SEMINAR presentation on Henderson theory.pptx

SEMINAR presentation on Henderson theory.pptx

1. VIRGINIA HENDERSON THEORY

2. VIRGINIA HENDERSON THEORY The  Nursing need theory  was developed by Virginia to define the unique focus of nursing practice. The theory focuses on the importance of increasing the patient’s independence to hasten their progress in the hospital.

3. Conti… “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”.

4. BIOGRAPHY Virginia Henderson was born in Missouri, on November 30 th ,1897. Henderson’s interest in nursing evolved during World War I from her desire to help the sick and wounded military personnel. She received a diploma in nursing from the army school of nursing at Walter reed hospital, Washington, D.C. in 1921.

5. Conti… In 1923, she worked on a position of teaching nursing at the north folk protestant hospital in Virginia for several years. In 1929, Henderson determined that she needed more education and entered teachers college at Columbia University where she earned her, bachelor’s degree in 1932 and Master’s degree in 1934. Since 1953, she has been a research associate at Yale University, school of nursing. She died on 19 th March in 1996.

6. HONORS Henderson has received numerous honors. The  International Council of Nurses  presented her with the inaugural  Christiane Riemann  Prize in 1985 considered the most prestigious award in nursing. She was an honorary fellow of the United Kingdom's  Royal College of Nursing  (FRCN). She received the Virginia Historical Nurse Leadership Award in 1985.

7. CONTRIBUTIONS In 1937 Henderson and others created a basic nursing curriculum for National League for Nursing in which education was “patient centered and organized around nursing problems rather than medical diagnosis”. In 1939 she revised: Harmer’s classic textbook of nursing for its 4 th edition, and later wrote the 5 th edition.

8. EVOLUTION OF THEORY Virginia Henderson was the nurse-theorist who devoted her career to defining nursing practice. She believed that an occupation that affects human life must outline its functions particularly if it is to be regarded as profession. Her ideas about definition of nursing were influenced by her nursing education and practice by her students and colleagues at Columbia University School of Nursing, and by distinguished nursing leaders of her time.

9. Conti… Two events are the basis for her definition of nursing and these are: First , she participated in the revision of a nursing text book. During revision of the “Textbooks of the principles and practice of nursing” written with Bertha Harmer (1922) Henderson realized the need to be clear about the functions of the nurse.

10. Conti… Second, she was concerned that the many states had no provision for nursing licensure to ensure safe and competent care for the consumers . She examined the earlier statements of the nursing functions by American Nurses Association and viewed these statements as non-specific and unsatisfactory definition of nursing practice.

11. Contd .. In 1966, Henderson’s first definition of nursing was published in Bertha harmer’s revised nursing text book. It reads as “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 peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge .”

12. ASSUMPTIONS OF VIRGINIA HENDERSON’S NEED THEORY (1) Nurses care for patients until they can care for themselves once again. Although not precisely explained, (2) Patients desire to return to health. (3) Nurses are willing to serve and that “nurses will devote themselves to the patient day and night.” (4) Henderson also believes that the “mind and body are inseparable and are interrelated.”

13. MATAPARADIGM OF HENDERSON’S THEORY

14. INDIVIDUAL Have basic needs that are component of health. Requiring assistance to achieve health and independence or a peaceful death. Mind and body are inseparable and interrelated. Considers the biological, psychological, sociological, and spiritual components. The theory presents the patient as a sum of parts with biopsychosocial needs.

15. ENVIRONMENT Settings in which an individual learns unique pattern for living. All external conditions and influences that affect life and development. Minimally discusses the impact of the community on the individual and family. Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided.

16. HEALTH Definition based on individual’s ability to function independently as outlined in the 14 components. Nurses need to stress promotion of health and prevention and cure of disease. Good health is a challenge -affected by age, cultural background, physical, and intellectual capacities, and emotional balance Is the individual’s ability to meet these needs independently.

17. NURSING Temporarily assisting an individual who lacks the necessary strength, will and knowledge to satisfy 1 or more of 14 basic needs. Assists and supports the individual in life activities and the attainment of independence. Nurse serves to make patient “complete” “whole", or "independent."

