Virginia Hendersons Needs Theory

Published Date: 02 Nov 2017

Introduction

Nursing is an art of caring. Nursing has undergone a dramatic change over the past few decades. But the basic principal of nursing ‘caring’ remained unchanged. Caring the main aspect of nursing is difficult to measure. So it is necessary to have a well-defined nursing theory to explain and analysis what nurses do. Nursing theory is defined as’ a conceptualisation of some aspect of nursing reality for the purpose of describing, explaining, predicting nursing care’ (Meleis, 1997 as cited in Parker 2001, p.5). Nursing theory describes and explains the phenomena of interest to nursing in an organised way to provide understanding for use in nursing practice and research (Parker, 2001, p.5). Benefits of a well-defined nursing theory includes better patient care, improved communication between nurses, enhanced professional status for nurses and guidance for research and education (Catalano, 2009). One of the most famous nursing theories is Virginia Henderson’s Nursing Theory, which is also known as ‘The Needs Theory’.

In this assignment the author will be focusing on Virginia Henderson’s, the needs nursing theory and the concepts of four meta paradigms which include person, health, environment and nursing. The Meta paradigm offers the boundaries and limitations of a discipline, recognise the common perspective and helps to focus the activities of members of that discipline. A meta paradigm is the most abstract component of knowledge in a discipline that set forth the phenomena of concerns to that discipline (DeLenue & Ladner, 2011). Additionally the author will explore the application of Virginia Henderson’s theory in rehabilitation setting.

Virginia Henderson’s Needs Theory

Virginia Henderson’s theory was developed in an era where patients need was the primary concerns. So it often called as the needs theory. Henderson believes that it is important to increase patient’s independence so that patient can recover and return home faster. Virginia Henderson (1964) defines ‘nursing as assisting the individual sick or well in the performance of those activities contributing to health or its recovery or to peaceful death that he wold 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’ (as cited in Abrams, 2007, p. 382). Henderson’s definition of nursing is the first on that visibly distinguish nursing from medicine. It focuses on assisting individuals in performing activities that contribute to health.

Henderson postulates that nurse function in relation with patient, physician and other health care professionals. Each type of this relationship gives nurses specific responsibilities. She stated that there are three levels in nurse-patient relationship. According to her, the nurse is a substitute to patient because the nurse is doing for patient, a supplement because the nurse is helping the patient, a complement because the nurse is working with patient to gain as much independence as possible (Parker, 2001).

In addition Henderson proposed fourteen components of basic nursing care. These are based on human needs. They are ‘Breathe normally, Eat and drink adequately, Eliminate body waste, Move and maintain desirable body position, Sleep and rest, Select suitable cloth –dress and undress, Maintain body temperature by adjusting cloth and modifying the 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 emotional needs, fears or options, Worship according to one’s faith, Working in such a way that there is accomplishment, Play or participate in various form of recreations, Learn discover or satisfy the curiosity that lead to normal development and health and use the available health facilities’ (George, 2002 p.87).

Henderson wrote ‘the nurses is temporarily the consciousness of unconscious, the love of life for suicidal, the leg of amputee, the eyes of newly blind, a means of locomotion for the infant, knowledge and confidence for the young mother, the voice for those too weak or withdrawn to speak’ (Halloran, 1996 p.20). This statement is most applicable in rehab settings.

The Four Meta Paradigms

Person

The person is an individual with whom the nurse is interacting (Potter &Perry, 2005). Henderson introduces the idea of the mind and body of a person work as a single unit. She stated that person is an individual who requires assistance in achieving health and independence or a special peaceful death (Tourville & Ingalls, 2003). The fourteen components of nursing care consist of every individual’s basic needs. A person to function to the fullest, he must be able to maintain emotional and physiological balance. Henderson considered patient and family as a single unit (Parker, 2001). In rehab centre family will be involved in patients care. Programs like caregiver training will empower the family members to care for the patient post discharge. Involving family members in patient care will reduce emotional and psychological distress experienced by patient as family is the main support system of the patient.

