The Nursing Need Theory was developed by Virginia Henderson and was derived from
her practice and education. Henderson's goal was not to develop a theory of nursing,
but rather to define the unique focus of nursing practice. The theory emphasizes the
importance of increasing the patient's independence so that progress after hospitalization
would not be delayed. Her emphasis on basic human needs as the central focus of nursing
practice has led to further theory development regarding the needs of the patient and
how nursing can assist in meeting those needs.
Henderson identifies three major assumptions in her model of nursing. The first is that
"nurses care for a patient until a patient can care for him or herself," though it
is not stated explicitly. The second assumption states that nurses are willing to
serve and that "nurses will devote themselves to the patient day and night." Finally,
the third assumption is that nurses should be educated at the college level in both
sciences and arts.
The four major concepts addressed in the theory are the individual, the environment,
health, and nursing.
According to Henderson, individuals have basic needs that are components of health.
They may require assistance to achieve health and independence, or assistance to
achieve a peaceful death. For the individual, mind and body are inseparable and interrelated,
and the individual considers the biological, psychological, sociological, and spiritual
components. This theory presents the patient as a sum of parts with biophysical needs
rather than as a type of client or consumer.
The environment is made up of settings in which an individual learns unique patterns
for living. All external conditions and influences that affect life and development.
The environment also includes individuals in relation to families. The theory minimally
discusses the impact of the community on the individual and family. Basic nursing care
involves providing conditions in which the patient can independently perform the
fourteen components explained in the model.
There are fourteen components based on human needs that make up nursing activities. These components are:
Breathe normally. Eat and drink adequately.
Eliminate body wastes.
Move and maintain desirable postures.
Sleep and rest.
Select suitable clothing. That is, dress and undress appropriately.
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.
These components show a holistic approach to nursing that cover the physiological,
psychological, spiritual, and social. 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.
The theory's definition of health is based on an individual's ability to function
independently as outlined in the fourteen components. Nurses need to stress the promotion
of health and prevention, as well as the curing of diseases. According to Henderson's
model, good health is a challenge because it is affected by so many different factors,
such as age, cultural background, emotional balance, and others.
Henderson's definition of nursing states: "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." The nurse is expected to carry out a physician's therapeutic plan, but
individualized care is result of the nurse's creativity in planning for care. The
nurse should be an independent practitioner able to make independent judgments as
long as he or she is not diagnosing, prescribing treatment, or making a prognosis,
since those activities are the function of the physician.
Henderson explains in Nature of Nursing
that the role of a nurse 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 needs of the patient, help him or her meet
health needs, and provide an environment in which the patient can perform activity unaided.