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Mindanao Sanitarium and Hospital College

Tibanga, Iligan City

Department of Nursing

Course Title: HUMAN BEHAVIOR

Course Description:

Human Behavior is a behavioral science that deals on the fundamental


principles, theories and concepts that explains human action in relation to his self
and his environment. This subject includes behavioral theorists which aim to explain
the human natures, motives and goals towards a maintained continuum balance.
This will also present an overview on various behavioral ideas and modalities in
relation to application in the nursing practice.

Course Objective:

On a given clinical situation, the student will be able to integrate


concepts of human behavior and nursing process to address concerns in the
prevention and preservation of mental health in the clinical and community set up.

Specific Objectives:

1. Describe the meaning of theory in behavioral sciences and its importance


to clinical practice.

2. Differentiate and understand the Human self concepts and behavior.

3. Describe the conceptual frameworks of human behavior and its


importance in understanding clients.

4. Internalize the human behavior in relation to neurobiologic theories.

5. Explain human behavior basing on the theories of personality and growth


and development.

6. Assess normal human behavior and mental health.

7. Discuss trends, issues and goals related to human behavior and delivery
of mental healthcare.

8. Integrate spirituality and its emphasis in maintaining a mental health.

Methodology :

1. Interactive Lecture and Discussion

2. Library works and assignments

3. Visual Aids ( Film Showing and or Overhead Projector)


4. Group Dynamics

5. Research

Requirements :

1. Class Attendance

2. Quizzes

3. Worksheets and activities

4. Long Test and Examination

5. Reaction Paper

Evaluation:

Grading System: Modified Carreon Method

Quizzes/Oral Participation - 20%

Long Test - 30%

Group Activities/Requirements -10%

Examination -40%

100% x.50

FORMULA : Student’s Score x 70 +30 = GRADE

Perfect Score

Number of Hours : 8 hours

Student : Third Year Level , Nursing Department, NCM 102 AY 2009-2010

Prepared by : Al-Azanereeh Ramos Madale, RN

Updated : June 2009

REFERENCES:

1. De Laune, Sue, “Fundamentals of Nursing : Standards of Nursing; 2 nd


Edition” , Thomson Learning, USA, 2002

2. Dillan, Patricia M., “Nursing Health Assessment”, FA Davis


Company,USA,2005

3. Fortrnich and Worret, “Psychiatric Nursing Care Plans”, Elsevier Inc,.


Singapore, 2007
4. Keltner, Norman L .,“ Psychiatric Nursing; Fifth Edition ” , Elsevier Inc.,
Singapore 2007

5. Kozier et. al , “Fundamentals of Nursing; 8th Edition ”, Pearson Education


Inc., Singapore, 2008

6. McCann et. al, “ Straight A’s in Psychiatric and Mental Health Nursing”,
Lippincot Williams and Wilkins, USA, 2006

7. Mohr, Wanda K., “Psychiatric-Mental Health Nursing; 8th Edition” Lippincot


Willam and Wilkins, Philadelphia, 2006

8. Netha, Sandra M. , “Lippincot Manual of Nursing Practice ” Lippincot


William and Wilkins

9. Norris, Joan et. al , “Mental Health – Psychiatric Nursing” , Delmar


Publishing , New York , 1987

10.Peate, Ian et. al, “Caring for Children and Family”, TJ International Ltd.,
England , 2006

11.Pederson , Darlene , “Psych Notes”, FA Davis Company , USA, 2005

12.Pilliteri, Adele , “Maternal and Child Nursing: Care of the Childbearing and
Childrearing Family; 4th Ed.”, Lippincot , Philippines , 2003

13.Rosse, Barbara M., “Holistic Nursing : A handbook for Practice”, Jones and
Bartlett Publishing, Massachussets, 2005

14. Shives, Loiuse Rebecca, “Basic Concepts of Psychiatric- Mental Health


Nursing”, Lippincot Williams and Wilkins, USA , 2005

15.Saddock, Benjamin et. al , “Synopsis of Psychiatry; 10th Edition”, Lippincot


William and Wilkins, USA, 2007

16.Udan , Josie , “Fundamentals of Nursing; 3 rd Edition ”, Educational


Publishing House, Philippines, 2009

CLASS TEXTBOOK :

