Virginia Henderson's Need Theory This page was last updated on March 1, 2011 Abdellah Nursing theories mirror

different realities, throughout their development; they reflected the interests of nurses of that time. Introduction y y y y y y y y y y y y y y 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 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. Her work influenced the nursing profession throughout the world. awell 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: Harmer s classic textbook of nursing for its 4th edition, and later wrote the 5th; edition, incorporating her personal definition of nursing (Henderson,1991)

King Orlando Peterson and Zderad Henderson Paplau Orem Travelbee Wiedenbach Analysis of nursing theories according to 1st School Focus Human being A developmental being. Patient Orientation Need Deficit Illness, disease Dependent on medical practice. Role of nurse Beginnings of independent functions Fulfill needs requisites Decision making Primarily health care professional Problems A set of needs or problems. Roy Rogers Johnson Levine

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Henderson s Theory Background y y y Henderson s 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 patient s 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).

School of thoughts in Nursing Theories-1950-1970 Need theorists Interaction Theorists Outcome theorists y

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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:

"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 y y y y y 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.

"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 y y y y y y y y y y y y y 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.

2. Environment y y y y y 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 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: y y y 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 y y y y 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 physician s therapeutic plan Individualized care is the result of the nurse s creativity in planning for care. Use nursing research o Categorized Nursing : nursing care o 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 patient s 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."

Assessment 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. 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. 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 Breathe normally Physiological needs 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

Nursing implementation Nursing implementation Nursing process

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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 Nursing Henderson s 14 components and definition of nursing Henderson s 14 components

y Safety Needs Avoid environmental dangers and avoid injuring other

Ideally the nurse would improve nursing practice by using her definition and 14 components to improve the health of individuals and thus reduce illness.

Belongingness and love needs

Communicate with others worship according to one's faith Work at something providing a sense of accomplishment

Usefulness y y Nursing education has been deeply affected by Henderson s clear vision of the functions of nurses. The principles of Henderson s 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)

Esteem needs

Play or participate in various forms of recreation Learn, discover, or satisfy curiosity y

Characteristic of Henderson s theory y y 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.. Maslow s Hierarchy of human needs; concept of interactioncommunication 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.

Limitations y y y y y y 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.

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Conclusion y y y Henderson provides the essence of what she believes is a definition of nursing. She didn t 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.

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