VIRGINIA AVENAL

HENDERSON`S NEED
THEORY
Presented by: shagun
 VIRGINIA HENDERSON
• Biography :
• the theorist was born in November 30,1897, in Kansas city, Missouri, but spent her for
formative years in Virginia.
• She was 5th child of a family of 8 children.
• In 1921, she graduate from the army school of nursing in Washington, D.C, a federally
funded diploma program in nursing to help overcome a nurse shortage.
• Worked at the Henry street visiting nurse service for 2 years after graduation.
• In 1923, worked in teaching nursing at Norfolk protestant hospital in Virgina for several
years.
• In 1932, she earned a bachelor`s degree & in 1934 master`s degree from teacher`s college ,
Columbia university, in New York city.
• She served on the faculty there from 1934 to 1948.
• Over the ensuring years, she revised the textbook of the principles & practice of nursing &
published basic principles of nursing for the international council of nursing (ICN)
• In 1953, she then joined the yale university as a faculty as well as research associate, where
she continued to work after she retired until her death on march 9, 1996 , at the age of 98.
 ACHIEVEMENTS
• “Nightingale of modern nursing”.
• O’ MALLEY (1996), states: “modern day mother of nursing”.
• Halloran wrote ,20th century Florence Nightingale.
• In 2000, the Virginia nurses association recognized Henderson as one of the fifty-one
pioneer nurses in Virginia.
• Outstanding contributing to nursing as a teacher during her years at teachers college .
• Nursing educator & a prolific author.
 ACHIEVEMENTS
• Received honorary doctoral degree from:
1. Catholic university of America
2. Pace university
3. Yale university
4. University of western Ontario
5. University of Rochester
• In march 22,1966, warranted an obituary in New York times as a nurse, teacher, author,
researcher & consumer health advocate.
• In 1985, honoured at the annual meeting of the nursing & allied health section of the
medical library association.
 CONTRIBUTION
• In 1939, her revision of Bertha Harmer`s Textbook of the principles & practice of nursing
(4th edition)
• After retirement , frequent visitor to nursing schools well in to her nineties.
• Directed a 12 year project entitled nursing studies index, four volumes recognized as an
essential reference for many years.
• Early advocate for the introduction of psychiatric nursing in the curriculum & served on a
committee to develop such a course at eastern state hospital in Williamsburg, Virginia in
1929.
• 1978, revised fundamental concepts of nursing from Yale university school of nursing.
 PUBLICATIONS
• 1956-( with B. Harmer)- textbook for the principles & practice of nursing.
• 1966- the nature of nursing: a definition & its implication for practice, research, education.
• 1991: the nature of nursing reflections after 20 years.
 WHY NURSING
• Henderson`s interest in nursing began during world war-1 & grew out of her desire to help
the sick & wounded in the military.
 14 COMPONENTS / BASIC NEEDS
Breath normally.
Eat & drink adequately.
Eliminate body wastes.
Move & maintain a desirable posture .
Sleep & rest.
Select suitable clothes-dress & undress .
Maintain body temperature within normal range by adjusting clothing & modifying the
environment.
Keep the body clean & well groomed to promote integument(skin)
Avoid dangers in the environment & avoiding injuries others.
 CNTD.
• Communicate with others in expressing emotions, need , fears or opinions.
• Worship according to one`s faith.
• Work in such a way that one feels a sense of accomplishment.
• Play or participate in various forms of recreation.
• Learn , discover or satisfy the curiosity that leads to normal development & health, & using
available health facilities.
 MASLOW`S HIERARCHY OF HUMAN
NEEDS & HENDERSON 14 COMPONENTS
• The first 8 components are physiological & 9 relates to safety.
• 10th & 11th relates to belongingness & love needs.
• 12th , 13th & 14th relates to self esteem needs.
• 14th one component “ satisfy” more relates to self actualization.
 METAPARADIGM OF THEORY
• INDIVIDUAL:
• Have basic needs that are component of health.
• Requiring assistance to achieve health & independence or a peaceful death.
• Mind & body are inseparable & interrelated.
• Considers the biological, psychological, sociological & spiritual components.
• The theory presnts the patient as a sum of parts with biopsychosocial needs.
 HEALTH
• Definition based on individual`s ability to function independently as outlined the 14
components .
• Nurses need to stress promotion of health & prevention & cure of disease.
• Good health is a challenge affected by age, cultural background, physical & intellectual
capacities, & emotional balance is the individual`s ability to meet these needs independently.
 ENVIRONMENT
• Settings in which an individual learns unique pattern for living.
• All external conditions & influences that affect life & development .
• Individuals in relation families.
• Minimally discusses the impact of the community on the individual & family.
• Basic nursing care involves providing conditions under which the patient can perform the 14
activities unaided.
 NURSING
• According to Henderson:
• “ 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. & to do this in such a
way as to help him gain independence as rapidly as possible”.
• Nurses must be knowledgeable in both biological & social sciences & must have the ability
to assess basic human needs.
• Henderson`s definition of nursing was considered as the “signature” of the profession.
 CHARACTERISTICS
• There is interrelation of concepts.
• Concepts of fundamental human needs are borrowed from other discipline e.g. Maslow`s
theory
• Her definition & components are logical & the 14 components are a guide for the individual
& nurse in reaching the chosen goal.
• Relatively simple yet generalizable .
• Applicable to the health of individuals of all ages.
• Can be the bases for hypothesis that can be tested.
