DR.

CARLOS LANTING COLLEGE

COLLEGE OF NURSING

NURSING NEED THEORY

VIRGINIA HENDERSON

BIOGRAPHY

- Virginia Henderson was born in Kansas City, Missouri on

March 19, 1897 and died on November 30, 1996.
- “The Nightingale of Modern Nursing”
- “Modern-Day Mother of Nursing”
- “The 20th Century Florence Nightingale”
- Her interest in nursing evolved during World War I from her
desire to help the sick and wounded military personnel.
- She enrolled in the Army School of Nursing in
Washington, DC, and graduated in 1921.
- She began the continuation of her education at Columbia
University Teachers College and completed her B.S. (1932)
and M.A. (1934) degrees in nursing education.
- In the 1980s, Henderson supported the idea that nursing
must accept the responsibility for conducting investigation on
nursing practice, and that the focus ought to be on measures of consumer welfare,
satisfaction, and cost-effectiveness.
- She directed the Nursing Studies Index Project which clearly showed her interest in
supporting nursing research.
- She was a Senior Research Associate Emeritus at Yale University.
- One of her outstanding contributions to nursing was the Sigma Theta Tau International
Nursing Library, which bears her name.
- In June 1985, the International Council of Nurses presented her with the first Christianne
Reimann Prize in recognition of her influence as nursing consultant to the world.
- Her publications include The Nature of Nursing and Basic Principles of Nursing Care.
- One of her last publications, in 1991, was The nature of nursing – Reflections after 25
years.

THEORY BACKGROUND

 She called her definition of nursing her concept.

 She emphasized the importance of increasing the patient’s independence so that the
progress after hospitalization will not be delayed.
 “Assisting individuals to gain independence in relation to the performance of activities
contributing to health or its recovery”
 She categorized nursing activities into 14 components, based on human needs.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

NURSING NEED THEORY

VIRGINIA HENDERSON

 She described the nurse’s role as follows substitutive, supplementary, and complementary.
 She defined nursing.

VIRGINIA HENDERSON’S NURSING DEFINITION

“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 to help him gain independence as rapidly as possible”
(Henderson, 1966).

ROLES OF NURSES

ROLE RESPONSIBILITY EXAMPLE

Substitutive Doing for a patient the activities Giving a complete bed bath
contributing to its health or recovery
Supplementary Helping/assisting the patient in the Doing a self-help bed bath
performance of activities contributing to her
health or recovery
Complementary Working with the patient in the performance Patient taking a shower unaided
of activities contributing to her health or
recovery

14 NURSING COMPONENTS

NEEDS
(The individual can)
Biological Breathe normally
Biological Eat and drink adequately
Biological Eliminate body wastes
Biological Move and maintain desirable postures
Biological Sleep and rest
Biological Select suitable clothes; dress and undress
Biological Maintain body temperature within normal range by
adjusting clothing and modifying environment
Biological Keep the body well-groomed and protect the integument
Biological Avoid dangers in the environment and avoid injuring
others

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

NURSING NEED THEORY

VIRGINIA HENDERSON

COMPONENTS
(The individual can)
Psychological Communicate with others in expressing emotions,
needs, fears, or opinions
Spiritual Worship according to one’s faith
Sociological Work in such a way that there is accomplishment
Sociological Play and participate in various forms of recreation
Psychological Learn, discover, or satisfy the curiosity that leads to
normal development and health and use the available
health facilities

 The definition of nursing and the 14 components together outline the functions the nurse can
initiate and control.
 Humans have basic needs that are included in the 14 components.
 These needs are satisfied by infinitely varied patterns of living, no two of which are alike.
 Mind and body are inseparable

ASSUMPTIONS

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.
 Nurses should be educated at the university level in both arts and sciences.
 The nurse serves as a substitute for whatever the patient lacks in order to make him or her
“complete”, “whole”, or “independent” considering his or her available physical strength, will or
knowledge to attain good health.

NEED THEORY AND THE NURSING METAPARADIGMS

 Person
- have basic needs that are components 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 a patient as a sum of parts with biopsychosocial needs

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

NURSING NEED THEORY

VIRGINIA HENDERSON

 Environment
- settings in which an individual learns a 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 to on the individual and family
- basic nursing care involves providing conditions under which the patient can perform
the 14 activities unaided
 Health
- definition based on individual’s ability to function independently as outlined in the 14
components
- nurses need to stress promotion of health and prevention of cure and disease
- good health is a challenge affected by age, cultural backgrounds, physical and
intellectual capabilities, and emotional balance
 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.

NURSING PROCESS AND THEORY APPLICATION

Case Study: Mr. L. is 25 years old, married, and the father of two preschool-age children. His wife is 6 months pregnant. Mr. L. quit
school in the 10th grade. He works 8 hours a day as a skilled laborer in a factory and holds a second job washing dishes at a restaurant
for an additional 8 hours in order to meet family expenses.