18. Conti… The nurse is expected to carry out physician’s therapeutic plan. Individualized care is the result of the nurse’s creativity in planning for care. “Nurse should have knowledge to practice individualized and human care and should be a scientific problem solver.”

19. Contd … In the Nature of Nursing Nurse role is,” to get inside the patient’s skin and supplement his strength will or knowledge according to his needs.”

20. 14 COMPONENTS OF HENDERSON THEORY

21. A. Physiological components Breathe normally Eat and drink adequately Eliminate body wastes Maintain postures Sleep and rest

22. Contd … 6. Select suitable clothes. 7.Maintain body temperature within normal range by adjusting clothing. 8. Keep the body clean and well-groomed 9. Avoid dangers in the environment and avoid injuring others.

23. B. Psychological aspects of communicating and learning 10. Communicate with others in expressing emotions, needs, fears, or opinions. 11. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

24. C. Spiritual and moral 12. Worship according to one’s faith

25. D. Sociologically oriented to occupation and recreation 13.Work in such a way that there is sense of accomplishment. 14. Play or participate in various forms of recreation.

26. THEORETICAL ASSERTIONS

27. 1. The Nurse Patient relationship: Three levels comprising the nurse patient relationship can be identified, ranging from a very dependent to independent relationship: a. The nurse as a substitute for the patient b. The nurse as a helper to the patient c. The nurse as a partner with the patient .

28. 2. The Nurse Physician relationship: Henderson insisted the nurse has a unique function, distinct from that of physician. The care plan, formulated by the nurse and patient together, must be implemented in such a way as to promote the physician’s prescribed therapeutic plan.

29. 3. The Nurse as a member of health care team: The nurse works interdependence with other health care professionals. Henderson reminded us that “no one of the team should make such heavy demands on another member that anyone of them is unable to perform his or her unique function.”

30. Contd … Henderson compared the entire medical team, including the patient and his family, to wedges on pie graph. The size of each member’s section depends upon patient’s current need and therefore changes as the patient progresses towards independence.

31. APPLICATION OF THEORY INTO CLINICAL PRACTICES: Meeting the 14 fundamental needs of the client has been a great basis to further improve our performances towards nursing care. It has been the day-to-day components of delivering nursing care core from infancy till death.

32. Contd … She further elaborated that the mind and body is inseparable and comprised as one entity. Her patient-centered theory stressed the importance of the nurse's relationship to the patient and the development of nursing practices. As a direct care giver, it will be rewarding to see the patient as he progresses to independence.

33. APPLICATION OF THEORY INTO NURSING EDUCATION: Henderson’s designed three phases of curriculum in her book “the nature of nursing: a definition and its implications for practice, research and education”. It implies that students should progress through in their learning. Furthermore, these three phases of curriculum emphasized the importance for the students to be involved in the complete study of the patient and all his needs.

34. APPLICATION OF THEORY INTO NURSING RESEARCH “No profession, occupation or industry in this age can evaluate adequately or improve its practice without research”. Her strong advocacy for nursing brings forth a challenge to all of us to identify new needs beyond the 14 she enumerated. Henderson’s believe that research in nursing is essential for nursing practice in the age of technological advancements.

35. Contd … Her work has been a foundation for improving the preparation for nursing. She even emphasized the importance of research in evaluating and improving the nurses’ practice.

36. HENDERSON’S NURSING PROCESS

37. Nursing Assessment Henderson’s 14 components Analysis: compare data to knowledge the base of health and disease. Nursing Diagnosis Identify individual’s ability to meet own needs with or without assistance , taking into consideration Strength, will or knowledge.

38. Nursing Plan Document how the nurse can assist the individual, sick and well. Assist the sick or well individual in the performance of activities in meeting human needs to Maintain health, recover from illness, or to aid in peaceful death

39. Nursing Implementation Implementation based on the physiological principle such as age, cultural background, emotional balance and physical and intellectual capacities. Carry out treatment prescribed by the physician.

