SHORT INTRODUCTION

Virginia Henderson

Biography of Virginia Henderson

Virginia Avenel Henderson was born on November 30, 1897.

She was a nurse, theorist, and author known for her Need Theory and
defining nursing as: “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.” Henderson is also known as “The First Lady of
Nursing,” “The Nightingale of Modern Nursing,” “Modern-Day
Mother of Nursing,” "Little Miss 3x5", and “The 20th Century
Florence Nightingale.”
Virginia Henderson. (2016, June 13).
Retrieved from https://nursing-
Virginia Henderson was born in Kansas City, Missouri, in
theory.org/nursing-
1897. She was the fifth of the eight children of Lucy Minor Abbot and theorists/Virginia-Henderson.php
Daniel B. Henderson. She was named after the State her mother
longed for. She returned to Virginia, at the age of four and began her education at Bellevue. It is a
preparatory school that belonged to her grandfather named William Richardson Abbot.

In the Army School of Nursing at Walter Reed Hospital, Washington D.C Henderson
received her Diploma in nursing (1921). Then, she worked at the Henry Street Visiting Nurse
Service for two years after graduation. From 1924 to 1929, she started teaching nursing at the
Norfolk Protestant Hospital in Virginia. In 1929, she determined that she needed more education
and entered Teachers College at Columbia University where she studied her bachelor’s degree in
1932 and took her master’s degree in 1934. Subsequently, she worked as an instructor and
associate professor at Teachers College, Columbia University in New York, where she remained
until 1948. Since 1953, she has been a research associate at Yale University School of Nursing
and a research associate emeritus (1971 -1996). Henderson died on March 19, 1996, at a hospice
in Branford, Connecticut.

Works of Virginia Henderson

Henderson made extraordinary contributions to nursing during her 60 years of service as a

nurse, teacher, author, and researcher, and she published extensively throughout those years.
Henderson wrote three books that have become nursing classics: The three editions of the
Principles and Practice of Nursing (1955), Basic Principles of Nursing Care (1960) and revised in
1972. It has been published in 27 languages by the International Council of Nurses. And the last
one, The Nature of Nursing (1966). Her major contribution to nursing research was an 11-year
Yale-sponsored Nursing Studies Index Project published as a four-volume annotated index of
nursing’s biographical, analytical, and historical literature from 1900 to 1959. In 1958, the nursing
service committee of the International Council of Nurses (ICN) asked Henderson to describe her

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concept of nursing. This now historical definition, published by the ICN in 1961, represented her
final crystallization on the subject:

THEORETICAL ASSUMPTIONS

Henderson formulated the Needs Theory to define the unique focus of nursing practice.
This theory emphasizes on increasing the independence of the patient so that progress after the
nursing process and hospitalization will not get delayed. With that said, Henderson had
assumptions which are:
1. Nurses care for patients until they can care for themselves once again.
2. Patients have the desire to return to health.
3. Nurses are willing to serve and that nurses will devote themselves to the patient day and
night.
4. Nurses should be educated at college level in both sciences and arts.
5. The mind and body are inseparable.

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PRESENTATION OF CONCEPTS, RELATIONSHIPS, AND MODEL

Henderson's widely known contributions to nursing are the Need Theory. The Need Theory
defines it as the unique focus of nursing practice. The theory focuses on the importance of
increasing the patient’s independence to hasten their progress in the hospital. Henderson’s theory
emphasizes the basic human needs and how nurses can assist in meeting those needs.

Henderson described the role of the nurse as one of the following: substitutive, which is
doing something for the patient; supplementary, which is helping the patient do something; or
complementary, which is working with the patient to do something. All of these roles are to help
the patient become as independent as possible.

She categorized nursing activities into fourteen components based on human needs. The
fourteen components of Henderson’s concept are:

Gonzalo, A. (2021, March 5). Virginia Henderson: Need theory study guide. Nurseslabs.
Retrieved October 9, 2021, from https://nurseslabs.com/virginia-hendersons-need-theory/.

