Virginia Henderson’s Nursing Need Theory

Virginia Henderson’s Nursing Need Theory

Herzing University

Virginia Henderson’s Nursing Need Theory

Introduction

This paper is an introduction to the “nursing need theory”, which was developed by Virginia Henderson. “The theory presents the patient as a sum of parts with biopsychosocial needs, and the patient is neither client nor consumer.” (McEwens, 2014, p. 137) “The theory focuses on the importance of increasing the patient’s independence to hasten their progress in the hospital. Henderson’s theory emphasizes on the basic human needs and how nurses can assist in meeting those needs. Henderson’s concept of nursing was derived from her practice and education; therefore, her work is inductive.” (Vera, 2014) “Henderson did not manufacture language to elucidate her theoretical stance; she used correct, scholarly English in all of her writings. She called her definition of nursing her concept.” (McEwens, 2014, p. 137) This paper will present all components of her theory. It will also presents how to connect the theory, research, and practice.

Background of the Theorist

Virginia Henderson was born in Kanas City, Missouri, on November 30, 1987. Henderson was born fifth of eight children to Lucy Abbot Henderson and Daniel B. Henderson. In 1901, during her childhood, Henderson’s family relocated to Virginia. She joined the Army School of Nursing at Walter Reed Hospital, in Washington, DC in 1918. In 1921 she received her diploma in nursing. In 1923 she accepted her first position as an instructor at the Norfolk Protestant Hospital in Virginia. She received her bachelor of science in 1932 and a Master of Arts degree in nursing in 1934 at the Teachers College at Colombia University. Upon completing her masters she accepted a position as faculty at Colombia University where she remained for the next 14 years. Henderson then accepted a position at Yale University School of Nursing, in 1953. There she was a research associate for a funded project meant to survey and assess the status of nursing research in the United States. From 1959 to 1971, Henderson directed the Nursing Studies Index Project. This project produced the first annotated index of nursing research, a four volume publication, Nursing Studies Index. At the age of 75 she began a new phase of her career and focused on international teaching and speaking engagements. 1979 she was the first recipient of the Virginia Henderson Award for outstanding contributors to nursing research, established by the Connecticut Nurses Association. Virginia Henderson died in 1996 at the age of 98. The Sigma Theta Tau International Nursing Library was named in her honor.

Philosophical Underpinnings of the Theory

During her graduate education, Henderson was introduced to physiologic principles, which was her basis for her patient care. She received her education during a time that focused on patient’s needs. She believed that her theoretical ideas grew and matured through her experiences. Henderson stated that “Thorndike’s fundamental needs of man had an influence on her beliefs.”

Assumptions

“The major assumption of the theory is that nurses care for patients until patients can care for themselves once again” (McEwen, 2014, p. 137) Henderson described the nurse’s role as substitutive (doing for the person), supplementary (helping the person), and complementary (working with the person), with the goal of helping the person become as independent as possible. “She assumes the patients desire to return to health, but this assumption is not explicitly stated. She assumes that nurses are willing to serve and that nurses will devote themselves to the patient day and night.” (McEwen, 2014, p. 137) “Henderson called her definition of nursing her concept and emphasized the importance of increasing the patient’s independence so that progress after hospitalization would not be delayed.” (Ahtisham, Jacoline, & Sommer, 2015, p. 444)

Major Concepts

“The major concepts of the theory relate to the metaparadigm (nursing, health, patient, and environment).” (McEwen, 2014, p. 137)

The Individual

Henderson defined the patient [individual] as someone who needs nursing care but did not limit nursing to illness care. According to Henderson, a person achieves wholeness by maintaining physiological and emotional balance. The patient is a sum of parts and the mind and body are interrelated.

The Environment

Henderson did not define environment but stated that maintaining a supportive environment is one of the elements of her fourteen activities for client assistance. “Henderson’s theory supports the task of the private and public health sector or agencies in keeping people healthy. She believes society wants and expects the nurse’s service of acting for individuals who are unable to function independently. (Vera, 2014)

Health

Henderson did not define health but it is taken to mean balance in all realms of human life. An individual’s health is based on the individual’s ability to function without any aid in the fourteen components of basic human needs. “Nurse, on the other hand, are key in promoting health, prevention of illness, and being able to cure. According to Henderson, a good health is a challenge because it is affected by numerous factors such as age, cultural background, emotional balance, and others. (Vera, 2014)

