- Was born in Brooklyn since 1908- 1970. - Some people may have deprived of lower-level needs but strive for
- Was a psychologist who studied the lives and activities of self-actualization.
individuals that he found considered them to be "successful and - There is lack of direct cause and effect relationship between need
productive". and behavior.
- Famous theorist which encompass everything from basic needs to - Sometimes people are not aware of their own needs.
self-actualization in order to demonstrate what motives people. - Measurement or satisfaction of needs is not possible.

MASLOW THEORIES CONCLUSION

This theory indicates:
- The basis or Maslow’s motivation theory is that human beings are
- There are 5 levels or needs. motivated by unsatisfied needs, and that certain lower factors
- All these needs are arranged in a hierarchy. need to be satisfied before higher needs can he satisfied.
- Once one level is satisfied, the next level will emerge as the
depressed need seeking to be satisfied.
- The physiological and security needs are finite but the needs of
Lesson 2: Transactional Analysis Theory – Eric Berne
higher order are infinite and are likely to be dominant in persons at
higher levels in the organization.
- Maslow suggests that various levels are interdependent and ERIC BERNE
overlapping. - Leonard Eric Burnstein (1910-1970).
- Was born on May 10, 1910, in Montreal, Canada to a writer and a
physician.
- Died on July 15, 1970 in Carmel-by-the-Sea, California, USA.
- He was 60 years old when he suffered a fatal heart attack Was a
Canadian-born psychiatrist who created the Theory or
Transactional Analysis as a way of explaining human behavior.
- Berne's theory of transactional analysis was based on the ideas
of Freud but was distinctly different.

INTRODUCTION
- Transactional Analysis Theory is the study of human behavior that
is very complex and complicated concept.
- It is affected by the psychological factors such as perception,
learning, personality and motivation.
PHYSICAL NEEDS (LEVEL 1) - Individual behavior affects and is affected by the behavior of others.
- These are the basic human needs including food, clothing, shelter - One of the major problems in the study of organizational behavior
and other necessities of life. is to analyze and improve, the interpersonal relationships.
• Air - Transactional analysis is one basic approach to Study
• Food interpersonal relations in an organizational system.
• Rest - This analysis deals with understanding, predicting and controlling
• Exercise interpersonal relationships.
- According to Maslow's theory, if such needs are not satisfied then
one's motivation will arise from the quest to satisfy them. Higher TRANSACTIONAL ANALYSIS
needs such as social needs and esteem are not felt until one has - Technique used to help people better understand their own and
met the need's basic to one's bodily functioning. other's behavior, especially in interpersonal relationships
- It offers a model of personality and the dynamics of self and its
SAFETY NEEDS (LEVEL 2) relationship to others that makes possible clear and meaningful
- These include economic security, protection from physical dangers discussion of behavior.
• Safety
• Security PRIMARY CONSIDERATIONS OF TRANSACTIONAL
• Protection ANALYSIS
• Freedom from fear • Analysis of self-awareness
- According to Maslow's hierarchy, if a person feels that he or she is • Analysis of ego states
in harm's way, higher needs will not receive much attention.
• Analysis of transactions
• Analysis of life positions
SOCIAL NEEDS (LEVEL 3) • Script analysis
- Need for love, affection, emotional needs, warmth and friendship. • Games analysis
• Love • Stroking
• Belongingness
• Affection ANALYSIS OF SELF-AWARENESS
- Once a person has met the lower level physiological and safety
- The interpersonal relationships are composed of interself.
needs, higher level motivators awaken. Social needs are those
- Self - is the core of personality pattern which provides integration.
related to interaction with others.
- Self-awareness - is an important concept, it describes the self in
terms of image, both conscious and unconscious.
ESTEEM NEEDS (LEVEL 4) - Joseph Luft and Harrington have developed a diagram to that can
- Ego or self-esteem, self -respect, self-confidence, recognition. be known and unknown to self and unknown to others.
• Strength (esteem) - This diagram is known as the JOHARI WINDOW.
• Status (esteem)
- Maslow later refined his model to include a level of an esteem
needs and self-actualization the need for knowledge and aesthetics

