A man like any other Living being, is programmed by nature to survive, and for this it needs certain conditions and means. If at some point these conditions and means are not available, then a state of need arises, which causes the emergence of selectivity of response human body. This selectivity ensures the occurrence of a response to stimuli (or factors) that are this moment are the most important for normal functioning, preservation of life and further development. The subject’s experience of such a state of need in psychology is called need.

So, the manifestation of a person’s activity, and accordingly his life activity and purposeful activity, directly depends on the presence of a certain need (or need) that requires satisfaction. But only a certain system of human needs will determine the purposefulness of his activities, as well as contribute to the development of his personality. The human needs themselves are the basis for the formation of motive, which in psychology is considered as a kind of “engine” of personality. and human activity directly depends on organic and cultural needs, and they, in turn, generate, which directs the individual’s attention and activity to various objects and objects of the surrounding world with the aim of their knowledge and subsequent mastery.

Human needs: definition and features

Needs, which are the main source of a person’s activity, are understood as a special internal (subjective) feeling of a person’s need, which determines his dependence on certain conditions and means of existence. The activity itself, aimed at satisfying human needs and regulated by a conscious goal, is called activity. The sources of personality activity as an internal driving force aimed at satisfying various needs are:

• organic and material needs (food, clothing, protection, etc.);
• spiritual and cultural(cognitive, aesthetic, social).

Human needs are reflected in the most persistent and vital dependencies of the body and the environment, and the system of human needs is formed under the influence of the following factors: social conditions people's lives, the level of development of production and scientific and technological progress. In psychology, needs are studied in three aspects: as an object, as a state and as a property (a more detailed description of these meanings is presented in the table).

The meaning of needs in psychology

In psychology, the problem of needs has been considered by many scientists, so today there are quite a lot various theories, who understood needs as a need, a state, and a process of satisfaction. For example, K. K. Platonov saw needs primarily as a need (more precisely mental phenomenon reflecting the needs of the body or personality), and D. A. Leontyev looked at needs through the prism of activity in which it finds its realization (satisfaction). Famous psychologist last century Kurt Lewin understood by needs, first of all, a dynamic state that arises in a person at the moment he performs some action or intention.

Analysis different approaches and theories in the study of this problem allows us to say that in psychology the need was considered in the following aspects:

• as a need (L.I. Bozhovich, V.I. Kovalev, S.L. Rubinstein);
• as an object to satisfy a need (A.N. Leontyev);
• as a necessity (B.I. Dodonov, V.A. Vasilenko);
• as the absence of good (V.S. Magun);
• as an attitude (D.A. Leontiev, M.S. Kagan);
• as a violation of stability (D.A. McClelland, V.L. Ossovsky);
• as a state (K. Levin);
• as a systemic reaction of the individual (E.P. Ilyin).

Human needs in psychology are understood as dynamically active states of the individual, which form the basis of his motivational sphere. And since in the process of human activity not only personal development occurs, but also changes in the environment, needs play the role of the driving force of its development here too. special meaning has their substantive content, namely the volume of material and spiritual culture of humanity that influences the formation of human needs and their satisfaction.

In order to understand the essence of needs as a motive force, it is necessary to take into account a number of important points, allocated E.P. Ilyin. They are as follows:

• the needs of the human body must be separated from the needs of the individual (in this case, the need, that is, the need of the body, can be unconscious or conscious, but the need of the individual is always conscious);
• need is always associated with need, which must be understood not as a deficiency in something, but as desirability or need;
• from personal needs it is impossible to exclude the state of need, which is a signal for choosing a means of satisfying needs;
• the emergence of a need is a mechanism that includes human activity aimed at finding a goal and achieving it as a need to satisfy the emerging need.

Needs are characterized by a passive-active nature, that is, on the one hand, they are determined biological nature a person and the deficiency of certain conditions, as well as the means of his existence, and on the other hand, they determine the activity of the subject to overcome the resulting deficiency. Essential aspect human needs– this is their social and personal character, which finds its manifestation in motives, motivation and, accordingly, in the entire orientation of the individual. Regardless of the type of need and its focus, they all have the following characteristics:

• have their own subject and are an awareness of need;
• the content of needs depends primarily on the conditions and methods of satisfying them;
• they are capable of reproducing.

In the needs that shape human behavior and activity, as well as in the motives, interests, aspirations, desires, drives and value orientations is the basis of individual behavior.

Types of human needs

Any human need is initially an organic interweaving of biological, physiological and psychological processes, which determines the presence of many types of needs, which are characterized by strength, frequency of occurrence and methods of satisfying them.

Most often in psychology, the following types of human needs are distinguished:

• depending on the origin they are distinguished natural(or organic) and cultural needs;
• distinguished by direction material needs and spiritual;
• depending on what area they belong to (areas of activity), they distinguish the needs for communication, work, rest and cognition (or educational needs);
• by object, needs can be biological, material and spiritual (they also distinguish social needs of a person);
• by their origin, needs can be endogenous(occur due to water exposure internal factors) and exogenous (caused by external stimuli).

IN psychological literature there are also basic, fundamental (or primary) and secondary needs.

The greatest attention in psychology is paid to three main types of needs - material, spiritual and social (or social needs), which are described in the table below.

Basic types of human needs

Material needs of a person are primary, since they are the basis of his life. Indeed, in order for a person to live, he needs food, clothing and shelter, and these needs were formed in the process of phylogenesis. Spiritual Needs(or ideal) are purely human, since they primarily reflect the level of personal development. These include aesthetic, ethical and cognitive needs.

It should be noted that both organic and spiritual needs are characterized by dynamism and interact with each other, therefore, for the formation and development of spiritual needs, it is necessary to satisfy material ones (for example, if a person does not satisfy the need for food, he will experience fatigue, lethargy, apathy and drowsiness, which cannot contribute to the emergence of a cognitive need).

