Model of the 14 basic needs

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The 14 basic needs model is a nursing theory developed in 1966 by nursing scientist Virginia Henderson . The model is one of the trend-setting nursing models of the 20th century and has significantly influenced a number of the subsequent nursing theories.

Basics of their theory

Man cannot be seen in detail. Not only the disease should be treated, but the person as a whole ( holistic care ). Family, job, social environment, friends and especially needs have to be included.

Human needs form the basis of Henderson's theory. The nurse's job is to help people meet their needs in the event that they can no longer meet their needs. However, the main focus has to be on instructing people to be able to meet their needs again themselves.

Virginia Henderson's definition states that: “The sick or healthy person [should be helped] in the performance of activities which are conducive to health or recovery (or even peaceful death) and which he would do without assistance if he would have the necessary strength, willpower or knowledge. [The carer] helps in such a way that the person being cared for regains his independence as quickly as possible ”.

Henderson is of the opinion that every person has different priorities in his needs and their satisfaction, depending on his culture, his social and individual basis. The factors influencing needs are "his socio-cultural background, his physical and psychological resources, his energy, his will, his motivation and his age" (Henderson 1997). The most important function of the nurse is to find out which needs the patient can no longer meet themselves and where they must be supplemented. Henderson emphasizes that the needs of the patient must not be determined unchecked, but that the nurse, in cooperation with the patient, supported by their observation skills, must assess the needs and develop possible solutions.

Henderson's Basic Needs Model

Henderson has identified 14 basic needs that she believes are the foundation of every human being and that should be used as an assessment basis. Henderson believed that mental equilibrium is inseparable from physical equilibrium. The Maslow's hierarchy of needs , which begins with the physical needs and ends with the psychosocial components can be found back in the 14 elements. The nurse provides help where necessary and creates conditions under which the patient can carry out these activities independently. According to Henderson, basic needs include:

  1. normal breathing,
  2. adequate food and fluid intake,
  3. Elimination by means of all elimination organs,
  4. Moving and maintaining the desired position,
  5. Rest and sleep,
  6. Selection of suitable clothing, dressing and undressing,
  7. Maintaining normal body temperature,
  8. Cleanliness and personal hygiene, protection of the exterior,
  9. Avoidance of dangers in his environment and of endangering others,
  10. expressing feelings, needs, fears or feelings in dealing with others,
  11. to pursue one's religious beliefs
  12. satisfactory employment,
  13. Play or participate in various forms of entertainment
  14. learn, discover or satisfy the thirst for knowledge that lead to normal development and health,
  15. Use of the existing health care facilities.

Henderson originally listed 15 basic needs. Of these 15th, however, only the first 14 were named by the subsequent authors who took Henderson's work as a basis. Virginia Henderson's model has become known as the model of the 14 basic needs.

For Henderson, it was clear that the nurse was responsible and responsible for meeting the patient's needs.

According to Henderson, the patient has to be the focus for everyone involved in therapy. Nursing care must not allow itself to be deterred from its task by non-care activities, such as bureaucratic or administrative activities. In emergency situations, if the doctor is not present, the nurse has to step in for him. For the caregiver, supporting the patient and restoring his or her independence is a top priority. The goal must be to enable health promotion, healing or a peaceful death. The nurse must be there for all matters that limit the patient's needs and make him incomplete. It must be she who stands up for his “limitations” and tries to compensate and supplement them with all means so that the patient is “complete” again. Henderson knew this was an almost insoluble problem for the caregiver.

