Understanding the nursing metaparadigm as one of the main theoretical foundations is a critical task for all nurses. Nursing science has undergone multiple shifts to identify the most important services and environments where nurses and patients cooperate (Rogers, 1992). The metaparadigm defines interest in nursing science and consists of four major concepts, namely person, environment, health, and nursing (Fawcett, 1984).
Person (patients, families, or communities) is a recipient of nursing care. Environment is a surrounding that may affect the quality of care and the patient’s well-being. Health is a degree of well-being that a person might experience, and nursing includes all interventions that nurses offer to their clients. All nursing theories and models should be based on these four concepts to ensure solid guidelines for nurses. At the beginning of the 1900s, Virginia Henderson introduced her need theory, addressing the rules for nurse-patient relationships. It was not just an ordinary theory but a unique nursing practice focused on the patient’s independence (Henderson’s nursing need theory, n.d.). Henderson’s beliefs about basic human needs affect nursing practice and promote the development of the person-centered approach in any healthcare facility.
When people think of nursing care, they usually introduce a group of experts who examine and diagnose patients, develop treatment plans, and control recovery processes. However, a distinctive feature of nursing science is the intention to involve as many individuals as possible and underline their specific contributions. Henderson developed her theory to stabilize the relationships between nurses and patients because she believed that patients had to know how to take care of themselves (Virginia Henderson, n.d.).
Following her practical experience and education, Henderson explained how to interpret human needs through the prism of nursing practice. There are fourteen examples of human needs in her theory, including normal breathing, adequate drinking/eating, body waste elimination, desirable posture maintenance, sleep/rest, suitable clothing, body temperature, cleanness, safety, communication, faith worship, accomplishment, recreation, and education (Henderson’s nursing need theory, n.d.). It is wrong to prioritize or neglect some of these needs because Henderson developed a holistic care approach, including physiological, emotional, spiritual, and social aspects (Gligor & Domnaru, 2020). Nurses should understand how to support patients, families, and communities and encourage a sense of responsibility for their own well-being.
Theory and Metaparadigm
The success of contemporary nursing care is predetermined by understanding how nursing concepts can be expressed within the chosen beliefs. The metaparadigm, as a combination of global concepts, remains an abstract component in nursing science (Fawcett, 2000). However, when the theory is discussed within these four concepts, detailed and concrete definitions are revealed and can be implemented in nursing with time. Henderson’s theory contains 14 tasks for patients, and the role of a nurse is to ensure that these needs are met. The first concept, person, should reveal a direct recipient of care. Henderson believed that all individuals have a number of basic needs and should use professional support to obtain independence in caregiving. Therefore, nurses continue developing their knowledge and assisting people, either ill or healthy, to complete their tasks that enhance recovery, health, or peaceful death (Chinn, 2018).
Individuals may strive for independence or neglect such requirements, depending on their awareness levels. However, if they decide to take care of themselves, they can ask for help, consider the relationship between mind and body, and examine the impact of all biopsychosocial needs.
The metaparadigm concept of environment should not be limited to home or hospital only. According to Fawcett (2000), it usually includes all national, regional, social, political, and economic conditions that might affect nursing care. In Henderson’s theory, not much attention is paid to the identification or definition of the environment because the author indicates the needs of a person, not the conditions under which these needs are met. However, it is possible to interpret the offered needs and gain a better understanding of what kind of environment may be presupposed in this theory. For example, Henderson underlines the importance of keeping the body clean, protecting the integument, avoiding dangers, and wearing suitable clothing (Henderson’s nursing need theory, n.d.).
It means that the setting should be safe and comfortable for a person. Besides, the nurse explains the basics of care to the patient, which promotes a supportive environment where a nurse and a patient cooperate. Individuals have to learn how to protect themselves, establish family contact, and minimize the number of threats to their health.