Separately should be considered social needs(or social), which are formed and developed under the influence of society and are a reflection of the social nature of man. Satisfaction of this need is necessary for absolutely every person. social being and accordingly as individuals.

Classifications of needs

From the moment psychology became a separate branch of knowledge, many scientists have undertaken a large number of attempts to classify needs. All these classifications are very diverse and mainly reflect only one side of the problem. That is why, today, a unified system of human needs that would meet all the requirements and interests of researchers of various psychological schools and directions, has not yet been presented to the scientific community.

• natural and necessary human desires (it is impossible to live without them);
• natural desires, but not necessary (if there is no possibility of satisfying them, then this will not lead to inevitable death person);
• desires that are neither necessary nor natural (for example, the desire for fame).

Author of the information P.V. Simonov needs were divided into biological, social and ideal, which in turn can be the needs of need (or conservation) and growth (or development). Social and ideal human needs, according to P. Simonov, are divided into needs “for oneself” and “for others.”

Quite interesting is the classification of needs proposed by Erich Fromm. The famous psychoanalyst identified the following specific social needs of a person:

• human need for connections (group membership);
• need for self-affirmation (feeling of importance);
• need for affection (need for warm and reciprocal feelings);
• the need for self-awareness (own individuality);
• the need for a system of orientation and objects of worship (belonging to a culture, nation, class, religion, etc.).

But the most popular among all existing classifications is unique system human needs by American psychologist Abraham Maslow (better known as the hierarchy of needs or pyramid of needs). The representative of the humanistic trend in psychology based his classification on the principle of grouping needs by similarity in a hierarchical sequence - from lower to higher needs. A. Maslow's hierarchy of needs is presented in table form for ease of perception.

Hierarchy of needs according to A. Maslow

Having proposed my classification of needs, A. Maslow clarified that a person cannot have higher needs (cognitive, aesthetic and the need for self-development) if he has not satisfied basic (organic) needs.

Formation of human needs

The development of human needs can be analyzed in the context of the socio-historical development of mankind and from the perspective of ontogenesis. But it should be noted that in both the first and second cases, the initial ones will be material needs. This is due to the fact that they are the main source of activity of any individual, pushing him to maximum interaction with environment(both natural and social)

On the basis of material needs, human spiritual needs developed and transformed, for example, the need for knowledge was based on satisfying the needs for food, clothing and housing. As for aesthetic needs, they were also formed thanks to the development and improvement of the production process and various means life, which were necessary to provide more comfortable conditions for human life. Thus, the formation of human needs was determined by socio-historical development, during which all human needs developed and differentiated.

As for the development of needs during a person’s life path (that is, in ontogenesis), here, too, everything begins with the satisfaction of natural (organic) needs that ensure the establishment of relationships between the child and adults. In the process of satisfaction basic needs Children develop needs for communication and cognition, on the basis of which other social needs appear. The process of upbringing has an important influence on the development and formation of needs in childhood, thanks to which the correction and replacement of destructive needs is carried out.

Development and formation of human needs according to the opinion of A.G. Kovaleva must obey the following rules:

• needs arise and are strengthened through practice and systematic consumption (that is, habit formation);
• the development of needs is possible in conditions of expanded reproduction in the presence of various means and methods of satisfying them (the emergence of needs in the process of activity);
• the formation of needs occurs more comfortably if the activity necessary for this does not exhaust the child (ease, simplicity and a positive emotional attitude);
• the development of needs is significantly influenced by the transition from reproductive activity to creative;
• the need will be strengthened if the child sees its significance, as in personally, and in the public (assessment and encouragement).

In addressing the issue of the formation of human needs, it is necessary to return to A. Maslow’s hierarchy of needs, who argued that all human needs are given to him in a hierarchical organization at certain levels. Thus, every person from the moment of his birth in the process of growing up and developing his personality will consistently manifest seven classes (of course, this is ideal) of needs, starting from the most primitive (physiological) needs and ending with the need for self-actualization (the desire for maximum realization personality of all its potentialities, the fullest life), and some aspects of this need begin to appear no earlier than adolescence.

According to A. Maslow, a person’s life at a higher level of needs provides him with the greatest biological efficiency and, accordingly, more long life, better health, sleep better and appetite. Thus, goal of satisfying needs basic – the desire for the emergence of higher needs in a person (for knowledge, self-development and self-actualization).

Basic ways and means of satisfying needs

Satisfying human needs is an important condition not only for his comfortable existence, but also for his survival, because if organic needs are not satisfied, a person will die in the biological sense, and if spiritual needs are not satisfied, then the person dies as social education. People, satisfying different needs, learn in various ways and acquire a variety of means to achieve this goal. Therefore, depending on the environment, conditions and the individual himself, the goal of satisfying needs and the methods for achieving it will vary.

In psychology, the most popular ways and means of satisfying needs are:

• in the mechanism of formation of individual ways to satisfy their needs(in the process of learning, formation various connections between stimuli and subsequent analogy);
• in the process of individualizing ways and means of satisfying basic needs, which act as mechanisms for the development and formation of new needs (the very methods of satisfying needs can turn into them themselves, that is, new needs appear);
• in specifying ways and means of meeting needs(one method or several are consolidated, with the help of which human needs are satisfied);
• in the process of mentalization of needs(awareness of the content or some aspects of the need);
• in the socialization of ways and means of satisfying needs(their subordination to the values ​​of culture and norms of society occurs).

So, at the basis of any human activity and activity there is always some kind of need, which finds its manifestation in motives, and it is the needs that are the motivating force that pushes a person to movement and development.

A need is a psychological and physiological deficiency of what is essential to a person's health and well-being.

