Theory Critique: Virginia Henderson’s Need Theory

Virginia Henderson’s Need Theory

Virginia Henderson is one of the first nurses who tried to describe nursing as a profession at the end of the 19th century. The ideas of Henderson had a considerable impact on many subsequent theories of nursing. Nursing derives from the concept of the fundamental needs of a person. The primary responsibility of a nurse is to satisfy the needs of a patient. Henderson’s theory represents an attempt to define a special role of nursing in the process of provision of health care services. The theory tries to describe nursing care, relying on the general universal principles irrespective of the diagnosis and treatment (Basavanthappa, 2007, p.61). The given term paper will present a detailed critique of Henderson’s Needs Theory through utilizing Chinn and Kramer’s basis for evaluation of nursing models. The theory critique will cover such criteria as semantic clarity, semantic consistency, structural clarity, structural consistency, and simplicity, generality, accessibility, and importance of the theory.

Semantic Clarity

Semantic clarity is understood as the easy perception and practical meaning of the theory (Chinn & Kramer, 1999). Henderson’s need theory is clear for understanding and can be effectively used in the clinic practice. According to the theory, a person is an independent individual having certain requirements depending on his or her social and cultural accessory (Ahtisham & Jacoline, 2015, p. 448). In usual conditions, people can satisfy their needs, but due to a disease or changes in an organism they cannot make the amount of efforts necessary to satisfy his/ her requirements. In such cases, arises a need for nursing care. The possibilities to understand the needs of the other people are limited. A nurse should make all efforts to understand what a patient needs. It is necessary to remember about the fundamental human needs irrespective of the condition of a patient and his/ her diagnosis.

Semantic Consistency

Semantic consistency means the steadiness of application of the philosophical concepts of the nursing theory (Chinn & Kramer, 1999). Despite the fact that the theory is considered to be clear and logical, there are some ambiguities, which on closer examination, reveal mismatch of some concepts and ideas. Henderson claims that nursing should be based on the fundamental human needs. However, if to consider the list of the human needs allocated by Henderson as fundamental, it is easy to notice that the basic principles of nursing are not coordinated (Ahtisham & Jacoline, 2015, p. 444). There are only eight of basic needs, but not all of them (for example, dwelling and love) comply with the list of the basic principles. In her theory, Henderson describes the examples from the nursing practice, mentioning other human needs that were not reflected in the theory, such as the requirement of preservation and reasonable distribution of internal resources.

Another ambiguity of the theory is connected with the description of factors that influence fundamental human needs. The researcher relates physical and mental capabilities, will, and knowledge to them. However, she does not provide any detailed description of these concepts. The list of factors influencing the basic elements of Henderson’s theory is incomplete (Basavanthappa, 2007, p. 63). When describing patient’s conditions that can affect fundamental human needs, Henderson mentions only purely “physical” pathological states. Psychological and social factors, according to the theorist, have an invariable character (Ahtisham & Jacoline, 2015, p. 448). It is absolutely unacceptable to neglect psychological and social factors since they can also affect the fundamental human needs. Thus, there is some semantic inconsistency in the theory.

Structural Clarity

Structural clarity represents structural logics of the concepts and their interrelation within the model (Chinn & Kramer, 1999). The theory of Henderson is descriptive and structurally clear. The author describes the fundamental needs of a person and the way nursing should be provided. Henderson does not set an objective to explain why particular needs are inherent in people. The principles of the approach to nursing in Henderson’s theory are structurally concrete, and it is easy to follow them. They represent the general scheme of nursing care. Besides, Henderson gives a set of examples illustrating each of these principles. Some of them are perceived as outdated, while others are extremely urgent and can be easily applied in the nursing practice.

Structural Consistency

Structural consistency presupposes the constant use of all structural methods in the theory (Chinn & Kramer, 1999). The need theory of Henderson is structurally consistent. Henderson prioritizes human needs as follows (Henderson, 1964, p. 67):

· The first level – physiological needs: to breath normally, to consume a sufficient amount of food and liquids, to release body waste, to move and have a correct posture, to rest and sleep;

· The second level – security needs: to get dressed, to choose clothes, to maintain a normal body temperature, to change the environment, to practice good hygiene, to take care of one’s own appearance, and to provide one’s own security;

· The third level – social needs: to communicate with other people, to express emotions, to conduct religious rituals in accordance with one’s faith;

· The fourth level – the needs for respect and self-respect: to work with pleasure, to take part in different types of entertainment, to learn something new and satisfy one’s curiosity.

Simplicity of the Theory

The criterion of simplicity means simple description of the fundamental points of the theory. All famous nursing theories are simple for understanding and effective application (Chinn & Kramer, 1999). Despite the fact that there are fourteen fundamental physiological and psychological needs, the theory is rather simple. The principles of nursing care are directed at providing help to a patient, but at the same time they can be used in relation to healthy people. Henderson’s theory concerns a unique, independent, and active individual. It emphasizes the importance for a nurse to realize all the opportunities in order to understand a patient’s needs. Henderson lays particular stress on the responsibility of a nurse for performing actions which a patient cannot carry out himself/ herself due to a disease (Henderson, 1964, p. 68).

Generality of the Theory

Generality of a theory refers to the scope of application of the theory’s main point at all nursing levels (Chinn & Kramer, 1999). The theory of Henderson can be effectively applied in all nursing environments. This theory is one of the most known among the practicing nurses. It presupposes indispensable interaction with a patient at all stages of provision of health care services. At the stage of primary assessment of a patient’s condition, nurses should collaborate with patients in order to define which one out of the fourteen daily needs should be satisfied first of all (McEwen & Wills, 2011, p. 126).

Accessibility of the Theory

Accessibility of the theory presupposes free access to abstract and concrete concepts of the theory. Moreover, accessibility means the possibility to easily measure of the theory’s elements (Chinn & Kramer, 1999). Henderson’s need theory is accessible as it allows measuring the majority of its elements – human needs. Unlike Maslow, who pays much attention to the psychology of nursing, Henderson denies a hierarchical approach to basic human needs (Ahtisham & Jacoline, 2015, p. 443). This facilitates easily access and application of the basic concepts of the theory, such as nursing, person, health, and environment in practice.

Importance of the Theory

Importance of the theory presupposes its application in the nursing practice and the contribution it made to nursing as a science (Chinn & Kramer, 1999). The mechanisms of satisfaction of the main human needs constitute the focus of nursing interventions. The methods and ways of these interventions can be different – from medicinal therapy to psychological consultation of a patient and members of his or her family. The role of a nurse is considered twofold by Henderson. On the one hand, a nurse is an independent expert having the right to make decisions; on the other hand, a nurse is a doctor’s assistant. The expected result of nursing is the full satisfaction of the patient’s needs. Henderson’s theory exerted a huge impact on the perception of nursing worldwide, and many models of nursing created later are based on Virginia Henderson’s theory (McEwen & Wills, 2011, p. 128).

Conclusion

To sum up, Henderson’s need theory represents one of the first attempts to describe nursing as an absolutely independent profession. Despite the fact that Virginia Henderson’s attempts were not entirely successful, the theorist presented a system of principles which can be utilized for nursing management in the process of caring. The theory states that the main responsibility of a nurse is to help a patient satisfy his or her needs. Henderson considers health as something more than just absence of a disease. Nurses are responsible for changing patient’s life for better. Thus, the term paper represents a thorough critique of Henderson’s need theory on the basis of Chinn and Kramer’s evaluation of nursing models.