1. Videbeck, Shiela, L. “Psychiatric Mental Health Nursing; 3rd Edition”,


Lippincot William and Wilkins, Philippines, 2006

ADDITIONAL READINGS :

1. Bible ( Any Version )

2. Palapar, Shielah “Lecture Guide on Human Behavior and Mental Health


Psychiatric Nursing”,MSHC, 2008

Course Outline
I. Introduction on Human Behavior: Self Concept

1. Definition and Dynamics of Behavior

2. Definition of Self Concept and Components of Self

2.1Identity

2.2Body Image

2.3Self Esteem

2.4Role Performance

II. Neurobiological Theories in Human Behavior

1. Parts of the Brain

2. Neurotransmitters

III. Theoretical Models on Personality and Behavior

1. Psychoanalytic Theory

1.1 Sigmund Freud (Personality Components and Psychosexual


Development)

2. Developmental Theory

2.1 Erik Erikson (Psychosocial Stages)

2.2 Jean Piaget (Stages of Development-Cognitive)

3. Interpersonal Theory

3.1 Harry Stack Sullivan (Five Life Stages)

4. Humanistic Theory

4.1 Abraham Maslow (Maslow’s Hierarchy of Needs)

5. Behavioral Theory

5.1 Ivan Pavlov (Classical Conditioning)

5.2 B.F. Skinner (Operant Conditioning)

6. Existential Theory

IV. Basic Concept of Stress, Anxiety and Crises as Behavior

1. Stress

1.1Levels of Stress

1.2Physiologic Response to Stress

1.3Manifestations of Stress

2. Anxiety (Levels of Anxiety)

3. Crises ( Types of Crises )

4. Grief and Loss

V. Defense Mechanisms in Focus


VI. Therapeutic Communication

VII. Human Sexuality

1. Human Sexual Development

2. Human Sexual Response

Prepared By

AL AZANEREEH RAMOS MADALE, RN

Instructor

Chapter I

Introduction to Human Behaviour

Human is a complex and unique being thus sometimes he or


she is unpredictable. Their perception to any stimulus around
them is individually and differently perceived and interpreted.
However in past studies in behaviour science many theories
and concepts were formulated in order to explain and predict
human behaviour. Through time ideas on human behaviours
evolved to further understand its complexity.

I. Dynamics of Behaviour

A. Definition : Behaviour refers to the way which an organism responds


to stimuli.

B. Sub Concepts

All behaviour is meaningful and purposeful.


It is influenced by development, thought, choice and perceived
consequences.

(Norris, 1987)

C. Types of behaviour

1. Reflex action – an autonomic response

2. Goal directed – needs the existence of two factors :

a. Presence of need within the individual

b. Presence of goal outside the individual

Ex. Hunger ( change in internal environment ) will make him search for food
( goal )

3. Response to frustration – unmet goals

II. Self Concept

A. Definition : a mental image of oneself. ( Kozier 2008)

B. Self Awareness : refers to the relationship between ones perception of


himself or herself and others perceptions. ( Kozier 2008)

C. Formation of self Concept

1. Global Self – collective feelings and images one holds about oneself.

2. Core Self- most vital belief and images.

3. Ideal self – how a person prefers to be.

D. Components of Self Concept (Kozier 2008)

1. Personal Identity – the conscious sense of individuality and


uniqueness that is continually evolving throughout life.

2. Body Image – how a person perceives his physical appearance.

3. Role performance – reflects what a person in a particular role does


to behaviour expected of that role.

a. Role mastery – persons behaviour meet social expectations.

b. Role development- socialization into a particular role.

c. Role ambiguity- occurs when expectations are unclear.

d. Role strain – feeling of inadequacy or unsuited to role.

e. Role conflict – arise from incompatible expectations.

E. Self Esteem – is ones judgement of one’s own worth, that is how that
person standards and performances compare to others and ideal self.

1. Global Self – how much likes oneself as a whole.

2. Specific Self Esteem – how much one approves of a certain part of


oneself.