Environment

Environment encompasses any place where the therapeutic interaction between patient and nurse occurs (Catalano, 2009). As illness occurs the ability of person to control his environment will diminish. It is the duty of the nurse to manage the patients surrounding to protect patient from any harm or injuries. In rehab setting every patient will be asses for fall risk. This assessment will help the nurse to make necessary modification to patient’s environment like adequate lighting, and anti-slippery mat, to ensure patients safety. In rehab, the multi-disciplinary team including the nurse will do a home visit to ensure the home environment is safe for the patient and will provide necessary recommendation in home modification and equipment purchase. The environmental press model is the conceptual frame work used in many rehab settings (Lawton & Simon, 1986). This modal describes how physical environment interact with patient recovery and emphasis on the importance of modified environment to avoid harm to self and others, one of the basic component of Henderson’s basic nursing functions. Modified environment place an important role in the recover of a sick person.

Health

Nursing has viewed health as a continuum. Henderson views health as the quality of life and is the basic for the individual to perform the fourteen components independently (Tourville & Ingalls, 2003). Apart from basic nursing care, nurses play an important role in promotion of health and prevention of illness through health education. Age, culture, physical and intellectual capacities and emotional balance can affect health. The fourteen basic nursing functions are guide for the nurses in health teaching. Promotion of health is more important in caring for sick. In rehab centre, each patient and family receives education about their illness and how to cope with its outcome. Examples include group education for spinal cord injury patients and amputee education. Periodically, the rehab team will discusses each patient’s progress and prognosis and update family and patient. This will enable the patient to be aware of their rehab goals and to work towards achieving these goals.

Nursing

Nursing profession uses assessment, nursing diagnosis, care planning, intervention and evaluation in the care of a person (Potter &Perry, 2005). Henderson asserted that nurses should function independently but in co-ordination with the therapeutic plan executed by the health care team. Nurses are knowledgeable in social and biological science to assess the fourteen basic needs of a person. Nurse-patient relationship is an important factor in patient’s recovery. When the patient is severely ill, the nurse acts as replacement for patient. When the patient is on the period of recovery, the nurse is act as an aid for the patient. The nurse assists the patient to gain independence. Henderson indicated the many roles of nurses are overlap with that of physicians (Henderson, 1982). The nurse works in collaboration with other health care professionals to provide excellent quality care to patient. Henderson explains that the duty of a nurse is to temporarily assist an individual to satisfy basic needs. The rehab nurses assist the disabled person to adapt with the altered life style and to regain and maintain maximum independence when a partial or complete recovery is possible (Henderson, 1982).

Strength and Limitation

Henderson’s definition of nursing and the fourteen component of basic nursing care are logical and simple to understand. It can act as a guide for the patient and nurse to reach the chosen goal. Henderson’s idea of nursing are well accepted as a basis for nursing care throughout the world. Her idea of nursing practice and be applied to the well-being of individuals of all ages (Tourville & Ingalls, 2003). Like any other nursing theory, Henderson’s nursing theory has its limitation. The concept of holistic nature of human being not involved in her theory (Tourville & Ingalls, 2003). The relationship among the fourteen component of basic nursing care is unclear. Henderson used other discipline to guide her concept of basic human needs (Turville & Ingalls, 2003). For example her fourteen components of basic nursing care can be compared with Maslow’s hierarchy of human needs. Despite the limitation the author believes that Henderson’s theory is the most applicable theory in rehab setting.

Conclusion

Nursing has deeply influenced by Henderson’s clear view of nursing function. Henderson provides the core of what she believes as a definition of nursing. Her intention was to describe the unique focus of nursing rather than formulate a nursing theory. Her emphases on basic human needs are central focus in today’s nursing practice. Her fourteen components of basic nursing care are simple and are used by nurses globally to describe predict and explain daily experience. This theory is most applicable in rehab settings, where every patient aims to achieve maximum potential.