There are several classifications of needs. According to the classification of the American psychologist A. Maslow, every person has 14 vital needs:

· HIGHLIGHT

· MOVE

· BE HEALTHY (MAINTAIN YOUR CONDITION)

· MAINTAIN BODY TEMPERATURE

· SLEEP AND REST

· DRESS AND UNDRESS

· BE CLEAN

· AVOID HAZARD

· COMMUNICATE

· HAVE LIFE VALUES

· WORK, PLAY AND LEARN

Any disease, that is, the presence in the body pathological process, is accompanied by dysfunction of various organs and systems. The nurse, due to her knowledge and skills, is able to determine not the disease itself, but its external manifestations. Dysfunction externally manifests itself as a violation of the satisfaction of certain needs. For example, pneumonia leads to dysfunction respiratory system and disruption of satisfying the need to BREATHE. The patient feels a violation of the satisfaction of needs as discomfort, which serves as a reason to seek medical help.

Because the final goal the work of a nurse is the comfort of her patient, insofar as in order to eliminate the discomfort that has arisen, she is obliged to find out its causes - which is reflected in the nursing history of the disease, the effectiveness of meeting needs.

A nursing examination is independent, specific and cannot be substituted for a medical examination.

Usage 14 consecutive steps Maslow's hierarchy allows you to achieve a systematic nursing examination, makes it comprehensive and complete, forming, as it were, an organizational framework for the nursing examination.

Need to BREATHE:

Concept of need:

Need BREATHE ensures constant gas exchange between the body and the environment.

The nurse learns about the violation of the need by conducting an objective and subjective examination of the patient.

1. Subjective examination: carried out in the process of conversation with the patient, identifying his complaints.

When a need is violated BREATHE the patient may have COMPLAINTS on the:

· shortness of breath,

· cough,

· pain in chest.

In a conversation with the patient, the nurse also identifies RISK FACTORS, affecting the need BREATHE:

· smoking;

· working, living in a polluted or dusty atmosphere.

2. Objective examination: The nurse carries out a general examination of the patient.

An objective examination may reveal:

· change in skin color - cyanosis(cyanosis);

Difficulty breathing through the nose;

· change in frequency, rhythm or depth of breathing;

· fever.

:

1) shortness of breath;

2) cough;

3) chest pain associated with breathing;

4) suffocation;

5) the risk of breathing problems due to smoking;

6) high risk from suffocation.

:

1) the nurse will provide a flow of fresh air into the room where the patient is;

2) the nurse will give the patient a forced position that makes breathing easier for the patient (if necessary, drainage);

3) the nurse will provide the patient oxygen therapy ;

4) the nurse will carry out measures to cleanse the respiratory tract;

5) the nurse will perform simple physical procedures in the absence of contraindications.

THE NEED IS:

Concept of need:

Satisfying a need EAT, a person delivers food to the body - the main source of energy and nutrients necessary for normal life. Food is one of the main resources for health.

Some characteristic features during nursing examination:

1. Subjective examination:

COMPLAINTS:

· loss of appetite;

· burping;

· nausea;

· stomach ache.

RISK FACTORS, affecting the need EAT:

· error in diet;

· violation of diet;

· binge eating;

alcohol abuse;

· missing teeth, carious teeth.

2. Objective examination:

· smell from the mouth;

presence of carious teeth;

Vomiting during the examination.

:

1) abdominal pain;

2) nausea;

4) loss of appetite;

5) excessive nutrition, exceeding the needs of the body;

6) obesity.

Some examples of possible nurse involvement in meeting a need:

1) the nurse will ensure compliance with the prescribed diet;

2) the nurse will create a forced position for the patient;

3) the nurse will assist the patient with vomiting;

4) the nurse will teach the patient techniques to combat nausea and belching;

5) the nurse will talk with the patient and his relatives about the nature of the diet prescribed to him and the need to comply with it.

Need to DRINK:

Concept of need:

Using the need DRINK, a person delivers water to the body. Life is impossible without water, since all vital chemical reactions in cells occur only in aqueous solutions.

:

1. Subjective examination:

COMPLAINTS:

· dry mouth.

RISK FACTORS, influencing the need DRINK:

· consumption of poor quality water;

Consumption of insufficient or excess water.

2. Objective examination:

· dry skin and mucous membranes.

Some examples of possible nursing diagnoses:

2) dry mouth;

3) dehydration.

Some examples of possible nurse involvement in meeting a need:

1) the nurse will provide the patient with a rational drinking regimen;

2) the nurse will talk with the patient about the need to drink good-quality water.

Need to highlight:

Concept of need:

Satisfying a need HIGHLIGHT, a person removes from the body harmful substances that are formed in the process of life, waste food residues.

This need is provided by the function of the urinary and digestive systems, skin and respiratory organs.

1. Subjective examination:

COMPLAINTS:

· bloating;

· disturbance of urination and urine formation;

· lack of urine;

· small amount of urine;

increased amount of urine;

Frequent painful urination;

RISK FACTORS, affecting the need HIGHLIGHT:

· violation of diet;

· sedentary lifestyle;

· hypothermia.

2. Objective examination:

· obvious swelling;

· hidden edema;

· change in stool character;

· dry skin, decreased firmness and elasticity of the skin, skin coloring;

· change in the amount of urine;

visual change in urine.

Some examples of possible nursing diagnoses:

4) acute urinary retention;

5) the risk of diaper rash in the area of ​​the crotch folds.

Some examples of possible nurse involvement in meeting a need:

1) the nurse will provide the patient with the prescribed diet and drinking regimen;

2) the nurse will provide the patient with an individual bedpan and urinal bag;

3) the nurse will train the patient, and, if necessary, carry out hygienic measures herself after physiological functions;

4) the nurse will teach the patient physical therapy skills and self-massage of the abdominal area;

5) the nurse will talk with the patient and relatives about the nature of the prescribed diet and the need to comply with it.

Need to SLEEP:

Concept of need:

The burden of everyday worries and affairs weighs down a person, causing concern, anxiety, and stress throughout the day. This leads to exhaustion nervous system, and therefore, to disruption of the functions of various organs.

Satisfying a need SLEEP, a person overcomes these harmful effects, restores the body's strength.

