Virginia Henderson
Theory Presentation
By
Kirsten Kulkarni
Neeta Monteiro
Pierre Nkurunziza
Why this theorist’s model/theory?
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“The Nightingale of Modern Nursing.”
“Modern-Day Mother of Nursing.”
“The 20th century Florence Nightingale.”
“The first lady of Nursing”
“First truly international nurse”
Nursing Theorist
Virginia Avenel Henderson
1897-1996
Background
• Born in Kansas City Missouri, in 1897
• Received a Diploma in Nursing from the Army School
of Nursing at Walter Reed Hospital, Washington, D.C.
in 1921
• Worked at the Henry Street Visiting Nurse Service
for two years after graduation
Background
• In 1923, she started teaching nursing at the Norfolk
Protestant Hospital in Virginia
• In 1929, she entered Teachers College at Columbia
University for Bachelor’s Degree in 1932, and
Master’s Degree in 1934
• In 1939, she revised: Hamer’s classic textbook of
nursing for its 4th edition, and later wrote the 5th
edition incorporating her personal definition of
Nursing (Henderson, 1991)
Background
• Joined Columbia as a member of the faculty,
remained until 1948
• Since 1953, a research associate at Yale School of
Nursing
• Recipient of numerous recognitions
• Her work influenced the nursing profession
throughout the world
• A well known nursing educator and a prolific author
Background
• Honorary doctoral degrees from the Catholic
University of America, Pace University, University of
Rochester, University of Western Ontario, Yale
University (held honorary degrees from 13 universities).
• In 1985, honored at the Annual Meeting of the
Nursing and Allied Health Section of the Medical
Library Association
• Died: March 19th , 1996
Theory history
• Henderson did not intend to develop a theory of
nursing
• She attempted to define the unique focus of nursing
• She emphasized on basic human needs as the central
focus of nursing practice.
• Two events that lead to the creation of the definition
of Nursing
* Helped revise a Nursing textbook
* She was concerned that many states had no
provision for nursing licensure
Nursing defined by Henderson
Virginia Henderson’s definition of nursing was one of
the first statements clearly delineating nursing from
medicine:
“ 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” (Henderson, 1966).
Henderson’s philosophy
“She emphasized the importance of increasing the
patient’s independence so that progress after
hospitalization would not be delayed. She described
the nurse’s role as:
*substitutive (doing for the person)
*supplementary (helping the person)
*complementary (working with the person)
with the goal of helping the person become as
independent as possible.”
Original purpose
• Improving patient’s outcomes by application
of nursing process
• Collaborative care
• Patient centered care
• Amelioration of health in general
Virginia Henderson’s 14 Components
She categorized nursing activities into 14 components, based on human needs
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Breathe normally
Eat and drink adequately
Eliminate body wastes
Move and maintain desirable postures
Sleep and rest
Select suitable clothes-dress and undress
Maintain body temperature within normal range by adjusting clothing and modifying the
environment
Keep the body clean and well groomed and protect the integument
Avoid dangers in the environment and avoid injuring others
Communicate with others in expressing emotions, needs, fears, or opinions
Worship according to one’s faith
Work in such a way that there is a sense of accomplishment
Play or participate in various forms of recreation
Learn, discover, or satisfy the curiosity that leads to normal development and health and
use the available health facilities
1.
2.
3.
4.
5.
6.
7.
1.
Breathe normally
Eat and drink adequately
Eliminate body wastes
Move and maintain desirable postures
Sleep and rest
Select suitable clothes-dress and undress
Maintain body temperature within normal range
by adjusting clothing and modifying the
environment
Keep the body clean and well groomed and
Breathe8.normally
protect the integument
9.
Avoid dangers in the environment and avoid
injuring others
10.
Communicate with others in expressing
emotions, needs, fears, or opinions
11.
Worship according to one’s faith
12.
Work in such a way that there is a sense of
accomplishment
13.
Play or participate in various forms of recreation
14.
