Concept Analysis on Henderson’s Nursing Theory

November 5, 2021

The Need Theory developed by Virginia Henderson is among the nursing theories that promote holistic care. This paper presents a thorough conceptual analysis of the Need Theory. The metaparadim of nursing concepts as they apply to the theory will be discussed. The theorist provides explicit definitions of the individual and nursing, but fails to define environment and health. However, the descriptions of these concepts can be found in the explanations of the theory. Furthermore, this paper will explain the 14 components that nurses should consider when providing holistic care to patients. Some of the elements include eating and drinking, sleeping and resting, maintaining body temperature, etc. The relationship between nursing and those factors will be explained. Finally, this paper explains the way the Need Theory applies to medical and surgical wards in terms of patient management. Although this theory has a wide application in nursing, it lacks a framework that can make the mastery of all 14 concepts easy. For that reason, the theory applies to nursing research since identification of a clear way to master it will necessitate proper application.

Concept Analysis: Henderson’s Need Theory

Nursing theories have played a significant role in helping nurses assess patient needs so that they can design fitting plans of care. One such theory is Henderson’s Need Theory. Virginia Henderson advocated for the assessment of basic needs of patients, both in the healthcare environment and outside the health facilities (as cited in Fernandes, Guedas, de Silva, Borges, & de Freitas, 2016). This indicates that nurses can utilize the theory to offer appropriate healthcare to both the sick and those perceived to be healthy so that they can avoid illness. Accordingly, the theory makes nursing a distinct profession that not only focuses on treating people but also promoting health. The theory applies the four concepts of the metaparadigm of nursing; it has 14 additional components that can enhance the care for patient needs, which makes it applicable to evidence-based care in medical wards, surgical wards, individual practice, and nursing research.

Concept Analysis

Just like other nursing theories that utilize the metaparadigms of nursing, Henderson’s Need Theory has various explanations that consider the importance of the four concepts. The descriptions of the concepts, in this case, focus on the needs of the individuals and the way nurses can help meet them. The four concepts are explained below.

Patient

The theory describes a patient as an individual who has needs that require interventions that can help them achieve independence in terms of health outcomes. According to Fernandes et al. (2016), Virginia Henderson indicated that a patient had biological, psychological, and sociological aspects. Fernandes et al. (2016) further suggest that these factors have to exist in harmony to ensure that an individual is healthy. A consideration of these factors in terms of nursing care is crucial since they help nurses focus on assisting the individuals on improving their health in its entirety. For instance, when it comes to the biological factors, nurses can assess all the physiological mechanisms that may be causing instability in the health status of the patient. Then, nurses can make a proper diagnoses and intervene appropriately to ensure that an individual achieves proper physical health.

Environment

The Henderson’s Need Theory does not provide an explicit explanation of the environment. However, various comments in the theory show that Virginia Henderson focused on the modification of the environment to ensure that it suited the needs of each patient. For example, according to Fernandes et al. (2016), the theorist ensured that the application of this theory could focus on protecting people from various environmental risks, such as increased temperatures, and making them comfortable. This affirmation is vital, considering that patients expose themselves to multiple environmental risks that can affect their health outcomes negatively. The theory does not only apply to the sick. Truca, Popa, Marcean, Paunica-Panea, and Gingu (2016) indicate that Virginia Henderson intended the nurses to help people be independent in their environment, even when they were well. Therefore, nurses can apply this part of the theory to help patients exist in appropriate environments that prevent the occurrences of diseases.

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Nursing

The theory explicitly explains the function of nursing as well as its aims. According to Smith and Grami (2017), the theorist advocated for the nurses to perform various activities that patients could not. The goal of doing such activities is to help patients develop the desire, strength, and necessary knowledge to perform them independently. This definition of nursing is essential to nursing practice since it not only focuses on the independence and health of patient but the competencies nurse must possess to promote freedom. Furthermore, Smith and Grami (2017) assert that according to Henderson’s theory, the aim of nursing is to help individuals reduce their need for nurses and increase their willingness to engage in healthy behavior that can improve their health outcomes. This statement of the theorist shows that patients should eventually have less contact with the nurse and develop the necessary skills that will ensure they lead a healthy lifestyle even when they do not have diseases.

