Maslow Hierarchy of Needs and Behavior Change

    Abraham Maslow is a well know Psychologist, many nursing schools base their teachings on Maslow's hierarchy of needs. Which in general terms appear to be simplistically laid out. But when looking deeper into Maslow's work, it is not simplistic at all. Maslow outlined principles of self-actualization theory, he emphasizes encouraging our inner nature, and when we deny or suppress expressions of our inner nature is when one experiences illness.

    During my recent research, there are so many aspects to his work.  The depth and realizations of who we are, illness, health, wholism, psychology, spiritual issues and behavior change are a few. He speaks of "deficiency needs" and if they are not met we do not function well. This carry's into all levels within the hierarchy. Obviously for example, if someone is starving, they must meet that deficiency need to maintain health, otherwise illness or death will result. Now looking at it more complex, apply defiency needs to all levels, safety, belonging and self-esteem needs. Maslow states we still must meet these deficiency needs to maintain health and avoid illness - for example, psychopathology may occur if any of those are deficiency needs are not met. Very insightful.
   
    More interesting I am intrigues with behavior change and the drive behind successful change. There are so many contributing factors when dealing with change that we will address in another blog, but Maslow hits this one on the head as well. Looking at it on such a deep innate level, making it easy to understand and difficult to deal with. He goes on to say that INSIDE US ARE TWO SET OF FORCES:

1. ONE THAT CLINGS TO SAFETY AND DEFENSIVENESS OUT OF FEAR
2. ONE THAT URGES US TOWRD WHOLENESS AND FULL EXPRESSION OF OR TRUE SELVES.

    Again looking at expressing our true nature, if we deny that and cling to safety and defensiveness out of fear - illness will result. Look at your own lives for a second and think of one example or behavior that you can identify you function thru fear and defensiveness, because it may be all you know, it is the safe thing to do you think. But then look and see if there is success in that aspect or situation in your life.

    So let the fear and clinging to safety go and see how you can feel your own true expression of your inner self. I am not saying this is easy, It is the opposite of easy, but what it takes to make positive changes in your life!!!  Good luck

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Hierarchy of Needs

Self-Actualization
Esteem Needs
Belonging Needs
Safety Needs
Physiology Needs

Please visit www.chandraklaiber.com for more information.

Arlowski, M. (2009). Wellness Coaching for a Lasting Lifestyle Change. Duluth, Minnesota: 

          Whole Person Associates.

 

Whole-Person Caring Model

Whole-Person Caring Model (WPCM) 

Uniqueness of WPCM

•  Interdisciplinary 

•  Easy to Understand 

•  Practical Application 

•  Re-defines who we are 

•  Embrace our infinite and spiritual nature 

(Thornton, 2005)

Framed around Nurse Theorists 

Florence Nightingale – “ We are the reflection of the divine, with

physical, metaphysical and intellectual attributes” 

(Thornton, 2005).

Martha Rogers describes each person as: “ irreducible, indivisible, pandimensional energy field that is open and infinite in nature, and inseparable from the environment” (Thornton, 2005).

Jean Watson’s contemporary theory states, “ We are sacred

beings (and) we must regard ourselves and others with

deepest respect, dignity, mystery, and awe” (Thornton, 2005).

Model of Whole-Person Caring theory & framework is derived

•  Nursing Theory 

•  Physics Theory 

•  Systems Theory

(Thornton, Gold, & Watkins, 2002)

Key Concepts of the WPCM 

•  Sacredness of being

•  Therapeutic partnering 

•  Self-care and self-healing 

•  Optimal whole-person nourishment

•  Self-care and self-healing 

•  Optimal whole-person nourishment 

•  Transformational healthcare leadership, and 

•  Caring as a sacred practice 

(Thornton, 2005)

WPCM Definitions 

•  Person

•  Environment 

•  Health 

•  Whole-Person caring 

•  Spiritual

Person

Thornton et al. (2002) defines a person as:

“The art and science of whole-person caring defines person as an energy field that is infinite and spiritual in essence and in continual mutual process with the environment. Each person manifests unique physical, mental, emotional and social-relational patterns that are interrelated, inseparable, and continually evolving”.