Learn, discover, or satisfy the curiosity that leads
to normal development and health and use the
available health facilities
The 14 components
1. Breathe normally
14 components
2. Eat and drink adequately
14 components
• 3. Eliminate body wastes
14 components
4. Move and maintain desirable postures
14 components
5. Sleep and rest
14 components
6. Select suitable clothes- dress and undress
14 components
7. Maintain body temperature within normal range by
adjusting clothing and modifying environment
14 components
8. Keep the body clean and well groomed and protect
the integument
14 components
9. Avoid dangers in the environment and avoid injuring
others.
14 Components
10. Communicate with others in expressing emotions,
needs, fears, or opinions
14 Components
11. Worship according to one’s faith
14 components
12. Work in such a way that there is a sense of
accomplishment
14 components
13. Play or participate in various forms of recreation
14 components
14. Learn, discover, or satisfy the curiosity that leads to
normal development and health and use the available
health facilities.
The 14 components
•
•
•
•
Physiological :
Psychological:
Spiritual
:
Sociological :
The first 9 components
10th and 14th
11th component
12th and 13th
Comparison with
Maslow’s Hierarchy of Needs
Internal Theory Analysis
• Relative importance of concepts. Is each given
equal weight?
Each of the 14 components as described by
Virginia Henderson are given equal importance.
Nevertheless the patient may need assistance
with only some of the components at a given
time depending on the patient’s health
condition.
The Collaborative Team
Henderson’s Theory
and the four major concepts
1. Individual
– 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 the patient as a sum of parts
with biopsychosocial needs, and the patient is
neither client nor consumer
Four major concepts
2. Environment
Settings in which an individual learns 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 on
the individual and family
Supports tasks of private and public agencies
Four major concepts
Environment (continued)
• Society wants and expects nurses to act for
individuals who are unable to function
independently. In return she expects society
to contribute to nursing education.
• Basic nursing care involves providing
conditions under which the patient can
perform the 14 activities unaided.
Four major concepts
3. Health
• Definition based on individuals ability to
function independently outline in the 14
components.
• Nurses need to stress promotion of health and
prevention and cure of disease.
• Good health is a challenge. Is the individual
able to meet these needs independently?
Four major concepts
4.Nursing
• Temporarily assisting an individual who lacks
the necessary strength, will, and knowledge to
satisfy one or more of the 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.”
Four major concepts
Nursing (continued)
• Henderson’s classic definition of nursing
• Carry out physician’s therapeutic plan.
• Individualized care is the result of the nurse’s
creativity in planning care.
Four major concepts
Nursing (continued)
• Use nursing research
– Categorized Nursing: nursing care
– Non nursing: ordering supplies, cleanliness and
serving food
• In the nature of Nursing “that the nurse is and
should be legally an independent practitioner
and able to make independent judgments as
long as s/he is not diagnosing, prescribing
treatment for disease, or making a prognosis, for
these are the physicians function.”
Four major concepts
Nursing (continued)
• Nurse should have knowledge
• 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.”
Four major concepts
Nursing (continued)
• Nurse has responsibility to
*assess patient’s needs
*help individual meet their need
*provide a safe environment
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 (not explicit).
• 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 science.
External Analysis
Semantic clarity
The terminologies that are used in this theory
are clear, easily understandable and simple.
Structural Clarity
There is no model to represent this theory.
Simplicity
This theory is simple and easy to use
External analysis
Generalizability
This theory is applicable to people of all age groups,
cultures, gender, health conditions and different
settings.
Accessibility
Information regarding this theory is accessible, but
newer theorists have since then developed ideas
that are built from the concepts proposed in this
theory.(An example of this is Orem’ s basic needs
theory)
External Analysis
How is this theory applicable to nursing clinical practice
or education or administration?
