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Need Theory

Virginia Henderson was one of the most influential nurses in the 20th century. Not only was she a nursing theorist, but an educator, researcher, author and public speaker. She has left a wealth of publications that chronicle her thoughts on nursing practice and education as well as the results of her research and the process that led to her all-important Nursing Need Theory.

Virginia Avenel Henderson was born in Missouri in 1897 and received her early education in Virginia. In 1921, she received her diploma in nursing from the Army School of Nursing in Washington, D.C., and then completed her academic studies at Columbia University's Teachers College, receiving both bachelor's and master's degrees. She went on to teach at Teachers College until she became a research associate at Yale University in 1953. Her many years of education, clinical experience and research prepared her to develop a practical concept of nursing that evolved into the Nursing Need Theory.

Henderson's unique view of nursing was that the nurse cared for patients by performing tasks that they could not do because of lack of strength, will or knowledge. However, she went on to say that the nurse should strive to make the patient independent as soon as possible. Seeing the nursing process as the logical approach to problem solving, she advocated higher education in the arts and sciences at the university level, giving nurses the background to accomplish these goals.

The Nursing Need Theory consists of 14 components or concepts. These components include the following:
  • Breathing normally
  • Eating and drinking sufficiently
  • Having the ability to eliminate bodily wastes
  • Moving well
  • Sleeping and resting
  • Having the ability to dress and undress
  • Maintaining proper body temperature
  • Keeping the body clean and well groomed
  • Avoiding environmental dangers and not injuring others
  • Having good communication skills
  • Having the ability to worship as desired
  • Working with a sense of accomplishment
  • Participating in recreation
  • Having the ability to learn
Nine of these components are physiological, two are psychological, two are sociological and one is spiritual. The meeting of all of these needs provides holistic care of the patient. The assumptions of this approach to nursing care, both stated and unstated, are that nurses meet the needs of patients until patients can function on their own, and that patients have a desire to return to good health. Another assumption of the theory is that nurses are willing to perform this function.

Within the 14 components of Henderson's theory are four major concepts. The first is that the individual patient has basic needs that are required for health and requires assistance to return to good health, or, if that is not possible, is entitled to a peaceful death. The holistic view recognizes that the mind and body cannot be separated and takes into consideration the 14 stated components that present the healthy person as an integrated whole.

The second major concept is the environment. This recognizes the surroundings that affect the life and learning of the patient. It also takes into consideration family dynamics and the influence of the community. The basis of nursing care is to provide a safe environment in which the patient can return to health and function independently.

Optimum health is the third major concept. Health is defined as the ability of the patient to perform independently all 14 components included in Henderson's Nursing Need Theory. Nurses stress the prevention and cure of disease while caring for the patient. Good health is affected by numerous factors such as diet, exercise, lifestyle, family background, age, cultural differences and emotional and intellectual capabilities.

The fourth major concept is nursing care. The ideal outcome of nursing care is to return the patient to a state of wholeness as outlined in the 14 components of the need theory. The nurse is responsible for adhering to the physician's medical plan, but within these parameters, is in charge of the nursing process that provides the individualized care to make the patient independent and healthy. The highly educated and experienced nurse is one who anticipates and solves problems in a scientific way.

Henderson's Nursing Need Theory and her philosophy of nursing meshes well with the nursing process. The 14 components can be used as the nursing assessment. The nursing diagnosis compares patient data with accepted parameters of health and disease while the patient's abilities dictate the nursing plan. Nursing implementation follows the nursing plan and requires documentation. The nursing process includes the medical treatment ordered by the doctor and takes into consideration cultural factors, age, psychological and intellectual capabilities. Success of the nursing process can be measured by comparing the 14 components to the patient outcome and including that in the nursing evaluation. Quality of care is influenced by the preparation and skill of the nursing personnel and the more quickly a patient is returned to a state of wholeness, the more successful the outcome.

The Nursing Need Theory is one of Virginia Henderson's definitive contributions to nursing during her more than 70 years in the profession. Her long career included clinical practice, teaching, research, writing and public speaking, but nothing defined her view of nursing more than her Nursing Need Theory. The theory focuses on basic human needs and the way that the nursing process meets these needs. It is easy to understand and can be used in all areas of nursing. The principles that were valid in the 30s still define nursing care in the 21st century.

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