Nursing Assessment

 Assess need of human being based on the 14 components of basic nursing care
1. Breathe normally. Respiration rate – 18, regular; smokes 2 packs of cigarettes/day; dry cough in A.M.; no
shortness of breath. (Data about work environment needed.)
2. Eat and drink adequately Height 5 ft., 10 in.; weight 164 lbs.; skin turgor good. Takes sandwich, fruit, potato chips
for lunch; skips breakfast; buys soft drink; eats evening meals at restaurant. (Results of
72 hours diet recall needed.)

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

NURSING NEED THEORY

VIRGINIA HENDERSON

3. Elimination of body wastes Reports no problem related to elimination.

4. Move and maintain posture Reports pain in left leg after 8 hours of washing dishes. No problems with mobility.
5. Sleep and rest Reports 5-6 hours of sleep/night. “Feels tired most of the time.”
6. Suitable clothing – dress and Wears jeans and shirt to work – both jobs. Owns ski jacket and boots for cold weather
undress wear. (Work environment data needed.)
7. Maintain body temperature Temperature 98.6 degree Fahrenheit. Reports no problem with being hot or cold.
8. Keep body clean and well- Showers and shampoos hair daily
groomed
9. Avoid environmental hazards Wears clothes to match weather conditions. (Home environment safety – need more
data.)
10. Communication Able to speak and be understood. (Communication with family – need more data.)
11. Worship according to faith Attends church (Baptist) with family every other Sunday.
12. Work accomplishments Reports happy with jobs.
13. Recreation “Needs more time to spend with family”
14. Learn, discover, or satisfy Reports interest in finishing high school. Plans to pursue college education.
curiosity
Analysis According to Erikson’s (1963) developmental theory, Mr. L. is in the intimacy stage. He is
able to support his family and take care of most of their needs, except for
recreational needs. Physiologically, Mr. L. is functioning within the normal
range. Three concerns are: his smoking, pain in his legs, inadequate pattern of
rest and sleep, Mr. L. plans for the future to upgrade his education and to seek
better employment.

Nursing Diagnosis

 Identify individual’s ability to meet own needs with or without assistance, taking into
consideration strength, will and knowledge.

1. Inadequate sleep and rest pattern resulting in feeling tired and no time to spend with family.
2. Knowledge deficit regarding cigarette smoking resulting in potential health hazard for health and
family.
3. Leg pain resulting from standing 8 hours on the job.

Outcomes

 Establish desired outcomes based on return to independence.

Long range plan for stable family income that will allow for rest and recreation.
Decreased smoke exposure for himself and his family.
Decreased leg pain.

Nursing Plan
 Document how the nurse can assist the individual, sick or well.

1. Explore with Mr. L. and his wife:

a. Alternatives to his working two jobs.
b. Adjusting schedule to include family recreation.
2. Assure that Mr. L. is fully aware of the hazards of smoking and of resources to help him quit
smoking.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING
3. Teach Mr. L. isometric exercises for his legs.

NURSING NEED THEORY

VIRGINIA HENDERSON

Nursing implementation

 Assist the sick or well individual and the family in the performance of activities in meeting
human needs to maintain health, recover from illness, or to aid in peaceful death.
Implementation based on physiological principles, age, cultural background, emotional
balance, and physical and intellectual capacities. Carry out treatment prescribed by physician.

1. Discuss with Mr. L. and his wife:

a. Feasible alternatives to his working 2 jobs.
b. Schedule changes that would allow for more family recreation.
2. With Mr. L. and his wife:
a. Discuss pros and cons of smoking.
b. Teach the health hazards of smoking, including the effects of second-hand smoke on
the family.
c. Discuss options available to help Mr. L. stop smoking.
3. Teach Mr. L.
a. Isometric exercises for his legs.
b. To walk around or march in place instead of standing in one position
c. To elevate his feet when sitting.

Evaluation
 Use the acceptable definition of nursing and appropriate laws related to the practice of nursing
–can person now meet the basic human needs? The quality of care is drastically affected by
the preparation and native abilities of the nursing personnel rather than the number of hours of
care. Successful outcomes of nursing care are based on the speed with which or the degree to
which the patient performs independently the activities of daily living that are normal to him.

The outcomes of nursing care were successful because Mr. L. demonstrated his independence in
making changes in his activities of daily living by:
Deciding to work toward his GED so he can meet his long-range goal of going to college; Mrs. L. will go
to work when children are all in school so Mr. L. can quit his second job.
Working with his employers to adjust his work shifts so at least 2 days of the week he works only one
job. This allows him to get more sleep and to participate in family recreation. The family is taking
walks together on the evenings he is home.
Not smoking in the house, cutting back to 1 pack a day, and he is considering using a nicotine patch or
nicotine gum to help him quit completely.
Doing leg exercises regularly. He reports his legs feel better and that makes the shift go faster.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

NURSING NEED THEORY

VIRGINIA HENDERSON
CHARACTERISTICS OF HENDERSON’S THEORY

 There is interrelations of concepts.

 Concepts of fundamental human needs, biophysiology, culture, and interaction,
communication are borrowed from other discipline. E.g. Maslow’s Theory
 Her definition and components are logical and the 14 components are a guide for the individual
and the nurse in reaching 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.

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