Page 1 of 4
THEORETICAL FOUNDATION OF NURSING
BSN - 1D | SEM 1 2022

JOHARI WINDOW - Life script - is that life plan the individual’s “child” selected early in
Open Blind their developmental years based mostly on the overt or covert
Known to others and known Unknown to self but known to messages or injunctions received from the “child” in your parents.
self others
Hidden Unknown
Known to self but unknown to Unknown to self and unknown
ANALYSIS OF LIFE POSITION
others to others - In the process of growing up people make basic assumptions about
their own self-worth as well as about the worth of significant people
ANALYSIS OF EGO STATES in their environment
- Life positions - The combination of assumptions about self and
- The ego plays an important role in human behavior. other person.
- People interact with each other in terms of psychological positions - There are 4 possible life positions:
or behavioral patterns known as ego states.
• I am OK, you are OK - it appears to be an ideal life position.
- Ego states are person's way of thinking, feeling and behaving at People with this type of life position have confidence in
any time. themselves as well as trust and confidence in others.
- A person of any age has these ego states in varying degree.
• I am OK, you are not OK - this is distrustful psychological
- A healthy person is able to move from one ego states to another. position. This is the attitude of those people, who think that
- There are 3 important ego states: whatever they do is correct.
• Child • I am not OK, you are OK - this is a common position for those
• Adult people who feel powerless when they compare themselves to
• Parents others.
• I am not OK, you are not OK - people in this position tend to
Parent Ego State feel bad about themselves and see the whole world as
- That the values, attitudes, and behavior of parents is an miserable. They do not trust others and have no confidence in
integral part or the personality or an individual. These people themselves.
tend to talk to people and treat others like children.
- People are in this state when they are reactive to a situation
ANALYSIS OF TRANSACTIONS
and act out of their conditioning, copying how their parents (or
another authority figure) treated them and others, instead of - A transaction is a basic unit of social interaction.
analyzing each situation. - The heart of transactional analysis is the study of diagramming of
- The characteristic of a person with parent ego state are the exchanges between 2 persons.
judgmental, rule maker, moralizing, over protective and - Thus, where a verbal or nonverbal stimulus from one person is
indispensable. being responded by another person a transaction occurs.
- There are 2 subdivisions of the parent state: - Transactional analysis can help us to determine which ego state is
• Critical/Controlling parent state - disapproving in a most heavily influencing our behavior and the behavior of the other
harsh and possibly aggressive way. people with whom we interact.
• Nurturing parent state - tries to take over a situation in - Depending on the ego states of the persons involved in
more of a rescuing way, trying to sooth others which can transactions, there are 3 types of transactions:
be very inappropriate when talking to other adults rather • Complementary Transaction
than children. • Crossed Transaction
• Ulterior Transaction
Adult Ego State
- The adult ego state is authentic, direct, reality based, fact Complementary Transaction
seeking and problem solving. They assume that human - Both people are operating from the same ego state. There can
beings as equal, worthy and responsible. be 9 complementary transactions:
- The process of adult ego state formation goes through one's • Adult-Adult Transactions
own experiences and continuously updating attitudes left over • Adult-Parent Transactions
from childhood. • Adult-Child Transactions
- People with adult ego state, gather relevant information, • Parent-Parent Transactions
carefully analyze it, it generates alternatives and make logical • Parent-Adult Transactions
choices. • Parent-Child Transactions
- Interacts with people and its environment in the here and now, • Child-Parent Transactions
not from past conditioning or how other people have told them • Child-Adult Transactions
to be. • Child-Child Transactions

