Betty Neuman's System Model (1924)

The Neuman systems model is a nursing theory based on the individual's relationship to stress,
the reaction to it, and reconstitution factors that are dynamic in nature.
The central core of the model consists of energy resources (normal temperature range, genetic
structure, response pattern, organ strength or weakness, ego structure, and knowns or
commonalities) that are surrounded by several lines of resistance.
The lines of resistance represent the internal factors that help the patient defend against
a stressor.
The normal line of defense represents the person's state of equilibrium.
The flexible line of defense depicts the dynamic nature that can rapidly alter over a short period
of time.
The purpose of the nurse is to retain this system's stability through the three levels of prevention:
1. Primary prevention to protect the normal line and strengthen the flexible line of defense.
2. Secondary prevention to strengthen internal lines of resistance, reducing the reaction, and
increasing resistance factors.
3. Tertiary prevention to readapt and stabilize and protect reconstitution or return to wellness
following treatment.
 Sister Callista Roy’s Adaptation Theory (1976)

“Roy’s work focuses on human adaptive system responses and environmental stimuli, which are
constantly changing. . . . [The] goal of nursing [is] to promote adaptation for individuals and
groups in the four adaptive modes, thus contributing to health, quality of life, and dying with
dignity by assessing behavior and factors that influence adaptive abilities and by intervening to
expand those abilities and to enhance environmental interactions.”

Types of stimuli

 Focal stimuli are those that immediately confront the individual in a particular situation.

 Contextual stimuli are those other stimuli that influence the situation.

 Residual stimuli include the individual's beliefs or attitudes that may influence the situation.
 Coping Process

Regulator: Physical status of the family in terms of health? i.e., nutritional state, physical
strength, availability of physical resources

Cognator: Educational level, knowledge base of family, source of decision making, power base,
degree of openness in the system to input, ability to process

Four Modes of adaptation

 Physiologic mode, adaptation involves the maintenance of physical integrity. Basic human needs
such as nutrition, oxygen, fluids, and temperature regulation are identified with this mode.

 Self-concept mode is the need for maintenance of psychic integrity. Perceptions of one's
physical and personal self are included in this mode.

 Role can be assessed by observing the communication patterns in the family. Assessment should
include how decisions are reached, the roles and communication patterns of the members, how
role changes are tolerated, and the effectiveness of communication.

 Interdependence involves maintaining a balance between independence and dependence in

one's relationships with others. Dependent behaviors include affection seeking, help seeking,
and attention seeking. Independent behaviors include mastery of obstacles and initiative taking.

Levels of Adaptation
 Integrated Process
The various modes and subsystems meet the needs of the environment. These are usually stable
processes (e.g., breathing, spiritual realization, successful relationship).
 Compensatory Process
The cognator and regulator are challenged by the needs of the environment, but are working to
meet the needs (e.g., grief, starting with a new job, compensatory breathing).
 Compromised Process
The modes and subsystems are not adequately meeting the environmental challenge (e.g.,
hypoxia, unresolved loss, abusive relationships).