Virginia Henderson's Nursing Theories PDF

Nursing Theorist & their theories Virginia Henderson Education Early education: In Virginia with her aunts, and uncle Charles Abbot, at his school for boys in the community Army School of Nursing at Walter Reed Hospital in Washington D.C. In 1921, she received her Diploma in Nursing from the...

Nursing Theorist & their theories Virginia Henderson Education Early education: In Virginia with her aunts, and uncle Charles Abbot, at his school for boys in the community Army School of Nursing at Walter Reed Hospital in Washington D.C. In 1921, she received her Diploma in Nursing from the Army School of Nursing at Walter Reed Hospital, Washington D.C. 1923: She started teaching nursing at the Norfolk Protestant Hospital in Virginia. 1929: She entered Teachers College at Columbia University and earned r her Bachelor’s Degree in 1932 1934: Master’s Degree Virginia Henderson Professional Life She worked at the Henry Street Visiting Nurse Service for two years after graduation in 1921. In 1923, she initially planned to switch professions, but her strong desire to help the profession averted her plan. From 1924 to 1929, she was an instructor and educational director at Norfolk Protestant Hospital, Norfolk, Virginia. In 1930, she was a nurse supervisor and clinical instructor at the outpatient department of Strong Memorial Hospital, Rochester, New York. For 14 years of her career, from 1934 to 1948, she worked as an instructor and associate professor at Teachers College, Columbia University in New York. Since 1953, Henderson was a research associate at Yale University School of Nursing and a research associate emeritus (1971 -1996). Virginia Henderson Works of Virginia Henderson In 1939, she was the author of three editions of “Principles and Practices of Nursing,” a widely used text. Her “Basic Principles of Nursing,” published in 1966 and revised in 1972, has been published in 27 languages by the International Council of Nurses. Principles and Practice of Nursing: Henderson co-authored the fifth (1955) and sixth (1978) editions of the Textbook of Principles and Practice of Nursing when the original author, Bertha Harmer, died. At age 75, she began the sixth edition of the Principles and Practice of Nursing text. Over the next five years of her life, she led Gladys Nite and seventeen other contributors to synthesize the professional literature she completed indexing. One of Henderson’s famous works is the Nursing Index (ICN, 1963) Virginia Henderson’s Need Theory Henderson’s widely known contribution to nursing is the Need Theory, among her other works. The Need Theory emphasizes the importance of increasing the patient’s independence and focusing on basic human needs so that progress after hospitalization would not be delayed. The theory emphasizes the importance of increasing the patient’s independence to hasten their progress in the hospital. Henderson’s theory emphasizes basic human needs and how nurses can meet those needs. “I believe that the function the nurse performs is primarily an independent one – that of acting for the patient when he lacks knowledge, physical strength, or the will to act for himself as he would ordinarily act in health or in carrying out prescribed therapy. This function is seen as complex and creative, offering unlimited opportunity to apply the physical, biological, and social sciences and develop skills based on them.” (Henderson, 1960) Virginia Henderson’s Need Theory Assumptions of the 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 “nurses will devote themselves to the patient day and night.” (4) Henderson also believes that the “mind and body are inseparable and are interrelated.” Virginia Henderson’s Major Concepts (Metaparadigms) Individual Henderson states that individuals have basic health needs and require assistance to achieve health and independence or a peaceful death. According to her, an individual achieves wholeness by maintaining physiological and emotional balance. She defined the patient as needing nursing care but did not limit nursing to illness care. Her theory presented the patient as a sum of parts with biopsychosocial needs; the mind and body are inseparable and interrelated. Environment Although the Need Theory did not explicitly define the environment, Henderson stated that maintaining a supportive environment conducive to health is one of her 14 activities for client assistance. Henderson’s theory supports the private and public health sector’s tasks or agencies to keep people healthy. She believes that society wants and expects the nurse’s act for individuals who cannot function independently. Virginia Henderson’s Major Concepts (Metaparadigms) Health Although not explicitly defined in Henderson’s theory, health meant balance in all realms of human life. It is equated with the independence or ability to perform activities without aid in the 14 components or basic human needs. On the other hand, nurses are key in promoting health, preventing illness, and curing. According to Henderson, good health is a challenge because it is affected by factors such as age, cultural background, emotional balance, etc. Nursing Virginia Henderson wrote her definition of nursing before the development of theoretical nursing. She defined nursing as “the unique function of the nurse is to assist the individual, sick or well, in performing those activities contributing to health or its recovery that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.” The nurse aims to make the patient complete, whole, or independent. In turn, the nurse collaborates with the physician’s therapeutic plan. Virginia Henderson’s Major Concepts explained Nurses temporarily assist individuals lacking the strength, will, and knowledge to satisfy one or more of the 14 basic needs. She states: “The nurse is temporarily the consciousness of the unconscious, the love life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge, and confidence of the young mother, the mouthpiece for those too weak or withdrawn to speak.” Additionally, she stated that “…the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But the nurse makes the patient independent of them as soon as possible.”