Major Concepts

The major concepts of Virginia Henderson's Needs Theory relate to the metaparadigm (ie, nursing, health, patient and environment) as seen in this page. Also, the assumptions of the theory are also discussed.

PERSON

• Individual person or client is a whole, complete, independent being with biological, sociological, and spiritual components
• With 14 fundamental or basic human needs
• Mind and body are inseparable
• Patient will require assistance to achieve health and independence or peaceful death
• Patient and family as a unit

The fourteen components or the basic human needs of Henderson's concept are as follows: 

1. Breathe normally. Eat and drink adequately.
2. Eliminate body wastes.
3. Move and maintain desirable postures.
4. Sleep and rest.
5. Select suitable clothes—dress and undress.
6. Maintain body temperature within normal range by adjusting clothing and modifying environment.
7. Keep the body clean and well groomed and protect the integument.
8. Avoid dangers in the environment and avoid injuring others.
9. Communicate with others in expressing emotions, needs, fears, or opinions.
10. Worship according to one's faith.
11. Work in such a way that there is a sense of accomplishment.
12. Play or participate in various forms of recreation.
13. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.[1]

HEALTH

• Individuals will achieve or maintain health if they have the necessary strength, will or knowledge (concept of independence)
• “The quality of health rather than life itself, that margin of mental physical vigor that allows a person to work most effectively and to reach his highest potential level of satisfaction in life”
• Basic to human functioning
• Promotion of health is more important than care of the sick

NURSING

Role of The Nurse: A Continuous Diagram Approach  

http://nursing-theory.org/nursing-theorists/Virginia-Henderson.php

“In this paper, the activities of which basic nursing is composed are outlined. Their origin in universal human needs is stressed and the nurse’s continuous interpretation of the way in which these needs are modified by a particular state of the person he or she serves is shown.”

“The intent is to describe the care that any person requires no matter what the physician’s diagnosis and prescribed therapy…. The nurse’s basic care (approach) is the same whether the patient is considered physically or mentally ill…. Because this booklet deals generally with nursing and is applicable to the care of any patient, it can only mention basic nursing activities…” (pp. 17-18).[2]

Henderson's Need Theory emphasizes the importance of patient independence so that the patient will continue to progress after being released from the hospital. Henderson described the role of the nurse as one of the following: substitutive, which is doing something for the patient; supplementary, which is helping the patient do something; or complementary, which is working with the patient to do something. All of these roles are to help the patient become as independent as possible. 

Henderson believed that:

“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 a peaceful death) that the person would perform unaided given the necessary strength, will or knowledge, and to do this in such a way as to help the individual gain independence as rapidly as possible.” [3]

She categorized nursing activities into fourteen components based on human needs.

While a nurse's job is to care for patients, it is also to help patients be able to care for themselves when they leave the healthcare facility. This will help ensure that the patient has fewer setbacks during recovery from the illness or injury, and will help the transition into self-care be smoother since a nurse will be helping and supervising along the way until the patient goes home. For those nurses who work in rehabilitation, Henderson's theory is one that can be easily used every day, and it will be the patients who benefit from it.[4]

Overall, Henderson expressed the view that a nurse’s role is to follow and assist with the medical plan of care outlined by a physician and also to assume the leadership role of planning and providing basic nursing care. Nurses are independent practitioners for providing appropriate basic nursing care, however, they should not independently diagnose an ailment, prescribe medical treatment, or formulate a prognosis. The method by which the nurse facilitates optimal independence for the patient varies from patient to patient and is based on the nurse’s professional judgment. Empathy coupled with knowledge and interest on the part of the nurse will enhance the healing process. The overall goal of nursing should be the promotion of as much independence as possible for the patient with regards to Henderson’s 14 points.

The nurse is an independent practitioner with expertise in aiding the patient to become as independent as possible in life activities. Patient independence is accomplished through appropriate medical intervention that is supported by the nurse and also by excellent basic nursing care that is formulated and carried out by the nurse autonomously. The nurse attends to the holistic needs of the patient through the educated and emphatic attention to the 14 needs outlined by Henderson. The nurse is an independent authority on excellent basic nursing care and also a vital aide to other practitioners in the field of healthcare in ensuring the provision of germane medical treatment for patients with conditions requiring it.

