Using Henderson's 14 Basic Needs theory, this paper attempts a concept analysis. Some background on concept analysis is provided. Concept analysis is a controversial issue because it is not believed to be very useful in the field. However, it is still used to define concepts and help provide the defining variables that distinguish one concept from another. The full concept analysis is provided.
¶ … arbitrary," "troublesome," "vacuous," and even "wrong," Walker & Avant's method can be a useful method of communicating concepts and developing theories (Risjord, 2008). At the very least, a concept analysis can provide some clarity on a complex issue in the nursing realm. As Walker & Avant (2005) put it, concepts are "the building blocks of theory" (p. 26). For example, Virginia Henderson's Theory of 14 Basic Needs is rather complex and benefits thoroughly from a Walker & Avant-style concept analysis.
Walker & Avant (2005) present eight key steps in a concept analysis. These steps include the following:
Determine the aims of the concept.
Identify all uses of the concept possible.
Determine the defining attributes.
Identify model case.
Identify borderline, related, contrary, invented, and illegitimate cases.
Identify antecedents and consequences.
Define empirical referents.
Concept Analysis of Henderson's 14 Basic Needs
Determine the aims of the concept.
The aims of Henderson's 14 Basic Needs ultimately center on the improvement of nursing practice. The term "need" is a fundamental one: referring to the core needs of patients. However, Henderson was also aware of the environmental factors that place constraints on patient needs. Needs can refer to things like comfort and the presence of loved ones; or needs can refer to those practices that are beneficial for the patient in the long run such as medial procedures. When Henderson's 14 Basic Needs theory is applied in a broader sense to healthcare administration, needs may even apply to community, institutional and financial needs.
Identify all uses of the concept possible.
Henderson identified the fourteen needs in terms of the basic elements of health care: environment, health, nurse, and person. For the purpose of narrowing the concept analysis, it will be helpful to focus on one of these aspects. Uses of Henderson's fourteen needs concept include informing institutional philosophy and practice; and influencing nursing praxis and education. Henderson's 14 Basic Needs can be used at the level of policy development equally as well as the concept can be used at the level of bedside practice.
Determine the defining attributes.
The defining attributes of Henderson's 14 Basic Needs include nursing, person, and care. Nursing is defined in a "functional manner," such as by assisting individuals in participating and pursuing health-promoting activities ("Key Concepts," n.d.). Another defining attribute of Henderson's 14 Basic Needs theory is person: defined as a whole being with spiritual as well as physical and emotional components. Moreover, the environment impacts the individual's entire dynamic. The environment can even influence needs. Henderson defined nursing as a facilitation of health in a model that empowers the patient. "Promoting independence" is a primary objective of nursing according to Henderson and the 14 Basic Needs theory ("Key Concepts," n.d.). One of the defining attributes of Henderson's 14 Basic Needs Theory as it applies to patients is that nursing empowers patients to become independent.
Identify model case.
Thirst is a basic physiological need, but it is more than that for a patient. A model case that illustrates Henderson's 14 Basic Needs was conducted by Porth & Erickson (1992). "Thirst and drinking function to maintain body water balance and are basic to survival," (p. 273). On this level, thirst is ascertained as a bodily need; indicating that the body needs water in order to survive and live. Yet there are other aspects of thirst that are relevant for nursing theory and practice. Thirst is an uncomfortable feeling. As Porth & Erickson (1992) put it, "Thirst is often associated with a dry unpleasant-tasting mouth and the feeling of a need to obtain water; it can result from dehydration, decreased vascular volume, dry mouth, pharmacologic agents," and other environmental causes (p. 273). A nurse can help the patient fulfill the need to hydrate when the patient is bed-ridden. In some cases, the nurse might need to identify root causes for the thirst that might indicate deeper health issues. Until the patient has a normal, comfortable level of thirst that can be alleviated simply and independently, a nurse is needed.
Identify borderline, related, contrary, invented, and illegitimate cases.
A borderline case related to Henderson's 14 Needs can be identified, as well as related, contrary, invented, and illegitimate cases. Patient A complains of thirst but will not drink water. Their need when calling for the nurse was diagnosed as loneliness rather than thirst. A concept strongly related to that of Henderson's 14 Basic Needs is Maslow's Hierarchy of Needs. The hierarchy ranges from basic physiological needs like thirst and hunger to spiritual needs like self-actualization ("Key Concepts," n.d.). A related case may be related to patient hunger, which can be construed in a number of different ways and is a different sensation to thirst. Similarly, a patient who needs to have his or her family around is expressing basic needs that are not related to physiological but psychological and spiritual needs. Invented cases and illegitimate cases are those that do not identify patient needs that are within the nurse's domain of responsibility. Issues related to "love and belongingness" were de-emphasized by Henderson herself ("Key Concepts," n.d.).
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