| Her definition of nursing distinguished a nurse’s role in health care: The nurse is expected to carry out a physician’s therapeutic plan, but individualized care results from the nurse’s creativity in planning care. The nurse should be an independent practitioner able to make an independent judgment. In her work Nature of Nursing, she states the nurse’s role is “to get inside the patient’s skin and supplement his strength, will or knowledge according to his needs.” The nurse is responsible for assessing the patient’s needs, helping them meet health needs, and providing an environment where the patient can perform unaided activities.  Virginia Henderson’s 14 Needs Physiological Components 1. Breathe normally 2. Eat and drink adequately 3. Eliminate body wastes 4. Move and maintain desirable postures 5. Sleep and rest 6. Select suitable clothes – dress and undress 7. Maintain body temperature within normal range by adjusting clothing and modifying environment 8. Keep the body clean and well-groomed and protect the integument 9. Avoid dangers in the environment and avoid injuring others  Virginia Henderson’s 14 Needs Psychological Aspects of Communicating and Learning 10. Communicate with others in expressing emotions, needs, fears, or opinions. 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Spiritual and Moral 11. Worship according to one’s faith Sociologically Oriented to Occupation and Recreation 12. Work in such a way that there is a sense of accomplishment 13. Play or participate in various forms of recreation Hildegarde Peplau – Interpersonal Relations Born: September 1, 1909 and died March 17, 1990 Education In 1931, Hildegard graduated from the Pottstown Hospital School of Nursing. In 1943, Hildegard earned her Bachelor's in Interpersonal Psychology. During 1943-1945, Hildegard served as an Army Corps Nurse. In 1947, Hildegard earned her master’s degree in Psychiatric Nursing. Certified in psychoanalysis by the William Alanson White Institute of New York City. Hildegarde Peplau – Interpersonal Relations Professional Life In the early 1950s, she developed and taught the first classes for graduate psychiatric nursing students at Teachers College. Peplau was a member of the College of Nursing faculty at Rutgers University from 1954 until her retirement in 1974. She was a professor emeritus at the said university. She created the first graduate-level program to prepare clinical specialists in psychiatric nursing (Rutgers University). Advocated for the academic advancement of nurses to provide therapeutic care to the mentally ill. Supervised summer workshops for nurses throughout the United States, primarily in state psychiatric hospitals. Hildegarde Peplau – Interpersonal Relations Professional Life Served as a visiting professor at the University of Leuven in Belgium in 1975 and 1976 and assisted in establishing the first graduate nursing program in Europe. The only nurse who served the ANA (American Nurses Association) as executive director and later as president. She served two terms on the Board of the International Council of Nurses (ICN). As a New Jersey State Nurses Association member, she actively contributed to the ANA by serving on various committees and task forces. She participated in many government policy-making groups. Peplau was an advisor to the World Health Organization and a visiting professor at universities in Africa, Latin America, Belgium, and the United States. Peplau served as a consultant to the U.S. Surgeon General, the U.S. Air Force, and the National Institute of Mental Health- known as the Mother of Psychiatric Nursing Hildegarde Peplau – Interpersonal Relations Hildegard E. Peplau’s theory defined Nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.” It is a “maturing force and an educative instrument” involving an interaction between two or more individuals with a common goal.  Hildegarde Peplau – Interpersonal Relations Works Interpersonal Relations in Nursing: A conceptual frame of reference for psychodynamic nursing Interpersonal theory on nursing practice: Selected works of Hildegard E. Peplau Basic Principles of patient counseling Extracts from two clinical nursing workshops in psychiatric hospitals A Glance Back in Time: An article from Nursing Forum On Semantics (psychiatric nursing): An article from Perspectives in Psychiatric Care, The Psychiatric Nurse–Accountable? To Whom? For What?: An article from Perspectives in Psychiatric Care and Psychotherapeutic Strategies: An article from Perspectives in Psychiatric Care. Her book on her conceptual framework, Interpersonal Relations, completed in 1948 IPR book published in 1952 Hildegarde Peplau – IPR Assumptions Hildegard Peplau’s Interpersonal Relations Theory’s assumptions are: (1)Nurse and the patient can interact. (2)Peplau emphasized