Child Ego State Crossed Transaction

- Characterized by very immature behavior. - Is one in which the sender sends message a behavior on the
- The important feature of child ego state are creativity, anxiety, basis of his ego state, but this message is reacted to by an
depression, dependence, fear, joy, emotional sentiment. etc. unexpected ego state on the part of the receiver.
- There are 2 subdivisions of the child state: - Crossed communication should be avoided as far as possible.
• Adapted child state - conforms and acts in accordance Whenever such transactions occur, communication tends to
to others wishes in order to please them and be seen as blocked and a satisfactory transaction is not accomplished.
good and liked, but it also has a rebellious side when
faced with perceived conflict and causes responses of Ulterior Transaction
resistance, hostility and emotional reactivity. - 2 ego states within the same person but one disguises the
• Free child ego state - can be creative, spontaneous, other one.
playful and pleasure seeking.
STROKING
Personality Operation - Berne believed that people have the rationality
and freedom to make decisions and solve their own problem. The well- - An important aspect of the transactional analysis.
adjusted person allows the situation to determine which ego state is in - The term stroke refers to “giving some kind of recognition to others”
control attempting to strike a balance between all three. - People need strokes for their sense of survival and well-being on
the job. Lack of stroking can have negative consequences both on
physiological and psychological well-being of a person.
SCRIPT ANALYSIS
- In a layman’s view, a script is the text of play, motion picture or a Types of stokes:
radio or TV programme • Positive Strokes - The stroke one feel good, is a positive stroke.
- In transactional analysis, a person’s life is compared to a play and Recognition approval are some of the examples.
the script is the text of the play • Negative Strokes - A stroke one feel bad or not good is a negative
- According to Eric Berne, “A script is an ongoing programme stroke. It hurts physically or psychologically.
developed in early childhood under parental influence which direct • Mixed Strokes - A stroke may be of a mixed type also. Example:
the individual’s behavior in the most important aspects of his life the boss comment to a worker, “You did an excellent job inspire your
- Script - is a complete plan of living, offering prescriptions, limited experience.”
permissions and structure which makes one winner or loser in life.
Page 2 of 4
THEORETICAL FOUNDATION OF NURSING
BSN - 1D | SEM 1 2022

GAME ANALYSIS - Motivate persons by getting them ready for change and
- Game analysis occurs when people fail to get enough strokes at increase willingness to change.
work. People try a variety of things. - Build trust and recognition for the need to change.
- One of the most important thing is that they play psychological - Actively participate in identifying problems and generate
games. alternative solutions.
- Is the development through problem awareness of a need for
Characteristics of psychological games: change.
• The transaction ten to be repeated. - There are 3 methods that can lead to the achievement of
• They make sense in superficial or social level. unfreezing:
• One or more transactions is ulterior. • To increase the driving forces that direct behavior away
from the existing situation or status quo
Types of games: • Decrease the restraining forces that negatively affect the
• First Degree Game – One which is socially acceptable in the movement from the existing equilibrium
agent’s circle. • Finding a combination of the first 2 methods.
• Second Degree Game – One which more intimate end up with bad
feelings. (Emotional harm) The Change State
• Third Degree Game – One which usually involves physical injury. - Which is also called "moving to a new level" or "movement",
involves a process of change in thoughts, feeling, behavior or
all three that is in some way more liberating or more
BENEFITS AND UTILITY OF TRANSACTIONAL ANALYSIS productive
• Improved interpersonal communication
• Source of positive energy Refreezing
• Understanding ego state - Is establishing the change as the new habit, so that it now
• Motivation becomes the "standard operating procedure"
• Organizational development - Without this final stage, it can be easy for the patient to go
back to old habits
- Are the integration of the change into one’s personality and
Lesson 3: Lewin’s Change Theory - Kurt Lewin the consequent stabilization of change then reinforce the new
patterns of behavior (positive change)
- New level of equilibrium
KURT LEWIN - Frequently personnel return to old behavior after change effort
- A German-American psychologist, known as one of the modern case (negative change)
pioneers of social, organizational, and applied psychology in the
US.
- Proposed that human behavior should be seen as part of a Lesson 4: Psychosocial Development - Erik Erikson
continuum, with individual variations from the norm being a function
of tensions between perceptions of the self and of the environment.
- His most influential theory is “Change Theory”, Lewin’s definition of ERIK ERIKSON'S PSYCHOSOCIAL DEVELOPMENT
behavior in this model is “a dynamic balance of forces working in - Erikson maintained that personality develops in a predetermined
opposing directions.” order through 8 stages of psychosocial development, from infancy
to adulthood. During each stage, the person experiences a
CHANGE THEORY: MAJOR CONCEPTS psychosocial crisis which could have a positive or negative
outcome for personality development.
- Lewin provides a social-psychological view of the change process. - For Erikson (1958, 1963), these crises are of psychosocial nature
He sees behavior as a dynamic balance of forces working in because they involve psychological needs of the individual i.e.,
opposing directions. psycho) conflicting with the needs of society (i.e., social).
- There are 3 major concepts: - According to the theory, successful completion of each stage
• Driving Forces results in a healthy personality and the acquisition of basic virtues.
• Restraining Forces ✓ Basic virtues are characteristic strength which the ego can
• Equilibrium use to resolve subsequent crises.