Henderson summed it up like this:

“For a while it is the consciousness of the unconscious, the love of life for the suicidal person, the leg for the amputee, the eyes of the blind person, the means of transport for the toddler, knowledge and confidence for the young mother, for those who are too weak or too poor of contact to communicate, the "mouthpiece" and so on. "

It is also important to Henderson that the patient should cooperate as far as he can. As a basis, however, the care plan must be discussed with the patient. Only then does the patient understand the entire process of which he is the focus. Only in this way is it possible for him to cooperate and accelerate his recovery. Henderson never developed a definition of health himself, but it can be assumed that she regards a person as healthy if he can perceive all 14/15 basic needs himself without any help, i.e. is independent. For Henderson, death was also an important task for care and this cannot be ruled out. The caregiver can do a lot to contribute to a peaceful death by making the patient as comfortable and comfortable as possible. According to Henderson, care has to consider not only the promotion of health, but also the possibility of death.

According to Henderson, care is a service in which more is required of the caregiver than the specialist knowledge acquired in training. A nurse has to empathize with her patient, try to feel and think like him ( empathy ). The patient must notice that the nurse is doing everything possible to empathize with him. The caregiver must not take their own needs and desires as a yardstick. Everyone has different priorities in their life. The nurse must see the patient's needs as the basis of their work. She must correspond to his ideas about health, healing and a peaceful death and try to live up to his ideas.

To illustrate a patient's dependency, Henderson designed a pie chart model. The individual sectors of the diagram are divided according to the need for care. The less a patient can do for himself, the smaller his part in the pie chart and the larger the parts of everyone involved in the patient's recovery. If one compares the pie chart with a cake, the patient has a goal: "The patient's goal is to get the largest possible piece of the cake or to have the whole cake". Every nurse must work towards this goal.

The connection of the nursing theory of Virginia Henderson with the shape circle model of the internist Viktor von Weizsäcker and the control circle model of the medical historian Heinrich Schipperges ' took place at the nursing school of the University of Heidelberg in connection with the Institute for the History of Medicine of the University of Heidelberg by the nursing scientist Antje Grauhan . The nursing school at Heidelberg University was the first university institution to work with Virginia Henderson's nursing theory in Germany after the Second World War .

Purpose of your theory

Henderson's goals were:

  • To make it clear that everyone has basic needs and that these, if they are restricted, must be taken over by a caregiver.
  • Everyone is an individual and must be seen that way.
  • The well-being of the patient is paramount.
  • Always act according to the patient's wishes.
  • Try by all means to enable the patient to regain independence.
  • The patient is not to be seen alone, but also his environment (family, work, etc.).
  • The patient is to be included in the care as much as possible.

Professional care

For Henderson, professional care means perceiving the patient's needs, supplementing them if necessary and enabling the patient to regain independence.

However, the care must also be based on the medical treatment plan and is therefore also dependent on the responsible doctor. The nurse must therefore also include the medical instructions in their care plan.

Type of nursing relationship / interaction

The relationship between patient and caregiver takes place on different levels, from very dependent to completely independent. The levels are represented as follows:

  1. the nurse as a substitute for the patient,
  2. the nurse as a helper for the patient and
  3. the nurse as the patient's partner.

This means that initially the caregiver is a substitute for some or all of the patient's needs. If the care is successful, the patient should be able to satisfy more and more of his needs himself. In this phase the nurse should only act as a helper. Ideally, the patient should become independent again.

The patient should be able to maintain his usual daily routine as far as possible. The caregiver should keep the patient's daily routine as normal as possible.

literature

  • Marit Kirkevold: Nursing Theories. Urban & Schwarzenberg, Munich / Vienna / Baltimore 1997, ISBN 3-541-18891-X .

Afaf Ibrahim Meleis : Nursing Theory. Subject, development and perspectives of theoretical thinking in nursing. Huber, Bern / Göttingen / Toronto / Seattle 1999, ISBN 3-456-82964-7 . Hilde Steppe : Care models in practice, 2nd episode: Virginia Henderson. In: The sister, the nurse. 1990, pp. 584-588.

Individual evidence

  1. ^ Christine R. Auer: The Heidelberg School of Anthropological Medicine and Nursing. Posthumously for Antje Grauhan. Lecture at the Florence Nightingale Congress at Royal Holloway College London. Self-published, Heidelberg 2010, ISBN 978-3-00-033011-7 .