The most characteristic signs during a nursing examination:

1. Subjective examination:

COMPLAINTS:

· insomnia;

· sleep disturbance;

Intermittent sleep

· drowsiness;

· falling asleep in the morning.

RISK FACTORS, affecting the need SLEEP And REST:

· lack of rest;

· excessive workload;

· no vacations or days off.

2. Objective examination:

· facial expression (fatigue, tiredness, dull look, poor facial expressions);

· yawning.

Some examples of possible diagnoses:

1) lack of sleep;

2) sleep disturbance.

Some examples of possible nurse involvement in meeting a need:

1) the nurse will provide the patient with the prescribed regimen;

2) the nurse will teach the patient skills that help regulate sleep;

For example: a glass of warm milk with a spoon of honey at night, a walk on fresh air before bed, skills auto-training .

3) the nurse will talk with the patient about the need for daily rest;

4) the nurse will teach the patient how to create a daily routine: frequent change activities, recreation.

The need to MAINTAIN A CONSTANT BODY TEMPERATURE:

Concept of need:

Normal functioning of organs and tissues is impossible without temperature constancy internal environment person. This is ensured:

1) through complex regulation of heat production and heat transfer from the body;

2) clothes for the season;

3) maintaining the microclimate of the premises where a person is located.

The most characteristic signs during a nursing examination:

1. Subjective examination:

COMPLAINTS:

· sweating;

· feeling of heat;

· headache;

· aches in the body, joints;

· dry mouth.

2. Objective examination:

· appearance of “goose bumps”;

· skin that is hot to the touch;

· dry skin and mucous membranes;

· cracks on the lips;

· change in body temperature

Increased heart rate and respiratory rate;

· moist skin;

deviation in temperature conditions premises.

Some examples of possible diagnoses:

· violation of integrity;

· unpleasant odor;

· bad breath;

· dirty laundry;

· unkempt nails;

· greasy hair.

Some examples of possible diagnoses:

1) lack of knowledge about personal hygiene;

2) high risk of infection associated with violation of the integrity of the skin and mucous membranes;

3) lack of self-hygiene;

4) violation of the integrity of the skin in the area of ​​natural folds.

Some examples of possible nurse involvement in meeting a need:

1) carry out a set of hygienic measures for the patient;

2) the nurse will teach the patient personal hygiene skills;

3) the nurse will talk with the patient about the need for personal hygiene;

4) the nurse will monitor the patient’s hygiene skills on a daily basis.

Need to MOVE:

Concept of need:

Movement is life! Movement strengthens muscles, improves blood circulation, nutrition of cells and tissues, excretion harmful substances from the body.

Improves performance internal organs, supports the mood.

The most characteristic signs during a nursing examination:

1. Subjective examination:

COMPLAINTS:

impossibility or limitation motor activity in connection with:

Weakness;

Absence of a limb;

The presence of paralysis;

· mental disorder.

RISK FACTORS, affecting the need MOVE:

· sedentary work;

· constant use of public transport.

2. Objective examination:

· pain when moving;

· changes in the joint area;

· hyperemia;

· local increase in temperature;

· configuration change;

· passive position in bed;

· absence of a limb.

Some examples of possible diagnoses:

1) limitation of physical activity;

2) lack of physical activity;

3) the risk of bedsores;

Some examples of possible nurse involvement in meeting a need:

1) in the absence of movement or its sharp limitation, the nurse will carry out a set of measures to care for the patient;

2) the nurse will carry out the simplest exercise therapy complexes and massage as prescribed;

3) the nurse will teach the patient the necessary simple complex of exercise therapy and self-massage and monitor its implementation;

4) the nurse will talk with the patient about physical inactivity and its consequences.

The need to DRESS or UNDRESS:

Concept of need:

To ensure a constant body temperature, it is not enough just to regulate heat production and heat transfer by the body itself. A person also has to regulate body temperature with clothing, depending on climatic conditions. Clothing selected according to age, gender, season, and environment provides the patient with moral satisfaction.

The most characteristic signs during a nursing examination:

1. Subjective examination:

COMPLAINTS:

· inability to undress and dress independently;

· pain when moving;

· paralysis of limbs;

· severe weakness;

· mental disorders.

2. Objective examination:

The patient cannot independently GET DRESSED And UNDRESS;

· the patient’s clothing does not match the size (small or large), which makes movement difficult;

· clothes do not correspond to the season (lack of warm clothes in winter).

Some examples of possible diagnoses:

1) inability to dress and undress independently;

2) high risk of hypothermia;

3) high risk of overheating;

4) violation of a comfortable state due to incorrectly selected clothing.

Some examples of possible nurse involvement in meeting a need:

1) the nurse will help the patient undress and dress;

2) the nurse will dress the patient in clothing appropriate for the patient;

3) the nurse will talk with the patient about the need to dress according to the season.

NEED TO BE HEALTHY:

Concept of need:

This need reflects Each person's desire for health reflects the patient's independence in meeting his basic vital needs. Violation of need satisfaction TO BE HEALTHY occurs when a person loses independence in care. For example, the patient is limited in physical activity (bed rest or strict bed rest). In this state, he cannot independently satisfy his needs, which leads to a violation of the need to be healthy. Another example: the patient is in an emergency condition (massive bleeding, coma, etc.). At the same time, it is also impossible to satisfy needs independently.

The most characteristic signs during a nursing examination:

1. Subjective examination:

In the first case, the nurse determines which needs the patient can satisfy independently, that is, independently of anyone, and in meeting which needs he needs help and to what extent.

For example:

· can the patient independently carry out personal hygiene measures;

· does he need outside help with physiological functions (bring him to the toilet, bring him a bedpan);

Can the patient dress and undress independently?

· whether the patient can move without assistance;

· Can the patient eat and drink independently?

In the second case, the nurse constantly monitors the patient’s condition and, if it worsens, will call a doctor and provide emergency pre-medical care before he arrives.

