Hendersons Theory Background

Hendersons concept of nursing was derived form her practice and education therefore, her work is inductive.. She called her definition of nursing her concept (Henderson1991 !lthough her ma"or clinical e#periences were in medical$surgical hospitals, she worked as a visiting nurse in %ew &ork 'it(. )his e#perience enlarges Hendersons view to recogni*e the importance of increasing the patients independence so that progress after hospitali*ation would not +e dela(ed (Henderson,1991 ,irginia Henderson defined nursing as -assisting individuals to gain independence in relation to the performance of activities contri+uting to health or its recover(- (Henderson, 19.. . She was one of the first nurses to point out that nursing does not consist of merel( following ph(sician/s orders. She categori*ed nursing activities into 10 components, +ased on human needs. She descri+ed the nurse/s role as su+stitutive (doing for the person , supplementar( (helping the person , complementar( (working with the person , with the goal of helping the person +ecome as independent as possi+le. Her definition of nursing was one of the first statements clearl( delineating nursing from medicine1

"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! "nd to do this in such a way as to help him gain independence as rapidly as possible" (Henderson, #$%% ! The development of Hendersons definition of nursing )wo events are the +asis for Hendersons development of a definition of nursing.

2irst, she participated in the revision of a nursing te#t+ook. Second, she was concerned that man( states had no provision for nursing licensure to ensure safe and competent care for the consumer.

3n the revision she recogni*ed the need to +e clear a+out the functions of the nurse and she +elieved that this te#t+ook serves as a main learning source for nursing practice should present a sound and definitive description of nursing. He +elieved the principles and practice or nursing must +e +uilt upon and derived from the definition of the profession. Henderson/s 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 10 components of +asic nursing care to augment her definition. 3n 1944, Hendersons first definition of nursing was pu+lished in 5ertha Harmers revised nursing te#t+ook. The #& components

5reathe normall(. 6at and drink ade7uatel(. 6liminate +od( wastes. 8ove and maintain desira+le postures. Sleep and rest. Select suita+le clothes$dress and undress. 8aintain +od( temperature within normal range +( ad"usting clothing and modif(ing environment 9eep the +od( clean and well groomed and protect the integument !void dangers in the environment and avoid in"uring others. 'ommunicate with others in e#pressing emotions, needs, fears, or opinions. :orship according to ones faith. :ork in such a wa( that there is a sense of accomplishment. ;la( or participate in various forms of recreation. <earn, discover, or satisf( the curiosit( that leads to normal development and health and use the availa+le health facilities.

)he first 9 components are ph(siological. )he tenth and fourteenth are ps(chological aspects of communicating and learning )he eleventh component is spiritual and moral )he twelfth and thirteenth components are sociologicall( oriented to occupation and recreation "ssumption )he ma"or assumptions of the theor( aret1

-%urses care for patients until patient can care for themselves once again. ;atients desire to return to health, +ut this assumption is not e#plicitl( stated. %urses are willing to serve and that nurses will devote themselves to the patient da( and night ! final assumption is that nurses should +e educated at the universit( level in +oth arts and sciences.

Hendersons theory and the four ma'or concepts #! (ndividual 1

Have +asic needs that are component of health. =e7uiring assistance to achieve health and independence or a peaceful death. 8ind and +od( are insepara+le and interrelated. 'onsiders the +iological, ps(chological, sociological, and spiritual components. )he theor( presents the patient as a sum of parts with +iops(chosocial needs, and the patient is neither client nor consumer.

