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September 9, 2013ign="center">
 
 Virginia Henderson's Need Theory
This page was last updated on February 4, 2012

“Nursing theories mirror different realities, throughout their development; they reflected the interests of nurses of that time.”

Introduction

  • “The Nightingale of Modern Nursing”
  • “Modern-Day Mother of Nursing.”
  • "The 20th century Florence Nightingale."
  • Born in Kansas City, Missouri, in 1897.
  • Diploma in Nursing from the Army School of Nursing at Walter Reed Hospital, Washington, D.C. in 1921.
  • Worked at the Henry Street Visiting Nurse Service for 2 years after graduation.
  • In 1923, started teaching nursing at the Norfolk Protestant Hospital in Virginia
  • In 1929, entered Teachers College at Columbia University for  Bachelor’s Degree in 1932, Master’s Degree in 1934.
  • Joined Columbia as a member of the faculty, remained until 1948.
  • Since 1953, a research associate at Yale University School of Nursing.
  • Recipient of numerous recognitions.
  • Honorary doctoral degrees from the Catholic University of America, Pace University, University of Rochester, University of Western Ontario, Yale University
  •  In 1985, honored at the Annual Meeting of the Nursing and Allied Health Section of the Medical Library Association.
  • Died: March 19, 1996.
  • In 1939, she revised: Harmer’s classic textbook of nursing for its 4th edition, and later wrote the 5th; edition, incorporating her personal definition of nursing (Henderson,1991)

Theory Background

  • She called her definition of nursing her “concept” (Henderson1991)
  • She emphasized the importance of increasing the patient’s independence so that progress after hospitalization would not be delayed (Henderson,1991)
  • "assisting individuals to gain independence in relation to the performance of activities contributing to health or its recovery" (Henderson, 1966).
  • She categorized nursing activities into 14 components, based on human needs. 
  • She described the nurse's role as substitutive (doing for the person), supplementary (helping the person), complementary (working with the person), with the goal of helping the person become as independent as possible.
  • Her definition of nursing was:

"The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible" (Henderson, 1966).

The 14 components

  • Breathe normally. Eat and drink adequately.
  • Eliminate body wastes.
  • Move and maintain desirable postures.
  • Sleep and rest.
  • Select suitable clothes-dress and undress.
  • Maintain body temperature within normal range by adjusting clothing and modifying environment
  • Keep the body clean and well groomed and protect the integument
  • Avoid dangers in the environment and avoid injuring others.
  • Communicate with others in expressing emotions, needs, fears, or opinions.
  • Worship according to one’s faith.
  • Work in such a way that there is a sense of accomplishment.
  • Play or participate in various forms of recreation.
  • Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

The first 9 components are physiological. The tenth and fourteenth are psychological aspects of communicating and learning The eleventh component is spiritual and moral The twelfth and thirteenth components are sociologically oriented to occupation and recreation

Assumption

The major assumptions of the theory are:

  • "Nurses care for patients until patient can care for themselves once again. Patients desire to return to health, but this assumption is not explicitly stated.
  • Nurses are willing to serve and that “nurses will devote themselves to the patient day and night” A final assumption is that nurses should be educated at the university level in both arts and sciences.

Henderson’s theory and the four major concepts

1. Individual

  • Have basic needs that are component of health.
  • Requiring assistance to achieve health and independence or a peaceful death.
  • Mind and body are inseparable and interrelated.
  • Considers the biological, psychological, sociological, and spiritual components.
  • The theory presents the patient as a sum of parts with biopsychosocial needs.

2. Environment

  • Settings in which an individual learns unique pattern for living.
  • All external conditions and influences that affect life and development.
  • Individuals in relation to families
  • Minimally discusses the impact of the community on the individual and family.
  • Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided

3. Health

  • Definition based on individual’s ability to function independently as outlined in the 14 components.
  • Nurses need to stress promotion of health and prevention and cure of disease.
  • Good health is a challenge -affected by age, cultural background, physical, and intellectual capacities, and emotional balance Is the individual’s ability to meet these needs independently.

