HENDERSON’S THEORY

Virginia Henderson was born in 1897, the fifth of eight children in her family.
A native of Kansas City, Missouri, Henderson spent her developmental years in
Virginia because her father practiced law in Washington, D.C.

During World War I Henderson developed an interest in nursing. So in 1918

she entered the Army School of Nursing in Washington, D.C. Henderson graduated in
1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse
Service in New York. In 1922 Henderson began teaching nursing in Norfolk
Protestant Hospital in Virginia. Five years later she entered Teacher’s college at
Columbia University, where she subsequently earned her BS and MA degrees in
nursing education. In 1929 Henderson served as a teaching supervisor in the clinics of
Strong Memorial Hospital in Rochester, New York, She returned to Teacher’s college
in 1930 as a faculty member, teaching courses in the nursing analytical process and
clinical practice until 1948.

Henderson has enjoyed a long career as an author and researcher. While on the
Teacher’s college faculty she rewrote the fourth edition of Bertha Harmer’s Textbook
of the Principles and Practice of Nursing, follow by the author’s death. This edition
with published in 1939. The fifth edition of textbook was published in 1955 and
contain Henderson’s own definition of nursing Henderson has been associated with
Yale University since the early 1950s, and had do much to further nursing research
through association. From 1959 to 1971 Henderson directed the Nursing Studies Index
Principle sponsored by Yale. The Nursing Studies In was developed into a four
volume announce index to nursing’s biographical, analytical historical literature fro
1900 to Concurrently, Henderson authors coauthored several other important
was Her pamphlet, Basic Principles of Nursing was published for the International C
of Nurses in 1960 and translated into than 20 languages. Henderson’s 50 collaboration
with Leo Simmons prod national survey of nursing research the published in 1964.
Her book, The National Nursing, of Nursing, was published in and described the
concept of nursing’s primary, unique function. It was reprinted by the National
League of Nursing in 1991. The sixth edition of The Principles and Practice of
Nursing, published in 1978, was coauthored by Henderson. This textbook has been
widely used in the curricula of various nursing schools. Her classic textbooks have
been translated into more than 25 languages. Through the 1980s. Henderson remained
active as a Research Associate Emeritus at Yale. Henderson’s achievements and
influence in the nursing profession have brought her more than nine honorary doctoral
degrees and the first Christiana Reimann Award. Henderson has been given the Mary
Adelaide Nutting Award from the U.S. National League for Nursing, honorary
fellowship in the American Academy of Nursing, honorary membership in the
Association of integrated and Degree Courses in Nursing, London, and an honorary
Fellowship in the Royal College of Nursing in England. In 1983, she received Sigma
Theta Tau International’s Mary Tolle Wright Founders Award for Leadership, one of
the honor society’s highest honors. At the 1988 American Nurses Association
Convention, she received a special citation of honors for her lifelong contributions to
nursing research, education, and professionalism. Sigma Theta Tau International
named its international electronic computer nursing library in her honors.

EVOLUTION OF THEORY

Henderson first published her definition of nursing in the 1955 revision of

Harmer and Henderson’s, The Principles and Practice of Nursing. There were three
major influences on Henderson’s decision to synthesize her own definition of nursing.
First, she revised Textbook of Principles and Practice of Nursing in 1939. Henderson
identifies her work for this text as the source that made her realize “the necessity of
being clear about the function of nurses. A second source was her involvement as a
committee member in a regional conference of the National Nursing Council in 1946.
Her committee work was incorporated into Esther Lucile Brown’s 1948 report,
nursing for the Future. Henderson says this report represented” my point of view
modified by thinking of others in the group. “Finally, the American Nurses
Association’s 5-year investigation of the function of the nurse interested Henderson,
who was not fully satisfied with the definition adopted by the ANA in 1955.

Henderson labels her work a definition rather than a theory because theory was
not in vogue at that time. She describes her interpretation as the “synthesis of many
influences, some positive and some negative. In the Nature of Nursing she identifies
the following sources of influence during her early years of nursing.

