Betty Neuman Theory PDF

26/08/2020
DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY
Biography
Ateneo de Davao University • Betty Neuman (1924 – present) is a nursing
theorist who developed the Neuman Systems Model.
• She gave many years perfecting a systems model that
Betty Neuman views at patients holistically.
• She inquired theories from several theorists and
Neuman Systems Model philosophers and applied her knowledge in clinical and
teaching expertise to come up with the Neuman
Systems Model that has been accepted, adopted, and
Lectured by: applied as a core for nursing curriculum in many areas
JENNY-ANN B. SORIANO, RN MAN
Clinical Instructor, Ateneo de Davao
around the world.
University
Davao City, Philippines
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
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Biography Biography
• Betty Neuman was born in 1924 near Lowell, Ohio. • As a young girl, she attended the same one-room
• She grew up on a farm which later encouraged her to help schoolhouse that her parents had attended and was excited
people who are in need. when she went to a high school that had a library. She was
always engaged and fascinated with the study of human
• Her father was a farmer who became sick and died at the age behavior.
of 36. Her mother was a self-educated midwife, that led the
young Neuman to be always influenced by the commitment • During World War II, she had her first job as an aircraft
that took her away from home from time to time. instrument technician. In 1947, she received her RN Diploma
from Peoples Hospital School of Nursing, Akron, Ohio.
• She had one older brother and a brother who was younger
which makes her the middle child among her siblings. • Betty Neuman moved to California and worked in a variety of
capacities as a hospital nurse and head nurse at Los Angeles
• Her love for nursing started when she took the responsibility County General Hospital, school nurse, industrial nurse, and
of taking care of her father which later created her clinical instructor at the University of Southern California
compassion in her chosen career path. Medical Center, Los Angeles.
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Biography Works
• In 1957, she received a baccalaureate degree in public health • Neuman persisted to start a private practice as a marriage and family
and psychology with honors. Amidst her hectic life as a nurse,
she also managed to work as a fashion model and learned to therapist, specializing in Christian counseling.
fly a plane.
• She is a Fellow of the American Association of Marriage and Family
• She got married, supported her husband’s medical practice,
and had their daughter in 1959.
Therapy and of the American Academy of Nursing.
• She also earned a master’s degree in mental health, public • Until 2009, she was the director of the Neuman Systems Model
health consultation in 1966 from the University of California, Trustees Group, Inc. that she established in 1988, and still attends as
Los Angeles (UCLA).
a consultant.
• After her graduation, she was hired as a department chair in
the UCLA School of Nursing graduate program. Neuman • The Trustees Group was created to preserve and maintain the
developed the first community mental health program for
graduate students in the LA area from 1967 to 1973.
message of her nursing theory for the health care community.
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Betty Neuman’s Nursing Theory

• In 1972, Neuman published a draft of her model.
• She developed and improved the concepts and published her
book, The Neuman System Model: Application to Nursing Education
and Practice, in 1982.
• Further revisions were made in later editions. As a speaker and
author, she spent countless hours teaching and explaining the many
concepts and aspects of the model to students and professors.
• Betty Neuman has done many things including a nurse, educator,
health counselor, therapist, author, speaker, and researcher.
• Throughout the years, she earned many awards and honors
including several honorary doctorates and was an honorary
member of the American Academy of Nursing. The profound effect
of her work on the nursing profession is well known throughout the
world.
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Betty Neuman’s Nursing Theory Betty Neuman’s Nursing Theory

