Virginia Henderson’s Need Theory

Virginia Henderson’s Need Theory


Henderson’s Theory Background

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)
Although her major clinical experiences were in medical-surgical hospitals, she worked as a visiting nurse in New York City. This experience enlarges Henderson’s view to recognize 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, p. 15).
She was one of the first nurses to point out that nursing does not consist of merely following physician’s orders.
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 famous 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, p. 15).

The development of Henderson’s definition of nursing

Two events are the basis for Henderson’s development of a definition of nursing.

First, she participated in the revision of a nursing textbook.
Second, she was concerned that many states had no provision for nursing licensure to ensure safe and competent care for the consumer.

In the revision she recognized the need to be clear about the functions of the nurse and she believed that this textbook serves as a main learning source for nursing practice should present a sound and definitive description of nursing.
Furthermore, the principles and practice or nursing must be built upon and derived from the definition of the profession.
Although official statements on the nursing function were published by the ANA in 1932 and 1937, Henderson viewed these statements as nonspecific and unsatisfactory definitions of nursing practice.
Then in 1955, the earlier ANA definition was modified.
Henderson’s focus on individual care is evident in that she stressed assisting individuals with essential activities to maintain health, to recover, or to achieve peaceful death.
She proposed 14 components of basic nursing care to augment her definition.
In 1955, Henderson’s first definition of nursing was published in Bertha Harmer’s revised nursing textbook.

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 assumption of the theory is that:

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
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.

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

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?

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 physician’s therapeutic plan
Individualized care is the result of the nurse’s creativity in planning for care.
Use nursing research
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 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.”