40. Nursing Evaluatio -n Use the acceptable definition of nursing 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 the amount of hours of care. Successful outcomes of nursing care based on the speed with which the patient performs independently the activities of daily living

41. Case Scenario: Ms. X, 25 years old female client was admitted in the surgical unit, with attempted suicide. Two weeks ago, she ingested toilet cleaner. Her chief complaints were difficulty in breathing and mood swings. Her CT scan and endoscopy showed damaged larynx, mouth and stomach ulcers respectively.

42. Contd … The dietician advised liquid diet but 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.

43. Henderson's 14 Components Assessment Findings 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

44. 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 37 C  

45. 8 Keep the body clean and well groomed   Mother reported that she was very conscious of her physical appearance and hygiene but was not well groomed at that time.   9 Avoid dangers in the environment Fatigue, feeble walk and history of attempted suicide.   10 Communication She had damaged larynx and had speech difficulty  

46. 11.Worship according to one’s faith Religion Islam, mother reported that she was not spiritual. 12 Work accomplishment Lost interest in self-care 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

47. NURSING DIAGNOSIS

48. Breathing Activity intolerance related to dyspnea   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.

49. Sleep and Rest   Disturbed Sleep pattern related to external factors i.e. hospitalization 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

50. STRENGTHS: Henderson’s concept of nursing is widely accepted in nursing practice today. Her theory and 14 components are relatively simple, logical, and can be applied to individuals of all ages.

51. WEAKNESSES: A major shortcoming in her work is the lack of a conceptual linkage between physiological and other human characteristics. No concept of the holistic nature of human being. Lacks inter-relate of factors and the influence of nursing care.

52. Contd … Assisting the individual in the dying process she contends that the nurse helps, but there is little explanation of what the nurse does. “Peaceful death” is curious and significant nursing role.

53. RESEARCH INPUT: 1.Sleep and rest needs of seniors: a study grounded in the work of Henderson. ABSTRACT: To identify the sleep/rest needs of an elderly population cared for the family health strategy, based on Virginia Henderson's theoretical framework. This descriptive, quantitative study was conducted from May to June, 2011 through the application of a questionnaire to 52 seniors living in an area covered by a primary health care (PHC) unit in Brazil. The data were analyzed using statistical software.

54. Contd … The sleep disorders most frequently reported by the seniors were: sleeping less than four hours a night (84.6%), daytime sleepiness (71.2%), nighttime awakenings (71.2%), and the use of sleep medications (21.2%). association was significant in relation to the variables: age (p=0.05), morbidities (p=0.02), smoking (p=0.01), and pain when moving (p=0.05) which concluded that the sleep/rest needs of seniors were significantly associated with socio-economic factors and health conditions.

55. CONTI… 2. Effective Factors in Providing Holistic Care: A Qualitative Study.  ABSTRACT: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses’ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring.

56. Contd … A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis) software. Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

57. CONCLUSION: Nursing has deeply influenced by Henderson’s clear view of nursing function. Henderson provides the core of what she believes as a definition of nursing. Her intention was to describe the unique focus of nursing rather than formulate a nursing theory. Her emphases on basic human needs are central focus in today’s nursing practice.

58. Contd … Her fourteen components of basic nursing care are simple and are used by nurses globally to describe predict and explain daily experience. This theory is most applicable in rehab settings, where every patient aims to achieve maximum potential.

59. SUMMARIZATION: Today we have discussed: Biography Honors Contributions Evolution of theory Assumptions of Virginia Henderson’s Need based theory Metaparadigm 14 components

60. Contd … Theoretical assertions Application of theory into clinical practice Application of theory into nursing education Application of theory into nursing research Nursing process Strengths Weakness Conclusion

61. REFERENCES George b. Julia (2010). “ Nursing theories: the base for professional nursing practice”.  Pearson higher ed USA,, fourth edition, page number: 67-82. Alligood Raile Martha and Tomet Mariner Ann, “Nursing theories and their work”, fourth edition, page number: 103-108. Basavanthappa , B.T. “chapter 4: Henderson’s unique function of nurses". Nursing theories. Jaypee brothers. pp. 61-71. Basheer.P.Shabeer , Khan Yaseen S, “A concise textbook of advanced nursing practice” . emmess medical publisher. pp. 264-270. http://www.nursingworld.org/virginiaahenderson.

62. Thank You