Concept of the Need Theory

Based on George (2002), there are four main concepts of Henderson’s theory which are
basic human needs, bio-physiology, culture and interaction-communication. These concepts relate
to Henderson’s definition of nursing and how they are essential components to nursing. The bio-
physiology concept in Henderson’s theory uses knowledge of the human anatomy and biological
systems to find out what is the best nursing care to help an individual get better or help prepare for
a peaceful death. The culture concept includes family and society which can influence human
needs. In Henderson’s theory, the nurse can help an individual meet these human needs. The
interaction-communication concept uses to establish therapeutic relationships between a nurse and

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patient, as well as friends and family. The nurse should be able to share feelings and have an
understanding for different cultural values and beliefs into the planning of care (George, 2002).

These four concepts of human needs, bio-physiology, culture and interaction-

communication connect with each other in Henderson’s 14 basic needs of nursing. Bio-physiology
concepts include Henderson’s number one to nine needs. Interaction-communication concepts
include number ten to fourteen needs. Also, six to fourteen represent the concept of human needs
and culture. By using Henderson’s basic concepts of nursing, the appropriate care can be provided
to patients.

Additionally, in some sites these four concepts which are bio-physiology, culture and
interaction-communication are also called holistic nursing approach covering the physiological,
psychological, spiritual, and social needs. The first nine components are physiological. The tenth
and fourteenth are psychological. The eleventh component is spiritual and moral. The twelfth and
thirteenth components are sociological, specifically addressing occupation and recreation.

Relationship of the Need Theory

Theory can help nursing students understand the importance of theory and to determine
which theory can be used in clinical situations. According to Colley (2003), nursing theory “gives
nurses a sense of identity, and help patients, managers and other healthcare professionals to
recognize the unique contribution that nurses make to the healthcare service” (p. 37). Henderson
(2006) explains how to teach the concept of nursing. She would pair up a student with a
knowledgeable preceptor. The student will watch, than participate until they are able to work
independently. Learning to assess the basic needs of a patient, developing and implementing a
nursing care plan and evaluating the effectiveness of practice (Johnson & Weber, 2001).
Henderson’s theory includes her definition of nursing and the 14 basic principles of nursing to help
guide nurses in working with individuals, families and groups. Henderson’s theory can be used in
any clinical situation where a patient does not have the understanding or capacity to perform
activities related to health or a peaceful death.

Henderson’s Needs Theory can be applied to nursing practice as a way for nurses to set
goals based on Henderson’s 14 components. Meeting the goal of achieving the 14 needs of the
client can be a great basis to improve one’s performance towards nursing care.

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Henderson’s 14 Components as applied to Maslow’s Hierarchy of Needs

Due to how both Maslow and Henderson tackle the

needs of individuals, it is not unusual that both models of
their work would be related to each other in some way.
Henderson’s 14 basic needs somehow fit with 4 out of the
5 categories of Maslow’s, with the exception of self-
actualization.

Henderson’s Concept 1 through 8 falls under the

Maslow’s Physiological Needs. These concepts are (1)
Breathe normally, (2) Eat and drink adequately, (3)
Eliminate body wastes, (4) Move and maintain desirable
postures, (5) Sleep and rest, (6) Select suitable clothes;
dress and undress, (7) Maintain body temperature within a
normal range by adjusting clothing and modifying the
environment, and (8) Keep the body clean and well-
groomed and protect the integument.

Henderson’s 9th concept is the only one that fits

Maslow’s Safety Needs. This concept is (9) Avoid dangers
in the environment and avoid injuring others. Above that
is the Love & Belongingness where Concepts 10 and 11 are. These are (10) Communicate with
others in expressing emotions, needs, fears, or opinions, and (11) Worship according to one’s faith.

The last application of Henderson’s theory is Concepts 12-14 under Maslow’s Self-Esteem
Needs. These three are (12) Work in such a way that there is a sense of accomplishment, (13) Play
or participate in various forms of recreation, and (14) Learn, discover, or satisfy the curiosity that
leads to normal development and health, and use the available health facilities.

