Book contents
- Frontmatter
- Contents
- List of contributors
- List of figures, tables and boxes
- Preface
- Part I Theoretical overview
- Part II Changes and conflicts
- 11 Medical leadership skills: what is needed to be a successful leader?
- 12 Understanding systems
- 13 Working with the team
- 14 Managing multicultural and multinational teams in healthcare
- 15 Management of change
- 16 Managing the psychiatrist's performance
- 17 Revalidation for psychiatrists
- 18 Quality improvement tools
- 19 Quality and quality governance
- 20 Measurement of needs
- 21 Service users’ expectations
- 22 Clinical audit
- 23 Confidentiality and management in healthcare organisations
- 24 Patient complaints: every doctor's business
- 25 Mental health review tribunals. Or, tribunals, and how to survive them
- Part III Personal development
- Index
20 - Measurement of needs
from Part II - Changes and conflicts
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- List of contributors
- List of figures, tables and boxes
- Preface
- Part I Theoretical overview
- Part II Changes and conflicts
- 11 Medical leadership skills: what is needed to be a successful leader?
- 12 Understanding systems
- 13 Working with the team
- 14 Managing multicultural and multinational teams in healthcare
- 15 Management of change
- 16 Managing the psychiatrist's performance
- 17 Revalidation for psychiatrists
- 18 Quality improvement tools
- 19 Quality and quality governance
- 20 Measurement of needs
- 21 Service users’ expectations
- 22 Clinical audit
- 23 Confidentiality and management in healthcare organisations
- 24 Patient complaints: every doctor's business
- 25 Mental health review tribunals. Or, tribunals, and how to survive them
- Part III Personal development
- Index
Summary
Defining needs
The American psychologist Maslow established a seminal hierarchy of need when attempting to formulate a theory of human motivation (Maslow, 1954). In Maslow's model, fundamental physiological needs (such as the need for food) underpin the higher needs of safety, love, self-esteem and self-actualisation. He proposed that people are motivated by the requirement to meet these needs, and that higher needs could be met only once the lower and more fundamental needs were met. This approach can be illustrated by the example of a homeless man, who is not concerned about his lack of friends while he is cold and hungry. However, once these physiological needs have been met he may express more interest in having the company of other people (Slade & McCrone, 2001).
Since the work of Maslow, several approaches have been developed for defining need with respect to healthcare. The sociologist Bradshaw (1972) proposed a ‘needs taxonomy’ with three types of need: (1) felt or expressed need that is mentioned by the user; (2) normative need which is assessed by the expert; and (3) comparative need, which arises from comparison with other groups or individuals. Such an approach helps to emphasise that need is a subjective concept, and that the judgement of whether a need is present or not will, in part, depend on whose viewpoint is taken. Other, somewhat more philosophical approaches to needs have also been proposed (e.g. Mallman & Marcus, 1980; Liss, 1990).
In the Medical Research Council (MRC) Needs for Care Assessment (NCA), a need is defined as being present when a person's functioning falls below, or threatens to fall below, some specified level, and when there is some remediable, or potentially remediable, cause (Brewin et al, 1987). Slade (1994) discussed the issue with respect to differences in perception between the users of mental health services and the involved professionals, and he argued that once differences are identified, then negotiation between staff and user can take place to agree a care plan.
Despite the common view that services should be based upon assessed needs, there is no consensus on how needs should be defined (Holloway, 1994) or on who should define them (Slade, 1994).
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- Information
- Management for Psychiatrists , pp. 296 - 312Publisher: Royal College of PsychiatristsPrint publication year: 2016