Environment & Health 

“An energy field beyond and inclusive of the person. Because person and environment are in a state of constant mutual process, there is no distinction from an energetic perspective” (Thornton et al., 2002).

Health 

“The subjective experience of well-being” (Thornton, 2005).

Whole Person Caring 

“The delivery of care and services to promote well-being. Whole-person caring is based on the concepts of sacredness of being; therapeutic partnering: self-care and self-healing; optimal whole-person nourishment; transformational health care leadership; and caring as sacred practice” (Thornton, 2005).

Spirit 

“The spiritual dimension is a unifying field that integrates the physical, mental, emotional, and social/relational aspects of being. The spiritual dimension is the essence of self and also transcends the self. It is our closest, most direct experience of the universal life force” (Thornton et al., 2002).

Concept of Whole-Person 

•Self – Realization

•Emotional 

•Physical 

•Social/Relational 

•Mental

•Spiritual Energy Field 

•(Field of Love) 

(Thornton, 2005)

Development of WPCM 

The Model of Whole-Person Caring was created while Three

Rivers Community Hospital was developing a curriculum with the purpose to create a healing and nurturing environment for both patients and employees (Thornton, 2005).

The New England School of Whole Health Education conducted

A 2-year pilot study, and a behavioral model for creating healing for patients as well as for practitioners and others in the work environment (Donadio, 2005).

Proven Effectiveness 

At Three Rivers Community Hospital, Oregon, the theoretical

WPCM has resulted in quantifiable and sustainable results in the areas of:

•  Increased patient satisfaction 

•  Increased employee satisfaction 

•  Decrease nursing turnover, below the National average 

•  Increased integration of organizational values by employees 

•  Enhanced healing environment 

(Thornton, 2005)

The New England School of Whole-Health Education illustrated its congruency and demonstrated the transformational effects of whole-health education in an educational setting during a 2-year pilot study in 1997 (Donadio, 2005).

Leadership within WPCM 

•  Assess organization’s ideology and culture 

•  Elicit support of key people 

•  Customize strategies for implementation 

•  Involve everyone 

•  Honor and recognize exemplary people 

•  Initiate programs for personal growth and transformation 

•  Incorporate whole-person caring concepts in performance

criteria

References

Donadio, G. (2005). Improving Healthcare Delivery with the

Transformational Whole Person Care Model. Holistic Nursing Practice 19(2) 74-77.

Thornton, L. (2005). The model of whole-person caring: Creating and

      sustaining a healing environment. Holistic Nursing Practice 19 (3),

      106-115.

Thornton, L., Gold, J., & Watkins, M. (2002). The art and science of 

     whole-person caring: an interdisciplinary model for health care

     practice. International Journal for Human Caring 6 (2). 38

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Nurse Theorist Quote's

"We are a reflection of the divine, with physical, metaphysical, and intellectual "We are a reflection of the divine, with physical, metaphysical, and intellectual attributes."   - Florence Nightingale

“The process and outcome whereby thinking and feeling people, as individuals or in groups, use conscious awareness and choice to create human and environmental integration.” Callista Roy

Martha Rogers describes each person as,

“ Irreducible, indivisible, pandimensional energy field that is open and infinite in nature, and inseparable from the environment.”

Jean Watson’s contemporary theory states, 

“ We are sacred beings (and) we must regard ourselves and others with deepest respect, dignity, mystery, and awe”.

Stress Affirmations

 By: Chandra Klaiber, RN

 Use these powerful words to

 transform you life thru your

 intentional thoughts.

       

Mindful Affirmations

Love Corner Blog

Quotes on Love 

By: Chandra Klaiber, RN

Quote By: Merle Shain

"Many of us spend our lives saying we would give anything for love, while we're often really pushing it away."

Quote By: Marianne Williamson

"Love is what we were born with. Fear is what we learned here."

Quote By: Anonymous

"You can close your eyes to the things you do not want to see, but you cannot close your heart tot he things you do not want to feel."

Quote By: Houssaye

"Tell me whom you love and I will tell you who you are."

Quote By: Oprah Winfrey

"Lots of people want to ride with you in the limo, but what you want is someone who will take the bus with you when the limo breaks down."