ROLES = MADE ConStrain


Chapter II

NeuroBiological Theories on Human


Behavior

This Chapter summarizes and overview on physiological and


anatomical concepts in relation to human behaviour. How the
anatomic structures relates to each other and substances that
affect behaviour. This explains the present major
neurobiological theories in relation to mental health.

I. The Nervous System

The nervous system is divided into the Central nervous System (CNS) and
Peripheral nervous System. The nurse should have an appreciation for the
neuroanatomy and physiology of the brain and human behaviour.
( Keltner 2007)

A. Central Nervous System – Composed of the brain , spinal cord and


associated nerves that control voluntary acts. It is divided further into
the cerebrum, cerebellum,brain stem and limbic system. (Videbeck
2006 )

B. Cerebrum is divided into two

1. Right hemisphere – controls the left side of the body and center
for:

a. Creative thinking

b. Intuitive

c. Artistic abilities

d. Visual Spatial

2. Left hemisphere – controls the right side of the body and center
for :

a. Logical reasoning

b. Reading

c. Writing

d. Arithmetic

C. Lobes of the Brain

FRONTAL LOBE PARIETAL LOBE TEMPORAL LOBE OCCIPITAL LOBE LIMBIC


Organization of Sensation (sense Smell Language Hypothalamus
Thought and touch) Hearing Visual - Temperature
Body Movement Spatial Memory interpretation - Appetite
Memories orientation Emotional - Endocrine
Emotions expression function
Moral behaviour - Sexual drive
Arousal - Rage,anger
Focus - Excitement
Problem Solving
Decision Making
Thalamus
- Activity
- Sensation
- Emotion

Hippocampus
- Emotional
arousal
- memory

II. Neurotransmitters

A chemical substance manufactured in the neuron that aid in the


transmission of information throughout the body.

Major Neurotransmitters
TYPE ACTION EFFECTS INCREASE DECREASE
D D
Dopamine Excitatory Movement
Motivation Schizophreni Parkinson’s
Emotions a Dse.
Cognition
Norepinephrin Excitatory Attention
e Learning
Memory Anxiety Depression
Sleep and Disorders Memory Loss
wake
Mood
Epinephrine Excitatory Fight or flight
Serotonin Inhibitory Feeding
Sleep and
wake Bipolar Mania Depression
Temperature
Pain control
Sexual
behaviour
Emotions
Histamine Modulator Alertness
Allergic
Responses
Acetylcholine Excitatory Sleep and
and wake MDD Alzheimer’s
Inhibitory Dse.

Neuropeptides Modulators Buffer


Glutamate Excitatory Toxicity
GABA Inhibitor Modulator Anxiety
Disorders
*Source Videbeck 2006 and Keltner 2007

SEND HANGG!
XXX In Mo Xin Mo XinMo
Chapter III

Theoretical Models on Personality and Behaviour


This part of the course summarizes theoretical models on personality and
behavior. These theories attempts to explain the human behaviour and mental
health. Each theories are based on the idealists’ point of view and opinion.

I. Sigmund Freud Psychoanalytical theory

A. Personality Components – composed of three personality


structures

1. Id – the pleasure seeking, no regard for rules and social


convention

2. Ego- the balancing and mediating force

3. Superego – opposite of id, reflects moral and ethical concepts

B. Level of Consciousness

1. conscious – aware and awake

2. subconscious/preconscious – memories and experiences


partially stored

3. Unconscious – totally forgotten

a. Unexplained behaviour

b. Dreams

c. Slip of tongue

C. Psychosexual Development

Phase Age Focus

Oral Birth to 18 months Major site of gratification is


mouth, lips and tongue;
includes biting ad sucking
Id present at birth
Ego starts to develop
Anal 18- 36 months Anus and surrounding area
are major interest
Toilet Training
Phallic/Oedipal 3-5 years Genital focus of interest,
stimulation and excitement
Penis is organ of interest for
both sexes ( Penis envy)
Masturbation is normal
Electra and oedipal Complex
Latency 5-11 or 13 years Resolution of oedipal Complex
Sexual drive rechanneled
Formation of superego
Final stage of psychosexual
development