These assertions may affect the follow-up aspect of nursing negatively, but it can enhance healthy behavior among patients and guarantee recovery. As for the follow-ups, nurses often schedule follow-ups after treating diseases. According to Najafi, Shaabani, Momennassab, and Aghasadeghi (2016), continuous monitoring with the use of such methods as the telephone can ensure that nurses assess the progress of their patient towards recovery and adjust the interventions to ensure that their charges stay healthy. However, based on the theory, the reduced need for the nurse after the patient recovers may prevent them from proper follow-ups and education of the people who perceive themselves as healthy. As for enhancement of healthy behavior, nurses can instill discipline regarding the observance of various health practices that can guarantee improved outcomes holistically. For example, Fernandes et al. (2016) focus on explaining the way nurses should focus on the biological, psychological, and social aspects of patients. Thus, nurses should utilize the little time they have with patients to teach them about the biopsychosocial factors that can influence their health and ways of dealing with them. Understanding of such factors can help patients improve their health, even without follow-up strategies.

Health

This theory does not provide an explicit explanation of health. Nevertheless, one can derive the definition from the interpretations of the theory. For example, according to Truca et al. (2016), Henderson’s Need Theory suggests that patients must balance their physical and psychological well-being with social skills. This statement shows that health, as per this theory, is a harmonious interaction of all factors that influence the well-being of a person. For example, a patient could have proper physical health without having healthy relationships. Therefore, this theory is necessary to help provide holistic care to such patients with the aim of not only treating the disease but developing behavior patterns that allow the patient to stay healthy. The theory has 14 components that can help nurses understand the ways of enhancing patient behavior to promote their health.

14 components of the Need Theory

The theorist developed the 14 components that focus on a holistic approach to handling patient issues. The elements can help nurses address social, spiritual, physical, and psychological problems. An explanation of all 14 components is as follows.

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Breathe Normally

Henderson’s Need Theory indicates that patients should have normal breathing to be considered healthy. According to Truca et al. (2016), the theorist demonstrated that normal breathing can reveal enhanced circulation if one uses the nursing process. Some of the breathing abnormalities include shortness of breath indicative of lung problems, which may be accompanied by edema which points to cardiovascular problems. Therefore, nurses can help patients be free from breathing abnormalities and improve their respiratory and circulatory status.

Eat and Drink Adequately

Nutrition is vital to growth and development of body tissues. Truca et al. (2016) explain Henderson’s Need Theory and demonstrate that lack of appetite can lead to inadequate food intake. Additionally, if a person does not take nutrients in the required quantities, they risk facing a nutritional imbalance that can affect their health status negatively (Truca et al., 2016). Therefore, nurses should help patients be free from such problems as anorexia and loss of appetite to allow them to take foods in adequate amounts and have a reduced need for nurses to address nutritional problems in the future.

Elimination of Body Waste

Inadequate elimination of waste can signify a health problem. According to Truca et al. (2016), patients should eliminate waste in the required quantities and of the required quality to be considered healthy. This part of the theory can help nurses check the amount or color of urine and stool to diagnose health problems and assist the patient with treatment. The nurse can then teach the patient how to avoid any predisposing factors to eliminate the chance of similar problems after recovery.

Moving and Maintaining Desirable Postures

Appropriate posture and flexible body movements reveal that an individual may be free from health issues. According to Truca et al. (2016), nurses should use the Need Theory to assess the causative factors of immobility, such as pain or muscle weakness. A proper assessment can help nurses develop interventions that improve mobility and further help the patients implement practices that lead to increased mobility.

Sleep and Rest

A person needs to sleep without problems to be considered healthy. According to Truca et al. (2016), some patients may have insomnia due to a number of issues such as fear of surgical procedures, anxiety, or sadness among others. Truca et al. (2016) assert that, according to Henderson’s Need Theory, people must overcome such factors and have restful sleep to be considered healthy. Therefore, nurses should investigate the causative factors for insomnia and intervene appropriately to enhance the sleep-rest pattern in patients.