Quote By: Jalal ad-din Rumi

"Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it."

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Affirmation Corner

Enjoy this wonderful, upbeat affirmation corner. Look daily for new positive affirmations. You can think them in your head, say them aloud, write them down, even write them and hang around to see them to remind you to think them. These can reprogram your mind and improve your health and happiness.

By: Chandra Klaiber

        Here are some simple basic positive affirmations to start. These are fundamental and can be used all day everyday throughout our lives. These very powerful thoughts will produce change in your life. You can make your own affirmations and customize them for your specific issues you would like to work on. Continue to watch for many many more enlightening thoughts. This is such a great way to improve anything in our lives. There are no side or adverse effects ever. If you are finding it difficult to use these as often as you would like, just keep trying, eventually your mind will get the hang of it and you will think about positive thoughts and affirmations without even knowing it. GOOD LUCK!!!

* I AM VERY HAPPY!

* I AM HEALTHY!

* I LOVE MYSELF!

* I AM LOVED!

* UNLIMITED PROSPERITY FLOWS IN MY LIFE!

* I AM AT PEACE!

* I AM VERY SUCCESSFUL!

* I AM ABUNDANT!

* I AM FILLED WITH JOY!

* I AM GRATEFUL FOR__________________________. Fill it in everyday with something new.

* I AM GIVING!

        So far these are very simple and fundamental positive thought words and phrases. Please feel free to expand on them and make them personal with your name and your circumstances.

With Love, Chandra

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Aromatherapy Corner

Aromatherapy Case Study

Aromatherapy:

AROMATHERAPY  IS THE THERAPEUTIC USE  OF ESSENTIAL OILS(AROMATIC PLANT EXTRACTS) FOR PHYSICAL, EMOTIONAL AND MENTAL WELLBEING. RELIEVING HEALTH PROBLEMS AND IMPROVING QUALITY OF LIFE. 

 By: Chandra Klaiber, RN

         My researched based Topical Pain Relief Aromatherapy Blend. 

Consists of a blend of essential oils including 8 drops of lemongrass, 8 drops of rosewood, 8 drops of cypress and 6 drops of black pepper. The essential oils were mixed with 2.5 ounces lotion base.

Medium 

        The medium used is a pure unscented lotion. This medium was used as it provides a great base for the essential oils to absorb into the skin and distributes evenly (Worwood, 1991). A lotion is an amalgamation of oil in water or water in oil, both containing an emulsifying agent. Essential oils may then be added to obtain a pure and natural product (Worwood, 1991).

Essential Oil Properties and Purpose

        Cymbopogon citratus (lemongrass) is used for its analgesic effects. It also has many other properties that value the recipe such as anti-depressant, anti-oxidant, nervine, sedative and tonic, which all will help in over pain relief. (Lawless, 1995). Lemongrass’s principal chemical constituents are citral, myrcene, dipentene, methlheptenone, linalool, geraniol, nerol, citronellol and farnesol. Chemical constituents will vary depending on type (Lawless, 1995). Due to it’s myrcene content lemongrass may have analgesic effects (Buckle, 2003) Lemongrass is also beneficial for inflammation and acute low back pain (Buckle, 2003). 

        Aniba rosaeodora (rosewood) is used for its mildly analgesic effect (Lawless). It also contains other properties, which are valuable to the pain relief blend such as its anti-convulsant, antidepressant, and anti-septic properties. Rosewood is also an immune system stimulant, tissue regenerator and tonic (Lawless, 1995). Its chemical constituents are linalol (majority), cineol, terpineol, geraniol, citronellal, limonene and pinene (Lawless, 1995). 

        Cupressus sempervirens (cypress) has a few properties valuable to the pain relief recipe. It has anti-rheumatic, antiseptic, antispasmodic, diuretic and tonic properties. Its chemical constituents are pinene, camphene, sylvestrene, cymene, sabinol and other (Lawless, 1995). Cypress is known for its comforting, deodorizing and hormonal effects on menopausal woman (Buckle, 2003). Cypress is also good for inflammation (Lawless, 1995).