that both the patient and nurse mature as the result of the therapeutic interaction. (3)Communication interviewing skills remain fundamental nursing tools. (4)(4) Peplau believed that nurses must clearly understand themselves to promote their client’s growth and avoid limiting their choices to those that nurses value. Major Concepts Person Health Environment Nursing Hildegarde Peplau – Metaparadigms Man Peplau defines man as an organism that “strives in its own way to reduce tension generated by needs.” The client is an individual with a felt need. Health Health is “a word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living.” Society or Environment Although Peplau does not directly address society/environment, she does encourage the nurse to consider the patient’s culture and mores when the patient adjusts to the hospital routine. Hildegarde Peplau – Metaparadigms Nursing Hildegard Peplau considers nursing a “significant, therapeutic, interpersonal process.” She defines it as a “human relationship between an individual who is sick, or in need of health services, and a nurse specially educated to recognize and to respond to the need for help.” Therapeutic nurse-client relationship A professional and planned relationship between client and nurse focuses on the client’s needs, feelings, problems, and ideas. It involves interaction between two or more individuals with a common goal. The attainment of this goal, or any goal, is achieved through a series of steps following a sequential pattern. Nursing Roles Roles explained Stranger: offering the client the same acceptance and courtesy that the nurse would respond to any stranger Resource person: providing specific answers to questions within a larger context Teacher: helping the client to learn formally or informally Leader: offering direction to the client or group Surrogate: serving as a substitute for another, such as a parent or a sibling Counselor: promoting experiences leading to health for the client, such as the expression of feelings Technical Expert: Provides physical care for the patient and operating equipment Hildegarde Peplau – Phases of IPR Orientation. The first interaction between the nurse and patient. Goals are set to lay the foundation for building trust between the nurse and the patient. The nurse’s orientation phase involves engaging the client in treatment, providing explanations and information, and answering questions. Problem-defining phase It starts when the client meets the nurse as a stranger. Defining the problem and deciding the type of service needed Client seeks assistance, conveys needs, asks questions, and shares preconceptions and expectations of past experiences. Nurse responds, explains roles to the client, identifies problems, and uses available resources and services. Hildegarde Peplau – Phases of IPR Identification Phase The identification phase begins when the client works interdependently with the nurse, expresses feelings, and begins to feel stronger. Selection of appropriate professional assistance The patient begins to feel connected and capable of dealing with the problem, which decreases the feeling of helplessness and hopelessness. Hildegarde Peplau – Phases of IPR Exploitation Phase The client makes full use of the services offered. Use of professional assistance for problem-solving alternatives Advantages of services are based on the needs and interests of the patients. The individual feels like an integral part of the helping environment. They may make minor requests or attention-getting techniques. The principles of interview techniques must be used to explore, understand and adequately deal with the underlying problem. Patient may fluctuate on independence. Nurses must be aware of the various phases of communication. The nurse aids the patient in exploiting all avenues of help, and progress is made towards the final step. Hildegarde Peplau – Phases of IPR Resolution Phase In the resolution phase, the client no longer needs professional services and gives up dependent behavior. The relationship ends. Termination of the professional relationship. The patient’s needs have already been met by the collaborative effect of patient and nurse. Sometimes, it may be difficult for both as psychological dependence persists. The patient drifts away and breaks the nurse’s bond, and a healthier emotional balance is demonstrated, and both become mature individuals. Madeleine Leininger-Transcultural Nursing Theory Early Life Madeleine Leininger was born on July 13, 1925, in Sutton, Nebraska After graduation from Sutton High, she was in the U.S. Army Nursing Corps while pursuing a basic nursing program. Her aunt, who had congenital heart disease, led her to pursue a career in nursing. Education In 1945, Madeleine Leininger entered the Cadet Nurse Corps, a federally funded program to increase the number of nurses trained to meet anticipated needs during World War II. She earned a nursing diploma from St. Anthony’s Hospital School of Nursing and undergraduate degrees at Mount St. Scholastica College and Creighton University. Leininger opened a psychiatric nursing service and educational program at Creighton University in Omaha, Nebraska. She earned the equivalent of a BSN through her studies in biological sciences, nursing administration, teaching, and curriculum during 1951-1954 In 1954 she received a Master of Science in Nursing from the Catholic University of America. In 1965, Leininger embarked upon a doctoral program in Cultural and Social