Selecting Suitable Clothes

Appropriate attire that matches the temperature and occasion shows that an individual is healthy. According to Truca et al. (2016), putting on dirty clothes indicates that a person has health issues. Thus, nurses must help patients select appropriate clothing and teach them proper hygiene to ensure improved experience for their patients after the conclusion of nursing care.

Maintaining Body Temperature

In addition to proper clothing, patients must have normal temperature. Truca et al. (2016) indicate that patients must have a temperature that is within the standart limits. The failure of the body to regulate its temperature can be a sign of illness. In this case, nurses may intervene by administering medications or modifying the environment of the patient. Additionally, nurses may investigate the causative factors of increased temperature and intervene appropriately. This approach can help the patient regulate their body temperature and develop strategies for doing so when the nurse in no longre present.

Protection of Integument Through Body Grooming

Protection of the body by clothing it appropriately shows that a person is healthy. According to Truca et al. (2016), people that do not dress according to the weather conditions or significant circumstance may be unhealthy. Thus, nurses must help patients understand the role of clothing in protecting the integument to enhance dressing behavior patterns.

Avoiding Environmental Dangers and Refraining from Harming Others

Patients must learn how to escape the dangers in the environment to be considered healthy. For example, a patient must understand that a needle can prick the eye and lead to blindness. Thus, bringing a needle near an eye should make the patient close their eyes. Similarly, a person must learn to protect others from harm (Fernandes et al., 2016). Thus, nurses can help patients recognize various dangers in the environment and teach them ways of escaping to ensure their health.

Communication Using Emotions, Needs, Opinions, or Fears

A healthy person must be willing to communicate well with other people. Fir instance, Truca et al. (2016) indicate that a healthy person must incorporate emotion into their speech and have a reasonable verbal flow. Additionally, a person must use their feelings well to communicate to family members, friends, or colleagues at work. Inappropriate application of emotions during communication may indicate that a person is not healthy. In that case, a nurse must investigate the cause of the problem and help the patient communicate appropriately to different people.

Worship According to One’s Faith

The theory posits that observing one’s faith is a significant indicator of being in a satisfactory state of health. According to Fernandes et al. (2016), Henderson’s Need Theory demands that people not only worship but also practice what they learn in their respective belief systems. Thus, a nurse can do a spiritual assessment to understand whether a patient is observing the necessary spiritual beliefs and detect other religious concerns that they may have. The findings can help the nurse to come up with interventions to help patients develop strategies to valuing their faith.

Work and a Sense of accomplishment

Drawing satisfaction from one’s work is an indicator that one is healthy. Fernandes et al. (2016) assert that people need to have a feeling of accomplishment from what they do to be considered healthy. In this case, a nurse must assess the patients that are unhappy with their jobs and then recommend ways in which they can become more content with their respective occupations.

Participating in Recreation

Working without participating in leisure activities may signify either physical or social health problems. According to Fernandes et al. (2016), the theory indicates that people must participate in some form of hobby to be considered healthy. Therefore, nurses must encourage relaxation in addition to advocating for hard work.

Satisfying Curiosity

A person who does not feel the need to learn and discover how things work may be unhealthy. According to Fernandes et al. (2016), the theory advocates for curiosity among patients. This assertion indicates that nurses can encourage their charges to investigate and understand problems that lead to their illnesses. This method can help them use health facilities to address their health issues.

Evidence-Based Practice

Medical Settings

The theory has a broad application since it is not specific to any setting. However, its concepts can be used in managing patients who are admitted to medical wards. According to Fernandes et al. (2016), patients in medical settings have various physical, social, and psychological health problems that occur due to aging. Therefore, nurses must investigate the factors that cause problems among such patients and implement individual and realistic interventions that can lead to their recovery.

For example, a patient may come to the hospital with signs of labored breathing. A nurse should assess the factors that cause dyspnea and provide such interventions as bronchodilators to enhance breathing. The nurse must help the patient understand the mechanisms in which the drugs work so that they may have the psychological preparedness to follow the recommended interventions to alleviate dyspnea. Furthermore, the nurse must understand the social background of the patient to understand the factors that may affect adherence to interventions (Fernandes et al., 2016). For that reason, the nurse must create interventions that ensure that, despite the social aspects of patients, they can comply with the recommended interventions. Therefore, Henderson’s Need Theory ensures that patients receive the necessary interventions that seek to improve their health outcomes holistically.