        Piper nigrum (black pepper) is used in this blend for its analgesic and antispasmodic effects. It is also an antitoxic rubefacient, which makes it great for muscle and joint pain. Additional beneficial properties are bactericidal febrifuge and diaphoretic, among others (Lawless, 1995). The main chemical constituent in black pepper is monoterpenes. Others include thujene, pinene, camphene, sabinene, myrcene, sesquiterpenes and oxygenated compounds (Lawless, 1995). In reference to the Port study (1999) the experimental group using a mixture of 3% black pepper and lavender oils in plain carrier oil, rubbed the mixture into painful joints once in the morning and once at night for seven days. The experimental group did experience a reduction in stiffness and pain. The pain for these patients did return after the study was over and they were no longer using the mixture on painful joints, while the control group did not have measurable effects from the process (Buckle, 2003).

When and How To Use This Blend

        This blend is designed to be applied topically to painful or swollen muscles and joints. The blend may be used at anytime of the day, although lemongrass is also a sedative (Lawless, 1995). All four essential oils will create a relaxed feeling as the properties indicate (Lawless, 1995). 

Patient/client and its intended use

This blend is designed for patients experiencing discomfort or pain. It is best for rheumatic patients. Patients with fibromyalgia will benefit from this blend. It is also designed for patients with acute back pain, inflammatory processes, neuralgia, poor circulation, aches, muscle atonia, sprains and stiffness. The analgesic, antirheumatic and antispasmodic properties contribute greatly to the medicinal effects of the blend. May be beneficial for flu’s and colds as they also contain diaphoretic, bactericidal and febrifuge properties. The properties in the blend are also is beneficial for exhaustion and fatigue, helping the overall healing process and stimulating the immune system (Lawless, 1995). 

Safety and Precautions 

        All oils or combination products need to be tested on a small area of the skin to check for sensitivity before use (Lawless, 1995). Using essential oils in pregnancy is a contentious subject especially during the first trimester. It is believed that lipophilic substances can diffuse between two circulations they are likely to cross the placenta (Buckle, 2003). It is advisable to urge caution when giving or using oils on pregnant women and avoid pennyroyal at all costs. Many experienced midwives are happy with the use of essential oils for their analgesic effect and feel it is safe and effect, but to avoid in the first 24 weeks of pregnancy (Buckle, 2003). These essential oils may cause toxicity if taken internally. Sometimes the mixture of a chemical and essential oils can trigger an allergic reaction (Buckle, 2003).  

        The monoterpene constituent and the rubefacient properties in black pepper can become skin-sensitizing if used over time and the phenols can be more irritating to the skin (Buckle, 2003). Aldehydes such as citral in lemongrass have sedative effects (Lawless, 1995).

                                                            References

Buckle, J.  (2003).  Clinical Aromatherapy: Essential Oils in Practice.  New

         York: Churchill Livingstone.

Lawless, J. (1995). The illustrated encyclopedia of essential oils: The

     complete guide to the use of oils in aromatherapy and herbalism. 

     Massachusetts: Element Books.

Worwood, V. (1991). The complete book of essential oils and aromatherapy. 

         San Rafael, California: New World Library.

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Thoughts on Nursing Theory

Quote:

“Caring is the essence of nursing.”

-Jean Watson

        

            My philosophy of caring, values, and belief system are amazingly similar to all of the Watson’s 10 carative/caritas assumptions. All relevant at different level’s of my own philosophy. Watson’s first carative factor formation of a humanistic altruistic system of values (Alligood, 2010) ascertain my beliefs of loving-kindness, sharing sense of self with a deep caring consciousness. This typically learned at an early age is believed to be changes within a patient through nurse education (Alligood & Tomey, 2010).

            Watson’s second carative factor, instillation of faith-hope (Alligood, 2010) is one of the strongest and closest to my philosophies. Positive and wholistic health seeking behaviors along with teaching the patient and giving them the tools and support to take care of themselves. The third carative factor, cultivation of sensitivity to self and to others, being genuine authentic and sensitive to others (Alligood, 2010). Nurses must be in touch with their feelings and have a strong recognition of self-acceptance and self-actualization (Alligood & Tomey, 2010). My philosophy directly correlates to the caritas process that going beyond the ego and being in touch with our transpersonal self and self-spiritual health. 