Some examples of possible diagnoses:

1) deficit of self-care.

Some examples of possible nurse involvement in meeting a need:

1) the nurse will provide direct assistance to the patient in activity Everyday life:

· washes,

· feeds,

· delivers the ship,

· dresses, undresses;

2) taking into account that the main thing for a person is independence and freedom, the nurse, at the slightest opportunity, will create conditions for the patient to independently satisfy his violated needs. For example: as the physical activity regime expands, the nurse does not wash him herself, but gives him washing supplies in bed;

3) the nurse will teach the patient skills of daily living in conditions of his disability.

Need to AVOID HAZARD:

Concept of need:

This need to adapt to living conditions with risk factors that negatively affect a person’s physical, psychosocial and spiritual comfort. Violation of need satisfaction AVOID THE HAZARD occurs when a person’s adaptation to living conditions with risk factors is low. For example, the patient is overweight, eats poorly, smokes, and moves little. All these are risk factors for which he is not adapted. Therefore, his satisfaction of the need to avoid danger is impaired.

The most characteristic signs during a nursing examination:

1. Subjective examination:

1. The nurse, in a conversation with the patient, finds out:

presence in his lifestyle RISK FACTORS and attitude towards them, the degree of adaptation of the patient to living conditions with risk factors;

Does the patient know how these FACTORS affect his health;

Does he have a desire to improve his lifestyle?

2. A nurse, in a conversation with a patient about his state of health, draws attention to feelings of fear, tension and fears for his health.

3. The nurse determines whether the client perceives family support for his condition.

Some examples of possible diagnoses:

1) indifference to the state of one’s health;

2) concern about your health;

3) fear of surgery or upcoming examination;

4) lack of adaptation to stress;

5) lack of knowledge about a healthy lifestyle;

6) threat to health due to risk factors.

Some examples of possible nurse involvement in meeting a need:

1) the nurse, when dealing with the patient, will help him psychologically, using words, intonation, facial expressions, and distraction techniques;

2) the nurse will provide the patient with adequate support from his environment;

3) the nurse talks with the patient about the need to improve his lifestyle;

4) the nurse, together with the patient, draws up a health improvement plan. For example: plan rational nutrition or daily routine for the patient;

5) the nurse will teach the patient the skills to eliminate or significantly reduce the impact of risk factors on the patient’s health. For example: there is a risk factor “stress”. Required:

· physical activity;

· daily allocation of time and its reserve;

· open “sending” for emotions;

· planning the daily routine;

· auto-training, relaxation;

6) the nurse will introduce the patient to another patient who leads a healthy lifestyle;

7) the nurse will select the necessary literature about propaganda for the patient healthy image life.

Need to COMMUNICATE:

Concept of need:

Man is a social being; for normal life he needs COMMUNICATION. He needs to constantly receive information about the environment and information about himself. The exchange of information is carried out using the senses (hearing, vision, smell, touch, etc.).

Types of communication:

· talk;

· reading;

· music;

· TV;

· religion.

The most characteristic signs during a nursing examination:

1. Subjective examination:

In a conversation with the patient, the nurse finds out the patient’s desire or unwillingness COMMUNICATE with the outside world:

· relatives;

· medical personnel;

· roommates;

· mass media;

2. Objective examination:

The nurse finds out the patient's ability COMMUNICATE:

· hearing impairment;

· visual impairment;

· movement disorder;

· intellectual impairment.

Some examples of possible diagnoses:

1) lack of communication with family;

2) distrust of the medical worker;

3) communication deficits associated with physical disabilities;

4) desire for self-isolation.

Some examples of possible nurse involvement in meeting a need:

1) the nurse organizes accessible communication for the patient.

The need to HAVE LIFE VALUES:

Concept of need:

In his life, every person focuses on certain ideals (values). It is a belief, a belief in what is good or bad in life. VALUES are formed in a person under the influence of his sociocultural environment, education, personal experience person. They are different for everyone, their own.

The nurse needs to determine LIFE VALUES patient, as they can positively or negatively affect his health. For example: the patient believes that the most important thing is to eat well (tasty, plentifully), which negatively affects his health. Or the patient’s main thing in life is health and he strives to do everything to preserve it. Knowledge LIFE VALUES The patient will help the nurse find arguments to motivate the patient to improve his lifestyle. For example: for a patient, caring for his family can be a motivation for getting healthy. He will strive to get better so he can take care of his family.

The most characteristic signs during a nursing examination:

1. Subjective examination:

A nurse, in a conversation with a patient, identifies him life values and their impact on health.

You are asked a minimum of questions that the nurse should find out when communicating with the patient:

1. What is the patient like, his mental and physical health?

2. What does he have (social-production, social-domestic, family status)?

3. What does a person say about himself, his health?

4. What does a person do in terms of maintaining or strengthening health (or, conversely, deteriorating it)? Moreover, find out whether there are discrepancies between words and deeds.

5. What does the patient give to people, how valuable is he to the family and society?

6. What does a person take from society, what does he need?

7. What does a person strive for, is he satisfied with life in general, with himself, with the people around him?

Some examples of possible diagnoses:

1) indifference:

· to life;

· to your health;

2) the need for spiritual participation and sympathy.

Some examples of possible nurse involvement in meeting a need:

1) through conversations, illustrative examples, literature, the nurse reorients the patient to main value in life - health;

2) many patients withdraw into themselves, trying not to burden others with their problems, which negatively affects their well-being. The nurse should tactfully challenge the patient to talk and let him talk. For example: a young woman with two children is hopelessly ill. She remains silent all day long, staring at the ceiling, alone with her problems. She needs to be given the opportunity to release her emotions (open the “gate” for emotions) in order for her to find spiritual balance.

Needs to PLAY, WORK and LEARN:

Concept of need:

This need creates Maslow's pyramid top. It is necessary for self-expression and self-realization of a person.

