Virginia Henderson’s Need Theory: Promoting Patient Independence After Hospitalization

The Need for Patient Independence

As patients undergoes treatment and are on their road to recovery, it is important that they are in a position to take care of themselves even after being released from the medical healthcare facility. To this end, Virginia Henderson, a nursing theorist, developed the Need Theory to address this concern. The theory requires nurses to take care of a patient and meet the 14 fundamental needs highlighted in the theory while helping them become more independent (Alligood, 2014). This paper will focus on how Virginia Henderson’s Need Theory addresses the implementation of strategies bynurses,enablingpatients to become independent and care for themselves upon leaving a healthcare setting and the need for additional research on the theory.

The Need Theory revolves around the concern of patients being released from a medical facility yet they cannot sufficiently take care of themselves when it comes to the basic everyday routine. These basic daily activities include feeding, using the washrooms, self-medication, grooming, and dressing. Upon discharge, there is the need for patients to engage in self-care voluntary activities in order to maintain their health, quality of life and overall wellness and also promote their recovery process (Hall, 2015). Some of the self-care activities pertaining to the recovery process that individuals need to assume after being released from a healthcare setting include taking their prescriptions, dressing their wounds, sampling and interpreting blood and urinary results, adhering to parenteral dietary, airway suctioning, adjusting and following up on fluid and nutritional input and output. In most cases, patients who have been discharged from the hospital are not capable of such self-care because they are not independent (Alligood, 2013). 

The nursing profession needs to be concerned about patients’ independence upon discharge to minimize the unnecessary readmissions, the life-threatening risks, and even death. For themajority of the patients especially those living alone, they are at their most vulnerable point during the period after hospitalization. Nurses need to assess and promote a patient’s readiness before discharging them. In the process of administering healthcare to them during their stay in the health facility, nurses ought to constantly engage the patient in activities that will enable them to rely on themselves for self-care activities once they are released from the hospital. This will help promote the patient’s independence and they will not require a caregiver to constantly be available for them (Blais, 2015). 

Nursing literature establishes that the lack of independence among patients is a major concern that undermines the recovery process upon discharging a patient and in some cases, the patient’s health deteriorates and some even succumb to death when they cannot administer self-care to themselves. In addition, it has been a rampant issue that is increasing the cases of unnecessary hospital admissions of patients who cannot depend on themselves when it comes to the basic daily living activities. Previous and current nursing literature advises on theapplication of several and concurrent interventions to promote patients’ independence and minimize the cases of unnecessary readmissions. Some of these recommendations encompass effective patient empowerment and education, enhanced coordination between the caregiving theteam and the patient, remote monitoring, reconciliation of prescribed medications, provision of aftercare services before discharge, regular follow-ups before discharge, frequent telephone and home visits. Orem’s theory known as the self-care deficit nursing theory emphasizes that individuals should be responsible and self-dependent when it comes to their own care and that nursing is an interactive action between the patient and the caregivers (Maltby, Williams, McGarry& Day, 2014). This patient independence is however hindered by some factors that affect a patient’s capability to manage and maintain their health and achieve optimal recovery from injuries or diseases. In his theory, Orem referred to these factors as the basic conditioning factors which are the healthcare system, availability and sufficiency of resources, standards of living, the environment, the development status, age and sociocultural values (Masters, 2014). 

The Need Theory and Patient Independence

The stakeholders affected by patients’ independence after being discharged from the hospital are the patients themselves, their caregivers at home who could be family or friends, those dependent on the patient such as children and siblings. The healthcare providers concerned with the patient’s health and recovery are also concerned because the lack of self-reliance will lead to failure of their treatment and preventable readmissions of the patient due to lack of recovery or deterioration (Smith & Parker, 2015).

The implementation of the 14 fundamental needs of the Need Theory by Virginia Henderson influences nurses in the way that they assist patients in satisfying their physical, emotional, social, or spiritual needs by assessing and addressing their ability to breath, eat and drink sufficiently and get rid of bodily wastes. In order to establish a patient’s independence and prevent a recurrence of the illness as a result of a deficit in self-care, a nurse needs to work with and through others in helping a patient to perform the 14 basic human needs by themselves. This could be achieved by involving the patient and family members in a daily routine that meets the broad range of the fundamental needs (Selanders, 2015). A nurse is the prime rehabilitative caregiver and should be in a position to assess their success with the performance of each patient based on the speed and degree with which they carry out basic activities independently. The practicing nurse must carry out their primary responsibility of executing the doctor’s therapeutic plan to attain patient’s independence through rehabilitation. To achieve this, the nurse needs to involve the patient in the performance of the therapeutic treatment plan and guide them through the process. Therefore, the theory is vital as it helps nurses satisfy the fundamental needs of their patients even after they have been released from their care (Ferrari, Rodrigues, Baldissera, Pelloso & Carreira, 2014).