Genital 11- 13 years Begins with puberty, capacity


to orgasm and true intimacy

O A PhaLa si Geni

II. Developmental Theory

A. Erik Erikson – in each stage the person must complete a task that is
essential to his mental health and well being.

STAGE VIRTUE AGE TASK


Trust vs Hope 0- 18 mos. Viewing the world as safe and reliable;
Mistrust infancy relationships as nurturing, stable and
dependable
Autonomy vs Will 18 mos. – 3 Achieving sense of control and free will
shame and years
doubt Toddler
Initiative vs Purpose 3- 6 Beginning development of a conscience;
guilt Pre – school learning to manage conflict and anxiety
Industry vs Competence 6-12 Emerging confidence in own abilities ;
inferiority School age taking pleasure in accomplishments
Identity vs role Fidelity 12- 18 Formulating a sense of belonging
confusion/diffu Adolescent
sion
Intimacy vs Love 18-25/30 Forming adult; loving relationships and
isolation Young adult meaningful attachments to others
Generativity vs Care 30-45/65 Being creative and productive;
stagnation/self Middle adult establishing the next generation
absorption
Ego integrity vs Wisdom 45/65 above Accepting responsibility for one’s self and
despair Maturity/senil life
e

B. Jean Piaget – believed that human intelligence progresses through


a series of stages based on age , with each child at each
successive stage demonstrating a higher level of functioning.
( Videbeck 2006)

1. Stages of Cognitive Development

STAGE AGE FOCUS


Sensorimotor Birth to 2 Development of sense of self as a separate from the
years environment; object permanence, formation of
mental images
Preoperational 2-6 Ability to express self with language, understands
symbolic gestures, classify objects
Concrete 6-12 Logical thinking,understands spatiality and
Operations reversibility, able to apply rules
Formal 12-15 and Learns reason in abstract terms,more logical
Operations beyond reasoning and thinking and achievement of
cognitive maturity

In Pre School A Young Adult


Matures

III. Interpersonal Theory

1. Harry Stack Sullivan – one’s personality involves more than


individual characteristics, particularly how one interacts with
others.

A. Five Life Stages

STAGE AGES FOCUS


Infancy Birth to Primary need for bodily contact and tenderness
onset of Prototaxic mode dominates
language Primary zones are anal and oral
Solitary play ( mobile and rattles)
Childhood Languag Parents viewed as source of praise and acceptance
e to 5 Shift to parataxic mode
years Primary zone is anal, gratification leads to self esteem
Parallel Play ( building blocks)
No stage and tantrums
Juvenile 5-8 years Shift to syntaxic , opportunities for approval and
acceptance of others; learn to negotiate own needs
Associative Play
Why stage, Imaginary Friend
Preadolescenc 8-12 Same sex relationship
e years Move away from family as source of satisfactions
Adolescence Puberty Opposite sex relationship
to Lust is added to interpersonal equation
Adulthoo Social experimentation
d

IV. Humanistic Theory

1.Abraham Maslow –used pyramid to arrange and illustrate the basic


drives or needs that motivate people.
Self actualization

Self Esteem

Love and belongingness

Safety and security

Physiologic Needs

Maslow’s hierarchy of Needs

V. Behavioral Theory

1. Ivan Pavlov : Classical Conditioning - behavior can be changed


through conditioning with external or environmental conditions or
stimuli.

2. B.F. Skinner : Operant Conditioning – people learn their behavior


from their history or past experiences, particularly those
experiences that were repeatedly reinforced.

a. Behavior modification – method to attempt to strengthen desired


behavior or responses by reinforcement.

b. Positive reinforcement- positive feedback.

c.Negative reinforcement – removing a stimulus immediately after


a behavior occurs.

VI. Existential Theory

Existential Theory believe that behavioural deviations result when a


person is out of touch with himself or the environment. The goal is to
help the person discover an authentic sense of self.
Therapy Therapist Therapeutic Process
Rational Albert Ellis Use of confrontation of irrational belief that
emotive prevent the individual from accepting
responsibility for self and behavior
Logotherapy Viktor Frankl To help individuals assume personal
responsibility; search of meaning
Gestalt Frederick Perls Identification of feelings here and now which
leads to self acceptance
Reality William Glasser Identity through responsible behavior

Chapter IV
Basic Concept of Stress, Anxiety and Crises as behavior

I. A. Stress – is an essential aspect of existence and has always been


part of human experiences, it is something that each person has to
cope. ( Udan 2009)

It is any positive or negative occurrence or emotion which produces a


physiological and psychological response . (Keltner 2007)
B. Coping - is a process that a person uses to mange events he or
she encounters, perceives and interpret as stressful.