• Assist the increasing the general body of knowledge within the discipline .
• Her ideas of nursing practices are well accepted.
• Can be utilized by practitioners to guide & improve the practice.
 THEORETICAL ASSERTION
( THE NURSE –PATIENT RELATIONSHIP)
1. The nurse as a substitute for the patient .
In times of illness, when the patient cannot function fully, the nurse serves as the substitute as
to what the patient lacks by assessing basic needs of patient.
2. The nurse as a helper to the patient .
In situations where the patient cannot meet his basic needs, the nurse serves as helper to
accomplish them.
3. The nurse as a partner with the patient.
The nurse & the patient formulate the care plan together. Both as an advocate & as a resource-
person, the nurse can empower the patient to make effective decisions regarding his care plans.
 THE NURSE PHYSICIAN
RELATIONSHIP
• Henderson asserted that nurses function independently from physicians.
Though the nurse & 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 NURSES AS A MEMBER OF
HEALTH CARE TEAM
• The nurses, as a member of the healthcare team, works & contributes in carrying out the
total program of care & identify the basic needs.
• However, working interdependently, as Henderson indicated, does not include other
member`s roles & responsibilities.
 STRENGTHS
• The concept of nursing formulated by Henderson in her definition of nursing & the 14
components of basic nursing is uncomplicated & self-explanatory. Therefore it can be used
without difficulty as a guide for nursing practices 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.
 APPLICATION OF THEORY IN
NURSING PROCESS
• 1. Assessment phase : the nurse would assess the 14 fundamental needs of the patients &
check which one is lacking or fully met.
• 2. planning phase: involves giving the plan of care to meet the needs & personality of the
patient. It must serve as a record & at the same time must fit in the prescribed plan made by
the physician.
• 3. implementation phase: nurses uses the 14 basic needs in answering the factors that are
contributing to the illness state of the patient. These intervention are focused on maintaining
health, to recover from illness, or to aid in peaceful death.
• 4. Evaluation phase: the nurse & the patient reviews the relationship & decides whether
the goals are met or not. The nurse also sees if the patient attained independence & if health
is achieved.
 APPLICATION IN OTHER FIELDS
• EDUCATION – THREE PHASES OF CURRICULUM DEVELOPMENT
• 1. first phase: emphasis is made on helping the patient perform activities of daily living.
Priorities are given on the fundamental needs of the patient & on the planning of nursing
care.
• 2. second phase: importance is placed on assisting patients achievements their needs in
times of marked body disturbances or illness. The student nurses are confronted with
problems with complexity then understands the rationale behind the prescribed therapeutic
plans made by the physicians.
• 3. third phase: centred on the patient & his family together with the dynamics affecting the
relationship inside the unit.
 RESEARCH
• Henderson supported the use of research in improving the practice of nursing. She supported
developing nurses at baccalaureate level, & advocates the use of library use of research &
purposes.
• It is the nurse`s responsibility to identity problems, continuously validate her practice,
improving the method used, & reassuring the effectiveness of her care.
 APPLICATION OF HENDERSON`S
THEORY
• Mr. Mikesh, 25 years old has been taken to the emergency room of the hospital after
sustaining multiple injuries after his motorcycle crashed in the course of his race. Multiple x-
rays were taken which revealed fractures on the left femur, 2 nd & 3rd ribs & fractured right
wrist. Surgery was immediately done to correct some of the dislocated bones & to stitch
some open wounds. He was placed on several casts, & an external fixator, to support
fractured bones, was attached on his left leg, which limited his movement for weeks to
months . His family, frequently their visits & tried to raise his confidence & assured him that
all would be fine.
• However Mikesh appeared to manifest self-pity & lowered self-esteem. Patient is failed to
bathe or feed himself. Every morning, when his family tries to bathe him, he will raise his
voice & say he`s not paralytic. At times, he also directs his anger to the nurses by shouting at
them during the routine daily care.
 ASSESSMENT
• In using the 14 fundamental needs of Henderson, she would be able to determine the ability
of Makoy to independently perform his activities of daily living was affected. Eating &
elimination patterns are altered as his mobility is restricted by his fixator & casts. He
depends on his family & the nurses to take care of him. Almost all of his activities are
restricted by his impaired mobility. Because of continued & prolonged state of dependency,
Makoy developed a negative self-image & decreased self-esteem manifested by anger
directed at his caregivers.
 PLANNING
• As the nurse uses the concepts introduced by Henderson., she would prioritize her
intervention towards the attainment of independence through the performance of the basic
human needs & restoration of his self-esteem.
 IMPLEMENTATION
• On the top of the nurse performing as a substitute for the patient, action must also be
directed in having him participate gradually over his care. By empowering & increasing his
self-esteem, the nurse can have the patient actively make decision as over his care with
confidence & with full understanding of his plan of care. The nurse can also act as support to
the family who could already be strained with the care –giving role they have. As the nurses
applies the definition of nursing as proposed by Henderson, she would begin to understand
the concept behind being the “substitute” of the patient by becoming his hand where he can`t
reach or the voice which carry his thoughts to people whose decisions directly affect his care
& future.
 EVALUATION
• Upon entering this phase, the entire process is evaluated & new goals are to be formulated .
As much as possible, the nurse would include Mikesh over setting new goals & makes sure
that his thoughts & concerns are addressed so as to assert his independence & his role as a
partner in his care.
• Mikesh, as planned, will initiate measures to regain independence & performance of basic
needs & to achieve a sense of worth & confidence.