Its about Henderson's Need Theory , its application in nursing.

1. THE ACADEMY OF NURSING SCIENCES AND
HOSPITAL,GWALIOR
VIRGINIA HENDERSON’S NURSING
NEED THEORY
By- Dr. Poonam Thakur
Professor,
The Academy Of Nursing
Sciences and Hospital, Gwalior

2. Background of theorist
 Virginia Henderson was born in Kansas
city, Missouri in 1897
 Her interest in nursing evolved during
world war I from her desire to help the
sick and wounded military personnel.

3. She is also known
as……………………….
THE LADY OF NURSING
THE NIGHTINGALE OF MODERN NURSING
MODERN DAY MOTHER OF NURSING
THE 20TH CENTURY FLORENCE NIGHTINGALE

4. TIMELINE OF VIRGINIA HENDERSON

6. How the idea of developing
nursing definition came to her
mind?

7. • Her ideas about nursing
definition were influenced by
her nursing education and
practice by her students at
Columbia University School of
Nursing.
• Two Events are basis for her
development of Nursing
definition
1. First she participated in the revision
of a nursing textbook written by Bertha
Harmer. With this Henderson realized
that there is need to clear the role and
functions of nurse.
2.Second she was concerned that
many states had no provisions for
nursing licensure to ensure safe and
competent care of the patients.

8.  In 1955, the earlier ANA definition was
modified and she published her first
definition of nursing in Bertha Harmer’s
revised nursing textbook.

9. So steel yourself for something
pleasant like listen to THE
LADY OF NURSING………………

12. In 1966 her ultimate
statement on the
definition of nursing
was published in “THE
NATURE OF
NURSING”

13. Virginia Henderson developed the NURSING NEED THEORY to
define the unique focus of nursing focus. The theory focuses on
the importance of increasing the patient’s independence to
hasten their progress in the hospital.
Henderson’s theory emphasizes the basic human needs and
how nurses can meet those needs.

14. Assumptions of nursing
need theory
The major assumptions of theory are-
• Nurses cares for patients until patient can care for
themselves again
• Nurses are willing to serve that nurses will devote
themselves to the patient day and night .

17. Metaparadigm of Henderson's need
Theory
Individual Environment
Health Nursing

18. INDIVIDUAL
• Have basic needs that are
components of health
• Require assistance to achieve health
and independence
• Mind and body are inseparable

19. ENVIRONMENT
• Settings in which individual learns
unique pattern of living
• Individual in relation to families

20. HEALTH
• Health is based on individual’s ability
to function independently as outlined
in 14 components.
• Good health is a challenge affected by
age, cultural background, physical and
intellectual capacities

21. NURSING
• Temporarily assisting an individual who lacks the
necessary strength, will and knowledge to satisfy
one or more of basic needs.
• Assist and supports the individual in life activities
and the attainment of independence
• Nurse's role is 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

23. CASE STUDY
Ms. X 22 years old female client was admitted in the surgical unit, with attempted suicide. Two weeks
ago, she ingested toilet cleaner because of a family dispute.
HISTORY REVEALED THAT-
• Ms. X lived a rural life and had studied till 10th standard.
• her marriage was planned two days before the incident.
• she was reluctant to share the reason for her suicide but stated that she was stressed out and tried
to kill herself.
• she was impulsive and emotional person {as said by her mother}
PHYSICAL ASSESSMENT REVEALED THAT-
• Her physical assessment revealed alert, oriented but depressed female.
• Her chief complaints were difficulty in breathing and mood swings.
CT scan and endoscopy showed damaged larynx, mouth and stomach ulcers respectively.
• Ms. X showed dislike and resisted eating. Due to her limited intake, Foley’s catheter was passed for
accurate record of her daily intake and output. She was noncompliance towards her intake and
developed dehydration, irritability and insomnia as evidenced by dry mouth, sunken eyes with
dark circles around.

24. Nursing Assessment of Ms. X
Acc. to Henderson's 14 Components Assessment
1 Breathing normally - She was experiencing difficulty in breathing; Respiratory rate-
16 irregular, Oxygen saturation 87%
2 Eat and drink adequately. Height 153 cm; weight 45kg; skin turgor good, She was
advised liquid diet but she resisted taking any liquid.
3 Elimination of body wastes Foley's catheter was in placed
4 Movement and Posturing Reports fatigue, Feeble to walk, Gait imbalance
5 Sleep and Rest Experiencing insomnia for three days, Dark circles around eyes
6 Select suitable clothes-dress and undress Wearing loose fitted dirty dress.
7 Maintain body temperature No signs of hyperthermia or hypothermia; Temperature
C
8 Keep the body clean and well-groomed Mother reported that she was very conscious
her physical appearance and hygiene but was not well groomed at that time.