Driving Forces
8 STAGES OF PSYCHOSOCIAL DEVELOPMENT
- Are those that push in a direction that causes change to occur
- They facilitate change because they push the patient in a 1. Trust vs. Mistrust
desired direction. 2. Autonomy vs. Shame and Doubt
- They cause a shift in the equilibrium towards change. 3. Initiative vs. Guilt
4. Industry vs. Inferiority
Restraining Forces 5. Identity vs. Role Confusion
- Are those forces that counter the driving forces. 6. Intimacy vs. Isolation
7. Generativity vs. Stagnation
- They hinder change because they push the patient in the
8. Ego Integrity vs. Despair
opposite direction.
- They cause a shift in the equilibrium that opposes change.
TRUST VS. MISTRUST (Birth – 18 months old)
Equilibrium - This stage begins at birth continues to approximately 18 months of
- A state of being where driving forces equal restraining forces, age.
and no changes occurs. - During this stage, the infant is uncertain about the world in which
- It can be raised or lowered by changes that occur between the they live, and looks towards their primary caregiver for stability and
driving and restraining forces consistency of care.
- If the care the infant receives is consistent, predictable and reliable,
CHANGE THEORY: STAGES they will develop a sense of trust which will carry with them to other
relationships and they will be able to feel secure even when
- There are 3 stages in change theory:
threatened.
• Unfreezing
- If these needs are not consistently met, mistrust, suspicion and
• The Change
anxiety may develop.
• Refreezing
- Success in this stage will lead to the virtue of hope.
✓ By developing a sense of trust, the infant can have nope that
Unfreezing
as new crises arise, there is a real possibility that other people
- Is the process which involves finding a method of making it
will be there as a source of support.
possible for people to let go of an old pattern that was
somehow counterproductive. it is necessary to overcome the
strains of individual resistance and group conformity. AUTONOMY VS. SHAME AND DOUBT (18 months – 3 years old)
- The existing equilibrium. - This stage occurs between the ages of 18 months to approximately
3 years old.
Page 3 of 4
THEORETICAL FOUNDATION OF NURSING
BSN - 1D | SEM 1 2022

✓ According to Erikson, children at this stage are focused on GENERATIVITY VS. STAGNATION (40 years – 65 years old)
developing a sense of personal control over physical skills and - This stage takes place during middle adulthood (ages 40-65 years).
a sense of independence.
- We give back to society through raising our children, being
- Success in this stage will lead to the virtue of will. productive at work and becoming involved in community activities
✓ If children in this stage are encouraged and supported in their and organizations. Through generativity, we develop a sense of
increased independence, they become more confident and being a part of the bigger picture.
secure in their own ability to survive in the world.
- Success leads to feelings of usefulness and accomplishment, while
- If children are criticized, overly controlled or not given the failure results in shallow involvement in the world.
opportunity to assert themselves, they begin to feel inadequate in
- By failing to find a way to contribute, we become stagnant and feel
their ability to survive and may then become overly dependent upon
unproductive. These individuals may feel disconnected or
others, lack self-esteem, and feel a sense of shame or doubt in their
uninvolved with their community and with society as a whole.
abilities.
- Success in this stage will lead to virtue of care.

