Virginia Henderson's fourteen basic needs
- Fundamental
Henderson saw the nurse's unique role as helping each person meet 14 basic needs until they can do it alone again.
What it is
Virginia Henderson (1897–1996), a US nurse and teacher, gave her own definition of nursing in 1955 and set it out for the International Council of Nurses in Basic Principles of Nursing Care (1960). In her view, the nurse helps the sick or well person with the activities that contribute to health, recovery or a peaceful death, which the person would do unaided with enough strength, will or knowledge, and does so in a way that helps them regain independence quickly. She grouped those activities into 14 basic needs, common to every person at every age. Many authors call her work a philosophy rather than a full theory, but it remains one of the most used frames for nursing assessment.
Key points
- Physiological needs: breathing, eating and drinking, elimination, movement and posture, sleep and rest.
- Body care needs: dressing suitably, keeping body temperature, and keeping the body clean and the skin protected.
- Safety: avoiding dangers in the environment and avoiding harm to others.
- Psychosocial needs: communicating feelings and needs, and living according to one's beliefs and values.
- Self-fulfilment needs: working or being useful, taking part in recreation, and learning or satisfying curiosity.
- Dependence appears when strength, will or knowledge is lacking; care aims to restore independence.
What it is for
- Strength: clear, simple and easy to teach; it gives a ready assessment structure.
- Strength: it centres care on the person and on independence, not on the disease.
- Limit: the nurse–patient relationship is implied rather than explained.
- Limit: critics say its concepts are not linked tightly enough to count as a model or theory.
Step by step
- Assess each of the 14 needs, asking what the person usually does and what they do now — so changes stand out.
- For each unmet need, ask whether strength, will or knowledge is missing — the cause decides the intervention.
- Decide the nurse's role for that need: substitute, helper or companion — so care fits the degree of dependence.
- Set goals in terms of independence (the person dresses with little help) — health is independence for Henderson.
- Re-assess often and step back as the person regains ability — so help does not create dependence.
Henderson and the metaparadigm
| Concept | How Henderson sees it |
|---|---|
| Person | A whole being, body and mind, with 14 basic needs to meet |
| Environment | The surroundings that help or hinder; care keeps them as close as possible to the person's usual life |
| Health | Independence in meeting the basic needs |
| Nursing | Helping the person do what they would do alone, and regain independence as soon as possible |
In nursing practice
- Example: after a hip operation, a man cannot wash alone because of pain and fear of falling. The nurse first washes him (substitute), then helps him sit and wash his face (helper), then supervises (companion).
- His need for elimination is met with help to the toilet, not with a bedpan, so he keeps as much independence as possible.
- Services that use her model build their nursing assessment form on the 14 needs.
Common mistakes
- Doing everything for the patient when he could do part of it.
- Assessing only the physical needs and skipping communication, beliefs, work, recreation and learning.
- Not asking why the need is unmet (strength, will or knowledge).
- Copying Henderson's list into a form without adapting it to the person's own routines.
Test yourself
Think of the answer, then tap the question to see it.
How does Henderson define health?
As independence in meeting one's basic needs.
What three sources of difficulty can make a person dependent, according to Henderson?
Lack of strength, lack of will and lack of knowledge.
What roles can the nurse take for an unmet need in Henderson's view?
Substitute (doing it for the person), helper (doing it with the person) and companion (supporting the person).
In which ICN publication did Henderson set out the components of basic nursing care?
Basic Principles of Nursing Care, published by the International Council of Nurses in 1960.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Fundamentos filosóficos de la propuesta de Virginia Avenel Henderson (Enfermería Universitaria, ENEO-UNAM (Redalyc), 2007); Where and how does fundamental care fit within seminal nursing theories: A narrative review and synthesis of key nursing concepts (Journal of Clinical Nursing (PubMed Central), 2020); Implementation of the nursing process in a health area: models and assessment structures used (Revista Latino-Americana de Enfermagem (PubMed Central), 2014).
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Representative model, for educational purposes only.