25. 9. Avoid dangers in the environment Fatigue, feeble walk, and history of attempted
suicide.
10. Communication She had damaged larynx and had speech difficulty
11. Worship according to one’s faith Religion; Hindu, mother reported that she was not
spiritual.
12. Work accomplishment Lost interest in self-care and inability to perform ADLs since
her marriage was planned as reported by mother
13. Play or participate in various forms of recreation Mother reported that she used to
spend time with family but had lost active participation in home activities.
14. Learn, discover, or satisfy the curiosity Finding difficult to cope with her stress and
present illness

26. Possible nursing diagnosis based on
assessment
 Breathing -Activity intolerance related to
dyspnoea
 Nutrition- Nutritional Imbalance less than
body requirement related to less desire to eat
 Elimination -Altered Elimination Pattern
related to catheter in-placement
 Movement and Posturing -Impaired physical
mobility related to fatigue and weakness
 Sleep and Rest- Disturbed Sleep pattern
related to external factors i.e. hospitalization
Safety
 High risk of Injury related to stress
 Communication- Impaired Verbal
Communication related to larynx injury
 Hygiene -Self-Care deficit related to stress and
fatigue
 Spirituality -Spiritual distress related to
inability to participate in religious activities
 Learning -Ineffective coping related to
situational crisis and inadequate psychological
resources

27. Nursing planning based on diagnosis
 Address all the physiological needs and provide respective nursing care.
 Encourage client to identify her strengths and limitations, share her concerns, and
participate in activities of daily living
 Discuss effective coping strategies and impulse control like talking, drawing any
pictures, asking questions for exploring her stress factors.
 Encourage family support by asking mother why she was upset due to her marriage?
What were the domestic problems leading to suicidal attempt? Did she have any
suicidal thoughts before attempting suicide

28. Nursing interventions based on planning
 Observe for strengths such as the ability to relate the facts and to recognize the source
of stressors.
 Monitor risk of harming self or others.
 Help client set realistic goals and identify personal skills and knowledge
 Use empathetic communication, and encourage client/family to verbalize fears,
express emotions, and set goals.
 Encourage client to make choices and participate in planning of care and scheduled
activities

29. Nursing interventions based on planning
 Encourage use of cognitive behavioural relaxation (e.g., music therapy, guided
imagery).
 Involve patient in spiritual activities according to her religion
 Discuss coping and stress management techniques like mind distraction, self-control
and effective decision making and recreation (watch tv, listen music, outing)
 Involve in daily life activities of hygiene and exercise.
 Maintain airway and pain management (medication, relaxation techniques)

30. Nursing outcome based on intervention
 The outcome of the care plan was successfully achieved by the client.
At the end of hospitalization, Ms. X verbalized her concerns with the
nurse and showed willingness for family decision. She talked to her
mother and decided to be a part of all family activities. She was able to;
walk on her own and perform all the daily life activities independently;
narrated the coping strategies like relaxation, recreational and spiritual
activity, and family involvement.

31. The above case was managed by employing Virginia Henderson’s theory into
nursing theory process. Nursing Theory Process Henderson viewed the nursing
process as an application of the logical approach to the solution of the problem.
The nursing theory process comprises of six elements; Assessment, Nursing
Diagnose, Outcome, Planning, Implementation and Evaluation (George, 2011).
POINTS TO REMEMBER-
• Assessment includes not only physiological data, but also psychological,
sociocultural, spiritual, economic, and life-style factors as well
• Use the concepts of fundamental human needs, bio physiology, culture, and
interaction communication, which give the theory a dynamic coverage regarding
patients need.
• Prioritize the nursing diagnosis{Here in above case it can be “Ineffective coping
related to situational crisis and inadequate psychological resources as evidenced
by attempted suicide.”}

32. Limitation of theory
 The models’ weaknesses are the lack of conceptual relationship between
physiological and other human characteristics, exclusion of the holistic nature
of an individual, and lack of an interconnection diagram that connects all
needs.
 Dying process is not well explained as what is the role of the nurse
 Peaceful death is curious and significant nursing role.

34. References
 Basavanthappa BT Nursing theories. 1st ed. New Delhi: Jaypee Brothers Medical Publisher; 2007.p. 61-
65.
 Basavanthappa BT. Fundamentals of nursing. 2nd ed. New Delhi: Jaypee Brothers Medical Publisher;
2007.p. 52.
 Kozier and Erb’s. Fundamental of nursing. 8th ed. New Delhi: Pearson; 2009. p. 43-44.
 https://libguides.twu.edu/c.php
 https://www.internationaljournalofcaringsciences.org/docs/23_ahtisham.pdf
 http://currentnursing.com/nursing_theory/Henderson.html
 http://vhenderson2011.blogspot.in/p/major-concepts.html
 http://currentnursing.com/nursing_theory/Henderson.html
 http://nursing-theory.org/theories-and-models/henderson- need-theory.php 29
 https://nursingpath.in2013

35. Gratitude for ECHO INDIA
“Technology is best when it brings people
together”