MAN and His Basic Human Needs:

CONCEPT OF MAN
A. ATOMISTIC APPROACH
The atomistic study of man views man as an organism composed
of different organ systems where each system is composed of organs
and each organ is composed of tissues and cells.
B. HOLISTIC APPROACH
This view traces man’s relationship with other human beings in
the suprasystem of society. This approach views man as a whole
organism with interrelated and interdependent parts functioning to
produce behavior. Man as a whole therefore is different from and more
than the sum of his component parts. The dimensions of man include
the physical, social, spiritual, cognitive and psychological aspects.
- Man as a social being is capable of relating with others. His first agent
of socialization is the family where he is nurtured, where he learns his
first language and where he first learns to socialize.
- Man as a spiritual being is capable of such virtues as faith, hope and
charity. Faith is the unquestioning belief in someone or something. It is
the foundation where hope rests. Charity means the love of man for his
fellowmen. Man as a spiritual being believes in a power beyond himself
and of transcending one’s limitations.
- Man as a thinking being is capable of perception, cognition, and
communication. He is also capable of logical thinking and reasoning.
- Man as a psychological being is capable of rationality. His
rational side makes him merciful, kind and compassionate.
 - Man as a physical being has such characteristics as genetic
endowment, sex, other physical attributes, physical structure and
functions.
Abraham Maslow’s
Hierarchy of Basic Human Needs
NEED - is something that is essential to the survival of humans.
A basic need is something whose:
1. Absence may lead to illness
2. Presence may signal health or prevent illness
3. If unmet needs are met or fulfilled, health may be restored
FIRST LEVEL: Physiological Needs
a. Oxygen e. Elimination
b. Fluids f. Shelter
c. Nutrition g. Rest
d. Temperature H. Sex
SECOND LEVEL: Safety and Security Needs
1. Physical Safety:
- involves reducing or eliminating threats to the body such as
illness, accident and environmental exposure.
2. Psychological Safety:
- understanding and the appropriateness of what to expect
from others, from new experiences and from encounters with the
environment.
THIRD LEVEL: Love and Belonging Needs
- need to establish social relationships and to experience
emotional nurturance and care to and from others.
FOURTH LEVEL: Esteem and Self-Esteem Needs
- linked with the desire for strength, achievement,
adequacy, competence, confidence, and independence.
FIFTH LEVEL: Need for Self-Actualization
- highest level of all needs.
Characteristics of a self-actualized individual:
1. Solves own problems.
2. Assists others in problem-solving.
3. Accepts suggestions of others.
4. Has broad interest in work and social topics.
5. Possesses good communication skills as a listener
and communicator.
6. Manages stress and assists others in managing stress.
7. Enjoys privacy.
8. Seeks new experiences and knowledge.
9. Shows confidence in abilities and decisions.
10. Anticipates problems and successes.
11. Likes self.
Characteristics of Basic Human Needs:
1. Needs are universal
 2. Needs may be met in different ways.
3. Needs may be stimulated by external and internal
factors.
4. Priorities may be altered.
5. Needs may be deferred.
6. Needs are interrelated.

HEALTH AND ILLNESS

CONCEPT OF HEALTH, WELLNESS, WELL-BEING AND ILLNESS
HEALTH
> is the fundamental right of every human being. It is the state of
integration of the body and mind.
- is a state of complete physical, mental, and social well-
being, and not merely the absence of disease or infirmity. (WHO)
- is the ability to maintain the internal milieu. Illness is the
result of failure to maintain the internal environment. (Claude
Bernard)
> is being well and using one’s power to the fullest extent. Health
is maintained through the prevention of diseases via environmental
health factors. (Florence Nightingale)
> is the ability to maintain homeostasis or dynamic equilibrium.
(Walter Cannon)
> is a dynamic state in the life cycle. Illness is an interference in
the life cycle. (Imogene King)
WELLNESS AND WELL-BEING
> Wellness is a state of well-being.
> Well-Being is a subjective perception of balance, harmony and
vitality.
> Wellness has different dimensions:
1. Physical - the ability to carry-out daily tasks (grooming,
mobility, etc.) and to achieve fitness of the different organ systems
of the body.
2. Emotional - the ability to manage stress and to express
emotions appropriately.
> is a state of a process of being becoming an integrated and a
whole as a person. (Sister Calista Roy)
3. Social - ability to interact successfully with people and within the
environment of which each person is a part, to develop and maintain
intimacy with significant others and to develop respect and
tolerance for those with different beliefs.
4. Intellectual - the ability to learn and use information effectively
for personal, family, and career development.
5. Spiritual - the belief in some force (nature, science, religion, or a
higher power) that serves to unite human beings and provide
meaning and purpose of life.
6. Occupational - ability to achieve balance between work and
leisure time.
MODELS OF HEALTH AND WELLNESS
 