Surgical Settings

Nurses can utilize this theory in surgical settings to prevent disease complications in patients. According to Fernandes et al. (2016), nurses can ask patients questions to determine any physical, social, and psychological issues that they may have. Alternatively, nurses may observe patients to determine any deviations that may exist in their physiological status (Fernandes et al., 2016). In the process, nurses can identify the way the four concepts of the metaparadigm contribute to the problems related to the 14 components. For example, many patients in the surgical settings may have reduced mobility due to surgical operations or be bedridden. Latimer, Chaboyer, and Gillespie (2015) indicate that bedridden patients in the healthcare settings can develop pressure ulcers. Such ulcers occur when patients do not turn and the pressure on skin increases. In the process, body cells are deprived of essential nutrients and die, leading to the development of pressure ulcers. According to Fernandes et al. (2016), Henderson’s Need Theory requires nurses to help patients perform individual activities in their environment when they are sick and stay free from diseases afterwards. In such a case, nurses can ensure an appropriate environment by turning patients and teaching the family members of their charges the importance of the practice. Such an approach can create a suitable environment for the skin and allow the cells nourish in order to prevent the occurrence of pressure ulcers in surgical settings.

Individual Utilization

I intend to use this theory to provide holistic care to my patients since it is applicable in every setting. Fernandes et al. (2016) identify the biopsychosocial aspects to be necessary for appropriate application of this theory. Therefore, I can plan patient assessment while considering the three elements of the theory and intervene appropriately to ensure that they are in harmony. This approach will ensure that I provide the best holistic care to my patients. A suitable example would involve patients who have chronic bronchitis. Rosenberg and Kalhan (2016) assert that smoking can exacerbate chronic bronchitis. Rosenberg and Kalhan (2016) further indicate that avoiding smoking can significantly minimize the chances of patients developing bronchitis. In this case, I can tell the patients to avoid the environments that expose them to smoke. This step can improve the physiological or biological outcomes of the patient. Then, I can encourage the patient to cease smoking by focusing on the risk factors. Patients can understand the risks and be psychologically prepared to quit the behavior during illness. Then, I can help the patients modify their social behavior by engaging in support groups, which have proven to be effective in promoting smoking cessation (Thrul, Klein, & Ramo, 2015). Eventually, patients can adopt the new behavior pattern and follow it independently without seeking the services of a nurse. This example shows that a consideration of the biological, psychological, and social aspects of my patient can help me provide holistic care.

Application to Research

This theory applies to nursing research because scholars can investigate the ways in which it can help enhance nursing practice. Evidently, the theory does not have a way to connect all of the 14 components for easy interpretation (Truca et al., 2016). Therefore, nursing researchers can investigate the way nurses apply the theory in practice without straining themselves to remember all of the components. For example, patients must have functional systems that align with the 14 elements of the theory to be considered healthy (Truca et al., 2016). Nursing researchers can examine the way nurses care for patients and coordinate their care to ensure an appropriate balance of the 14 factors. This approach can help the researchers create a theoretical framework that nurses can use to manage patient care. Moreover, the framework can become an approach to understanding patient problems in healthcare setting.

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Conclusion

Henderson’s Need Theory is one of the theories that can help nurses provide evidence-based holistic care. The theory utilizes the metaparadigm of nursing, making it applicable to the nursing practice. Although the theorist does not provide explicit explanations of the environment and health, an interpretation of these concepts can be derived from the descriptions of the theory. Furthermore, the theory has 14 components that nurses can use to assess patients and ensure improved physiological, psychological, and social outcomes. For example, some of the elements include communication, temperature control, and worship as per one’s faith. Evidently, these aspects cover the background of the patient in its entirety. Although Henderson’s Need Theory is essential in nursing practice, it does not have specific settings for application. Therefore, nurses can use it to care for patients in both medical and surgical wards. However, nursing researchers must identify a conceptual framework that nurses can use to interpret the theory quickly.