PRESENTATION OUTLINE
Betty Neuman
NEUMAN SYSTEMS MODEL
“Nursing is a unique profession that is concerned with all of the variables affecting an individual’s response to stress.”
- Betty Neuman
Betty Neuman (1924 – present) is a nursing theorist who developed the Neuman Systems Model. She gave many years perfecting a systems model that views at patients holistically. She inquired theories from several theorists and philosophers and applied her knowledge in clinical and teaching expertise to come up with the Neuman Systems Model that has been accepted, adopted, and applied as a core for nursing curriculum in many areas around the world.
NEUMAN SYSTEMS MODEL
The Neuman Systems Model is a unique, systems-based perspective that provides a unifying focus for approaching a wide range of nursing concerns. The Neuman Systems Model is a comprehensive guide for nursing practice, research, education, and administratiom that is open to creative implementation. It has the potential for unifying various health-related theories, clarifying the relationships of variables in nursing care and role definitions at various levels of nursing practice.
The Neuman Systems Model views the client as an open system that responds to stressors in the environment. The client variables are physiological, psychological, sociocultural, developmental, and spiritual. The client system consists of a basic or core structure that is protected by lines of resistance. The usual level of health is identified as the normal line of defense that is protected by a flexible line of defense. Stressors are intra-, inter-, and extrapersonal in nature and arise from the internal, external, and created environments. When stressors break through the flexible line of defense, the system is invaded and the lines of resistance are activated and the system is described as moving into illness on a wellness-illness continuum.
If adequate energy is available, the system will be reconstituted with the normal line of defense restored at, below, or above its previous level.
Nursing interventions occur through three prevention modalities. Primary prevention occurs before the stressor invades the system; secondary prevention occurs after the system has reacted to an invading stressor; tertiary prevention occurs after secondary prevention as reconstitution is being established.
METAPARADIGMS IN NURSING
NURSING
Neuman believes that nursing requires a holistic approach that considers all factors affecting a client's health—physical, physiological, psychological, mental, social, cultural, developmental and spiritual well-being.
PERSON
Neuman regarded the concept of a person as an individual family community or the society.
She sees a person as an open system that works together with other parts of its body as it interact with the environment.
HEALTH
Neuman considers health as dynamic in nature in which the person’s health is as the level of health continuum—wellness or illness.
Wellness exists when all the part or system of person works harmoniously.
ENVIRONMENT
The environment can be an internal and external.
Stressors are the forces created by the environment. Stressors are tensions that produce alterations in the normal flow of the environment. These stressors can be:
1. Intrapersonal - occurs within the self and comprises of man as a psycho-spiritual being
2. Interpersonal - occurs between one or more individual and consists of man as a social being
3. Extrapersonal - occurs outside the individual and may include environmental factors
System Model in Nursing Practice
1. Client Variables
- physiological, sociocultural developmental and spiritual—function to achieve stability in relation to the environmental stressors experienced by the client.
2. Lines of Resistance
- acts when the Normal Line of Defense is invaded by too much stressor causing alteration in the normal health pattern to facilitate coping and overcome the stressors that are present within the individual.
3. Normal Line of Defense
- acts in coordination with the normal wellness state. It is the normal reaction of the client in response to stress – the baseline determinants of wellness within the health continuum.
4. Flexible Line of Defense
- helps the body to adjust to situations that threaten the imbalance within the client's stability.
5. Stressors
- stressors are forces that produce tensions, alterations or potential problems causing instability within the clients system.
6. Reaction
- reactions are the outcomes or produced results of certain stressors and actions of the lines resistance of a client. It can be positive or negative depending on the degree of reaction the client produces to adjust and adapt with the situation.
a. Negentropy is set towards stability or wellness
b. Egentropy is set towards disorganization of the system producing illness
7. Prevention
- prevention is used to attain balance within the continuum of health
Three Levels of Prevention according to this theory:
A. Primary prevention – focuses on foreseeing the result of an act or situation and preventing its unnecessary effects as possible. It also aims to strengthen the capacity of a person to maintain an optimum level of functioning while being interactive with the environment. Ex. health promotion and disease prevention.
B. Secondary prevention – focuses on helping alleviate the actual existing effects of an action that altered the balance of health. It aims to reduce environmental influences that cause an alteration in the stability of the client. Ex. Early diseases detection and prompt treatment.
C. Tertiary prevention – focuses on the actual treatments or adjustments to facilitate strengthening of person after being exposed to stressor. Aims to prevent regression and recurrence of the disease. Ex. Rehabilitation
8. Reconstitution
- a state of returning back to old health self.
Application
Practice:
1. Holistic approach in the care of the patients.
Education:
1. Effective in conceptual transition among all levels of nursing education.
2. Basis for continuing education after graduation facilitating professional growth.
3. Validate nursing roles and activities and its applicability beyond nursing practice.
Research:
1. Widely used framework used in nursing research that guides enhancement of nursing care.
Analysis
Simplicity
1. It is simple for people especially health/medical related professionals whom can understand the concepts of health continuum.
Generality
1. Applicable in any health care settings.
2. The theory is comprehensive and adaptable.
Emperical Precision
1. Utilizes empiricism, wherein the theory is testable by mere use of observation.
Clarity
1. Congruent with traditional nursing values.
2. Consistent with other non-nursing theories.
Derivable Consequences
1. Introduction of the nursing process (assessment, nursing diagnosis, planning, implementation and evaluation)
2. Provides guidelines for professional nurses.