The next concept around which Henderson’s beliefs should be examined is health. One of the most interesting elements of the chosen theory is the necessity to promote health among sick and not sick people. There has to be a balance between all human needs, including an appropriate temperature, communication, eating habits, and learning techniques (Lopez et al., 2020). Health is not only some physiological stability and achievement but a combination of positive mental health outcomes, social determinants, and economic factors. People should respect their age, gender, and intellectual capacities to be confident that they make rational decisions and maintain independence in their life. Illness should not affect the quality of interpersonal relationships but show how nurses can assist people with limited or poor awareness of their diseases.
The last component of the nursing metaparadigm is nursing, and Henderson’s approach to the need theory clearly defines the role of nurses. Patients face different challenges and changes when they get sick, and they may not have enough knowledge to solve their problems alone. Thus, temporary assistance is the nurse’s responsibility, which helps encourage an individual and maintain independence. According to Henderson (1991, as cited in Gligor & Domnaru, 2020), a person needs nursing care, but it should not be limited to disease-related care. Thus, the offered 14 components define nursing care and the conditions under which the patient gains independence (Gligor & Domnaru, 2020).
In addition to a therapeutic plan developed by a physician, the nurse offers individualized care to solve problems and support patients. The role of a nurse in providing care is “to get inside the patient’s skin and supplement his strength will or knowledge according to his needs” (Henderson’s nursing need theory, n.d., para. 10). This evaluation of the relationships proves the success of Henderson’s theory because it covers nursing professionalism and patient contributions.
Healthy Development Promotion and Infection Prevention
Examining each element of the nursing paradigm in the chosen theory enhances understanding of Henderson’s beliefs about healthy development across the lifespan and infection prevention. Today, COVID-19 has become a new provocative example of how one infection can damage millions of people worldwide. In a short period, many hospitals and healthcare providers had to demonstrate resilience against a dangerous virus and readiness to help patients and their families. Although it was not a good time to apply the components of Henderson’s theory because of the virus’s unpredictability and the populations’ poor awareness, some elements could be proved as effective. The main idea of Henderson’s model is to encourage a nurse to take care of patients until they are able to take care of themselves (Gligor & Domnaru, 2020). Therefore, nurse devotion to patients is critical in recognizing their needs and contributing to recovery and well-being.
Healthy living needs vary, and Henderson successfully combined them within her list, removing unnecessary stuff and underling the most effective steps. For example, the creation of a safe environment can be achieved by avoiding dangers and enhancing healthy practices like normal breathing, adequate eating and drinking, and communication (Henderson’s nursing need theory, n.d.). Nursing assessments based on patient needs defined by Henderson have been significantly improved, leading to the standardization of care, the distribution of professional roles, and the use of available resources (Lopez et al., 2020). This theory has a direct impact on the promotion of healthy development in hospitals and other healthcare clinics.
In addition, the progress of infection prevention programs is frequently observed in modern facilities. One of the major integrity principles is the promotion of healing, which is infection-free, by choosing the correct physiological positioning (Fawcett, 2000). There are many elements in Henderson’s model that contribute to this goal. For example, the theorist offers to eliminate body wastes, move, and maintain desirable postures (Henderson’s nursing need theory, n.d.).
These approaches predict dangerous bedsores and other health complications when patients refuse to follow recommendations. Other components perfectly address hygiene needs: suitable clothing, normal temperature, and an overall sense of accomplishment (Henderson’s nursing need theory, n.d.). In this case, nurses support patients in their intention to feel comfort and convenience during their hospitalization and home treatment.
Theory’s Impact on Nursing Practice
In nursing practice, nurse-patient relationships are highly appreciated, and multiple ways are offered to achieve the best results and maintain positive health outcomes. Henderson is one of the theorists who believed that nurses should support their patients in different situations, both in sickness and health. There are specific recommendations for how to hasten the progress of healing in hospitals in her model. Basic human needs are not always properly recognized when patients are in critical conditions, and the task is to ensure that eating, drinking, and clothing needs are met. Henderson’s ideas are well-received in different parts of the world, including the USA and many countries in Central and Eastern Europe (Gligor & Domnaru, 2020).