ENVIRONMENT

• Webster’s New Collegiate Dictionary, 1961: the aggregate of all external conditions and influences affecting the life and development of an organism
• 7 essentials in the environment: light, temperature, air movement, atmospheric pressure, appropriate disposal of waste, minimal quantities of injurious chemicals, and cleanliness of surfaces and furnishings in contact with the individual
• Illness may interfere with the ability to control the environment
• Nurse’s function is to alter the environment in such a way as to support the patient

MAJOR ASSUMPTIONS

• Nurses care for patients until patients can care for themselves once again.

Independence is valued here not dependence. The care provided by the nurse is to allow the patient to take control his/her own can and do so unaided by providing or even regaining his strength, enriching his knowledge, and supplementing his will to do so. If dependence would be the result, the goal is not attained. The patients must be able to care for themselves with the basis of being able to satisfy the 14 needs.  An example would be for a patient who suffered from a mild stroke and has difficulty walking should be able to regain his strength and will to move at will with the appropriate energy as much as he would be able to do so prior to his illness but also bearing in mind that when he has recuperated, he no longer needs assistance in ambulation from the nurse.

However, an exception is made in situations wherein the care of the nurse is needed especially for the very young and very old.

•  Health has a meaning shared by the society at large

This encompasses all the various sectors of our society – from the very young, to the very old, from the different social and cultural backgrounds. Universally we have the same needs as others. Though there may be some differences, we all need water, air, and food to live. As such, everyone plays a part in contributing to the wellness of each and everyone thereby creating a healthy society.

  

• Patients desire to return to health or a peaceful death and will act in such a way to achieve this.

With this assumption, there is direction where nursing care and patient wellness can succeed. The will of a patient to achieve better health, or in some cases a peaceful death facilitates the movement from the patient's experience of illness, the nursing care applied to bring the patient back to health, until the patient has fully recovered and is back to where he/she was prior to the illness however, with more insight as to how the experience went about.

                

• Individuals will perform activities leading to health if they have the knowledge, capacity or will.

If one has the capacity, knowledge, and will to do so, they have the power to create change. Thus, people need to be given these attributes in order for them to initiate upon themselves healthy activities and become independent one way or the other.

• The individual’s goal and the nurse’s goal are congruent.

Having the same goal guides both of them to the same direction. Health with the intervention of a nurse has to be worked out by both the nurse and patient. An active voice from the patient leads to successful nursing.

•  The 14 basic needs represent nursing’s basic function.  

The 14 needs as listed by Virginia Henderson is the guide of nurses to facilitate care to his/her patients. These are basic needs and are applicable universally to everyone. Therefore, the nurse helps the patient attain these 14 needs.

• Nursing’s goal may be subsumed into the medical treatment plan.

Collaboration with the medical treatment plan addresses the needs of the patient. The nurse functions in a way as to be the client’s advocate for health. With that, the nurse reports to the physician what he/she sees since nurses are given the opportunity to care for their patients with bedside manner. Hence, this will facilitate a better understanding and better care for the patient.

• The major explicit assumption is Henderson’s contention that the nurse is an independent practitioner.

Although Henderson implies that a role of a nurse is to carry out the physician’s orders, she also contends that a nurse is an independent practitioner. This means that he/she can initiate some activities on his/her own. Thus, the nurse can aid the patient in attaining the 14 needs in some ways that a physician’s order is not necessary.

-Miguel Lorenzo Geocaniga

-Namnama Joy Matias

-Princess Gay Macha

-Rachell Patayon

REFERENCES:

Henderson v: The Nature of Nursing: A Definition and Its Implications, Practice, Research, and Education. Macmillan Company, New York, 1966. (Pages 16-17)

http://currentnursing.com/nursing_theory/Henderson.html

http://en.wikipedia.org/wiki/Virginia_Henderson

http://www.angelfire.com/ut/virginiahenderson/concepts.html

http://www.nytimes.com/1996/03/22/arts/virginia-henderson-98-teacher-of-nurses-dies.html

www.youtube.com/watch?v=AbuNz7RLHS8

www.youtube.com/watch?v=t89beHi7Xxw

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[1] Henderson v: The Nature of Nursing: A Definition and Its Implications, Practice, Research, and Education. Macmillan Company, New York, 1966. (Pages 16-17)

[2] Nursing theorists and their work

 By Ann Marriner-Tomey, Martha Raile Alligood pp. 54-57

[3] Henderson v: The Nature of Nursing: A Definition and Its Implications, Practice, Research, and Education. Macmillan Company, New York, 1966. (Pages 16-17)

[4] http://nursing-theory.org/nursing-theorists/Virginia-Henderson.php