Using peer-reviewed references, give one detailed example of Virginia Henderson’s theory in nursing practice and one detailed example of Virginia Henderson’s theory in nursing research?
Below are two detailed examples that apply Virginia Henderson’s Need Theory: one illustrating a nursing practice application and one illustrating a nursing research application. Each example maps actions to Henderson’s emphasis on assisting individuals to perform activities contributing to health, recovery, or a peaceful death, and cites relevant scholarly sources.
1) Detailed example in nursing practice (clinical application)
Clinical context: Elderly patient after hip replacement surgery with limited mobility and risk for functional decline.
Assessment using Henderson’s 14 basic needs framework:
Identify needs affected by surgery: breathing, eating/drinking, elimination, mobility, rest/sleep, hygiene, avoiding hazards, communication, learning, and independence in activities of daily living (ADLs).
Use structured nursing assessment tools aligned with Henderson’s categories to document baseline status (e.g., mobility score, pain level, nutritional intake, bowel/bladder function, risk of skin breakdown).
Nursing diagnoses and prioritized needs:
Impaired physical mobility related to postoperative pain and muscle weakness (affecting Henderson needs for mobility and performing ADLs).
Risk for constipation related to opioid analgesics (affecting elimination need).
Risk for impaired skin integrity related to limited mobility (affecting hygiene and avoiding hazards).
Interventions derived from Henderson’s theory:
Promote independence in ADLs: implement progressive mobilization plan (assisted ambulation, bedside exercises, stair training as appropriate) to restore the patient’s ability to walk, dress, and transfer—actions reflecting Henderson’s goal that nurses help patients become independent as soon and as fully as possible.
Manage pain and enable participation: provide multimodal analgesia and time pain interventions to coincide with rehabilitation sessions so the patient can actively participate in mobility and self-care tasks.
Support elimination and nutrition: encourage adequate hydration and fiber, monitor bowel function, and use stool softeners as ordered to reduce constipation risk and promote comfort for ADLs such as hygiene.
Prevent complications/avoid hazards: implement pressure-area care, frequent repositioning, fall-prevention measures, and education about safe transfers to reduce injury risk.
Education and enabling: teach wound care, safe transfer techniques, and medication management; provide written discharge instructions tailored to the patient’s needs so the patient (and family) can maintain independence at home—consistent with Henderson’s emphasis on teaching and supporting the patient to perform essential activities.
Expected outcomes and evaluation:
Short-term: patient able to ambulate with a walker the length of the corridor, perform seated hygiene and dress with minimal assistance, and maintain pain at a level that allows participation in rehabilitation sessions.
Discharge readiness: patient able to perform key ADLs (transfers, toileting, dressing) with independence or with planned minimal assistance, and family/caregiver demonstrates competence in any required support tasks.
Evaluation: repeated measurement of mobility scores, pain scores, elimination patterns, and skin integrity to demonstrate restoration of function and safety—fulfilling Henderson’s goal that nursing care should help patients regain independence.
Rationale: This care plan operationalizes Henderson’s view of the nurse’s role as assisting individuals to perform activities that contribute to health or a peaceful death when they lack the strength, knowledge, or will to do so. The interventions are chosen to restore patient independence across Henderson’s fundamental needs while preventing complications that would impede recovery (Henderson, 1966; Fawcett, 2005).
2) Detailed example in nursing research (theory-guided study)
Research context: A quasi-experimental study testing a nurse-led transitional-care intervention designed to improve self-care and reduce readmissions for older adults discharged after heart failure exacerbation.
Theoretical framing:
Use Virginia Henderson’s Need Theory as the conceptual framework: define primary outcomes in terms of patients’ ability to meet basic needs (e.g., breathing comfort, mobility, elimination, nutrition, rest, and knowledge to manage health), and specify that the nursing intervention aims to restore or support these needs to reduce adverse events and readmissions.
Intervention design (guided by Henderson’s constructs):
Nurse-led home visit within 48–72 hours after discharge focused on assessment across Henderson’s need categories (respiratory status, fluid balance and weight management, medication adherence, activity tolerance, nutrition, elimination, skin integrity, and self-care abilities).
Individualized teaching sessions targeting knowledge and skills for meeting needs at home (e.g., daily weight monitoring, dietary sodium management, medication reconciliation, safe activity pacing), plus written/taught action plans for symptom management and when to seek care.
Coordination of care and referrals to community services for assistance with ADLs if needed (aligning with Henderson’s emphasis on helping patients accomplish tasks they cannot do themselves).
Study measures and hypotheses:
Primary outcome: 30-day readmission rate (hypothesis: intervention group will have lower readmission due to improved ability to meet basic needs and manage early symptoms).
Secondary outcomes mapped to Henderson’s needs: self-care ability scales (measuring independence in ADLs), symptom burden (breathlessness, edema), medication adherence scores, patient knowledge tests, quality of life measures, and healthcare utilization (ED visits).
Process measures: fidelity to the nursing assessment across Henderson’s need domains and patient/caregiver competence in identified self-care tasks.
Data analysis and interpretation:
Analyze change in self-care ability and symptom burden between baseline (discharge) and follow-up (30 days) and relate these changes to readmission outcomes—testing the theory-driven hypothesis that improving patients’ abilities to meet fundamental needs reduces adverse outcomes.
Qualitative component: semi-structured interviews with patients/caregivers to explore experiences of regained independence and perceived barriers to meeting needs; use thematic analysis to link lived experiences to Henderson’s conceptual domains.
Contribution to nursing knowledge:
If the intervention reduces readmissions and improves measures of independence in ADLs and symptom control, the findings provide empirical support for the applicability of Henderson’s Need Theory to transitional care and outcomes in heart failure.
Qualitative findings enrich understanding of how assisting with basic needs translates into patient-perceived recovery and everyday functioning, informing refinement of nursing interventions grounded in the theory.
Rationale: Framing the research with Henderson’s theory clarifies which patient needs the nursing intervention targets, guides measurement selection, and provides a testable pathway from nursing actions (assessment, teaching, enabling) to patient outcomes (restored independence, reduced readmissions). Theory-guided research strengthens the link between nursing practice and measurable health outcomes (Alligood, 2014; Fawcett, 2005).
Selected peer-reviewed and scholarly references
Henderson V. The Nature of Nursing: A Definition and Its Implications for Practice, Research, and Education. 2nd ed. New York: Macmillan; 1966. (Foundational work outlining the 14 components of basic nursing care.)
Alligood MR. Nursing Theorists and Their Work. 8th ed. St. Louis, MO: Elsevier; 2017. (Comprehensive scholarly text describing Henderson’s theory and applications in practice and research.)
Fawcett J. The return to nursing theory. Nursing Science Quarterly. 2005;18(1):44–46. (Discusses the relevance of nursing theories, including classical need-based theories, for contemporary practice and research.)
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