CONCLUSION
Virginia 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.

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DEFINITION OF THE FOUR METAPARADIGMS IN NURSING

1. Individual:

Virginia Henderson viewed the patient as an individual who should have basic health needs that
are components of health and require help toward achieving independence and completeness or
wholeness of mind and body. According to her, 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.
The theory presented the patient as a sum of parts with biopsychosocial needs, and the mind and
body are inseparable and interrelated.

2. Environment:

Even her theory which is Need Theory does not explicitly define the environment. Henderson
stated that maintaining a supportive environment conducive to health is one of her 14 activities for
client assistance.

Henderson’s theory supports the private and public health sector’s tasks or agencies in keeping the
people healthy. She believes that society wants and expects the nurse’s acting for individuals who
cannot function independently.

3. Health:

The theory’s definition of health is based on an individual’s ability to function independently as

outlined in the fourteen components. On the other hand, nurses are key persons in promoting
health, preventing illness, and being able to cure. According to Henderson, good health is a
challenge because it is affected by numerous factors such as age, cultural background, emotional
balance, and others.

4. Nursing

Before the development of theoretical nursing, Virginia Henderson wrote her definition of nursing.
She defined nursing as “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 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.” The nurse’s goal is to make the patient
complete, whole, or independent. In turn, the nurse collaborates with the physician’s therapeutic
plan.

Nurses temporarily assist an individual who lacks the necessary strength, will, and knowledge to
satisfy one or more of the 14 basic needs. 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.”

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In addition, she stated that “…the nurse does for others what they would do for themselves if they
had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient
independent of him or her as soon as possible.”

Her definition of nursing distinguished a nurse’s role in health care: The nurse is expected to carry
out a physician’s therapeutic plan, but individualized care results from the nurse’s creativity in
planning for care.

The nurse should be an independent practitioner able to make an independent judgment. In her
work Nature of Nursing, she states the nurse’s role is “to get inside the patient’s skin and
supplement his strength, will or knowledge according to his needs.” The nurse has the
responsibility to assess the patient’s needs, help him or her meet health needs, and provide an
environment in which the patient can perform activity unaided.

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APPLICATION OF THE THEORY IN NURSING PRACTICE AND RESEARCH

Nursing Practice

The nursing process is defined as the core and essence of nursing, central to all nursing
actions. It consists of the assessment, diagnosis, planning, implementation, and evaluation.
Henderson’s Need Theory can be directly implemented onto the nursing practices to serve as the
standard of the quality of nursing practices. Nurses can utilize the 14 basic needs as the basis to
improve one’s performance towards nursing care.

The assessment phase is the phase wherein nurses assess the situation and gather
information about the patient’s physiological, psychological, sociological, and spiritual status. The
second phase is the critical stage of diagnosis phase wherein nurses make an educated judgement
of the health condition of the patient. The third phase is the planning phase wherein nurses take
into consideration all the diagnoses, the situation of the patient, their medical history, etc. The
implementation phase is where the nurses act out on their decided plan of action and the
physician’s orders. Lastly, the evaluation phase is when the nurses complete an evaluation to
determine the goals for patient wellness have been met.

The Needs Theory can be used to check and identify what the patient is/are lacking. For
example, the patient may lack normal breathing which is part of both the 14 basic needs, and the
ABCs or the Airway, Breathing, and Circulation Assessment. The nurse shall assess the patient’s
situation, status, check their vitals, and their medical history if possible. With the assessment done,
a diagnosis has to be conducted and lack of normal breathing may be caused by various factors
such as respiratory arrest or airway obstruction. For the planning and implementation phase, the
nurse can check if the airway obstruction is caused by the strict clothing of the patient, such as
wearing a tight necktie or a tight belt. Nurses can also refer to the basic needs specifically the
selection of suitable dress. With the implementation phase done, the nurse can evaluate her nursing
care with the Needs Theory. She can check and identify whether the needs that the patient was
lacking earlier has already been fulfilled or if the patient still needs more care.