Anthropology at the University of Washington in Seattle and became the first professional nurse to earn a Ph.D. in anthropology. Madeleine Leininger-Transcultural Nursing Theory Professional Life In 1954, Leininger served as Associate Professor of Nursing and Director of the Graduate Program in Psychiatric Nursing at the University of Cincinnati. Pursued further graduate studies in curriculum, social sciences, and nursing. She was the first in the 1960s to coin the concept of “culturally congruent care,” which was the goal of the Theory of Culture Care, and today the concept is being used globally. Appointed Professor of Nursing and Anthropology at the University of Colorado — the first joint appointment of a nursing professor and a second discipline in the United States. Appointed Dean of the University of Washington School of Nursing in 1969 and remained in that position until 1974. In 1973, the University of Washington was recognized as the outstanding public institutional school of nursing in the United States under her leadership. Recognized worldwide as the founder of transcultural nursing, a program that she created at the School in 1974. Leininger’s Culture Care Diversity and Universality, published in 1991, was developed in the 1950s. The theory was further developed in her book Transcultural Nursing, which was published in 1995 and revised and published in 2002. Madeleine Leininger-Transcultural Nursing Theory Professional Life From 1974 to 1980, Leininger served as dean, professor of nursing, adjunct professor of anthropology, and director of the Center for Nursing Research and the Doctoral and Transcultural Nursing Programs at the University of Utah College of Nursing. In 1975 she was the first full-time President of the American Association of Colleges of Nursing and one of the first members of the American Academy of Nursing in 1975. Leininger’s professional career is recognized as an educator and academic administrator from 1956 to 1995, a writer from 1961 to 1995, a lecturer from 1965 to 1995, a consultant from 1971 to 1992, and a leader in transcultural nursing from 1966 to 1995. She was Professor Emeritus of Nursing at Wayne State University and an adjunct faculty member at the University of Nebraska Medical Center in Omaha and retired as the former in 1995. Madeleine Leininger-Transcultural Nursing Theory Works Leininger’s theory’s main focus is for nursing care to fit with or have beneficial meaning and health outcomes for people of different or similar cultural backgrounds. With these, she has developed the Sunrise Model in a logical order to demonstrate the interrelationships of the concepts in her theory of Culture Care, Diversity, and Universality. Wrote and edited 27 books and founded the Journal of Transcultural Nursing to support the Transcultural Nursing Society’s research. She published over 200 articles and book chapters, produced numerous audio and video recordings, and developed a software program Established the Journal of Transcultural Nursing and served as editor from 1989 to 1995. She also initiated and promoted transcultural nurses’ worldwide certification (CTN) for client safety and knowledgeable care for people of diverse cultures. Madeleine Leininger-Transcultural Nursing Theory Major Concepts Transcultural nursing is defined as a learned subfield or branch of nursing that focuses upon the comparative study and analysis of cultures concerning nursing and health-illness caring practices, beliefs, and values to provide meaningful and efficacious nursing care services to their cultural values and health-illness context. Ethnonursing: This is the study of nursing care beliefs, values, and practices as cognitively perceived and known by a designated culture through their direct experience, beliefs, and value system Nursing: is a learned humanistic and scientific profession and discipline that is focused on human care phenomena and activities to assist, support, facilitate, or enable individuals or groups to maintain or regain their well-being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death. Madeleine Leininger-Transcultural Nursing Theory Major Concepts Professional Nursing Care (Caring) is as formal and cognitively learned professional care knowledge and practice skills obtained through educational institutions that are used to provide assistive, supportive, enabling, or facilitative acts to or for another individual or group to improve a human health condition (or well-being), disability, lifeway, or to work with dying clients. Cultural congruent (Nursing) Care is defined as those cognitively based assistive, supportive, facilitative, or enabling acts or decisions that are tailor-made to fit with the individual, group, or institutional, cultural values, beliefs, and lifeways to provide or support meaningful, beneficial, and satisfying health care, or well-being services. Health is a state of well-being that is culturally defined, valued, and practiced. It reflects individuals’ (or groups) ‘ ability to perform their daily role activities in culturally expressed, beneficial, and patterned lifeways. Madeleine Leininger-Transcultural Nursing Theory Major Concepts Human Beings Such are believed to be caring and capable of being concerned about others’ needs, well-being, and survival. Leininger also indicates that nursing as a caring science should focus beyond traditional nurse-patient interactions and dyads to include families, groups, communities, total cultures, and institutions. Society and