Virginia Henderson's Need Theory

This page was last updated on March 1, 2011

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. Received a 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 Bachelors Degree in 1932, Masters 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. Her work influenced the nursing profession throughout the world. a well known nursing educator and a prolific author. 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: Harmers classic textbook of nursing for its 4th edition, and later wrote the 5th; edition, incorporating her personal definition of nursing (Henderson,1991)

Nursing Theories Quiz-I Nursing Theories Quiz-II Nursing Theory Quiz-III Nursing Theory Quiz -IV Nursing Theory Quiz -V Nursing Research Quiz-I Nursing Research Quiz-II Nursing Research Quiz-III Nursing Research Quiz-IV Nursing Research Quiz-V Nursing Research Quiz-VI Nursing Research Quiz-VII Nursing Research Quiz-VIII Nursing Management Quiz-1 Nursing Management Quiz-2

Nursing Education Quiz-1 Introduction to Nursing Theories Development of Nursing Theories Virginia Hendersons Need Theory Theory if Interpersonal Relations Faye Glenn Abdellah's Theory Jean Watson's theory Johnsons behavior system model Theory of Goal Attainment Betty Neumans system model Levin's Four Conservation Principles Nursing Theorists Martha Rogers Science of unitary human beings Theories Based on Interactive Process Orem's Self-Care Deficit Theory Nursing Theories: An Overview Nursing Theories and Research Roy's Adaptation Model Orlando's Nursing Process Notes on Nursing: What it is, What it is not: Nightingale

School of thoughts in Nursing Theories-1950-1970

Interaction Need theorists Theorists King Orlando Abdellah Henderson Orem Peterson and Zderad Paplau Travelbee Wiedenbach
Analysis of nursing theories according to 1st School

Outcome theorists

Johnson Levine Rogers Roy

Understanding the works of Nursing Theorists: A creative beginning Health Promotion Model Health Belief Model Theories used in Community Health Nursing Application of Nursing Theories Application Goal Attainment Theory Application Orem's Self-care Deficit Theory Application of Suchmans Stages of Illness Model

Focus Human being Patient Orientation

Problems A set of needs or problems. A developmental being. Need Deficit Illness, disease Dependent on medical practice. Beginnings of independent functions

Application of Betty Neuman's Systems Model in Nursing Care Application of Roy's Adaptation Model in Nursing Process Application of Peplau's Interpersonal theory in Nursing Process Application of Health Belief Model in Nursing Practice Transcultural Nursing Helping and Human Relationships Theory: Robert R. Carkhuff Models of Prevention Care, Cure and Core: The Three Cs of Lydia Hall Human Becoming Theory:Rosemarie Rizzo Parse

Role of nurse

Fulfill needs requisites Decision making Primarily health care professional

Hendersons Theory Background

From Novice to Expert: Patricia Benner Erikson's Theory of Psychosocial Development Theory of Cognitive Dissonance by Leon Festinger Kurt Lewin's Change Theory Prochaska and DiClemente's Stages of Change Model Ernestine Wiedenbach's "The Helping Art of Clinical Nursing" A directory of open access nursing theory articles Maslow's Theory of Needs Models of Nursing Care Delivery Theories of Florence Nightingale Human-To-Human Relationship Model by Joyce Travelbee(1926-1973)

Hendersons concept of nursing was derived form her practice and education therefore, her work is inductive.. She called her definition of nursing her concept (Henderson1991) She emphasized the importance of increasing the patients independence so that progress after hospitalization would not be delayed (Henderson,1991) Virginia Henderson defined nursing as "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 one of the first statements clearly delineating nursing from medicine:

"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).

Newman's Health As Expanding Consciousness Comfort Theory by Katharine Kolcaba Tidal Model of Mental Health Nursing New!

The 14 components

The Trajectory Model by Corbin & Strauss

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 ones 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

Modeling and Role Modeling Theory by Erickson, Tomlin & Swain Life Perspective Rhythm Model by Joyce Fitzpatrick Functional Health Patterns by Majory Gorden

McGill Model of Nursing by F. Moyra Allen

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.

Hendersons 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, and the patient is neither client nor consumer.

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. Supports tasks of private and public agencies Society wants and expects nurses to act for individuals who are unable to function independently. In return she expects society to contribute to nursing education. Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided

3. Health

Definition based on individuals 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 individuals 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." Henderson's classic definition of nursing:

"I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible."

The nurse is expected to carry out physicians therapeutic plan Individualized care is the result of the nurses creativity in planning for care. Use nursing research

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Categorized Nursing : nursing care Non nursing: ordering supplies, cleanliness and serving food.