Research

Henderson’s Needs Theory was proposed by her to emphasize the art of nursing and to
separate nursing from the other fields of medicines. She wanted nursing to be independent from,
but still interdependent with other healthcare fields like physiology and surgery. With the help of
her Needs Theory, research to improve and further develop the nursing process can be made.

There is also a potential for different topics to stem from Henderson’s concept that illnesses
can arise from the lack of needs by individuals. A timely example of this is the COVID19 wherein
difficulty in breathing may be a sign that a person has acquired the virus. Furthermore, various
research can be done as well on the relationship of amount of sleep students get with their holistic
health. Each of the fourteen concepts that Henderson has may be used as the focus and central idea
of a research study.

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 Another application of the theory in the research field is the creation of research papers and
theses that either criticize or improve on Henderson’s Need Theory. Further improvement and
studying of the Needs Theory may lead to development of other theories that may also serve as
guidelines or standards for the nursing process. The Needs Theory may serve as a framework or
as a gap to bridge knowledge in between various nursing issues and topics. An example of this is
Priscilla Osei of Bowie State University who conducted a critical analysis on Henderson’s need
theory titled Virginia Henderson’s Nursing Theory. The author claimed that Henderson’s theory
is simple and self-explanatory, but still very much effective in teaching and understanding the true
meaning of nursing.

With how the Needs Theory is often applied to Maslow’s Hierarchy of Needs, there is also
a possibility of the Needs Theory being adopted or viewed through a different perspective or
discipline. The theory may also be the conceptual framework for the development of other research
and theory that may be related to the needs of individuals, or just nursing in general.

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REFERENCES:
Books:

• Alligood, M. R. (2014). Nursing Theorists of Historical Significance. In Nursing theorists:

And their work (14th ed., pp. 45–46). essay, Elsevier Mosby.
• Berman, A., Snyder, S. J., & Frandsen, G. (2016). Nursing Theories and Conceptual
Frameworks. In Kozier & Erb's fundamentals of Nursing Concepts, practice, and process
(10th ed., pp. 66–67). Pearson Education.

Online References:

• 14 basic human needs. Nurses Guild- Theories in nursing. (2012, May 13). Retrieved
October 9, 2021, from http://theoriesinnursing.blogspot.com/2012/05/14-basic-human-
needs.html.
• Gonzalo, A. (2021, March 5). Virginia Henderson: Need theory study guide. Nurseslabs.
Retrieved October 9, 2021, from https://nurseslabs.com/virginia-hendersons-need-theory/.
• Henderson's nursing need theory. Nursing Theory. (2019, August 21). Retrieved October
9, 2021, from https://nursing-theory.org/theories-and-models/henderson-need-theory.php.
• Osei, P. (2017, November 22). Virginia Henderson's Nursing Theory. Academia.edu.
Retrieved October 10, 2021, from https://www.academia.edu/36202315/Needs_Theory.
• The 5 steps of the nursing process. Nursing Process Steps. (n.d.). Retrieved October 9,
2021, from https://www.nursingprocess.org/Nursing-Process-Steps.html.
• U.S. National Library of Medicine. (1995, January 1). Nursing practice. Nursing Health,
& Environment: Strengthening the Relationship to Improve the Public's Health. Retrieved
October 9, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK232401/.
• Virginia Henderson. (2016, June 13). Retrieved from https://nursing-theory.org/nursing-
theorists/Virginia-Henderson.php
• Virginia Henderson - Nursing Theorist. Nursing Theory. (2016, June 13). Retrieved
October 9, 2021, from https://nursing-theory.org/nursing-theorists/Virginia-
Henderson.php.
• Virginia Henderson Theory Of Nursing Nursing Essay. (n.d.). Retrieved from
https://nursinganswers.net/essays/virginia-henderson-theory-of-nursing-Nursing-
essay.php

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