In addition to practical steps, the theory is added to the curriculum, and education focuses on evaluating and understanding the 14 fundamental components (Gligor & Domnaru, 2020). In other words, millions of nurses continue using this model in different situations to ensure that nurses take high-quality care of their patients.
Nurses should be trained from multiple perspectives because their awareness of theoretical basics is not enough to complete their tasks properly. Thus, Lopez et al. (2020) offer a study where patient assessments and nursing training are based on Henderson’s theory and prove the effectiveness of this approach in terms of improved record-making and defining risk factors. Nursing practice with a focus on patients’ basic needs is a unique contribution to human health and the promotion of the best care services.
Theory and the Person-Centered Nursing Framework
In 2006, a framework for person-centered nursing was developed and explained. McCormack and McCance (2006) identified four critical constructs, including prerequisites, the care environment, person-centered processes, and expected outcomes, and described their relationship in nursing practice. Prerequisites define the attributes that nurses should implement: job commitment, clarity of beliefs, and self-awareness (McCormack & McCance, 2006).
These skills enhance communication and promote strong assumptions about patients, their needs, and expectations. The care environment is the context through which services are delivered, and supportive systems are implemented. To achieve the necessary patient outcomes like satisfaction with care or feeling of well-being, several person-centered processes should be integrated (McCormack & McCance, 2006). Nurses demonstrate high-level engagement, sympathy, shared decision-making, and provision for physical needs.
Most of the elements from the person-centered framework can be observed in Henderson’s theory. Their main similarities are attention to human needs and the maintenance of a supportive environment. Besides, in both models, nurses perform the role of facilitators for patients who want to be involved in self-care and healing. However, certain differences in the offered frameworks cannot be ignored. For example, the person-centered approach does not recognize the worth of patient independence, while Henderson pays most of her attention to this achievement (Henderson’s nursing need theory, n.d.). On the contrary, McCormack and McCance (2006) admit the impact of risk-taking and innovation, while Henderson lacks these arguments. Still, despite the existing differences and similarities, both models contribute to the creation of a professional care environment.
In general, the application of Henderson’s theory in clinical and academic contexts is characterized by many benefits and successful changes. On the one hand, this model effectively recognizes nurses’ roles in patient care and the impact of cooperation that enhances patient independence and self-awareness. On the other hand, nurses learn to identify basic human needs and implement this knowledge in practice. Not all patients realize that their independence can become a key to healing and positive health outcomes. Thus, nurses need to memorize the offered fourteen recommendations in patient-centered care and inform patients about their personal contributions to healthy development and nursing practice.
Chinn, P. (2018). The nature of nursing. Nursology. Web.
Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Image: The Journal of Nursing Scholarship, 16(3), 84-87. Web.
Fawcett, J. (2000). Analysis and evaluation of contemporary nursing knowledge: Nursing models and theories. F. A. Davis Company.
Gligor, L., & Domnaru, C. D. (2020). Patient care approach using nursing theories-comparative analysis of Orem’s self-care deficit theory and Henderson’s model. Acta Medica Transilvanica, 25(2), 11-14. Web.
Henderson’s nursing need theory. (n.d.). Nursing Theory. Web.
Lopez, M., Jimenez, J. M., Fernández-Castro, M., Martin-Gil, B., Garcia, S., Cao, M. J., Frutos-Martin, M., & Castro, M. J. (2020). Impact of nursing methodology training sessions on completion of the Virginia Henderson assessment record. Nursing Reports, 10(2), 106-114. Web.
McCormack, B., & McCance, T. V. (2006). Development of a framework for person-centred nursing. Journal of Advanced Nursing, 56(5), 472–479. Web.
Rogers, M. E. (1992). Nursing science and the space age. Nursing Science Quarterly, 5(1), 27-34.
Virginia Henderson – Nursing theorist. (n.d.). Nursing Theory. Web.