The patient is an individual who requires help toward independence. The nurse
assists the individual, whether ill or not, to perform activities that will contribute to
health, recovery, or peaceful death-activities that the individual who had necessary
strength, will, or knowledge would perform unaided. The process of nursing strives to
do this as rapidly as possible, and the goal is independently of physicians. Help toward
indecent dance is given autonomously by the nurse in relation to (i) breathing, (ii)
eating and drinking, (iii) elimination, (iv) movement and posture, (v) sleep and rest,
(vi) clothing, (vii) maintenance of body temperature, (viii) cleaning and grooming of
the body and integument protection, (ix) avoidance of environmental dangers and
injury of other, (x) communication, (xi) worship, (xii) work, (xiii) play and
participation in recreation, and (xiv) learning and discovery. Nursing can be evaluated
as a profession on the basis of the extent to which it enables the individual to achieve
each of these functions autonomously.

The role and functions of professional nursing vary with the situation, If the
total health care team comprises a pie graph in health care situation, in some situations
no role exists for certain health care workers. Although there is always a role for
family and patients, the pie wedges for team members vary in size according to (i) the
problem of the patient, (ii) the patient’s self-help ability, and (iii) the help resources.
Central to nursing that seeks to help patients toward independence is empathetic
understanding and unlimited knowledge. Empathetic understand what a patient needs.
The ultimate goal for the nurse is to practice autonomously in helping patients who
lack knowledge, physical strength, or strength of will in growth toward independence.
Because of this function, nurses seek and promote research, education, and work
settings that facilitate this goal.

EVOLUTION OF DEFINITION OF NURSING

Virginia Henderson was the nurse-theorist who devoted her career to defining
nursing practice: She believed that an occupation that affects human life must outline
its function, particularly if it is to be regarded as professions. Her ideas about the
definition of Nursing were influenced by her nursing education and practice by her
student colleagues at Columbia University School of Nursing, and by distinguished n
leaders of her time. Two events are the for her development of definition of ran First,
she participated in the revision nursing textbook. Second, she was con that many
states had no provision for licensure to ensure safe and competition for the consumer.

In the revision of the ‘Textbooks of Principles and Practice of Nursing’, with

Bertha Harmer (1922) Henderson recognized the need to be clear ab functions of the
nurse. She beli textbook that serves, as main learning for nursing practice should
present and definitive description of n . Furthermore, the principles and practice
nursing must be built upon and derive the definition of the professional.

Henderson was committed to the of regulating nursing practice I licensure by

each state. She believed accomplish this, nursing must be e defined in Nurse Practice
Act that provide the legal parameter for that functions in caring for consumption
safeguard the public from unprepared incompetent practitioner.

She examined the earlier statement of nursing functions by American

Association (1932, 1937) and view statements as non-specific and unsal definition of
nursing practice.

In 1955, Henderson’s first define nursing was published in Bertha I revised

Nursing Text work. It read.

“Nursing is primarily assistant individual (sick or well) in the per of those

activities contributing to the its recovery (or peaceful death) that he would perform
unaided if he had the necessary strength, will, or knowledge. It is likewise the unique
contribution of nursing to help the individual to be independent f such assistance as
soon as possible”.

In this, some similarities are found with the earlier definition of nursing by
Bertha Harmer. It reads as follows:

“Nursing is rooted in the needs of humanity and is found on the ideal of

service. Its object is not only to cure the sick and heal the wounded but to bring health
and ease, rest and comfort to mind and body to shelter, nourish and protect and to
minister to all those who are helpless or handicapped, young, aged, or immature. Its
object is to prevent disease and to preserve health. Nursing is, therefore, linked with
every other social, which strives for the prevention of disease and the preservation of
health. The nurse finds herself not only concerned with the care of the individual but
with the health of a people”.

Henderson definition abbreviated and consolidated portions of Harmer’s belief

about nursing. Harmer’s definition highlighted disease prevention, health preservation
and the need for linkages with other social agencies to strive for preventive care and
stressed that nursing role in society was oriented toward the community and wellness.
Henderson placed more emphasis on the care of the sick and well individual and did
not mention nursing concern for the health and welfare of the aggregate.

CONCEPTS USED BY HENDERSON

Henderson viewed human being, health, environment and Nursing as follows:]

 Human being: The patient as an individual who requires assistance to achieve

health and independence or peaceful death. The mind and body are inseparable.
The patient and his family are viewed as a unit.