1. LEAVELL & CLARK’S: AGENT-HOST-ENVIRONMENT MODEL or
ECOLOGICAL MODEL
This model has three dynamic interactive elements:
  1. Agent: any environmental factor or stressor (biologic, chemical,
mechanical, physical, and psychological) whose presence or absence
can lead to illness or death
2. Host: person(s) who may or may not be at risk of acquiring a
disease based on family history of disease, lifestyle habits and age
3. Environment: all factors external to the host that may or may
not predispose the person to the development of disease
HEALTH-ILLNESS CONTINUA
DUNN’S: HIGH-LEVEL WELLNESS GRID
  - A health grid in which the health axis and the environment axis
intersect to demonstrate interaction. The health axis extends from
peak wellness to death and the environmental axis extends from
very favorable to very unfavorable. The intersection forms four
health/wellness quadrants:
1. High-level wellness in a favorable environment:
- example is a person who implements healthy lifestyle
behaviors and has economic resources to support this lifestyle and a
family or social environment who also practices or encourages the
practice of healthy lifestyle.
2. Emergent high-level wellness in an unfavorable environmental
- example is a person who knows the importance of
implementing a healthy lifestyle but could not do so because of
family responsibilities, job demands or lacks the resources to do so.
3. Protected poor health in a favorable environment -
example is an ill person confined in a hospital and whose needs are
met by the hospital personnel, who can afford appropriate
medication, proper diet and other treatments needed.
4. Poor health in an unfavorable environment
- example is a starving young child in a refugee camp in
Mindanao.
HEALTH BELIEF MODEL (HBM)
Becker, 1975
> describes the relationship between a person’s belief and
behavior.
> individual perceptions and modifying factors may influence
health beliefs and preventive health behavior.
Individual perceptions includes the ff:
1. Perceived susceptibility to an illness.
2. Perceived seriousness of an illness.
3. Perceived threat of an illness.
Modifying factors include the ff:
1. Demographic variables
2. Socio-psychologic variables
3. Structural variables
4. Cues to action
TRAVIS’: ILLNESS-WELLNESS CONTINUUM
-The model illustrates that movement to the right of the
neutral point indicates increasing levels of health and well-being for
an individual.
-This is achieved through awareness, education and growth.
-In contrast, movement to the left of the neutral point
indicates a progressively decreasing state of health.
SMITH’S: MODEL OF HEALTH
1. Clinical Model - absence of signs and symptoms of disease.
2. Role Performance Model - ability to fulfill societal roles.
3. Adaptive Model - views health as a creative process and
disease as a failure in adaptation or mal-adaptation.
4. Eudaemonistic Model - health is a condition of actualization or
realization of a person’s potential.

