Virginia Henderson’s Nursing Need Theory

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The Nursing Need Theory was developed by Virginia A. Henderson to define the unique focus of nursing practice. 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.

“I believe that the function the nurse performs is primarily an independent one – that of acting for the patient when he lacks knowledge, physical strength, or the will to act for himself as he would ordinarily act in health, or in carrying out prescribed therapy. This function is seen as complex and creative, as offering unlimited opportunity for the application of the physical, biological, and social sciences and the development of skills based on them.” (Henderson, 1960)

Assumptions

The assumptions of Virginia Henderson‘s Need Theory are: (1) Nurses care for patients until they can care for themselves once again. Although not precisely explained, (2) patients desire to return to health. (3) Nurses are willing to serve and that “nurses will devote themselves to the patient day and night.” (4) Henderson also believes that the “mind and body are inseparable and are interrelated.”

Major Concepts of the Nursing Need Theory

Individual

Henderson states that individuals have basic needs that are component of health and require assistance to achieve health and independence or a peaceful death. According to her, an individual achieves wholeness by maintaining physiological and emotional balance.

She defined the patient as someone who needs nursing care but did not limit nursing to illness care. Her theory presented the patient as a sum of parts with biopsychosocial needs and the mind and body are inseparable and interrelated.

Environment

Although the Need Theory did not explicitly define the environment, Henderson stated that maintaining a supportive environment conducive for health is one of the elements of her 14 activities for client assistance.

Henderson’s theory supports the tasks of the private and the public health sector or agencies in keeping the people healthy. She believes that society wants and expects the nurse’s service of acting for individuals who are unable to function independently.

Health

Although not explicitly defined in Henderson’s theory, health was taken to mean balance in all realms of human life. It is equated with the independence or ability to perform activities without any aid in the 14 components or basic human needs.

Nurses, on the other hand, are key persons in promoting health, prevention of illness and being able to cure. According to Henderson, good health is a challenge because it is affected by numerous factors such as age, cultural background, emotional balance, and others.

Nursing

Henderson wrote her definition of nursing before the development of theoretical nursing. She defined nursing as “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 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’s goal is to make the patient complete, whole, or independent. In turn, the nurse collaborates with the physician’s therapeutic plan.

Nurses temporarily assist an individual who lacks the necessary strength, will, and knowledge to satisfy one or more of the 14 basic needs. She 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”

Additionally, she stated 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.”

Her definition of nursing distinguished the role of a nurse in health care: The nurse is expected to carry out a physician’s therapeutic plan, but individualized care is the result of the nurse’s creativity in planning for care.

The nurse should be an independent practitioner able to make an independent judgment. In her work Nature of Nursing, she states the nurse’s role is “to get inside the patient’s skin and supplement his strength, will or knowledge according to his needs.” The nurse has the responsibility to assess the needs of the patient, help him or her meet health needs, and provide an environment in which the patient can perform activity unaided.

14 Components of the Need Theory

The 14 components of the Need Theory show a holistic approach to nursing that covers the physiological, psychological, spiritual and social needs.

14-Components-Virginia-Henderson-2
Click image to enlarge.

Physiological Components

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  • 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 range by adjusting clothing and modifying environment
  • 8. Keep the body clean and well groomed and protect the integument
  • 9. Avoid dangers in the environment and avoid injuring others

Psychological Aspects of Communicating and Learning

  • 10. Communicate with others in expressing emotions, needs, fears, or opinions.
  • 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

Spiritual and Moral

  • 11. Worship according to one’s faith

Sociologically Oriented to Occupation and Recreation

  • 12. Work in such a way that there is sense of accomplishment
  • 13. Play or participate in various forms of recreation

Henderson’s 14 Components as Applied to Maslow’s Hierarchy of Needs

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Since there is much similarity, Henderson’s 14 components can be applied or compared to Abraham Maslow’s Hierarchy of Needs. Components 1 to 9 are under Maslow’s Physiological Needs, whereas the 9th component is under the Safety Needs. The 10th and 11th components are under the Love and Belongingness category and 12th, 13th and 14th components are under the Self-Esteem Needs.

Analysis

One cannot say that every individual who has similar needs indicated in the 14 activities by Henderson are the only things that human beings need in attaining health and for survival. With the progress of today’s time, there may be added needs that humans are entitled to be provided with by nurses.

The prioritization of the 14 Activities was not clearly explained whether the first one is prerequisite to the other. But still, it is remarkable that Henderson was able to specify and characterize some of the needs of individuals based on Abraham Maslow’s hierarchy of needs.

Some of the activities listed in Henderson’s concepts can only be applied to fully functional individuals indicating that there would always be patients who always require aided care which is in contrary to the goal of nursing indicated in the definition of nursing by Henderson.

Because of the absence of a conceptual diagram, interconnections between the concepts and subconcepts of Henderson’s principle are not clearly delineated.

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Strengths

Henderson’s concept of nursing is widely accepted in nursing practice today. Her theory and 14 components are relatively simple, logical, and can be applied to individuals of all ages.

Weaknesses

There is an absence of a conceptual diagram that interconnects the 14 concepts and subconcepts of Henderson’s theory. On assisting the individual in the dying process, there is a little explanation of what the nurse does to provide “peaceful death.”

Application

Henderson’s Needs Theory can be applied to nursing practice as a way for nurses to set goals based on Henderson’s 14 components. Meeting the goal of achieving the 14 needs of the client can be a great basis to further improve one’s performance towards nursing care. In nursing research, each of her 14 fundamental concepts can serve as a basis for research although the statements were not written in testable terms.

See Also

References

  1. George B. Julia (2010). Nursing Theories: The Base for Professional Nursing Practice. Pearson Higher Ed USA.
  2. Meleis Ibrahim Afaf (1997). Theoretical Nursing: Development & Progress 3rd ed. Philadelphia, Lippincott.
  3. Henderson, V. (1966). The nature of nursing. In George, J. (Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.
  4. Henderson, V. (1991). The nature of nursing: Reflections after 25 years. In McEwen, M. and Wills, E. (Ed.). Theoretical basis for nursing. USA: Lippincott Williams & Wilkins.

With contributions by Wayne, G., Ramirez, Q., Vera, M. 

Last updated on
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Angelo Gonzalo, BSN, RN
Angelo Gonzalo earned his Nursing degree in the year 2010 and continued his studies at St. Paul University Manila taking up Masters of Arts in Nursing Major in Clinical Management. He worked as an intensive care nurse for more than six years. He advocates for proper training and development of new nurses, quality assurance and compassionate care. He has also been involved in community development for 10 years steering programs on good governance, health, sports, and education. Angelo aims to build a good foundation for aspiring nurses. He would like to impart the importance of understanding nursing theories that he hopes to be translated successfully to practice.

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