 Health: She views health in terms of the patient’s ability to perform unaided the
14 components of nursing care. She says it is “the quality of health rather than
life itself, that margin of mental physical vigor that allows a person to work
most effectively and to reach his highest potential of satisfaction in life. She
does not state her own definition of health.

 Environment: She used Webster Dictionary, which defines environment as “the

aggregate of all the external conditions and influences affecting the life and
development of an organism.

 Nursing: In 1996, Henderson’s ultimate statements in the definition of nursing

were published of her
as follows:
“ 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 as to help him gain independence as rapidly
as possible”.

Needs

Henderson does not give any definition of need. Her focus on individual care is
evident in that she stressed assisting individuals with essential activities to maintain
health, to recover, or to achieve peaceful death. She proposed 14 basic needs of
patient. For basic Nursing care to augment her definitions, which comprise, the
components of nursing care, Theses include the need to:
 1. Breathe normally.
2. Eat and drink adequately
3. Eliminate body wastes.
4. Move and maintain desirable position.
5. Sleep and rest.
6. Select suitable clothes-dress and undress.
7. Maintain body temperature within normal range by adjusting clothing and
modifying the environment.
8. Keep the body clean and well groomed and protect integument.
9. Avoid dangers in environment and avoid injuring others.
10. Communicate with others in expressing emotions, needs, and fears of opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a se of accomplishments.
13. Play or participate in various form recreations.
14. Learn, discover, or satisfy the curie that leads to normal development health
and use the available him facilities.

These needs were considered on being principles of nursing care.

Henderson does not directly cite what feels, Her underlying assumption include
but following assumptions have been adequate from her publication which include
assumption of Nursing, person, health environment.

14. Learn, discover, 1. Normal breathes 2. Adequate eat and drink

satisfy, curiosity

13. Participate in
recreations 3. Elimination of
body wastes

12. Work sense

accomplishments 14 4. Desirable movement
Basic and position
needs
11. Worship in faith.
5. Sleep and rest

10. Proper communication

6. Suitable dress and undress

9. Avoid dangers
7. Maintaining body
8. Clean and groomy
temperature
Nursing:

 The nurse has a unique function to help well or sick individual.

 The nurse functions as a member of a medical team.
 The nurse functions independently of the physician, but promotes his or her
plan, if there is physician in attendance.
 The nurse can and functions independently and must if her or she is the best-
prepared health worker in the situation.
 The nurse can and must diagnose and treat if the situation demands it.
 The nurse is knowledgeable in both biological and social sciences.
 The nurse can assess basic human needs.
 The 14 components of nursing care encompass all possible functions of
Nursing.

PERSON:

 The person must maintain physiological and emotional balance.

 The mind and body of the person are inseparable.
 The patient requires help toward independence.
 The patient and his family are a unit.
 The patient needs are encompassed by the 14 components of nursing.
Health
 Health is a quality of life.
 Health basic to human functioning.
 Health requires independence and interdependence.
 Promotion of health is more important than care of the sick.
 Individual will achieve or maintain health if they have the necessary
strength, will or knowledge.

Environment
 Healthy individuals may be able to control their environments, but illness may
interfere with that ability.
 Nurses should have safety education.
 Nurses should protect patients from mechanical injury.
 Nurses should minimize the chances of injury through recommendation
regarding construction of building, purchase of equipment and maintenance.
 Doctors like nurse observations and judgments upon which to base
prescriptions for protective devices.
 Nurses must know about social customs and religious practices to assess
dangers.
Metaparadigm of Henderson theory

In viewing the concept of human or individual she considers the biological,

psychological, and sociological and spiritual components. Her 14 (Fourteen)
components of nursing functions can be categorized in the following manner.

 First nine components are physiological.

 The tenth and fourteenth are psychological aspects of communicating and
learning.
 The eleventh component is spiritual and moral, and
 The twelfth and thirteenth components are sociologically oriented to
occupation and recreation.

Human

Henderson refers to humans as having basic needs that are include in the 14
components. She goes on to state, “It is equally important to realize, that these needs
are satisfied by infinitely varied patterns of living no two of which are alike.” She also
believes that mind and body are inseparable. It is implied that the mind and body are
interrelated.