Disease and Illness

Disease – alteration in the body functioning which results in the
reduction of capacities and shortening of life span.
Illness – a personal state in which the person feels unhealthy.
In other words: Disease is an illness with objective facts while Illness
is a subjective perception of not being well.
Stages of Illness:
Stage 1. Symptoms Experience - experience some symptoms,
persons believes something is wrong.
3 aspects – physical, cognitive and emotional.
Stage 2. Assumption of the Sick Role - acceptance of illness, seeks
advice.
Stage 3. Medical Care Contact - seeks advice to professionals for
validation of real illness, explanation of symptoms, reassurance or
predict of outcome.
Stage 4. Dependent Patient Role - the person becomes a client
dependent on the health professional for help; accepts or rejects
health professional’s suggestions; becomes more passive and
accepting.
Stage 5. Recovery/Rehabilitation - gives up the sick role and returns
to former roles and functions.
Classification of Diseases:
1. According to Etiologic Factors:
A. Hereditary – due to defect in the genes of one or other parent
which is transmitted to the offspring.
B. Congenital – due to defect in the development, hereditary factors
or prenatal infection
C. Metabolic – due to disturbance or abnormality in the intricate
processes of metabolism
D. Deficiency – results from inadequate intake or absorption of
essential dietary factor
E. Traumatic – due to injury
F. Allergic – due to abnormal response of the body to chemical and
protein substances or to physical stimuli
G. Neoplastic – due to abnormal or uncontrolled growth of cell
H. Idiopathic – cause is unknown; self-originated; of spontaneous
origin
I. Degenerative – results from the degenerative changes that occur in
the tissues and organs
J. Iatrogenic – result from the treatment of the disease
2. According to Duration or Onset:
A. Acute Illness – has short duration and is severe. Signs and
symptoms appear abruptly, intense, and often subside after a
relatively short period.
B. Chronic Illness – usually longer than 6 months, and can also affects
functioning in any dimension. Is characterized by:
> Remission – periods during which the disease is controlled and
symptoms are not obvious.
> Exacerbations – disease becomes more active given at a future
time, with recurrence of pronounced symptoms.
C. Sub-Acute – symptoms are pronounced but more prolonged than
the acute disease.
3. Disease may also be described as:
A. Organic F. Epidemic
B. Functional G. Endemic
C. Occupational H. Pandemic
D. Venereal I. Sporadic
E. Familial
Risk Factors of a Disease:
1. Genetic or Physiologic - genetic predisposition.
2. Age - increase or decrease client’s susceptibility to acquire
disease.
3. Environment - surroundings that can affect the person.
4. Lifestyle - habits that increases the chance of acquiring a disease.
5. Sex - gender.
Levels of Prevention:
1. Primary Prevention - applied on healthy individual.
focus: health promotion, disease prevention
2. Secondary Prevention - applied on patient’s with signs and
symptoms.
focus: screening, diagnosing, case-finding, early
detection, prompt treatment
3. Tertiary Prevention - applied on patients with chronic and
debilitative disease.
focus: rehabilitation

STRESS MANAGEMENT
1. Massage – manipulation of the client’s skin to promote blood
circulation.
2. Guided Imagery – suggestion of images which helps reduce
anxiety.
3. Mediation – relaxation of the mind, body and soul.
 4. Relaxation Technique – quite environment, passive attitude,
comfortable position, comfortable clothing.
5. Autogenic Training – teaching the mind and body to
follow verbal commands.
6. Therapeutic Touch – used to manage anxiety, relief
from pain.
7. Yoga – combination of exercise and meditation.
8. Progressive Muscle Relaxation – series of tensing
and relaxing group of muscles systematically.
9. Thought Stopping – stopping the negative thoughts.
10. Abdominal Breathing – breathing with the use of the
diaphragm.
11. Distraction – diverting one’s attention from one
thought to another.
12. Pharmacotherapy – the use of medication.

COMMUNICATION in NURSING
Communication - exchange of ideas, feelings, and information from
one person to another.
1. Is the means to establish a helping-healing relationships. All
behavior communication influences behavior.
2. Communication is essential to the nurse-patient relationship.
3. Is the vehicle for establishing a therapeutic relationship.
4. Is the means by which an individual influences the behavior of
another, which leads to the successful outcome of nursing intervention.
Components of Communication Process:
1. Sender – is the person who encodes and delivers the
message.
2. Message – is the content of the communication.
3. Channel – is the medium used to convey the message.
4. Receiver – is the person who receives the message.
5. Response/Feedback – is the message returned by the receiver. It
indicates whether the meaning of the sender’s message was
understood.
Modes/Types of Communication:
1. Verbal - use of spoken or written words.
2. Nonverbal - use of gestures, facial expressions, posture/gait, body
movements, physical appearance and body language.
Characteristics of Communication:
1. Simplicity - the use of commonly understood words.
2. Clarity - saying what is actually meant.
- speak slowly and enunciate words.
3. Timing and Relevance - appropriate time.
- consider client’s concerns and interests.
4. Adaptability - ability to adjust.
- consider circumstances and behavior
5. Credibility - pertains to worthiness of words and reliability
RECORDING AND REPORTING
Record - a formal and legal document that provides evidence of the
client’s care.
Purposes:
1. Communication 5. Education
2. Planning client care 6. Reimbursement
3. Audit and quality assurance 7. Legal documentation
4. Research 8. Statistics
Responsible for the disposal of medical records in government hospital:
- DOH
Criteria for disposal:
- DOH accredited
DOH Records Mgt & Archive Office
Where to get the chart of a pt who has been discharged:
- Medical Records Section
Where to obtain the client’s chart during period of
hospitalization :
- Nurse’ Station
2 Types of Records
1. Problem Oriented Medical Record - data are arranged based on the
client’s problem rather than the source of information.
Basic Components:
A. Database - primary information about the client.
 B. Problem List - involves all aspects of the person’s life that
requires health care.
C. Initial Orders and Health Care Plans
D. Progress Notes - SOAPIE, Graphic Flow Sheet, Discharge Notes
2. Source Oriented Medical Record
- chart is divided & organized according to the different
sources of data.
Basic Components:
A. Admission Sheet
B. Physician’s Order
C. Medical History
D. Nurse’s Notes
E. Special Records and Reports