INITIATIVE VS. GUILT (3 years – 5 years old)

EGO INTEGRITY VS. DESPAIR (65 years old – Death)
- During the initiative vs guilt stage, children assert themselves move
- This stage begins at approximately age 65 and ends at death.
frequently through directing play and other social interaction
- It is during this time that we contemplate our accomplishments and
- Central to this stage is play, as it provides children with the
can develop integrity if we see ourselves as leading a successful
opportunity to explore their interpersonal skill through initiating
life.
activities
- Individuals who reflect on their life and regret not achieving their
- Children begin to plan activities, make up games, and initiate
goals will experience feelings of bitterness and despair.
activities with others. If given this opportunity, children develop a
- Erik Erikson believed if we see our lives as unproductive, feel guilty
sense of initiative and feel secure in their ability to lead others and
about our past or feel that we did not accomplish our life goals, we
make decisions
become dissatisfied with life and develop despair, often leading to
- Conversely, if this tendency is squelched, either through criticism
depression or hopelessness.
or control, children develop a sense of guilt.
- Success in this stage will lead the virtue of wisdom.
- A healthy balance between initiative and guilt is important. Success
✓ Wisdom - enables a person to look back on their life with a
in this stage will lead to the virtue of purpose, while failure results
sense of closure and completeness and also accept death
in a sense of guilt.
without fear.

INDUSTRY VS. INFERIORITY (5 years – 12 years old)

- Occurs during childhood between the ages of 5-12.
- It is at this stage that the child's peer group will gain greater
significance and will become a major source of the child's self-
esteem. The child now reels the need to win approval by
demonstrating specific competencies that are valued by society
and begin to develop a sense of pride in their accomplishment.
- If children are encouraged and reinforced for their initiative, they
begin to feel industrious (competent) and feel confident in their
ability to achieve goals.
- If this initiative is not encouraged, if it is restricted by parents or
teacher, then the child begins feel inferior, doubting his own abilities
and therefore may not reach his or her potential.

IDENTITY VS. ROLE CONFUSION (12 years – 18 years old)

- It occurs during adolescence, from about 12-18 years.
- During this stage, adolescents search for a sense of self and
personal identity, through an intense exploration of personal
values, beliefs and goals
- During adolescence, the transition from childhood to adulthood is
most important. Children are becoming more independent, and
begin to look in the future in terms of career, relationships, families,
housing, etc. the individual wants to belong to a society and fit in
- This is a major stage of development where the child has to learn
the roles he will occupy as an adult. It is during this stage that the
adolescent will reexamine his identity and try to find out exactly who
he or she is. Erikson suggests that 2 identities involved:
• Sexual
• Occupational.
- Success in this stage will lead to the virtue of fidelity
- During this period, they explore possibilities and begin to form their
own identity based upon the outcome of their explorations.
- Failure to establish a sense of identity within society ("I don't know
what I want be when I grow up") can lead to role confusion.
✓ Role confusion - involves the individual not being sure about
themselves or their place in society.

INTIMACY VS. ISOLATION (18 years – 40 years old)

- This stage takes place during young adulthood between the ages
of approximately 18-40 years. During this stage, the major conflicts
centers on forming intimate, loving relationships with other people.
- We begin to share ourselves more intimately with others. We
explore relationships leading toward longer-term commitments with
someone other than a family member.
- Successful completion of this stage can result in happy
relationships and a sense of commitment, safety and care within a
relationship.
- Avoiding intimacy, fearing commitment and relationships can lead
to isolations, loneliness and sometimes depression.
- Success in this stage will lead to the virtue of love.

Page 4 of 4