Virginia Henderson: Nursing
Need Theory
Biography of Virginia Henderson
Virginia Avenel Henderson was born on November 30, 1897 in Kansas City,
Missouri.
She was a nurse, theorist, and author known for her Need Theory
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 (or to peaceful death) that he would perform unaided if
he had the necessary strength, will or knowledge.”
Henderson is also known as “The First Lady of Nursing,” “The Nightingale of
Modern Nursing,” “Modern-Day Mother of Nursing,” and “The 20th
Century Florence Nightingale.”
Attended the U.S. Army School of Nursing during WW1 where she graduated
in 1921.
She later received a Bachelors of Science degree in 1932 and a Masters
degree in 1934 from Teachers College, Columbia University. Afterwards, she
became part of the faculty.
In 1939, she revised Bertha Harmer’s Textbook on the Principles and Practice
of Nursing.
In 1953 she joined the Yale She remained there for 40 years
While there she Published:
Nursing Research: A survey and assessment. (1964)
Directed a twelve-year project entitled Nursing Studies Index (4
volumes)
Her most important writing, Principles and Practice of Nursing , is
considered the twentieth century equivalent of Nightingale’s book.
At the age of 75, she decided to direct her career to international teaching
and speaking.
She died March 19, 1996, when she was 98 years old.
The Sigma Theta Tau International Library was named in her honor.
She was selected to the American Nurses Association Hall of Fame.
She’s held honorary degrees from 13 universities
Virginia Henderson’s Need Theory
The Nursing Need Theory was developed by Virginia 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.
Assumptions of the Need Theory
The assumptions of Virginia Henderson’s Need Theory are:
1. Nurses care for patients until they can care for themselves once again.
2. Although not precisely explained 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
The following are the major concepts (nursing metaparadigm) and definitions of the
Need Theory of Virginia Henderson.
Individual
Defines the person as “patient”
An individual who requires assistance to achieve health and
independence, or in some cases, a peaceful death.
Introduced the concept of the mind and body of a person as inseparable
For a person to function to the utmost, he must be able to maintain
physiological and emotional balance
Environment
Important for a healthy individual to control the environment, but as one
becomes ill, this ability is affected
It becomes the nurses responsibility to manage the patient’s surroundings
To protect him from any harm or injury
Nurse must be educated about safety and aware of different social
customs and religious practices to assess dangers
Health
Viewed as quality of life
Requires independence and interdependence
Health is a multifactor phenomenon
Influenced by external and internal factors which play independent
and interdependent roles in achieving health
Emphasis on prioritizing health promotion more than care of the sick
Nursing
Nurses function independently from the physician, but they must promote the
treatment plan prescribed by the physician
Nurses help both the sick and healthy individual
From newborn to dying
Knowledgeable in biological and social sciences and must have the ability to
assess basic human needs.
14 Components of the Need Theory
The 14 components of Virginia Hendersons Need Theory show a holistic approach
to nursing that covers the physiological, psychological, spiritual and social needs.
Physiological Components
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
A Nurse’s Role
Substitutive : acting for a person
Supplementary : assisting a person
Complementary : working with the person
Henderson’s 14 Components as Applied to
Maslow’s Hierarchy of Needs
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
12th, 13th and 14th components are under the Self-Esteem Needs.
HENDERSON’S THEORY AND NURSING PROCESS
Nursing assessment: Assess needs of human being based in the
14 components of basic nursing care.
Nursing Diagnosis: Identify individual’s ability to meet own needs
with or without assistance, taking into consideration strength, will
or knowledge.
Nursing Plan: Document how the nurse can assist the individual,
sick or well.
Nursing Implementation: 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: 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
THEORETICAL ASSERTIONS
The Nurse-Patient Relationship:
Henderson stated that there are three levels compromising the nurse-
patient relationship:
The nurse as a substitute for the patient.
The nurse as a helper to the patient.
The nurse as a partner with the patient.
The Nurse-Physician Relationship
Henderson asserted that nurses function independently from
physicians. Though the nurse and the patient, as partners,
formulate the plan of care, it must be implemented in such a way
that will promote the physician’s prescribed therapeutic plan. She
also insisted that nurses do not follow doctor’s orders; rather they
follow in a philosophy which allows physicians to give orders to
patients or other healthcare team members.
The Nurse as a Member of the Healthcare Team:
For a team to work together in harmony, every member must
work interdependently. The nurse, as a member of the healthcare
team, works and contributes in carrying out the total program of
care. However, working interdependently, as Henderson
indicated, does not include taking other member’s roles and
responsibilities
APPLICATIONS:
Practice: The nurse can help the patient move to an independent state
by
Assessment- assess the patients for 14 fundamental needs and
determine what are lacking.
Planning- plan to meet the needs fit to the doctors prescribed plan.
Implementation- uses the 14 basic needs in answering the factors
contribute to the illness. Assist the sick or well individual to maintain
health or recover from illness.
Evaluation phase- decides whether goals are met or not.
Provide a rationale for collecting reliable and valid data about the
health status of clients.
Help build a common nursing terminology to use in
communicating with other health professionals.
Education: Development of 3 phases of curriculum development that
students should progress in their learning. The focus in all three phases
remains the same these are:
Assisting the patient when he needs strength, will or knowledge
in performing his daily activities or in carrying out prescribed
therapy with the ultimate goal of independence.
Develop a habit of inquiry; take courses in biological, physical,
and social sciences and in the humanities; study with students in
other fields, observe effective care, and give effective care in a
variety of settings.
Involve students in the complete study of the patient and all his
needs.
Research:
Research questions arise from each of the 14 components of
basic nursing care.
Henderson concluded no profession, occupation or industry in
this age can evaluate adequately or improve it practice without
research.
Offer a framework for generating knowledge and new ideas.
She emphasized the importance of research in evaluating and
improving the nurses’ practice
Strengths
The concept of nursing formulated by Henderson in her definition of nursing
and the 14 components of basic nursing is uncomplicated and self-
explanatory. Therefore, it can be used without difficulty as a guide for
nursing practice by most nurses.
Henderson’s work is relatively simple yet generalizable with some limitations.
Her work can be applied to the health of individuals of all ages.
Each of the 14 activities can be the basis for research
Weaknesses
A major shortcoming in her work is the lack of a conceptual linkage between
physiological and other human characteristics.
No concept of the holistic nature of human being.
Lacks inter-relate of factors and the influence of nursing care