>.)nvironment*

Settings in which an individual learns uni7ue pattern for living. !ll e#ternal conditions and influences that affect life and development. 3ndividuals in relation to families 8inimall( discusses the impact of the communit( on the individual and famil(. Supports tasks of private and pu+lic agencies Societ( wants and e#pects nurses to act for individuals who are una+le to function independentl(. 3n return she e#pects societ( to contri+ute to nursing education. 5asic nursing care involves providing conditions under which the patient can perform the 10 activities unaided

?. Health*

@efinition +ased on individuals a+ilit( to function independentl( as outlined in the 10 components. %urses need to stress promotion of health and prevention and cure of disease. Aood health is a challenge. !ffected +( age, cultural +ackground, ph(sical, and intellectual capacities, and emotional +alance 3s the individuals a+ilit( to meet these needs independentl(B

&! +ursing

)emporaril( assisting an individual who lacks the necessar( strength, will and knowledge to satisf( 1 or more of 10 +asic needs. !ssists and supports the individual in life activities and the attainment of independence. %urse serves to make patient complete whole-, or -independent.Henderson/s classic definition of nursing1 "I say 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." )he nurse is e#pected to carr( out ph(sicians therapeutic plan 3ndividuali*ed care is the result of the nurses creativit( in planning for care. Cse nursing research o 'ategori*ed %ursing 1 nursing care o %on nursing1 ordering supplies, cleanliness and serving food. 3n the %ature of %ursing that the nurse is and should +e legall(, an independent practitioner and a+le to make independent "udgments as long as sDhe is not diagnosing, prescri+ing treatment for disease, or making a prognosis, for these are the ph(sicians function. %urse should have knowledge to practice individuali*ed and human care and should +e a scientific pro+lem solver. 3n the %ature of %ursing %urse role is, to get inside the patients skin and supplement his strength will or knowledge according to his needs. !nd nurse has responsi+ilit( to assess the needs of the individual patient, help individual meet their health need, and or provide an environment in which the individual can perform activit( unaided

Henderson/s classic definition of nursing -3 sa( that the nurse does for others what the( would do for themselves if the( had the strength, the will, and the knowledge. 5ut 3 go on to sa( that the nurse makes the patient independent of him or her as soon as possi+le.-

Hendersons and +ursing ,rocess Henderson views the nursing process as reall( the application of the logical approach to the solution of a pro+lem. )he steps are those of the scientific method. %ursing process stresses the science of nursing rather than the mi#ture of science and art on which it seems effective health care service of an( kind is +ased. -ummari.ation of the stages of the nursing process as applied to Hendersons definition of nursing and to the #& components of basic nursing care! +ursing ,rocess +ursing "ssessment Hendersons #& components and definition of nursing Hendersons #& components

+ursing /iagnosis "nalysis* 0ompare data to knowledge base of health and disease! +ursing plan (dentify individuals ability to meet own needs with or without assistance, taking into consideration strength, will or knowledge! /ocument how the nurse can assist the individual, sick or well! "ssist the sick or well individual in to performance of activities in meeting human needs to maintain health, recover from illness, or to aid in peaceful death! (mplementation based on the physiological principles, age, cultural background, emotional balance, and physical and intellectual capacities! 0arry out treatment prescribed by the physician! Hendersons #& components and definition of nursing +ursing evaluation 1se the acceptable definition of 2nursing and appropriate laws related to the practice of nursing! The quality of care is drastically affected by the preparation and native ability of the nursing personnel rather that the amount of hours of care! -uccessful outcomes of nursing care are based on the speed with which or degree to which the patient performs independently the activities of daily living

+ursing implementation +ursing implementation +ursing process

0omparison with 3aslow4s Hierarchy of +eed 3aslow4s Henderson Breathe normally ,hysiological needs )at and drink adequately )liminate by all avenues of elimination 3ove and maintain desirable posture -leep and rest -elect suitable clothing 3aintain body temperature 5eep body clean and well groomed and protect the integument "void environmental dangers and avoid in'uring other 0ommunicate with others worship according to one4s faith 6ork at something providing a sense of accomplishment )steem needs ,lay or participate in various forms of recreation 7earn, discover, or satisfy curiosity
0haracteristic of Hendersons theory