Nursing

Henderson’s 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 so 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. The nurse is expected to carry out a physician’s therapeutic plan, but individualized care is result of the nurse’s creativity in planning care.” (Henderson, 1966) She was able to distinguish the role of a nurse in health care with her definition. Henderson wrote her definition of nursing before the development of theoretical nursing. The nurse collaborates with the physician’s therapeutic plan to meet the nurse’s goal of making the patient complete, whole, or independent. Henderson states: “The nurse is temporarily the consciousness of the unconscious, the love life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge and confidence of the young mother, the mouthpiece for those too weak or withdrawn to speak. 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.” (Henderson, 1991) As Henderson stated “in the nature of nursing, the nurse is and should be legally, an independent practitioner and able to make independent judgements as long as she is not diagnosing, prescribing treatment for disease, or making a prognosis, for these are the physicians function. Nurses should have knowledge to practice individualized human care and should be scientific problem solvers. The nurse role is to get inside the patient’s skin and supplement his strength, will, or knowledge according to his needs.” (Henderson, n.d.) Henderson focused on individual care. She described nursing role as assisting individuals with essential activities to maintain health, recover, or to achieve peaceful death. She proposed fourteen components required for effective nursing care. (Ahtisham et al, 2015, p. 444)

Fourteen Components

Henderson proposed fourteen components required for effective nursing care. “The first nine 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 orientated to occupation and recreation. (Ahtisham et al, 2015, p. 444)

Physiological Components

Psychological Aspects of Communicating and Learning

1. Breathe normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable postures
5. Sleep and rest
6. Select suitable clothes- dress and undress
7. Maintain body temperature within normal ranges by adjusting clothing and modifying environment
8. Keep body clean and well-groomed and protect the integument
9. Avoid dangers in the environment and avoid injuring others

14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities

1. Communicate with others in expressing emotions, needs, fears, or opinions

Spiritual and Moral

Sociologically Oriented to Occupation and Recreation

1. Worship according to one’s faith

Strengths of the Theory

1. Work in such a way that there is a sense of accomplishment
2. Play or participate in various forms of recreation

Virginia Henderson’s nursing need theory and the fourteen components is relatively simple and self-explanatory. Henderson’s concept of nursing is widely accepted. It can be used without difficulty as a guide for nurses in most practices with individuals of all ages. “Each of her fourteen concepts can be the basis for research. Although the statements are not written in testable terms, they may be reformulated into researchable questions.” (“The Principles and Practice of Nursing”, 2011)

Weakness of the Theory

Henderson’s theory lacks a conceptual linkage between physiological and other human characteristics. “There is an absence of a conceptual diagram that interconnects the fourteen concepts and subconcepts of Henderson’s theory. On the assisting the individual in the dying process, there is a little explanation of what the nurse does to provide peaceful death.” (Vera, 2014)

Application of the Theory

“Henderson’s Needs Theory can be applied to nursing practice as a way for nurses to set goals based on Henderson’s fourteen components. Meeting the goal of achieving the fourteen needs of the client can be a great basis to further improve one’s performance towards nursing care. In nursing research, each of her fourteen fundamental concepts can serve as a basis for research although the statements were not written in testable terms.” (Vera, 2014) Henderson’s vision of the functions of nurses has greatly affected the nursing education. “The principles of Henderson’s theory were published in the major nursing textbooks used from 1930s through the 1960s, and the principles embodied by the fourteen concepts are still important in the 21st century.” (McEwen, 2014, p. 138) “The fourteen concepts cover the whole of the practice of nursing, and her vision about the nurse’s role in patient care contributes to that complexity. (McEwen, 2014, p. 138)

Theory, Research, and Practice

Connecting theory, research, and practice can be somewhat difficult. “Henderson used concepts of fundamental human needs, bio physiology, culture, and interaction communication, which gave the theory a dynamic coverage regarding patient’s needs. Her fourteen concepts well addressed patient needs in different domains yet simple enough to apply in the clinical setting. It is applicable to different dimensions of client nurse relationship.” (Ahtisham et al, 2015, p. 449) Its design successfully implements the components of the nursing process. This theory assists the nurse to describe, explain, and predict everyday experiences. It guides the assessment, intervention, and evaluation of nursing care. It enhances autonomy of nursing through defining its own independent functions. In research, Henderson’s theory offers a framework for generating knowledge and new ideas. It can inductively look at nursing practice to discover theories or concepts to explain phenomena. It deductively looks for the compatibility of a general nursing theory with nursing practice. The Needs Theory offers a systematic approach to identify questions for study, select variables, interpret findings, and validate nursing interventions.