Environment Leininger did not define these terms; instead, she spoke of worldview, social structure, and environmental context. Worldview Worldview is how people look at the world, or the universe, and form a “picture or value stance” about the world and their lives. Madeleine Leininger-Transcultural Nursing Theory Major Concepts Cultural and Social Structure Dimensions are defined as involving the dynamic patterns and features of interrelated structural and organizational factors of a particular culture (subculture or society), which includes religious, kinship (social), political (and legal), economic, educational, technological, and cultural values, ethnohistorical factors, and how these factors may be interrelated and function to influence human behavior in different environmental contexts. Environmental Context is the totality of an event, situation, or particular experience that gives meaning to human expressions, interpretations, and social interactions in particular physical, ecological, sociopolitical, and/or cultural settings. Culture is learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guide their thinking, decisions, and actions in patterned ways. Culture Care is defined as the subjectively and objectively learned and transmitted values, beliefs, and patterned lifeways that assist, support, facilitate, or enable another individual or group to maintain their well-being, health, improve their human condition lifeway, or deal with illness, handicaps or death. Madeleine Leininger-Transcultural Nursing Theory Major Concepts Culture Care Diversity indicates the variabilities and/or differences in meanings, patterns, values, lifeways, or symbols of care within or between collectives related to assistive, supportive, or enabling human care expressions. Culture Care Universality indicates the common, similar, or dominant uniform care meanings, patterns, values, lifeways, or symbols manifest among many cultures and reflect assistive, supportive, facilitative, or enabling ways to help people. Cultural Care Preservation or Maintenance Maintain meaningful care beliefs and values for an individual well-being to recover from illness Cultural Care Accommodation or Negotiation Refers to creative professional care actions and decisions that help people of a designated culture. Culture Care Repatterning or Restructuring Refers to enabling professional actions and decisions that help clients modify their lifeways for beneficial health. Madeleine Leininger-Transcultural Nursing Theory Sub Concepts Generic (Folk or Lay) Care Systems are culturally learned and transmitted, indigenous (or traditional), folk (home-based) knowledge and skills used to provide assistive, supportive, enabling, or facilitative acts toward or for another individual, group, or institution with evident or anticipated needs to ameliorate or improve a human life way, health condition (or well-being), or to deal with handicaps and death situations. Emic: Knowledge gained from direct experience or directly from those who have experienced it. It is generic or folk knowledge. Professional Care Systems are formally taught, learned, and transmitted professional care, health, illness, wellness, and related knowledge and practice skills that prevail in professional institutions, usually with multidisciplinary personnel to serve consumers. Etic: The knowledge that describes the professional perspective. It is professional care knowledge. Ethnohistory includes those past facts, events, instances, experiences of individuals, groups, cultures, and instructions that are primarily people-centered (ethno) and describe, explain, and interpret human lifeways within particular cultural contexts over short or long periods. Madeleine Leininger-Transcultural Nursing Theory Sub Concepts Care as a noun is defined as those abstract and concrete phenomena related to assisting, supporting, or enabling experiences or behaviors toward or for others with evident or anticipated needs to ameliorate or improve a human condition or lifeway. Care e as a verb is defined as actions and activities directed toward assisting, supporting, or enabling another individual or group with evident or anticipated needs to ameliorate or improve a human condition or lifeway or face death. Culture Shock may result when an outsider attempts to comprehend or adapt effectively to a different cultural group. The outsider is likely to experience feelings of discomfort, helplessness, and some degree of disorientation because of the differences in cultural values, beliefs, and practices. Culture shock may lead to anger and can be reduced by seeking knowledge of the culture before encountering that culture. Cultural Imposition refers to the outsider’s efforts, both subtle and not so subtle, to impose their own cultural values, beliefs, and behaviors upon an individual, family, or group from another culture.  Sunrise Model of Madeleine Leininger’s Theory The Sunrise Model is relevant because it enables nurses to develop critical and complex thoughts about nursing practice. These thoughts should consider and integrate cultural and social structure dimensions in each context, besides nursing care’s biological and psychological aspects..  Sunrise Model of Madeleine Leininger’s Theory.  References. Alligood, M. R. (2021). Nursing theorists and their works (10th ed.). Elsevier Berman, A., Snyder, S.J., Frandsen, G. (2016). Kozier & Erb fundamentals of nursing: Concepts, process, & practice (10th ed.). Pearson Education Limited.