An adult realizes himself primarily in WORK. For this he needs STUDY, self-education and self-improvement are necessary. Also, every person in his life, under the influence of the environment, plays some kind of social role: mother, leader (manager), subordinate. Every person fulfills the need for some kind of hobby (hobby). For example: fishing, hunting, collecting, etc.

The most characteristic signs during a nursing examination:

1. Subjective examination:

The nurse needs to determine in a conversation with the patient how pronounced this need is in the patient:

· how he feels about his work, what place it occupies in his life;

Does he have a desire for self-education and study?

What social role does he play in life?

· how he spends his free time what he is interested in.

Some examples of possible diagnoses:

1) anxiety due to the inability to realize oneself due to illness:

· at work;

· in family;

2) belittling feelings self-esteem;

3) shortage of organized leisure.

Despite the fact that all people have the same needs, we satisfy them in different ways. Therefore, everyone’s health status is different.

Based on knowledge of human needs, the nurse must be able to identify the patient's unmet needs, establish the dominant need in order to satisfy it in priority order, using the nursing process.

Unmet patient needs are those conditions that require intervention. These are states of forced dependence of the patient due to some problems.

TASKS nurses is:

1. Assess the situation, identify the reasons for the change psychological state the patient and his behavior.
2. Formulate a patient's problem or conduct a nursing diagnosis.
3. Carry out planning necessary assistance to the patient:

• formulate goals (short-term, long-term) for the patient’s priority problem related to unmet needs;
• create a nursing intervention plan for each nursing problem.

Topic: Hierarchy of human needs according to A. Maslow

Kadyrova R.K.

Questions:

The concept of needs.

Various theories and classifications of needs.

Hierarchy of needs according to A. Maslow.

Characteristics of basic human needs.

Basic needs for daily human activities.

Conditions and factors influencing the method and effectiveness of meeting needs.

Possible reasons for the need for care (illness, injury, age).

The role of the nurse in restoring and maintaining the patient's independence in meeting his basic needs

The role of the nurse in improving the lifestyle of the patient and his family.

Concept of needs

The normal functioning of a person, as a social being, representing an integral, dynamic, self-regulating biological system, is ensured by a set of biological, psychosocial and spiritual needs. The satisfaction of these needs determines the growth, development, and harmony of a person with the environment.

Human life activity depends on many factors that are ordered in time and space and are supported by the life support systems of the human body in environmental conditions.

Need- this is a conscious psychological or physiological deficiency of something, reflected in the perception of a person, which he experiences throughout his life. (MANGO Glossary edited by G.I. Perfileva).

Basic theories and classifications of needs

The authors of the need-information theory, which explains the causes and driving forces of human behavior, are domestic scientists Simonov and Ershov. The essence of the theory is that needs are stimulated by the conditions of existence of the organism in a constantly changing environment.

The transition of needs into actions and actions is accompanied by emotions.

Emotions are indicators of needs. They can be positive and negative for satisfying needs. Simonov and Ershov divided all needs into three groups:

Group – vital (The need to live and provide for one’s life).

group – social (the need to take a certain place in society)

group – cognitive (the need to understand the external and internal world).

American psychophysiologist A. Maslow, of Russian origin, in 1943 identified 14 basic human needs and arranged them according to five stages (see diagram)

Physiological needs are lower needs controlled by the organs of the body, such as breathing, food, sexual, and the need for self-defense.

Reliability needs - the desire for material security, health, security for old age, etc.

Social needs - the satisfaction of this need is biased and difficult to describe. One person is satisfied by very few contacts with other people; in another person this need for communication is expressed very strongly.

The need for respect, awareness of one’s own dignity is here we're talking about about respect, prestige, social success. These needs are unlikely to be met by an individual; groups are required.

V. The need for personal development, for self-realization, self-realization, self-actualization, for understanding one’s purpose in the world.

Hierarchy of needs (stages of development) according to a. Maslow. The essence of the theory of needs a. Maslow. Characteristics of Basic Human Needs

Life, health, happiness, of a person depends on meeting the needs for food, air, sleep, etc. A person independently satisfies these needs throughout his life. They are provided by the function of various organs and systems of the body. The disease causes dysfunction of one or another organ, one or another system, interferes with the satisfaction of needs, and leads to discomfort.

In 1943, the American psychologist A. Maslow developed one of the theories of the hierarchy of needs that determine human behavior. According to his theory, some needs are more significant for a person than others. This allowed them to be classified according to a hierarchical system; from physiological to needs for self-expression.

Currently, in countries with a high level of social economic development, where priorities in meeting basic needs have changed significantly, it is not so popular. For our conditions today, this theory remains popular.

To live, a person needs to satisfy physiological needs for air, food, water, sleep, excretion of waste products, the ability to move, communicate, with others, feel touch and satisfy their sexual interests.

Oxygen requirement- normal breathing, one of the basic physiological needs of humans. Breath and life are inseparable concepts.

With a lack of oxygen, breathing becomes frequent and shallow, shortness of breath and coughing appear. A prolonged decrease in oxygen concentration in tissues leads to cyanosis, the skin and visible mucous membranes acquire a bluish tint. Maintaining this need should be a priority for the health care professional. A person, satisfying this need, supports the necessary for life gas composition blood.

NeedV food also has important to maintain health and well-being. Rational and adequate nutrition helps eliminate risk factors for many diseases. For example, coronary heart disease is caused by regular consumption of foods rich in saturated animal fats and cholesterol. A diet high in grains and plant fibers reduces the risk of colon cancer. High protein content in food promotes wound healing.

The health care professional should educate the patient and provide recommendations on rational and adequate nutrition to meet the person's nutritional needs.

Limit: consumption of egg yolks, sugar, sweet foods, salt, alcoholic beverages.

It is better to cook or bake food, but not to fry it.

It must be remembered that an unmet need for food leads to poor health.