Conclusion

“The need theory is relevant to clinical setting and can serve as a framework to recognize caring needs, deliver and evaluate holistic nursing care. It can help experienced nurses to collect reliable and valid data about the health status of clients, which sequentially enhances the quality of nursing care provided to the patients.” (Ahtisham et al, 2015, p. 449) Henderson’s concept of nursing enhanced nursing science, particularly the area of nursing education. “Her contributions to nursing literature extend from the 1930s through the 1990s. Her work has had an international impact on nursing research by strengthening the focus on nursing practice and confirming the value of tested interventions in assisting individuals to regain health. Internationally researchers continue to direct their work with Virginia Henderson’s model as a framework.” (McEwen, 2014, p. 139) By exploring Henderson’s nursing theory and understanding its key factors, and how it relates to my personal values and beliefs, I will be able to apply her theory to my clinical practice.

References

Ahtisham, Y., B.ScN., & Jacoline, Sommer,R.N., B.ScN. (2015). Integrating nursing theory and process into practice; virginia’s henderson need theory.International Journal of Caring Sciences, 8(2), 443-450. Retrieved from http://prx-herzing.lirn.net/login?url=http://search.proquest.com.prx-herzing.lirn.net/docview/1685874255?accountid=167104

Fairbrother, Greg, RN, BA,M.P.H., PhD., Chiarella, Mary, RN, RM, PhD,L.L.B.DipN.Ed, F.A.C.N., & Braithwaite, Jeffrey, BA, DipLR, MIR, MBA,PhD., F.A.I.M. (2015). Models of care choices in today’s nursing workplace: Where does team nursing sit? Australian Health Review, 39(5), 489-493. doi:http://dx.doi.org.prx-herzing.lirn.net/10.1071/AH14091

Forbes, Helen,PhD., R.N. (2011). Clinical teachers’ conceptions of nursing.Journal of Nursing Education, 50(3), 152-157. doi:http://dx.doi.org.prx-herzing.lirn.net/10.3928/01484834-20100930-06

Halloran, E. J. (1996), Virginia Henderson and her timeless writings**. Journal of Advanced Nursing, 23: 17–24. doi:10.1111/j.1365-2648.1996.tb03130.x

Kitson, A. (1999). The essence of nursing. Nursing Standard (through 2013),13(23), 42-6. Retrieved from http://prx-herzing.lirn.net/login?url=http://search.proquest.com.prx-herzing.lirn.net/docview/219813900?accountid=167104

McEwen, M. (01/2014). Theoretical Basis for Nursing, 4th Edition. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781469899992/

Nicely, Bruce, RN,B.S.N., C.P.T.C., & DeLario, Ginger T, PhD,M.T.(A.S.C.P.), C.P.T.C. (2011). Virginia henderson’s principles and practice of nursing applied to organ donation after brain death. Progress in Transplantation, 21(1), 72-7. Retrieved from http://prx-herzing.lirn.net/login?url=http://search.proquest.com.prx-herzing.lirn.net/docview/858241664?accountid=167104

Peplau, Hildegard E, RN,EdD., F.A.A.N. (1996). A virginia henderson reader: Excellence in nursing. Journal of Psychosocial Nursing & Mental Health Services, 34(10), 55. Retrieved from http://prx-herzing.lirn.net/login?url=http://search.proquest.com.prx-herzing.lirn.net/docview/1026710915?accountid=167104

Smith, J. (1999). Crossing the divide. Nursing Standard (through 2013), 13(37), 18. Retrieved from http://prx-herzing.lirn.net/login?url=http://search.proquest.com.prx-herzing.lirn.net/docview/219820380?accountid=167104

Vera, M. (2014, August 06). Virginia Henderson – Nursing Need Theory – Nurseslabs. Retrieved October 21, , from http://nurseslabs.com/virginia-hendersons-need-theory/

Virginia A. Henderson (1897-1996) 1996 Inductee. (n.d.). Retrieved October 22, , from http://www.nursingworld.org/VirginiaAHenderson

Virginia Henderson – The Principles and of Nursing. (2011). Retrieved October 23, 2016, from http://www.webinfobits.com/page/38c1f10cdefe

Wise, Pat S Yoder,R.N., M.S.N. (1981). To be a nurse. The Journal of Continuing Education in Nursing, 12(6), 39. Retrieved from http://prx-herzing.lirn.net/login?url=http://search.proquest.com.prx-herzing.lirn.net/docview/915650028?accountid=167104