C. Crisis – suggests a situation in which usual coping strategies are


ineffective and the person is disorganized or unable to solve
problems, appropriately.

A turning point in an individual’s life that produces


overwhelming emotional response that occurs 4-6 months .
( Videbeck 2006 )

D. Behavior Responses to Stress

1. Anxiety

2. Aggressiveness

3. Depression

4. Withdrawal

5. Suspiciousness

6. Somatic behavior

E. Levels of stress

STAGE PHYSICAL CHANGE PSYCHOSOCIAL CHANGE


1. Alarm Reaction Adrenalin and Increased level of alertness
norepinephrine production Increased level of anxiety
Increase glucose Task oriented,defense
oriented,
Inefficient or maladaptive
behavior may occur
2. Resistance Increased RR,BP,HR Increased and intensified use
Hormone levels readjust ( if of coping mechanisms
adapted) Tendency to rely on defense –
Reduction in activity and oriented behavior
size of adrenal cortex
3. Exhaustion Body stores depleted Emotional components not
Continual arousal of resolved
physiologic responses

F. Anxiety – the fear of unknown. A vague feeling of dread or


apprehension. It is a response to a stimuli that can have
behavioural, emotional, cognitive and physical symptoms.
Levels of Anxiety

LEVEL PSYCHOLOGICAL PHYSIOLOGIC


RESPONSE RESPONSE
MILD Wide perceptual filed Restless
Sharpened sense Fidgeting
Increased motivation GI Butterflies
Effective problem solving Difficulty sleeping
Increased learning ability Hypersensitivity to noise
irritability

MODERATE Perceptual field narrow Muscle tension


Selective attention Diaphoresis
Cannot connect thoughts Pounding pulse
or events independently Headache
Increased use of Dry mouth
automatisms High voice pitch
Fast rate of speech
GI upset
Frequent urination
SEVERE Perception reduced to Severe headache
one detail or scattered Nausea, Vomiting and
Cannot complete task diarrhoea
Doesn’t respond to Trembling
redirection Rigid stance
Feels awe, dread or Vertigo
horror Pale
Cries Tachycardia
Ritualistic behavior chestpain

PANIC Perceptual field reduced May bolt and run OR


to focus on self Totally immobile and
Cannot process any mute
environment stimuli Dilated pupils
Distorted perceptions Increased BP and pulse
Loss of rational thought Flight, Fight or Freeze.
Doesn’t recognize
potential danger
Cannot communicate
verbally
Possible delusions and
hallucinations
May be suicidal

G. Types of Crises

a. Maturational – predictable

b. Situational – unpredictable

c. Adventitious – social crises


MI MO SE PA !

Chapter V

Defense Mechanisms

These mechanisms are methods of attempting to protect the self and cope with
basic drives.

