Theoretical Foundations in Nursing
Week 4
TOPIC OUTLINE
1 Florence Nightingale – Environmental Theory
2 Virginia Henderson – Need Theory/14 Needs
3 Faye Glenn Abdellah – 21 Nursing Problems
1. Florence Nightingale
May 12, 1820 – August 13, 1910
 First Nurse Theorist: ENVIRONMENTAL THORY
 Founder of Modern Nursing
 “The Lady with the Lamp” because during the Crimean
war, she used to rounds holding a lamp
 From a British Family belonged to elite social circles
 3 month course of study in nursing at Kaiser Werth
Institute in Germany
Nightingale’s Environmental Theory
Defined Nursing as “the act of utilizing the environment of
the patient to assist him in his recovery”
Nurse’s Initiative to configure environmental settings
appropriate for the gradual restoration of the patient’s
health and that external factor (patient’s surroundings)
affects the life or biologic and physiologic processes and his
development.
Major Concepts of Environmental Theory
(prevention and promotion of health)
Nursing Put the patients in the best condition
for nature to act upon him.
“ought to signify the proper use of:
fresh air, light, warmth, cleanliness,
quiet, and the proper selection and
administration of diet – all at the least
expense of vital power to the patient.”
Human beings Relation of their environment and the
(Person) impact of the environment upon them.
Surroundings Described the concepts of: Ventilation,
(Environment) warmth, light, diet, cleanliness and
noise – components of surroundings
Observe the environment of the
patient
Health “We know nothing of health, the
positive of which pathology is negative,
except for the observation and
experience
Nursing should provide care to the
healthy and the ill and discussed
health promotion as an activity in
which nurses should engage
Recognize and agreed that cleanliness
prevents morbidity (illness)
Sub-Concepts of the Environmental Theory
1. Health of “Badly constructed houses do for the
Houses healthy what badly constructed
hospitals do for the sick. Once ensure
that the air is stagnant and sickness is
certain to follow.”
If a healthy individual lives in an
unhealthy environment they will
acquire illness, what more those
individual who stays in a badly
constructed hospitals they might
prolong their recovery.
2. Ventilation “Keep the air he breathes as pure as
and Warming external air without chilling him”
Person who repeatedly breathed them
own air would become sick or remain
sick.
Stressed the importance of room
temperature. The patient should not
be too warm or too cold.
3. Light 2nd to fresh air the sick needed sunlight
Direct sunlight was what patient
wanted.
4. Noise Patients should never be “waked
intentionally” or accidentally during
the first part of sleep.
Unnecessary noise are cruel and
irritating to the patients.
5. Variety Need for color and form changes
(bringing the patient brightly colored
flowers or plants).
6. Bed and Bed should be place in the lightest part
Bedding of the room and placed so the patient
could see out of a window.
She reminded the caregiver never to
lean against, sit upon, or unnecessarily
shake the patient’s bed.
7. Personal Keep pores of the skin free from all
Cleanliness obstructing excretions
“Every nurse ought to wash her hands
very frequently during the day.”
Hygiene
8. Nutrition and Individuals desire different foods at
Taking Food different times of the day and that
frequent small servings may be more
beneficial to the patient than a large
breakfast of dinner.
Patient should not be disturbed when
eating, they might lose appetite.
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Week 4
She urge that “NO business done with
patient while they are earing because
this was a distraction.”
9. Chattering No to false hope
hopes and to falsely cheer the sick by making
advice light of their illness; its danger is not
helpful.
She encouraged the nurse to heed
what is being said by visitors, sick
person should hear the good news that
would help them become healthier.
10. Social Nightingale supported the importance
Consideration of looking beyond the individual to the
social environment in which they lived.
Environmental Factor
1. Pure fresh air “to keep the air he breathes as pure as
the external air without chilling him.”
2. Pure water “well water of a very impure kind is
used for domestic purposes”
Always drink water (pure, mineral,
distilled, clean).
3. Effective “all the while the sewer may be
drainage nothing but a laboratory from which
epidemic disease and ill health are
being installed into the house (good
drainage)
4. Cleanliness “The greater part of nursing consist in
preserving cleanliness.”
5. Light Direct sunlight – the usefulness of light
in treating disease is very important,
2. Virginia Henderson
November 30, 1897 – March 19, 1996
 Known for her NEED THEORY or THE 14 NEEDS
 Nightingale of Modern Nursing
 Modern-Day Mother of Nursing
 The 20th Century Florence Nightingale
Henderson’s Need Theory
 Focuses on Independence of the patient
“The unique function of the nurse is to ASSIST the individual to
health or its recovery (or to peaceful death) that he would
perform unaided if he had the necessary strength, will or
knowledge.” Assist individual sick and well
Focuses on the importance of increasing the patient’s
independence
 Emphasizes the basic human needs and how nurses can
assist in meeting those needs.
 Henderson believe that the function on the nurse performs
is primarily an independent one – that of acting for 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.
Performs activity alone
 This function is seen as complex and creative, as offering
unlimited opportunity to apply the physical, biological, and
social sciences and the development of skill based on them.
Virginia Henderson’s Need Theory Assumptions
 Nurses care for patients until they can care for themselves
once again.
 Patient desire to return to health “encourage patient to do
what they used to do”
 Nurses are willing to serve, and that “nurses will devote
themselves to the patient day and night.”
 Henderson also believes that the “mind and body are
inseparable and interrelated.”
Promote and prevent
Major Concepts of Need Theory
(prevention and promotion of health)
Individual Individuals have basic health needs
and acquire assistance to achieve
health and independence or a
peaceful death.
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.
Environment Maintaining a supportive
environment conducive to health is
one of her 14 activities for client
assistance.
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 are key persons in
promoting health, preventing illness,
and being able to cure.
Nursing The nurse’s goal is to make the
patient complete, whole or
independent.
Nurses temporarily assist an
individual who lacks the necessary
strength, will, and knowledge to
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Week 4
satisfy one or more of the 14 basic 3. Faye Glenn Abdellah
needs March 13, 1919 – February 24, 2017