-afety +eeds Belongingness and love needs

)heories can interrelate concepts in such a wa( as to create a different wa( of looking at a particular phenomenon. 'oncepts of fundamental human needs, +ioph(siolog(, culture, and interaction, communication and is +orrowed from other discipline.6.g.. 8aslows Hierarch( of human needsE concept of interaction$communication i.e. nurse$patient relationship )heories must +e logical in nature. Her definition and components are logical and the 10 components are a guide for the individual and nurse in reaching the chosen goal. )heories should +e relativel( simple (et generali*a+le. Her work can +e applied to the health of individuals of all ages. )heories can +e the +ases for h(potheses that can +e tested. Her definition of nursing cannot +e viewed as theor(E therefore, it is impossi+le to generate testa+le h(potheses. However some 7uestions to investigate the definition of nursing and the 10 components ma( +e useful. 3s the se7uence of the 10 components followed +( nurses in the CS! and the other countriesB :hat priorities are evident in the use of the +asic nursing functionsB )heories contri+ute to and assist in increasing the general +od( of knowledge within the discipline through the research implemented to validate them. Her ideas of nursing practice are well accepted throughout the world as a +asis for nursing care. However, the impact of the definition and components has not +een esta+lished through research.

)heories can +e utili*ed +( practitioners to guide and improve their practice. 3deall( the nurse would improve nursing practice +( using her definition and 10 components to improve the health of individuals and thus reduce illness. )heories must +e consistent with other validated theories, laws, and principles +ut will leave open unanswered 7uestions that need to +e investigated.

,hilosophical claims

)he philosoph( reflected in Henderson/s theor( is an integrated approach to scientific stud( that would capitali*e on nursing/s richness and comple#it(, and not to separate the art from the science, the -doing- of nursing from the -knowing-, the ps(chological from the ph(sical and the theor( from clinical care.

8alues and Beliefs

Henderson +elieved nursing as primaril( complementing the patient +( suppl(ing what he needs in knowledge, will or strength to perform his dail( activities and to carr( out the treatment prescri+ed for him +( the ph(sician. She strongl( +elieved in -getting inside the skin- of her patients in order to know what he or she needs. )he nurse should +e the su+stitute for the patient, helper to the patient and partner with the patient. <ike she said... -)he nurse is temporaril( the consciousness of the unconscious, the love of life for the suicidal, the leg of the amputee, the e(es of the newl( +lind, a means of locomotion for the infant and the knowledge and confidence for the (oung mother...Henderson stated that )horndikes fundamental needs of man (Henderson, 1991, p.1. had an influence on her +eliefs.

,alue in e#tending nursing science

2rom an historical standpoint, her concept of nursing enhanced nursing science this has +een particularl( important in the area of nursing education. Her contri+utions to nursing literature e#tended from the 19?Fs through the 199Fs and has had an impact on nursing research +( strengthening the focus on nursing practice and confirming the value of tested interventions in assisting individuals to regain health.

1sefulness

%ursing education has +een deepl( affected +( Hendersons clear vision of the functions of nurses. )he principles of Hendersons theor( were pu+lished in the ma"or nursing te#t+ooks used from the 19?Fs through the 19.Fs, and the principles em+odied +( the 10 activities are still important in evaluating nursing care in thee>1st centaur(. Gthers concepts that Henderson (19.. proposed have +een used in nursing education from the 19?Fs until the present G/8alle(, 199.

Testability

Henderson supported nursing research, +ut +elieved that it should +e clinical research (G8alle(, 199. . 8uch of the research +efore her time had +een on educational processes and on the profession of nursing itself, rather than onE the practice and outcomes of nursing , and she worked to change that. 6ach of the 10 activities can +e the +asis for research. !lthough the statements are not. :ritten in testa+le terms, the( ma( +e reformulated into researcha+le 7uestions. 2urther, the theor( can guide research in an( aspect of the individuals care needs.

7imitations

<ack of conceptual linkage +etween ph(siological and other human characteristics. %o concept of the holistic nature of human +eing. 3f the assumption is made that the 10 components prioriti*ed, the relationship among the components is unclear. <acks inter$relate of factors and the influence of nursing care. !ssisting the individual in the d(ing process she contends that the nurse helps, +ut there is little e#planation of what the nurse does. ;eaceful death is curious and significant nursing role.

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