Nursing Theory Comparison: Assumptions, Concepts, and Relationships

Introduction

Nursing theories are important tools for nurse practitioners, researchers, and educators. They provide guiding frameworks supported by theoretical and empirical knowledge, enabling nurses to create a plethora of supporting frameworks centered around patient care. Modern nursing theories have a variety of approaches to patient care. Henderson’s theory focuses on enabling patient independence by focusing on the 14 needs that a patient has, whereas Leininger’s theory puts an emphasis on the patient’s cultural and racial heritage to inform the nursing approach towards them. The purpose of this paper is to outline both theories, their strengths and weaknesses, and their applications in the nursing environment.

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Theory Backgrounds

Henderson’s theory was created in 1939, right in the wake of the Second World War. The common approach towards patient care was nurse-centric, rather than patient-centric (Masters, 2015). Nurses were expected to do everything required for the patient to get better, while the only requirement towards patients was mindless obedience. Henderson’s “concept” was aimed at increasing the patient’s independence. It also altered the perceptions of the nursing role, establishing the nurse as a facilitator of care for patients, assisting them in performing activities they could not perform, thus increasing independence and self-reliance.

Leininger’s Transcultural Nursing theory was developed during the 1950s, the first ideas for it being born during the author’s work in a child guidance home (Alligood, 2017). She noticed that approaches based on assessing one’s cultural patterns had a drastic behavior on patients, which brought about positive results. At that point, the notion of multiculturalism was practically absent from healthcare. Leininger was the first to make an argument for the necessity of cultural education for medical professionals, as well as emphasized the importance of such education on a patient’s convalescence or decline.

Philosophical Underpinnings

Henderson’s philosophical underpinnings are based around the idea of nursing as a way to facilitate independence in a patient. These notions are based on her own experience as a medic, a psychiatrist, and a pediatrics nurse. The idea of independence as a virtue in nursing is very close to American culture, in which she was born and raised, which comes with an innate suspicion of authority (Alligood, 2017). Henderson’s theory seeks to win a patient’s trust by helping them facilitate independence.

Leininger’s theory, on the other hand, revolves around the philosophy of mutual respect and common values and beliefs as well as the respect of other peoples’ traditions. It is a holistic philosophy that seeks to earn the patient’s trust by knowing and respecting their boundaries. The philosophical underpinnings for this theory state that individuals who share the same culture can help one another better than an ineffectual outsider can (Smith & Parker, 2015).

Major Assumptions, Concepts, and Relationships

The major assumptions for Henderson’s theory revolve around the role of nurses in relation to their patients. The first statement outlines the role of the nurse as an assistant to the patient until they are capable of taking care of themselves.

The implicit concept is that all patients desire to get well soon and leave the hospital when assistance is no longer required. The second assumption is that nurses derive joy from helping patients and are willing to provide assistance whenever it is possible. The last assumption suggests that all nurses and medical workers have the proper credentials to provide high-quality healthcare (Alligood, 2017).

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Leininger’s transcultural theory is different. Its major assumption revolves around the concept of care (Sitzman & Eichelberger, 2015). According to Leininger, all human cultures have generic traits associated with care, which the theory seeks to build upon. Thus, a care program based on the patient’s culture can provide the most results, as the patient is more likely to understand and comply with it. Care is the cornerstone of Leininger’s theory, as without caring the processes of healing and nurturing cannot be properly facilitated.

Clinical Applications and Comparisons of the Use

Henderson’s theory of care has a wide range of clinical applications, ranging from primary care facilities to triage wards, hospitals, and long-term care facilities. Due to its emphasis on patient independence, it is useful in situations where patients can maintain themselves, and where the nursing personnel is lacking in numbers (Ahtisham & Jacoline, 2015). Enabling patients to take care of themselves and providing assistance in critical tasks could substantially reduce the among of overall assistance the patients need.

In addition, Henderson endorses patient education and a profound understanding of the care delivered to them. Understanding, according to Henderson, creates trust and makes patients take a more participative role in their healthcare.

Leidinger’s transcultural theory can be applied along with other theories, in healthcare settings that have multicultural patients. The USA is a multicultural nation, with representatives of more than 100 different countries and cultures utilizing its healthcare facilities (Betancourt, 2015). With a range of healthcare habits and beliefs this wide, Leidinger’s theory can provide better results compared to uniform care theories that ignore cultural influences. Particularly, Leidinger’s theory is useful in psychiatry and psychology, as it helps to understand the issues a patient has from a cultural perspective.