EGO DEFENSE MECHANISMS


Compensation Overachievement in one area to offset real or perceived deficiencies in
another area.
- Napoleon complex
- Nurse with low self esteem works double shifts so her supervisor will like
her
Conversion Expression of emotional conflict through the development of a physical
symptom
- A girl who doesn’t know how to dance, can’t move her legs when tried
dancing in the stage.
Denial Failure to admit the reality
- A dying cancer patient still seeks for second medical advice
- Spending money while broke
Displacement Ventilation of feelings towards less threatening person or thing.
- An angry boy kicked his pet dog, after quarreling with his mother
Dissociation Temporary alteration in consciousness or identity
- Amnesia that prevents recall of yesterdays accident
Fixation Immobilization of a portion of the personality resulting from unsuccessful
completion of tasks in a developmental stage
- Lack of clear sense of identity as adult
Identification Modeling actions and opinions of influential others
- A toddler girl wearing make ups and sandals of her mother
Intellectualizati Separations of the emotions of a painful event or situation from the facts
on involved
- A dying medical doctor explains to his nurse the disease process,
showing no emotional expression
Introjection Accepting others attitudes,beliefs and values of his own
- Person who dislike guns becomes an avid hunter just like his best friend
Projection Unconscious blaming of unacceptable inclinations or thoughts on an
external object
- A student who failed in a class blames her alcoholic father
Rationalization Makes or prove that ones feelings or behavior are justifiable
- A boy who failed in class reasons to his mother, that too much household
chores was the reason of his failure in the class.
Reaction Acting the opposite of what one thinks or feels
formation - A girl who hates her classmates claims her as her bestfreind.
Regression Return to an earlier and more comfortable developmental level
- A 8 year old boy has been bed wetting since the arrival of his baby sister
Repression Involuntary forgetting of painful ideas,events and conflicts
- An adult girl , victim of incest no longer remembers the reason why she
always hates her uncle who raped her.
Resistance Overt or covert antagonism toward remembering or processing anxiety –
producing information
- Nurse is too busy with tasks to spend time talking to a dying patient
Sublimation Channeling instinctual drives into acceptable activities
-Mr. smith a former perpetrator of incest who fears relapse, forms a local
chapter of Sex Addicts Anonymous
Substitution Replacing the desired gratification with one that is readily available.
- Woman who would like to have her own child opens a day care center
Suppression Exclusion from awareness, anxiety producing feelings, ideas and situations
- Ms. Ames states to the nurse that she is not ready to talk about her
recent divorce.
Undoing Doing something to counteract or make up for a transgression or
wrongdoing
- A mother baked the favorite cookie of her son after scolding him.

Chapter VI

Therapeutic Communication

The ability to establish therapeutic relationships with clients is one of the most
important skills a nurse can develop. Communication is the process that people use
to exchange information. ( Videbeck 2006)

Types

1. Verbal Communication

2. Non Verbal Communication

Therapeutic Communication

Is an interpersonal interaction between the nurse and client during which the
nurse focuses on the clients’ specific needs to promote an effective exchange of
information.

Distance Zones

1. Intimate Zone

2. Personal Zone

3. Social Zone

4. Public Zone
Touch

1. Functional Professional

2. Social Polite

3. Friendship warmth

4. Love Intimacy

5. Sexual Arousal

Verbal Communication Skills

1. using Concrete Messages

2. Communication techniques

3. Signals or Cues

Non verbal Communication Skills

1. Facial expression

2. Body Language

3. Vocal Cues

4. Eye Contact

5. Silence
Chapter VII

Human Sexuality

I. Sexuality – an individually expressed and highly personal


phenomena whose meaning evolves from life experiences .
( Kozier 2008)

A. Sexual Health – “the integration of the somatic, emotional,


intellectual and social aspect of sexual being, in ways that
are positively enriching and that enhance personality,
communication and love.” (WHO 1975)

B. Components of Sexual Health

1. Sexual self concept – how one values one’s self as a


sexual being

2. Body image – the central part of sense of self

3. Gender identity – one’s self image as female or male.

4. Gender role behavior- the outward expression of persons


sense of maleness or femaleness as mold on the
perception of what is perceived as gender appropriate
behavior.

5. Androgyny – flexibility in gender roles

C. Factors Affecting Sexuality

1. Family

2. Culture

3. Religion

II. Sexual Response Cycle

EXCITEMENT PLATEAU ORGASM RESOLUTION


Physical and Reached just before A point which the External and internal
psychological orgasm. body suddenly organs return to un
stimulation. discharges aroused state.
Male: full distention accumulated sexual
Male : of penis. tension.
erection,scrotal
thickening,and Male : 3-7 propulsive
elevation of testes, ejaculation at 0.8
Increase HR,RR,BP Female:nipple seconds
engorgement,vagina
Female : increase becomes extremely Female : 8-15
clitoral size,mucuid congested contractions at 0.8
fluid appear in seconds
vagina and widening
of the vagina

MINDANAO SANITARIUM AND HOSPITAL COLLEGE


SCHOOL OF NURSING
TIBANGA, ILIGAN CITY

Department of Nursing

A LECTURE GUIDE ON
HUMAN BEHAVIOR
(An integrated Concepts on Human Behavior)

AL – AZANEREEH RAMOS MADALE, RN

Instructor

JUNE 2009

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