Applying Henderson's Need Theory to Improve Patient Satisfaction
This paper examines the use of borrowed theory in nursing, applying Virginia Henderson's Human Need Theory to address declining patient satisfaction scores on a hospital ward. The paper begins by revisiting Benner's stages-of-proficiency model as a middle-range theory, then introduces Henderson's need-based framework—itself derived from Maslow's hierarchy of needs—as a borrowed theoretical lens. The paper explains Henderson's 14 fundamental components of nursing care and her four-step nursing process, demonstrating how recentering care on patient independence and emotional well-being can correct communication breakdowns and low satisfaction. It concludes by integrating Henderson's borrowed theory with Benner's middle-range theory to form a more comprehensive practice model.
- Introduction: Borrowed Theory in Nursing: Rationale for applying borrowed theory to nursing
- Problem Summary and Middle-Range Theory: Ward problem reviewed through Benner's proficiency stages
- Human Need Theory: Description and Origins: Henderson's theory traced to Maslow's hierarchy
- Applying Henderson's Borrowed Theory to Practice: Fourteen needs and four-step nursing process applied
- Applying Human Need Theory to the Ward Problem: Henderson's framework addresses low patient satisfaction
- Integrating Borrowed Theory with Middle-Range Theory: Benner and Henderson combined for comprehensive practice model
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What makes this paper effective
- Connects abstract theoretical frameworks to a concrete, real-world clinical problem — declining patient satisfaction scores — giving the argument practical grounding.
- Traces Henderson's theory back to its psychological origins in Maslow, showing how interdisciplinary borrowing works and why it is justified in nursing contexts.
- Moves logically from identifying a problem, to describing a solution, to applying that solution, demonstrating clear cause-and-effect reasoning throughout.
Key academic technique demonstrated
The paper models theoretical integration: it places a middle-range nursing theory (Benner) alongside a borrowed theory (Henderson/Maslow) and argues that combining both produces a more complete framework than either provides alone. This synthesis technique is central to theory-application papers in professional disciplines.
Structure breakdown
The paper opens with a brief rationale for borrowing theory, then recaps the ward problem through Benner's lens. It introduces Henderson's Need Theory, traces its roots in Maslow, and explains the 14 fundamental needs and four-step nursing process. A dedicated section applies the theory directly to the ward problem. The conclusion argues for integrating both theories. Citations follow APA format.
Introduction: Borrowed Theory in Nursing
Borrowed theory can be a valuable tool for understanding nursing problems and professional challenges. This essay addresses a clinical problem identified in previous work by applying a new theoretical model drawn from another discipline. The goal is to measure the effectiveness and relevance of this borrowed theory within the nursing and medical professions, and to explore how it can be integrated with an established middle-range nursing theory to form a more complete framework for practice.
Problem Summary and Middle-Range Theory
The original problem identified at the ward concerned declining patient satisfaction scores. The nursing and caring aspects of practice on the unit had deteriorated, prompting a search for theoretical guidance. A middle-range theory was applied to help understand the situation: Benner's learning theory was used to examine how nurses may or may not acquire new behaviors, and how those behaviors might be shaped by new practices, policies, and learning experiences.
Benner's theory describes how professionals — including nurses — move through learning in five distinct stages of proficiency: Novice, Advanced Beginner, Competent, Proficient, and Expert. According to Benner (1982) herself, "experience, as it is understood and used in the acquisition of expertise, has a particular definition that should be clarified. As it is described in this model, experience is not the mere passage of time or longevity; it is the refinement of preconceived notions and theory by encountering many actual practical situations that add nuances or shades of differences to theory. Theory offers what can be made explicit and formalized, but clinical practice is always more complex and presents many more realities than can be captured by theory alone" (p. 407). Benner ultimately reveals that while theoretical knowledge is essential, real learning must be gathered through experience and trial and error. In the nursing profession, however, mistakes are often catastrophic, and there is little margin for error when treating patients — making purely experiential learning an insufficient safeguard on its own.
Human Need Theory: Description and Origins
For the nursing profession to remain effective in healing and treating people in their communities, it must remain open to theoretical frameworks developed beyond its own disciplinary boundaries. Nursing theories borrowed from other fields suggest that common and general principles span the breadth of human knowledge. By opening up alternative means of applying knowledge through research, nurses may assume less risk in their practical application of new approaches, even when those approaches are initially met with resistance.
It is important to understand how and why nursing should borrow certain theories and how they may be appropriately applied. As one perspective on borrowed theory holds, "nurse researchers must examine the extent to which theories borrowed from other disciplines are empirically adequate in nursing situations. Nurse researchers must continue their commitment to the advancement of nursing knowledge. Only then can nursing be assured its continued development as a legitimate professional discipline. Indeed, no one discipline can claim health or health promotion as its sole domain. Nurses must be confident that their practice is based on theories that are appropriate for nursing situations. Nurses should be able to articulate to their interdisciplinary colleagues and to the public how what we do is consistent with theories and research from our professional discipline" (p. 163).
A useful borrowed theory for this case is the Nursing Need Theory developed by Virginia Henderson. Henderson derived this theory from a combination of education and experience. She viewed the patient as an individual with independent needs and believed that nursing should ultimately restore the patient's capacity for self-independence in relation to health and healing. In this framework, the nurse's role is supplementary and complementary, with the ultimate goal of helping the person become as independent as possible. In Henderson's (1966) own words: "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible."
Henderson was dissatisfied with the prevailing state of nursing education and the way it viewed patients. To her, nursing was a concept — an art form — in which the human being, not the treatment, doctor, or nurse, was the focal point. Human needs became the central element of the healing process. To support this model, Henderson identified 14 components of nursing care, an extremely practical framework demonstrating how care can be rendered in accordance with the patient's emotional, social, and familial needs.
Henderson's theoretical borrowing came primarily from Maslow's hierarchy of needs, a foundational concept from humanistic psychology. As Gawel (1997) explains, Maslow "postulated, based on his observations as a humanistic psychologist, that there is a general pattern of needs recognition and satisfaction that people follow in generally the same sequence. He also theorized that a person could not recognize or pursue the next higher need in the hierarchy until her or his currently recognized need was substantially or completely satisfied, a concept called prepotency." Henderson drew on this psychological theory to cross-reference and extend her own nursing framework. Maslow's hierarchy, ordered in five ascending levels — Physiological, Safety, Belongingness, Esteem, and Self-Actualization — provided Henderson with a model of human development and motivation that she adapted to the nursing context, treating both patient needs and the nurse's role in meeting them as central concerns.
References
Benner, P. (1982). Wolters Kluwer Health, Inc. The American Journal of Nursing, 82(3), 402–407.
Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370.
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