REPORTING: - either oral, taped or written exchanges of information

between nurses or other members of the health care team.
Purpose: To promote continuity of care.
KINDS:
I. Change of Shift Reports - exchange of information from the
nurse of the previous shift to the next shift.
A. Oral
B. Audiotape recording
C. Nursing Rounds
II. Telephone Orders & Reports - reports and orders via telephone.
Physician: capable of ordering the medication
RN: receives the medication order from the doctor
Important:
1. It must be countersigned by the physician within 24 hrs.
2. If it was not signed within 24 hours, notify the Head Nurse.
3. Ideally, 2 nurses must receive the telephone order.
III. Incidence Reports - record of accidents or unusual events that occurs
in the agency.
Purpose: To prevent future harm/accidents.
Data Included:
1. Client’s name and ID number
2. Date, time and place of the incidence
3. Facts of the incidence
4. Client’s account of the incident
5. Witnesses of the incident
6. Equipment and medications involved
Facts to Remember:
1. It must be filed within 24 hours.
2. It should be submitted to the Risk Manager.
3. It should not be included in the patient’s chart.
DOCUMENTATION:
DOCUMENTATION - is anything written or printed that is relied on as
record or proof for authorized person.
Nursing documentation must be:
 Accurate.
 Comprehensive.
 Flexible enough to retrieve critical data, maintain continuity of
care, track client outcomes, and reflects current standards of nursing
practice.
 As members of the health care team, nurses need to
communicate information about clients accurately and in timely
manner.
 Effective documentation ensures continuity of care, saves time
and minimizes the risk of error.
 Data recorded, reported, or communicated to other health care
professionals are CONFIDENTIAL and must be practiced.
Different Sheets:
1. Nursing Health History and Assessment Worksheet
- completed upon admission.
> Biographic data
> Age, sex and address
> Method of admission
2. Graphic Flowsheet
 - it allows the nurse to record specific measurements on a
repeated basis.
> Vital signs
> Intake and Output
3. Medicine & Treatment record
- allows for the repeated recording of medication and
treatment of the patient on a repeated basis.
4. Nursing Kardex

R – Readily accessible.
E – Ensure continuity of care.
S – Series of flips cards kept at a portable index file at the nurse’s
station.
T – Tool for communication.

2 Parts:
1. Activity and Treatment Section
2. Nursing Care Plan
5. Discharge Summary

- helps ensure that the client’s condition during discharge is

in desirable outcome.
F – Final physical assessment.
I – Instructions about medications and treatment regimen.
 R – Record pertinent data.
A – Assess the client support system.
H – Health teaching.
Guidelines of Quality Documentation and Reporting:
1. Factual
> A record must contain descriptive, objective information about what
a nurses sees, hears, feels and smells.
> The use of vague terms such as appears, seems and apparently, is not
acceptable because these words suggest that the nurse is stating an
opinion.
2. Accurate
> The use of exact measurements establish accuracy .
> Documentation of concise data is clear and easy to understand.
> It is essential to avoid the use of unnecessary words and irrelevant
details.
3. Complete
> The information within a recorded entry or a report needs to be
complete, containing appropriate and essential information.
4. Current
> Timely entries are essential in the clients ongoing care. To increase
accuracy and decrease unnecessary duplication, many healthcare
agencies use records kept near the client’s bedside which facilitate
immediate documentation of information as it is collected from a
client.
5. Organized
> The nurse communicates information in a logical order.
 Avoid using generalized, empty phrases such as “status
unchanged” or ‘had good day”.
 Begin each entry with time, and end with your signature and
title.
 Do not wait until end of shift to record important changes that
occurred several hours earlier. Be sure to sign each entry.
 For computer documentation keep your password to yourself.
 Maintain security and confidentiality.
 Once logged into the computer do not leave the computer
screen unattended.