Virginia Henderson's Need Theory

This page was last updated on February 4, 2012

“Nursing theories mirror different realities, throughout their development;

they reflected the interests of nurses of that time.”

Introduction

 “The Nightingale of Modern Nursing”

 “Modern-Day Mother of Nursing.”

 "The 20th century Florence Nightingale."

 Born in Kansas City, Missouri, in 1897.

 Diploma in Nursing from the Army School of Nursing at Walter

Reed Hospital, Washington, D.C. in 1921.

 Worked at the Henry Street Visiting Nurse Service for 2 years

after graduation.

 In 1923, started teaching nursing at the Norfolk Protestant

Hospital in Virginia

 In 1929, entered Teachers College at Columbia University for

Bachelor’s Degree in 1932, Master’s Degree in 1934.

 Joined Columbia as a member of the faculty, remained until

1948.

 Since 1953, a research associate at Yale University School of

Nursing.

 Recipient of numerous recognitions.

 Honorary doctoral degrees from the Catholic University of

America, Pace University, University of Rochester, University of
Western Ontario, Yale University

  In 1985, honored at the Annual Meeting of the Nursing and

Allied Health Section of the Medical Library Association.

 Died: March 19, 1996.

 In 1939, she revised: Harmer’s classic textbook of nursing for

its 4th edition, and later wrote the 5th; edition, incorporating her
personal definition of nursing (Henderson,1991)
Theory Background

 She called her definition of nursing her “concept”

(Henderson1991)
 She emphasized the importance of increasing the patient’s
independence so that progress after hospitalization would not
be delayed (Henderson,1991)

 "assisting individuals to gain independence in relation to the

performance of activities contributing to health or its
recovery" (Henderson, 1966).

 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 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) 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).

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 assumptions of the theory are:

 "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

1. 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.
2.  E n v i r o n m e n t

 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.

 Basic nursing care involves providing conditions under which

the patient can perform the 14 activities unaided

3. H e a l t h

 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.

4. 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."

 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.

 “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.”

Henderson’s and Nursing Process

”Summarization of the stages of the nursing process as applied to

Henderson’s definition of nursing and to the 14 components of
basic nursing care.

Nursing Process Henderson’s 14 components and definition of

nursing

Nursing Henderson’s 14 components

Assessment

Nursing Analysis: Compare data to knowledge base of

Diagnosis health and disease.

Nursing plan Identify individual’s ability to meet own needs

with or without assistance, taking into
consideration strength, will or knowledge.

Nursing Document how the nurse can assist the

implementation individual, sick or well.

Nursing Assist the sick or well individual in to

implementation performance of activities in meeting human
needs to maintain health, recover from illness, or
to aid in peaceful death.

Nursing process Implementation based on the physiological

principles, age, cultural background, emotional
balance, and physical and intellectual capacities.

Carry out treatment prescribed by the physician.

Nursing Henderson’s 14 components and definition of

evaluation nursing

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

Comparison with Maslow's Hierarchy of Need

Maslow's Henderson
Breathe normally
Eat and drink adequately Eliminate
by all avenues of elimination Move
Physiological and maintain desirable posture
needs Sleep and rest Select suitable
clothing Maintain body temperature
Keep body clean and well groomed
and protect the integument

Avoid environmental dangers and

Safety Needs
avoid injuring other

Belongingness Communicate with others

and love needs worship according to one's faith

Work at something providing a sense of

accomplishment

Esteem needs Play or participate in various forms of

recreation

Learn, discover, or satisfy curiosity

Characteristic of Henderson’s theory

 There is interrelation of concepts.

 Concepts of fundamental human needs, biophysiology, culture,
and interaction, communication are borrowed from other
discipline.Eg.. Maslow’s theory.

 Her definition and components are logical and the 14

components are a guide for the individual and nurse in reaching
the chosen goal.

 Relatively simple yet generalizable.

  Applicable to the health of individuals of all ages.

 can be the bases for hypotheses that can be tested.

 assist in increasing the general body of knowledge within the

discipline.

 Her ideas of nursing practice are well accepted.

 can be utilized by practitioners to guide and improve their

practice.

Limitations

 Lack of conceptual linkage between physiological and other

human characteristics.
 No concept of the holistic nature of human being.

 If the assumption is made that the 14 components prioritized,

the relationship among the components is unclear.

 Lacks inter-relate of factors and the influence of nursing care.

 Assisting the individual in the dying process she contends that

the nurse helps, but there is little explanation of what the nurse
does.

 “Peaceful death” is curious and significant nursing role.

Conclusion

 Henderson provides the essence of what she believes is a

definition of nursing.
 Her emphasis on basic human needs as the central focus of
nursing practice has led to further theory development
regarding the needs of the person and how nursing can assist
in meeting those needs.

 Her definition of nursing and the 14 components of basic

nursing care are uncomplicated and self-explanatory.