The Need Theory can be applied to solving the need for patients’ independence upon discharge by using a strategy that entails assessing and meeting the fourteen fundamental needs of a patient. According to Henderson, they are normal breathing, sufficient, drinking and eating, getting rid of body waste. Additionally, nurses should ensure mobility and maintaining an appropriate position, adequate sleep, and rest, appropriate dressing, maintaining normal body temperature, good grooming, avoiding injuring self and others. Further, a patient’s needs that require a nurse’s help are effective communication, worshipping in regard to one’s faith, feeling the sense of achievement from one’s work, participating in recreational activities and discovering or satisfying one’s curiosities (Grol,Wensing, Eccles & Davis, 2013). Assessing and facilitating these needs enables normal patient and health development in a manner that the patient will be self-reliant after the hospitalization period.

Implementation of the Need Theory

The nurse can implement the strategy through assessing the patient’s needs by first establishing the nursing care function that one intends to administer in order to maintain health, promote recovery, or merely meet the basic needs. It is pertinent for the nurse to also establish whether they will be administering care as a helper, a partner, or a doer of the entire care process. The nurse should also determine whether the patient is capable of meeting his or her own fundamental needs with or without help. In addition, nurses should consider the patient’s strength, will, and knowledge in participating in a strategy that promotes independence. The degree of intervention, involvement, and performance of both the nurse and the patient is determined by the level of the patient’s need and their ability to perform by themselves. Through the entire hospital stay, nurses need to use their skills and knowledge in supporting the helpless patients meet these needs and educate them together with their family on how to promote independence as the patient recovers their strength and ability to carry out various self-care activities by themselves (Masters, 2015). Meeting Henderson’s fundamental needs is a rewarding factor that enables nurses to see their patients’ progress to independence. The patient-focused theory stresses the significance of a healthy relationship between the nurse and the patient and the need to execute treatment and care according to the physician’s prescription. In this case, nurses should implement the theory by adhering to patient needsand promoting self-reliance. (McEwen, 2014).

According to Virginia Henderson, there is no single profession in this era that can sufficiently evaluate or improve its performance without further research and this fosters the need to conduct additional research that goes beyond her 14 fundamental Need Theory in order to promote patients’ independence after hospitalization. The Need Theory has some limitations that calls for additional research that provides a conceptual connection between the physiological characteristics and other human features. More investigation needs to be carried out on the holistic nature of a human being’s needs and how nurses can promote independence in satisfying all these needs upon discharging patients (Slatyer, Coventry,Twigg& Davis, 2015). In addition, there is need to carry out studies that inter-relate factors that influence patient’s independence and the nursing healthcare policy. Henderson’s work creates room for continuous polishing and improvements allowing for other researchers to come up with well-defined models and theories. Her theory was a foundation for increasing the performance in the nursing practice. The 14 basic components of needs arouse various research questions such as the nurse’s role in assuming the responsibility of identifying possible problems and addressing them without a physician’s instructions. In an age of continuous technological advancements, further research is required to validate the nurses’ functions in the healthcare improvement methods used and in enforcing nursing care in a manner, which promotes patient self-reliance (Ahtisham & Jacoline, 2015).

Additional Research on the Need Theory

Conclusion

To sum up, this paper explains the importance of promotion of the patient’s independence by a practicing nurse in meeting the needs of a patient. This will enable them to maintain their health, promote their recovery from an injury or disease, and minimize the cases of preventable readmissions due to deterioration of health or lack of recovery after being discharged from a healthcare facility. Virginia Henderson provides us with the Need Theory, which outlines the 14 fundamental needs of a patient that requires nursing care and highlights the need for patients to be independent once they leave a medical facility. Application of the Need Theory by nurses assists patients to have these needs satisfied in a manner that enables and encourages the patient to perform these daily living activities by themselves. From this theory, I have gained insight and knowledge on how to effectively implement the Need Theory in the nursing practice so that I can empower helpless patients during their hospital stay as I deliver the necessary care. In the process of meeting the 14 fundamental needs, I can effectively involve the patient in the daily activities in a manner that enables and encourages them to perform these tasks by themselves without relying on another person’s help.

References

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