Fluid requirement– this is drinking liquid, 1.5-2 liters daily - water, coffee, tea, milk, soup, fruits, vegetables. This amount replenishes losses in the form of urine, feces, sweat, and evaporation during breathing. To save water balance, a person must consume more fluid than he excretes, otherwise signs of dehydration appear, but no more than 2 liters, so as not to cause dysfunction of many organs and systems. The ability of the nurse to foresee the danger of dehydration or the formation of edema determines the patient’s ability to avoid many complications.

The need for excretion of waste products. The undigested part of food is excreted from the body in the form of urine and feces. Each person's excretion patterns are individual. Satisfaction of other needs can be postponed, but the release of waste products cannot be postponed until for a long time. Many patients consider the process of excreting waste products to be intimate and prefer not to discuss these issues. When satisfying a violated need, the nurse must provide him with the opportunity for privacy, respect the patient’s right to confidentiality,

Need for sleep and rest– with lack of sleep, the level of glucose in the blood decreases, brain nutrition deteriorates and thought processes slow down; attention is lost and short-term memory deteriorates. Research conducted by American experts shows that a person who has not slept half the night has a halved number of blood cells responsible for phagocytosis. For a free person, sleep is more necessary because it helps improve his well-being. Despite the fact that a person’s sensitivity to external stimuli during sleep is reduced, this is a fairly active state. As a result of research, several stages of sleep have been identified.

Stage 1- slow-wave sleep. Light sleep and last only a few minutes. At this stage, there is a decline in the physiological activity of the organism, a gradual decrease in the activity of vital organs and metabolism. A person can be easily woken up, but if sleep is not interrupted, then the second stage occurs after 15 minutes.

Stage 2– slow sleep Shallow sleep lasts 10-20 minutes. Vital functions continue to weaken, and complete relaxation sets in. It is difficult to wake a person.

Stage 3– slow sleep The stage of deepest sleep, lasting 15-30 minutes, makes it difficult to wake up the sleeper. The weakening of vital functions continues,

Stage 4– slow sleep Deep sleep lasting 15-30 minutes makes it very difficult to wake up the sleeper. During this phase, recovery occurs physical strength. Vital functions are much less pronounced than during wakefulness. Following stage 4, the 3rd and 2nd stages begin again, after which the sleeper moves into the 5th stage of sleep.

Stage 5- REM sleep. Vivid, colorful dreams are possible 50-90 minutes after the first stage. Rapid eye movements, changes in heart rate and breathing rates, and increases or fluctuations in blood pressure are observed. The tone of skeletal muscles decreases. During this phase, a person’s mental functions are restored; it is very difficult to wake up a sleeping person. The duration of this stage is about 20 minutes.

After stage 5 sleep on a short time the 4th, 3rd, 2nd stages begin, then again the 3rd, 4th and 5th stages, i.e. the next sleep cycle.

Several factors can influence a person's sleep; physical illness, medications and drugs, lifestyle, emotional stress, environment and exercise. Any disease that is accompanied by pain, physical illness, anxiety and depression leads to sleep disturbances. The nurse should familiarize the patient with the effect of the prescribed medicines and their effect on sleep.

Rest- a state of reduced physical and mental activity. You can relax not only by lying on the sofa, but also by taking a long walk, reading books or doing special relaxation exercises. In a medical facility, rest can be disrupted by loud noise, bright lights, and the presence of other people.

The need for rest and sleep for human life, knowledge of its stages and possible causes that cause disruption of the usual functions of the human body will enable the nurse to provide assistance to the patient and satisfy his need for sleep with the means available to her.

Need in movement. Limited mobility or immobility creates many problems for a person. This condition can be long or short, temporary or permanent. It can be caused by trauma followed by the application of a splint, traction of the limbs using special devices. Pain in the presence of chronic diseases, residual effects of cerebrovascular accident.

Immobility is one of the risk factors for the development of bedsores, dysfunction of the musculoskeletal system, and the functioning of the heart and lungs. With prolonged immobility, changes in the digestive system, dyspepsia, flatulence, anorexia, diarrhea or constipation are observed. Intense straining during defecation, which the patient must resort to, can lead to hemorrhoids, myocardial infarction, and cardiac arrest. Immobility, especially when lying down, interferes with urination and can lead to bladder infections and the formation of bladder and kidney stones.

And the main problem of the patient is that he cannot communicate with the environment, which has a significant impact on the formation of a person’s personality. Depending on the degree and duration of the state of immobility, the patient may develop certain problems in the psychosocial sphere, learning ability, motivation, feelings and emotions may change.

Nursing care aimed at maximizing the restoration of mobility and independence in movement using crutches, sticks, and prostheses is of great importance for improving the patient’s quality of life.

Sexual need. It does not stop even with illness or old age.

A person’s sexual health can be directly or indirectly affected by illness or developmental defects. But nevertheless, many people are reluctant to talk about this topic, even if they have serious sexual problems.

Addressing actual or potential sexual problems can help the patient achieve harmony in all aspects of health.

It is necessary when talking with a patient:

develop a solid scientific basis to understand healthy sexuality and its most common disorders and dysfunctions;

understand how sexuality is affected by a person’s sexual orientation, culture, and religious beliefs;

learn to identify problems that are beyond the scope of nursing competence and recommend the help of an appropriate specialist to the patient.

Need for security. For most people, security means reliability and convenience. Each of us needs shelter, clothing and someone who can help. The patient feels safe if the bed, wheelchair, gurney are fixed, the floor covering in the room and in the corridor is dry and there are no foreign objects on it, the room is sufficiently lit at night; at poor eyesight there are glasses. The person dresses appropriately for the weather, and the home is warm enough to receive help if necessary. The patient must be confident that he is able not only to ensure his own safety, but also not to cause harm to others. Avoid stressful situations.

Social needs– these are the needs for family, friends, their communication, approval, affection, love, etc.