4. Nursing

  • Temporarily assisting an individual who lacks the necessary strength, will and knowledge to satisfy 1 or more of 14 basic needs.
  • Assists and supports the individual in life activities and the attainment of independence.
  • Nurse serves to make patient “complete” “whole", or "independent."
  • The nurse is expected to carry out physician’s therapeutic plan Individualized care is the result of the nurse’s creativity in planning for care.
  • “Nurse should have knowledge to practice individualized and human care and should be a scientific problem solver.”
  • In the Nature of Nursing Nurse role is,” to get inside the patient’s skin and supplement his strength will or knowledge according to his needs.”

Henderson’s and Nursing Process

”Summarization of the stages of the nursing process as applied to Henderson’s definition of nursing and to the 14 components of basic nursing care.

Nursing Process Henderson’s 14 components and definition of nursing
Nursing Assessment
Henderson’s 14 components
Nursing Diagnosis
Analysis: Compare data to knowledge base of health and disease.
Nursing plan
Identify individual’s ability to meet own needs with or without assistance, taking into consideration strength, will or knowledge.
Nursing implementation
Document how the nurse can assist the individual, sick or well.
Nursing implementation
Assist the sick or well individual in to performance of activities in meeting human needs to maintain health, recover from illness, or to aid in peaceful death.
Nursing process

Implementation based on the physiological principles, age, cultural background, emotional balance, and physical and intellectual capacities.

Carry out treatment prescribed by the physician.

Nursing evaluation

Henderson’s 14 components and definition of nursing

Use the acceptable definition of ;nursing and appropriate laws related to the practice of nursing.

The quality of care is drastically affected by the preparation and native ability of the nursing personnel rather that the amount of hours of care.

Successful outcomes of nursing care are based on the speed with which or degree to which the patient performs independently the activities of daily living

Comparison with Maslow's Hierarchy of Need

Maslow's Henderson
Physiological needs

Breathe normally

Eat and drink adequately Eliminate by all avenues of elimination Move and maintain desirable posture Sleep and rest Select suitable clothing Maintain body temperature Keep body clean and well groomed and protect the integument

Safety Needs

Avoid environmental dangers and avoid injuring other

Belongingness and love needs

Communicate with others

worship according to one's faith

Esteem needs

Work at something providing a sense of accomplishment

Play or participate in various forms of recreation

Learn, discover, or satisfy curiosity

Characteristic of Henderson’s theory

  • There is interrelation of concepts.
  • Concepts of fundamental human needs, biophysiology, culture, and interaction, communication are borrowed from other discipline.Eg.. Maslow’s theory.
  • Her definition and components are logical and the 14 components are a guide for the individual and nurse in reaching the chosen goal.
  • Relatively simple yet generalizable.
  • Applicable to the health of individuals of all ages.
  • can be the bases for hypotheses that can be tested.
  • assist in increasing the general body of knowledge within the discipline.
  • Her ideas of nursing practice are well accepted.
  • can be utilized by practitioners to guide and improve their practice.

Limitations

  • Lack of conceptual linkage between physiological and other human characteristics.
  • No concept of the holistic nature of human being.
  • If the assumption is made that the 14 components prioritized, the relationship among the components is unclear.
  • Lacks inter-relate of factors and the influence of nursing care.
  • Assisting the individual in the dying process she contends that the nurse helps, but there is little explanation of what the nurse does.
  • “Peaceful death” is curious and significant nursing role.

Conclusion

  • Henderson provides the essence of what she believes is a definition of nursing.

  • Her emphasis on basic human needs as the central focus of nursing practice has led to further theory development regarding the needs of the person and how nursing can assist in meeting those needs.

  • Her definition of nursing and the 14 components of basic nursing care are uncomplicated and self-explanatory.

References

  1. Timber BK. Fundamental skills and concepts in Patient Care, 7th edition, LWW, N
  2. George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed. Norwalk, Appleton & Lange.
  3. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins.
  4. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott.
  5. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott.
  6. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.
  7. Vandemark L.M. Awareness of self & expanding consciousness: using Nursing theories to prepare nurse –therapists Ment Health Nurs. 2006 Jul; 27(6) : 605-15
  8. Reed PG, The force of nursing theory guided- practice. Nurs Sci Q. 2006 Jul;19(3):225
  9. Delaune SC,. Ladner PK, Fundamental of nursing, standard and practice, 2nd edition, Thomson, NY, 2002

 
     

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