Environment

Henderson views of environment are that she sees individuals in relation to

their families but minimally discussed the impact of the community on the individual
and family. She supported the tasks of the private and public agencies in keeping
people healthy. She believes that society wants and expects the nurse’s service of
acting for individuals who are unable to function independently. In turn, she expects
society to contribute to nursing education for preparation of good nurses to society.

Health

Henderson beliefs about Health are related to human functioning independently

goal for the individuals; she argues that it is difficult for the nurse to help the person
reach it. She also refers to nurses stressing promotion of health and prevention and
cure of disease and explains how the factors of age, cultural background, physical and
intellectual capacities and emotional balance affect one’s health. These Conditions are
always present and affect basic needs.

Nursing

She believes that nurses should be in the forefront of those who work for social
justice, for healthful environment, for access to adequate food, shelter, and clothing
and universal opportunities for education and employment, realizing that all of these
as well as preventive and creative health care are essential to the well-being of citizens
(Henderson 1989). By working on various social issues, nurses can have an impact on
people’s health.

Henderson believes that the function nurse performs is primarily and

independent one that of acting for the patient with lacks knowledge, physical strength,
will to act for himself as he would ordinance act in healthy, or in carrying our present
therapy. This function is seen as complaint creative, as offering unlimited
opportunities the application of the physical, biological social sciences, and the
development or on them. For Henderson the nurse knowledgeable. Has some base,
for practice individualized and human care, and scientific problem solver. It is
important nursing care be improved by implementing valid ideation and improvement
of not practice.

Virginia Henderson’s definition is ‘unique function’ of the nurse, who

deliberately calls not a definition, ‘personal’ that this is not all there nursing and this
statement was intended to define the entire discipline statement is about the unique
function nursing.. the aspect of her work. She ir and counties; of this she is maste
Henderson, this unique function is tl of nursing from which all other things and which
must be protected. “No one; make such heavy demands on around member (of the
Medical Team) that them is unable to perform his or her function.” In a passage so
lovely the almost poetry Henderson translate unique function.

“(The nurse) is temporarily the correct of the unconscious, the love of life fun
suicidal, the leg of the amputee, the newly blind, a mean of locomotion the infant,
knowledge and confidence young mother, the voice for those touch or with drawn to
speak”. This independent nurse-patient relationship, and role of nurse as substitute for
helper to and partner of patient.

In these activities the nurse is independent practitioner, and able to make

independent treatment for disease or making the prognosis, for these is physician
functions. But today the roles of the nurses as givers of “Primary health care” as those
who diagnose and treat when a doctor is unavailable, even as the midwife functions in
the absence of an obstetrician. Nurse may be general (Medical) practitioners of
tomorrow.

Henderson on nursing process:

Henderson (1980) views the nursing process as “really the application of the
logical approach of the solution of a problem. The steps are those of the scientific
method.” Even though Henderson’s definition and explanation of nursing process, a
relationship between the two can be demonstrated. Although she does not refer
directly to assessment, to but imply it in her description of the 14 components of basic
nursing care. The nurse uses the 14 components to assess the individual needs.
Following the analysis of the data collected, the nurse then determines the nursing
diagnosis. Ones the nursing diagnosis is made, the nurse proceeds to the planning
phases of the nursing process, ass stated by Henderson that “all effective nursing is
planned some extent A written plan forces those who make it to give some thought
and the individual needs-unless simply fit the person’s regimen into the institution’s
routine.

For Henderson, nursing implementation is based on helping the patient meet

the 14 components. One primary function of the practicing nurse, of course, must be
performed in such a way, that it promotes the physician’s therapeutic plan.” So the
nurse needs to carry out the physician’s levels of functioning need to be observed and
recorded. A comparison of data provides evaluation of nursing care provided.

Evaluation of each person according to the speed with which, he performs

independently the activity that makes for him, a normal day for evaluation purpose,
and changes in person’s levels of functioning need to be observed and recorded. A
comparison of data provided.

The stages of the nursing process as applied to Henderson’s definition of

nursing and to the 14 components of basic nursing care are as follows.