In the Nature of Nursing that the nurse is and should be legally, an independent practitioner and able to make independent judgments as long as s/he is not diagnosing, prescribing treatment for disease, or making a prognosis, for these are the physicians function.

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 patients skin and supplement his strength will or knowledge according to his needs. And nurse has responsibility to assess the needs of the individual patient, help individual meet their health need, and or provide an environment in which the individual can perform activity unaided Henderson's classic definition of nursing "I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible."

Hendersons

and

Nursing

Process

Summarization of the stages of the nursing process as applied to Hendersons definition of nursing and to the 14 components of basic nursing care.

Nursing Process
Nursing Assessment Nursing Diagnosis Nursing plan

Hendersons 14 components and definition of nursing

Hendersons 14 components

Analysis: Compare data to knowledge base of health and disease. Identify individuals ability to meet own needs with or without assistance, taking into consideration strength, will or knowledge.

Nursing implementation Nursing implementation

Document how the nurse can assist the individual, sick or well.

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 Hendersons 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 Breathe normally

Eat and drink adequately Eliminate by all avenues of elimination Move Physiological and maintain desirable posture Sleep needs and rest Select suitable clothing Maintain body temperature Keep body clean and well groomed and protect the integument Safety Needs Belongingness and love needs Avoid environmental dangers and avoid injuring other Communicate with others worship according to one's faith
Work at something providing a sense of accomplishment

Esteem needs

Play or participate in various forms of recreation

Learn, discover, or satisfy curiosity

Characteristic of Hendersons theory

There is interrelation of concepts in such a way as to create a different way of looking at a particular phenomenon. Concepts of fundamental human needs, biophysiology, culture, and interaction, communication are borrowed from other discipline.Eg.. Maslows Hierarchy of human needs; concept of interaction-communication i.e. nurse-patient relationship Her definition and components are logical and the 14 components are a guide for the individual and nurse in reaching the chosen goal. Theories should be relatively simple yet generalizable. Her work can be applied to the health of individuals of all ages. Theories can be the bases for hypotheses that can be tested. Her definition of nursing cannot be viewed as theory; therefore, it is impossible to generate testable hypotheses. However some questions to investigate the definition of nursing and the 14 components may be useful. Theories contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them. Her ideas of nursing practice are well accepted throughout the world as a basis for nursing care. However, the impact of the definition and components has not been established through research. Theories can be utilized by practitioners to guide and improve their practice. Ideally the nurse would improve nursing practice by using her definition and 14

components to improve the health of individuals and thus reduce illness.

Usefulness

Nursing education has been deeply affected by Hendersons clear vision of the functions of nurses. The principles of Hendersons theory were published in the major nursing textbooks used from the 1930s through the 1960s, and the principles embodied by the 14 activities are still important in evaluating nursing care in thee21st centaury. Others concepts that Henderson (1966) proposed have been used in nursing education from the 1930s until the present O'Malley, 1996)

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.

PURPOSES OF NURSING THEORIES In Practice:

Assist nurses to describe, explain, and predict everyday experiences. Serve to guide assessment, interventions, and evaluation of nursing care. Provide a rationale for collecting reliable and valid data about the health status of clients, which are essential for effective decision making and implementation. Help to describe criteria to measure the quality of nursing care. Help build a common nursing terminology to use in communicating with other health professionals. Ideas are developed and words are defined. Enhance autonomy (independence and self-governance) of nursing through defining its own independent functions.

In Education:

Provide a general focus for curriculum design Guide curricular decision making.

In Research:

Offer a framework for generating knowledge and new ideas. Assist in discovering knowledge gaps in the specific field of study. Offer a systematic approach to identify questions for study; select variables, interpret findings, and validate nursing interventions. Approaches to developing nursing theory Borrowing conceptual frameworks from other disciplines. Inductively looking at nursing practice to discover theories/concepts to explain phenomena. Deductively looking for the compatibility of a general nursing theory with nursing practice. Questions from practicing Nurse about using Nursing theory

Practice

Conclusion

Does this theory reflect nursing practice as I know it? Will it support what I believe to be excellent nursing practice? Can this theory be considered in relation to a wide range of nursing situation? Personal Interests, Abilities and Experiences What will it be like to think about nursing theory in nursing practice? Will my work with nursing theory be worth the effort?

Henderson provides the essence of what she believes is a definition of nursing. She didnt intend to develop a theory of nursing but rather she attempted to define the unique focus 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. 2. 3. 4. 5. 6. 7. 8.

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