Practice
• Assists nurses in everyday experiences
• Serves as a guide in the nursing process
• Provides a rationale for effective decision making and
implementation
• Nursing care evaluation criteria
• Facilitates communication among the health care team
members
• Ideas are developed and words are defined
• Enhance autonomy
External Analysis
Education
• Provide a general focus for curriculum design
• Guide curricular decision making
Research
• Offers a framework for generating knowledge
and new ideas
• Helps discover knowledge gaps
• Gives a foundation for other theories
Bibliography of Virginia Henderson
• 1956 (with B. Harmer)- Textbook for the
Principles and Practices of Nursing
• 1966- The Nature of Nursing. A definition and its
implication for practice, research and education
• 1991- The Nature of Nursing Reflections after 20
years
• 1950-1970- Analysis of Nursing Theory Images of
Nursing
• The development of Henderson’s definition of
Nursing
School of thoughts in Nursing theories
1950-1970
Need Theorists
Abdellah
Interaction
Theorists
King
Henderson
Orlando
Johnson
Orem
Peterson and
Zderad
Paplau
Levine
Travelbee
Roy
Wiedenbach
Outcome
Theorists
Rogers
Analysis of Nursing Theories
According to 1st School
Problem
Focus
Human Being
A set of needs or problems
A development being
Patient
Need Deficit
Orientation
Illness, disease
Role of nurse
Dependent on medical practice
Beginnings of independent functions
Fulfill needs requisites
Decision making
Primarily health care professional
Henderson’s Theory Background
• Henderson’s concept of nursing was derived
from her practice and education, therefore
her work is inductive
• She called her definition of nursing her
“Concept” (Henderson 1991)
• (Henderson, 1991)
Henderson’s Theory Background
Henderson’s Theory and
Nursing Process
• Summarization of the stages of the nursing
process as applied to Henderson’s definition
of nursing and to the 14 components of basic
nursing care.
– Nursing process
– Nursing assessment
– Nursing diagnosis
– Nursing plan
-- Nursing Intervention
-- Nursing implementation
-- Nursing Evaluation
Characteristic of Henderson’s Theory
• Interrelation of concepts
• Concepts are borrowed from other disciplines
• Her definition and components are logical and
the 14 components are a guide for the
individual and nurse in reaching the chose
goal
• Theories should be relatively simple yet
generalizable- Henderson’s theory can be
applied to individuals of all ages
Characteristics of Henderson’s theory
• Theories can be the bases for hypotheses that
can be tested- Her definition of nursing cannot
be viewed as a theory, therefore it is not
possible to generate testable hypotheses.
However some questions to investigate the
definition of nursing and the 14 components may be
useful.
Characteristics of Henderson’s Theory
• Theories contribute to and assist in increasing
the general body of knowledge within the
discipline through research implemented to
validate them
- Her ideas of nursing practice are well accepted
throughout the world as a basis for nursing care.
However, the impact of the definition and
components has not been established through
research.
Characteristics of Henderson’s Theory
• Theories can be utilized by practitioners to
guide and improve their practiceIdeally the nurse would improve nursing practice by
using her definition and 14 components to improve
the health of individuals and thus reduce illness.
Usefulness
• Nursing education has been deeply affected
by Henderson’s clear vision of the function of
the nurse.
• Published in nursing textbooks from 1930’s 1960’s.
• Still important in evaluating nursing care in
the 21st century
• Henderson’s other concepts have been used
from 1930’s to present.
Limitations
• Lack of conceptual linkage between
psychological and other human characteristics
• No concept of the holistic nature of human
being
• The relationship between the components is
unclear
• Lacks inter-relate of factors and the influence
of nursing care
Limitations (continued)
• Assisting the individual in the dying process
she includes that the nurse helps, but there is
little explanation of what the nurse does.
• “Peaceful death” is curious and significant
nursing role
Purposes of Nursing Theories
•
•
•
•
In practice
In Education
In Research
Personal practice
Conclusion
• Henderson provides the essence of what she believes
is a definition of nursing
• She didn’t intend to develop a theory of nursing but
rather she attempted to define the unique focus 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.
• Her definition of nursing and the 14 components of
basic nursing care are uncomplicated and selfexplanatory.
References