Nursing Assessment:

 Assess needs of human being based in the 14 components or basic nursing care.
- Breathe normally
- Eat and drink adequately
- Eliminate body wastes.
- Move and maintain posture.
- Sleep and rest.
- Suitable clothing, dress or uniform.
- Maintain body temperature.
- Keep body clear and well groomed.
- Avoid dangers in environment.
- Communicate.
- Worship according to one’s faith.
- Recreation.
- Learn, discover of satisfy curiosity.
 Analysis: Compare data to knowledge base of health and disease.

Nursing Diagnosis

 Identify individuals ability to meet own needs with or without assistance,

taking into consideration strength will or knowledge.

Nursing Plan

 Document how the nurse can assist the individual stick or well.
Nursing Implementation:

 Assist the sick or well individual in the performance of activities in meeting

human needs to maintain health, recover from illness or to aid in peaceful
death. Implementation based on principles age, cultural background, emotional
balance and physical and intellectual capacities carry out treatment prescribed
by the Doctor.

Nursing Evaluation:

 Use the acceptable definitions of nursing and appropriate laws related to the
practice of nursing. The quality of care distinctly affected by the preparation
and native ability of the nursing personnel rather than the amount of hours of
care. Successful outcomes of Nursing care is based on the speed with then
which the patient performs independently ADL.

Henderson’s Work and Characteristics of Theory

Prior to development of concepts and theories of nursing, Henderson

formulated the definition of nursing. Her intent was to identify the specific functions
the nurse performs, rather than to describe the theoretical basis for nursing practice.
But, her work can be applied to nurse and characteristics of theory as given below.

1. Theories can interrelate concepts in such a way as to create a difference.

Henderson uses the concepts of fundamental human needs, biopsychology, and
culture, and interaction, communication. Their concept borrowed from other
disciplines than being unique to nursing. M (1970) hierarchy of human need
fits with the 14 basic components. The nine components are physiological
safety needs. The remaining components deal with love and below social
esteem and self-acknowledge needs. She uses the biophysical con in making
decisions about nursing can physiology and its balances. The of culture on it
affects human learned from the family and other groups. She believes in
sensitivity to verbal communication is essential encourage the expression of fee
Furthermore, a prerequisite to VA patient needs is a constructive patient
relationship.

2. Theories must be logical: Henderson’s definition and compare logical. The

nurse assists the and to perform those activities contribute health or its recovery
or peaceful and encourages independences as possible. The fourteen
components a guide for the individual and in reaching the chosen goals. The co
ends start with physiological function and moves to the psychosocial which
conveys the idea that operation is a priority to emotion or cognitive status.

3. Theories should be relatively sin generalize. Henderson’s work is read simple

yet generalizable with limitations. Her work in can be ap health of the
individuals of all nurse functioning at various level diverse cultures has used
 her de But it is lacking in empirical testing to generalizabiltiy of the definition
and 14 components.

4. Theories can be the bases for the hypothesis that can be tested or for theory to
be explained. It is impossible to generate hypothesis from the Henderson
definition of nursing. Although she is an advocate of conducting research, in
nursing, favours studies directed to improving nursing practice rather than
those conducted as an academic or theoretical Endeavour. She believes that
research is not a substitute for instinctive and intuitive reactions to situations
but that these reactions are influenced by the nurse’s knowledge of science that
guides human behaviors in the society of which nursing is an integral part.

5. Theories complete to and assist in increasing body of knowledge within

discipline through research. To validate in Henderson’s ideas of nursing
practice are well accepted throughout the world as a basis of nursing care.
However, impact of the definition and components has not been established
through research. Well designed empirical \studies is needed to determine
Henderson’s contribution to worldwide knowledge about nursing practice and
patient out comes. This would help validate her beliefs about the unique
functions of Nursing.

6. Theories can be used practitioner to guide and improve their practice. Ideally,
the nurse would improve nursing practice by using the definition and 14
components of nursing given by Henderson to improve the health of the
individuals and thus reduce illness. The final desirable outcome would be
measure of recovery rate, health promotion and eminence or a peaceful death.

7. Theories must be consistent with other validated theses, laws, principles, but
leave open unanswered questions that need to be investigating.