            Developing of a helping-trust relationship is the fourth carative/caritas (Alligood, 2010) and is so important in the relation to my philosophy that a trusting transpersonal caring relationship with empathy helps to understand the person’s perceptions and feelings ultimately creating a bond and increasing effective communication. The fifth carative factor, promotion and acceptance of the expression of positive and negative feelings, recognizes that intellectual and emotional actions and reaction will differ in all situations. The safe expression of positive and negatives feelings encourage sustaining the care transpersonal relationship developed between patient and nurse or Nurse Practitioner (Alligood, 2010). 

            Systematic use of the scientific problem solving method for decision-making is the sixth carative (Alligood & Tomey, 2010). My philosophy and the caritas process both strongly support the artistry and expertise in caring-healing practices. The seventh carative factor promotion of interpersonal teaching-learning (Alligood & Tomey, 2010) is strongly ascertain with my beliefs that this technique of shifting the patients responsibility to the patient, to provide self-care and personal growth. Provision for supportive, protective, and corrective mental, physical, socio-cultural, and spiritual environment is the eight carative factor (Alligood, 2010) and again directly relates in my philosophical beliefs that to create well-being, these entire factors must be looked at and taken in consideration when treating the patient as a whole. Assistance with gratification of human needs agrees with my philosophy that taking care of self and intra-personal needs of self is just as important as taking care of patients. Recognition needs extend to; psych-physical self, biophysical self, psychosocial self is which are all inter-related and need to be nourished. The tenth carative allowance for existential-phenomenological forces, indicate spiritual care for self (Alligood, 2010).

            Nursing care is an art, an essence and dedication of healing and helping others (Alligood & Tomey, 2010). To accomplish this we must take care of ourselves first. Body, mind and spirit are connected as one and are considered the basis for holistic healing. Treating the patient and self as a whole, considering all aspect of healing including physical, emotional and spiritual.  Caring for patients is individualized with compassion and considering all aspects of the patient’s health and life. 

            The major characteristic within those situations stem directly for the 10 carative/caritas assumptions such as: expressing positive and negative feeling, developing strong trusting interpersonal relations, offering a genuine sense of ourselves with compassion and empathy for the other person, caring-healing practices, loving-kindness with a intentional caring consciousness in all interactions. Staying in touch with ones own feelings, thoughts and spirit while meditating and deep breathing on a daily basis. Expressing genuine, caring, moments, words, thoughts, senses, feelings, behaviors and energy field to those all around us everyday.  Creating peaceful and healing environment all around us. Surround our selves with beauty, comfort, wholeness; consciousness, basic needs and dignities, which will all, contribute to wonderful feeling and opportunities in my everyday clinical practice (Alligood & Tomey, 2010).

My wholistic approach to healing compares to Nurse Theorist Watson, which encompasses my entire body, mind and spirit philosophy. The Seven Basic Assumptions of the Science of Caring Model is the caring aspect and perceptions of wholistic healing. The art of caring is very beneficial and healthy for the patients and families in their relationships with self and others. 

As stated in Bailey (2009):

          1. Caring can be effectively demonstrated and practiced only interpersonally.

          2. Caring consists of carative factors that result in the satisfaction of certain human needs. 

3. Effective caring promotes health and individual or family growth. 

4. Caring responses accept a person not only as he/she is now but as what he/she

may become. 

5. A caring environment is one that offers the development of potential while

allowing the person to choose the best action for him/herself at a given point of

time. 

6. Caring is more “healthogenic” than is curing. The practice of caring integrates

biophysical knowledge with knowledge of human behavior to generate or promote

health and to provide ministrations to those who are ill. A science of caring is

therefore complimentary to the science of curing.

7. The practice of nursing is central to nursing.

                                            References

Alligood, M. R. (2010). Nursing theory: Utilization and application.

         Maryland Heights, MO: Mosby Elsevier.

Alligood, M.R., & Tomey, A. M. (2010). Nursing theorists and their work.

         Maryland Heights, MO: Mosby Elsevier.

Bailey, D.N. (2009). Caring defined: a comparison and analysis.

         International Journal For Human Caring, 13(1), 16-31.