This paper examines Maslow's hierarchy of needs as a borrowed theory within nursing, tracing its origins in Abraham Maslow's mid-twentieth-century psychology and analyzing its adaptation to clinical and educational nursing contexts. The paper outlines the five hierarchical need levels — physiological, safety, social, esteem, and self-actualization — and reviews how nursing theorists and practitioners have applied and critiqued the framework. Specific applications discussed include hospice and palliative care, nursing workforce motivation, and patient behavior change. The paper also addresses the theory's limitations, particularly its hierarchical assumptions and tensions with holistic nursing models such as Roy's Adaptation Model, concluding with reflections on its appropriate role in nursing education.
The paper effectively uses comparative analysis: it introduces Maslow's hierarchy, then tests it against real nursing applications and competing theoretical perspectives (such as Roy's Adaptation Model and middle-range theories). This technique — presenting a framework, applying it, and then critiquing its fit — is a strong model for evaluating any borrowed theory in an applied discipline.
The paper opens with a broad framing of borrowed theories in nursing, then narrows to Maslow specifically, covering his biographical context, the theory's components, and clinical applications. A practical motivation section connects the theory to patient behavior change. The conclusion synthesizes strengths and weaknesses and ends with a personal educator's perspective. Two appendix-style paragraphs briefly introduce Roy's Adaptation Model as a contrasting framework, grounding the critique in an alternative nursing theory.
In the pantheon of nursing theories, borrowed theories are those that derive from other disciplines and have been adapted to the nursing context. Many such borrowed theories come from the social sciences — such as psychology or sociology — because they directly reflect critical issues in care, including human nature and the role of human interaction in well-being. One could apply religious theories to the care of religious patients, and it is even possible to consider motivational theories when a nurse is trying to encourage a patient to change behavior as a means of improving health outcomes. Borrowed theories have perhaps received less study than either grand theories or mid-level theories, but they are nevertheless an important source of insight for the nursing educator.
It is important to understand a borrowed theory, where it comes from, and how it has been adapted to apply specifically to the nursing context. There is still debate within the nursing community about the usefulness of borrowed theories, because they may not adapt perfectly to nursing practice (Villarruel et al., 2001). That tension is precisely what makes them interesting — they are in common use yet may not be perfectly applicable. For the nursing educator, this matters because choosing what to teach requires understanding the nature of borrowed theories and their pros and cons alike.
Maslow's hierarchy of needs derives from psychology and was developed in the 1950s by Abraham Maslow. This theory outlines five different strata of human needs and proposes that they exist in hierarchical form. It has been widely applied in many fields where human motivation is studied, becoming important not only in psychology but also in the human resources curricula of business schools and, of course, in nursing education (McLeod, 2014). The five strata of needs are, in ascending order: physiological, safety, social, esteem, and self-actualization.
At the heart of the theory is the proposition that lower-order needs must be satisfied before a person can progress to higher-order needs. People who are hungry cannot attend to their social lives until they have acquired food and shelter. Only after those basic needs are met can they focus on social concerns. While exceptions exist — the starving artist archetype pursues self-actualization at the expense of basic physiological need — most people follow this progression. Over the years, Maslow's hierarchy has been subject to scrutiny, but its simplicity and broad applicability have allowed it to remain common in education and practical use across many disciplines.
Abraham Maslow sought to study the characteristics of successful people and what motivated them. His approach was both typical of the era and unconventional. Typical in that early twentieth-century psychology relied little on formal scientific method — he developed his theory more through observation and quasi-academic study than rigorous experimentation. Unconventional in that most psychological study of the time focused on the mentally ill, whereas Maslow was interested in learning how to help people succeed. His hierarchy was published in book form in 1954, and he spent the remainder of his career refining and defending it.
The key components of Maslow's hierarchy are the five types of needs. Although people have all of these needs simultaneously, the hierarchical element holds that most people prefer to satisfy basic needs first and then progress upward. Self-actualization, for example, is considered a higher-order concern available only to those who have already satisfied the other needs. The hierarchical structure in particular has been criticized for reflecting an individualistic cultural perspective in which self-actualization is prioritized over the social group. A counterargument is that people from cultures where social needs are primary simply stop at that level and do not pursue higher-order needs. Even within those cultures, individuals such as artists tend to place esteem and actualization needs above social needs.
In nursing practice, esteem and self-actualization are often not the primary focus when Maslow's hierarchy is applied. Instead, attention centers on meeting the three lower-order needs: physiological, safety, and social. Nurses typically address physiological needs in their role as caregivers and sometimes also deal with safety needs — particularly those related to physical health — as well as social needs.
The simplicity of Maslow's hierarchy makes it easy to apply to a wide range of studies involving people. It was developed in psychology before rigorous scientific practice was standard in that discipline, yet it has remained influential in psychology and numerous other fields. The theory has proven surprisingly robust, but it still requires adaptation for use in nursing. As a human resources tool for nursing administrators, Maslow's hierarchy functions much as it would in any other organizational context; for nurses working directly with patients, however, specific adaptations are necessary. Many nursing theorists have made such adaptations to help practitioners better understand patient motivations. These adaptations generally focus first on immediate pain and discomfort, then on broader health concerns, and finally on social and esteem dimensions.
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