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.”
14 Components of the Need Theory
 Need Theory show a holistic nursing approach covering
physiological, psychological, spiritual, and social needs.

 Developed the 21 Nursing Problems

 A nursing research pioneer (Military Nurse)
 Earn a nursing diploma from Fitkin Memorial Hospital’s
School of Nursing, now known as Ann May School of Nursing
1945 - BS
Nursing
1947 – Master of
Arts in Earn 3 degrees from Columbia University
Psychology
1955 – Doctor of
Physiological Components Education
1. Breathe normally It was sufficient to practice nursing during her time in 1940’s,
2. Eat and drink adequately but she believe that Nursing care should be based on
3. Eliminate body wastes research, not hours of care.
4. Move and maintain desirable posture Abdellah’s 21 Nursing Problem Theory
5. Sleep and rest  Nursing is based on an art and science that molds the
6. Select suitable clothes – dress and undress Attitude, intellectual competencies, and technical skills
7. Maintain body temperature within normal range by
adjusting clothing and modifying environment KSA = Knowledge, Skills, Good Attitude
8. Keep the body clean and well-groomed and protect
the integument (skin) 21 Nursing Problems Theory = pattern of nursing diagnosis
9. Avoid dangers in the environment and avoid injuring Enrich the 14 Human need of Henderson.
others
Psychological Aspects of Communicating and Learning Patient-Centered Approach to nursing was developed from
10. Communicate with others in expressing emotions, Abdellah’s practice
need, fears, or opinions. MAJOR: Patient Centered Approach
11. Learn, discover, or satisfy the curiosity that leads to
normal development and health and use the It was formulated to be an instrument for nursing education
available health facilities Intended to guide care in HOSPITAL INSTITUTIONS but can
Spiritual and Moral also be applied to community health nursing
12. Worship according to one’s faith
Sociologically Oriented to Occupation and Recreation More of Clinical/Hospital set up FOCUS
13. Work in such a way that there is a sense of Major Concepts of 21 Nursing Problems Theory
accomplishment The model has interrelated concepts of health and nursing
14. Play or participate in various forms of recreation problems and problem-solving, which is inherently logical in
nature.
Individual Recipients of nursing care (and families)
(Person)
Health Achieving is the purpose of nursing
services.
“total health needs” a “healthy state of
body and mind”

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Week 4
Society “planning for the optimum health on local,
(Environment) state, and international levels.”
Focus of nursing service is clearly the
Individual (patient)
Nursing The client’s health needs can be viewed as
Problems problems
(Nursing) OVERT Apparent/Obvious Objective
COVERT Hidden/Verbalize Subjective
Sub-Concepts of 21 Nursing Problems Theory
 21 Nursing problems fall 4. Types of Intrapersonal
into categories: relationships between
the patient and nurse
1. Physical 5. Common elements of
2. Sociological Patient care
3. Emotional
Needs of patient
She used Henderson’s 14 basic human needs and nursing
research to establish the classification of nursing problems
Basic Needs
1. To maintain good hygiene and physical comfort
2. To promote optimal activity: exercise, rest sleep
3. To promote Safety by preventing accidents, injuries,
or other trauma and preventing the spread of
infection.
4. To maintain good body mechanics and prevent and
correct deformity.
Sustenal Care Needs
5. To facilitate the maintenance of a supply of oxygen
to all body cells
6. To facilitate the maintenance of nutrition for all body
cells.
7. To facilitate the maintenance of elimination of waste
8. To facilitate the maintenance of fluid and electrolyte
balance
9. To recognize the physiologic response of body to
disease conditions-pathologic, physiologic, and
compensatory.
10. To facilitate the maintenance of regulatory
mechanisms and function
11. To facilitate the maintenance of sensory function
Remedial Care Needs
12. To identify and accept positive and negative
expressions, feelings, and reactions.
13. To identify interrelatedness of emotions and organic
illness
14. To facilitate the maintenance of effective verbal and
non-verbal communication.
15. To promote development of productive interpersonal
relationships.
16. To facilitate progress toward achievement and
personal spiritual goals.

17. To create or maintain a therapeutic environment

18. To facilitate awareness of self as an individual with
varying physical, emotional, and developmental
needs.
Restorative Care Needs
19. To accept the optimum possible goals in the light of
limitations, physical and emotional.
20. To use community resources as an aid in resolving
problems that arise from an illness.
21. To understand the role of social problems as
influencing factors in the cause of illness.

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