There is a potential for comparison of Henderson’s definition and components

with validated theories, laws and principles. The concepts of fundamental human
needs, culture, Independence and interaction-communication are widely investigated
by nurse-researchers as well as those in the social and psychological disciplines.

Evaluation of Theory

Before one attempts to evaluate Virginia Henderson’s theory of nursing with

respect to the generally accepted criteria of simplicity, generality, empirical precision,
and derivable consequences, one must understand that she did not intend to develop a
definitive nursing theory, Instead, she developed a personal concept or definition in an
attempt to clarify what she considers to be the unique function of nursing. She states,
“My interpretation of the nurse’s function is the synthesis of many influences, some
positive and some negative. I should first make clear that I do not expect everyone to
agree with me. Rather, I would urge every nurse to develop her own concept”.
 Henderson’s definition can be considered a grand theory or philosophy within
the preparation stage of theory development in nursing. Her concept is descriptive
and easy to read. It is defined in common language terms. Her definitions of nursing
and enumeration of the 14 basic nursing functions presents a perspective aimed at
explaining a totality of nursing behavior. Because she had no intention of developing a
theory, Henderson does not develop the interrelated theoretical statements or
operational definitions necessary to provide the theory testability. However, that can
be done.

 Henderson’s concept of nursing is complex rather than simplistic. It contains

many variables and several different descriptive and explanatory relationships.
It is not associated with structural organizations within a framework or model
from to enhance simplicity, although some work has been done in this area.
Diagrams of Henderson’s and Orem’s concepts of nursing from the Nursing
Development Conference Group’s book, Concepts Formation in Nursing, have
been reproduced in Henderson and Nite’s book. In addition, the 14 basic needs
appear simple as stated, but they become complex when an alteration of a need
occurs and all the parameters relating to that need are considered. The sixth
edition of Principles and Practices of Nursing is extremely comprehensive and
well illustrated to add clarity.

 Generality is present in Henderson’s definition since it is broad in scope. It

attempts to include the function of all nurses and all patients in their various
interrelationships and interdependencies.

 Henderson’s perspective has been useful in promoting new ideas and in

furthering conceptual development of en theorists. In her many publisher she
has discussed the import nursing’s independence from interdependence with,
other bran the health car field. She has influenced curriculum development
made a great contribution in progress the importance of research in the practice
of nursing. She has made en use of other theorists’ research in work. Evans
states that Principle Practice of Nursing has made revolutionary change in
one’s the about nursing research”. He states revolutionary thesis of the book.

“The habits of minds which infant everyday tasks of a nurse are exactly the as
those which under gird the veers published research; in this way, ever ought not just to
do simple research part of her work, but she ought also to be a researcher, whether or
not she or speaks a word in print or public”.

Since Henderson’s definitions of the function of nursing has been widely has
functioned as a major stepping the emergence of nursing as a prof scientific discipline.

She continues to be cited in current literature and publications in all a nursing

practice form holistic nursing process.
1) BT BASAVANTHAPPA,NURSING THEORIES,1ST EDITION,PAGE NO. 1 -39

2) S. YASEEN KHAN , ADVANCE NURSING PRACTICE, 1ST EDITION , PAGE

NO. 376-382

3) BT BASAVANTHAPPA,NURSING THEORIES,1ST EDITION,PAGE NO. 61-71

4) GEORGE B. JULIA,NURSING THEORIES-THE BASE FOR PROFESSIONAL

NURSING PRACTICE,3RD EDITION,PAGE NO. 61

5) POTTER A PATRICIA AND PERRY GRIFFIN ANNE,FUNDAMENTAL OF

NURSING,6TH EDITION,PAGE NO. 67
 SANDIPANI ACADEMY

PENDARI (MASTURI)

BILASPUR (C.G.)

SUBJECT :- NURSING EDUCATION

TOPIC:- HENDERSON’S THEORY

SUBMITTED TO SUBMITTED BY
MS. ANITA SINGH MRS SAVITA BHARDWAJ
ASSISTANT PROFESSOR MSC NURSING 1st YEAR
SANDIPANI ACADEMY BILASPUR C.G SANDIPANI ACADEMY BILASPUR
C.G