Specific Examples

Henderson’s 14 components of nursing care can be utilized in a situation where an individual is recovering from a suicide attempt by drinking toxic cleaning products (like detergents). In the specific scenario that occurred in my clinical setting, the patient was a 17-year old girl that was being heavily persuaded by her family to agree to an arranged marriage with the customer of their choosing. The family is the first generation of immigrants from India. The components of patient needs as outlined by Henderson’s theory are as follows (Ahtisham & Jacoline, 2015):

  • Breathing normally: The patient experienced difficulty in breathing due to damage of her pathways by the detergent. Provide assisted breathing.
  • Eating and drinking: The patient proved to be resistant to eating and drinking. Provide physical and psychological help to assist in nutrition.
  • Elimination of bodily waste: Provide catheterization.
  • Movement and posture: The patient experiences fatigue and imbalance, provides plenty of rest and assistance when walking until no longer needed.
  • Sleep and rest: The patient cannot sleep for three days. Provide medical solutions to the problem.
  • Suitable clothes: The patient’s dress is dirty and uncouth. Best replace with hospital garb.
  • Maintaining body temperature: No issues.
  • Keeping the body cleaned and groomed: The patient is very self-conscious, provides means and tools of taking care of oneself.
  • Avoid danger: The patient has a history of attempted suicide, best kept under supervision.
  • Communication: The patient has a damaged larynx and has trouble communicating. Provide writing tools if needed.
  • Faith: Does not practice any religions, comes from an Islamic background.
  • Accomplishments: Lost interest in herself after the arranged marriage plans have been announced.
  • Recreation: Used to spend time with family, now lost interest.
  • Learning and discovery: Finds it hard to concentrate due to stress and psychological issues.

As it is possible to see, using Henderson’s theory, it is possible to plan out an an effective plan of care for the patient by focusing on her physical and psychological limitations. However, while this theory provides a good framework for in-hospital care, it does not offer long-term solutions that could help prevent the incident from reoccurring. Leidinger’s transcultural theory, however, would help understand the root of the suicide attempt in the patient, which is her arranged marriage.

This cultural tradition is one of the darker sides of Indian culture that brings unhappiness to parents and children alike (Betancourt, 2015). While standard nursing procedures are likely to keep the patient alive and take care of the aftermath of ingesting domestic chemicals, Leidinger’s theory suggests the emphasis to be made on making peace between the daughter and her mother, by hopefully taking the parents out of arranged proposals, or at least by convincing them to take their daughter’s preferences into account. Reaching a consensus would help eliminate many issues highlighted in Henderson’s analysis.

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Parsimony

Parsimony in medicine stands for attributing the majority of the patient’s symptoms to a single cause. It stands for focusing the efforts on a single primary issue. Henderson’s theory is based on 14 patient needs, which provides a rather wide array of measures to deal with the cause. Leininger’s theory makes culture a primary focus, which makes it less effective in situations where culture is not a prevalent issue.

Conclusions

Henderson’s Needs theory is a popular framework that shifted the focus of the nurse and unto the patient and their needs. Leininger’s theory was the first of its kind to bring cultural education into nursing as a significant factor in facilitating treatment and improving outcomes. Both theories have their own strengths, weaknesses, and applications. Henderson’s theory is best used in general non-acute settings, whereas Leidinger’s theory is best used in multicultural environments and psychology.

References

Ahtisham, Y., & Jacoline, S. (2015). Integrating nursing theory and process into practice; Virginia’s Henderson need theory. International Journal of Caring Sciences, 8(2), 443-450.

Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). New York, NY: Elsevier.

Betancourt, D. A. B. (2015). Madeleine Leininger and the transcultural theory of nursing. The Downtown Review, 2(1), 1-7.

Masters, K. (2015). Nursing theories: A framework for professional practice (2nd ed.). Burlington, MA: Jones & Bartlett.

Sitzman, K., & Eichelberger, L. W. (2015). Understanding the work of nurse theorists: A creative beginning (3rd ed.). Sudbury, MA: Jones & Bartlett.

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Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice (3rd ed.). Philadelphia, PA: Davis.

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