People want to be loved and understood. No one wants to be abandoned, unloved and alone. If this happens, it means that the person’s social needs are not satisfied.

For severe illness, disability or old age often arises vacuum, social contacts are disrupted. Unfortunately, in such cases the need for communication is not satisfied, especially among older and lonely people. You should always remember about a person's social needs, even in cases where he prefers not to talk about it.

Helping the patient decide social problem, you can significantly improve his quality of life.

The need for self-esteem and esteem. When communicating with people, we cannot be indifferent to the assessment of our success by others.

A person develops a need for respect and self-esteem. But for this it is necessary that the work brings satisfaction to him, and the rest is rich and interesting; the higher the level of socio-economic development of society, the more fully the needs for self-esteem are satisfied. Disabled and elderly patients lose this feeling, since they are no longer of interest to anyone, there is no one to rejoice in their success, and therefore they have no opportunity to satisfy their need for respect.

Need for self-expression This is the highest level of human need. By satisfying their need for self-expression, everyone believes that they are doing better than others. For one, self-expression is writing a book, for another it is growing a garden, for another it is raising children, etc.

So, at each level of the hierarchy, the patient may have one or more unmet needs; the nurse, when drawing up a care plan for the patient, must help him realize at least some of them.

All living beings have basic needs, but humans still occupy a leading position. People satisfy their needs every day, starting with the basics: eating, drinking, breathing, etc. There are also secondary needs, for example, self-realization, the desire to achieve, the desire for knowledge and many others.

Basic types of needs

There are many different classifications and theories that help us understand this topic. We will try to highlight the most significant of them.

10 basic human needs:

1. Physiological. Satisfying these needs is necessary for survival. This group includes the desire to eat, drink, sleep, breathe, exercise, etc.
2. The need for physical activity. When a person is inactive and does not move, he does not live, but simply exists.
3. The need for relationships. It is important for people to communicate with others, from whom they receive warmth, love and other positive emotions.
4. Need for respect. To realize this basic human need, many strive to achieve certain heights in life in order to receive approval from others.
5. Emotional. It is impossible to imagine a person who would not experience emotions. It is worth highlighting the desire to hear praise, feel security, love, etc.
6. Intelligent. Since childhood, people have been trying to satisfy their curiosity, to find out new information. To do this, they read, study and watch educational programs.
7. Aesthetic. Many people have an instinctive need for beauty, so people try to take care of themselves in order to look neat and tidy.
8. Creative. Often a person is looking for an area where he can express his nature. This could be poetry, music, dance and other areas.
9. Need for growth. People do not want to put up with the situation, so they develop to reach a higher stage in life.
10. The need to be a member of society. A person strives to be a participant different groups, for example, family and team at work.

Human needs.

Lack of motivation is the greatest spiritual tragedy that destroys all the foundations of life. G. Selye.

Need- this is a need, the necessity of something for human life.

The manifestation of needs in animals is associated with a complex of corresponding unconditioned reflexes called instincts (food, sexual, orientation, protective).

The most a shining example human needs are cognitive. A person strives to get to know the world not only in his immediate environment, but also in remote areas of time and space, to understand causal connections phenomena. He strives to explore phenomena and facts, to penetrate the micro- and macrocosm. IN age development Human cognitive needs go through the following stages:

Orientations,

Curiosities,

Directed interest

Tendencies

Conscious self-education,

Creative search.

Need is a state of a living being, expressing its dependence on what constitutes the conditions of its existence.

The state of need for something causes discomfort, a psychological feeling of dissatisfaction. This tension forces a person to be active, to do something to relieve the tension.

Only unsatisfied needs have motivating power.

Satisfying needs- the process of returning the body to a state of balance.

You can select three types of needs:

Natural, or physiological, or organic needs that reflect the needs of our body.

Material, or objectively - material,

Spiritual - generated by life in society, associated with the development of personality, with the desire to express through creative activity everything that a person is capable of.

The first who developed and understood the structure of needs, identified their role and significance, was an American psychologist Abraham Maslow. His teaching is called the “hierarchical theory of needs.” A. Maslow arranged the needs in ascending order, from the lowest - biological, to the highest - spiritual.

This scheme is called "Pyramid of Needs" or "Maslow's Pyramid"

1. Physiological needs - food, breathing, sleep, etc.
2. The need for security is the desire to protect one's life.
3. Social needs - friendship, love, communication.
4. prestigious needs - respect, recognition by members of society.
5. Spiritual needs - self-expression, self-realization, self-actualization, self-realization.

Exist various classifications human needs. One of them was developed by the American social psychologist A. Maslow. It is a hierarchy and includes two groups of needs:

primary needs (innate) - in particular, physiological needs, the need for safety, secondary needs (acquired)-social, prestigious, spiritual. From Maslow's point of view, the need for more high level can appear only if the needs that lie at the top are satisfied low levels hierarchy. Only after satisfying his needs of the first level (the most extensive in content and meaning), a person develops needs of the second level.

Needs are only one motive for activity. There are also:

1. Social attitudes.
2. Beliefs.
3. Interests.

Under interests It is customary to understand such an attitude towards an object that creates a tendency to primarily pay attention to it.
When we say that a person has an interest in cinema, this means that he tries to watch films as often as possible, read special books and magazines, discuss the works of cinema he has watched, etc. It is necessary to distinguish from interests inclinations. Interest expresses focus on a specific item, and inclination - to a certain activity. Interest is not always combined with inclination (much depends on the degree of accessibility of a particular activity). For example, an interest in cinema does not necessarily entail the opportunity to work as a film director, actor or cinematographer.
A person's interests and inclinations are expressed focus his personality, which largely determines him life path, nature of activity, etc.

Beliefs- stable views on the world, ideals and principles, as well as the desire to bring them to life through one’s actions and deeds

The German scientist Max Weber notes that differences in actions depend on the wealth or poverty of personal experience, education and upbringing, and the uniqueness of the individual’s spiritual make-up.