• Three words frequently used in relation to stress are inevitable, • Betty Neuman describes the Neuman
painful and intensifying. Systems Model as “a unique, open-
• It is generally subjective, and can be interpreted as the system-based perspective that provides a
circumstances one regards as conceivably threatening and out of
their control. unifying focus for approaching a wide
range of concerns.
• A nursing theory developed by Betty Neuman is based on the
person’s relationship to stress, the response to it, and reconstitution • A system acts as a boundary for a single
factors that are progressive in nature. client, a group, or even a number of
• The Neuman Systems Model presents a broad, holistic and system- groups; it can also be defined as a social
based method to nursing that maintains a factor of flexibility. issue.
• It focuses on the response of the patient system to actual or
potential environmental stressors and the maintenance of the client • A client system in interaction with the
system’s stability through primary, secondary, and tertiary nursing environment delineates the domain of
prevention intervention to reduce stressors. nursing concerns.”
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Betty Neuman’s Nursing Theory Betty Neuman’s Nursing Theory

• Stressors are intra-, inter-, and extrapersonal in nature and arise from
• The Neuman Systems Model views the client as an the internal, external, and created environments.
open system that responds to stressors in the • When stressors break through the flexible line of defense, the system
environment. is invaded and the lines of resistance are activated and the system is
• The client variables are physiological, psychological, described as moving into illness on a wellness-illness continuum.
sociocultural, developmental, and spiritual. The client • If adequate energy is available, the system will be reconstituted with
system consists of a basic or core structure that is the normal line of defense restored at, below, or above its previous
level.
protected by lines of resistance.
• Nursing interventions occur through three prevention
• The usual level of health is identified as the normal line modalities. Primary prevention occurs before the stressor invades the
of defense that is protected by a flexible line of system; secondary prevention occurs after the system has reacted to
defense. an invading stressor; tertiary prevention occurs after secondary
prevention as reconstitution is being established.
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Assumptions Assumptions
• The following are the assumptions or “accepted truths” • Each client/client system has evolved a normal range of
made by Neuman’s Systems Model: responses to the environment that is referred to as a normal
line of defense.
• Each client system is unique, a composite of factors and
characteristics within a given range of responses. • The normal line of defense can be used as a standard from
which to measure health deviation.
• Many known, unknown, and universal stressors exist.
Each differs in its potential for disturbing a client’s usual • When the flexible line of defense is no longer capable of
protecting the client/client system against an environmental
stability level or normal line of defense. stressor, the stressor breaks through the normal line of
• The particular interrelationships of client variables at defense.
any point in time can affect the degree to which a client • The client, whether in a state of wellness or illness, is a
is protected by the flexible line of defense against dynamic composite of the interrelationships of the variables.
possible reaction to stressors. Wellness is on a continuum of available energy to support
the system in an optimal state of system stability.
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Assumptions Major Concepts of Neuman System Model

• Implicit within each client system are internal resistance factors known as lines of
resistance, which function to stabilize and realign the client to the usual wellness Human being
state.
• Human being is viewed as an open system that interacts with both
• Primary prevention relates to general knowledge that is applied in client assessment
and intervention, in identification and reduction or mitigation of possible or actual internal and external environment forces or stressors. The human is
risk factors associated with environmental stressors to prevent possible reaction. in constant change, moving toward a dynamic state of system
• Secondary prevention relates to symptomatology following a reaction to stressors, stability or toward illness of varying degrees.
appropriate ranking of intervention priorities, and treatment to reduce their noxious
effects.
• Tertiary prevention relates to the adjustive processes taking place as reconstitution
begins and maintenance factors move the client back in a circular manner toward
primary prevention.
• The client as a system is in dynamic, constant energy exchange with the
environment. (Neuman, 1995)
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Major Concepts of Neuman System Model Major Concepts of Neuman System Model
Environment Health
• The environment is a vital arena that is germane to the system and its function. The • In Neuman’s nursing theory, Health is defined as the condition or
environment may be viewed as all factors that affect and are affected by the system.
degree of system stability and is viewed as a continuum from
• In Neuman Systems Model identifies three relevant environments: (1) internal, (2)
external, and (3) created.
wellness to illness. When system needs are met, optimal wellness
exists. When needs are not satisfied, illness exists. When the
• The internal environment exists within the client system. All forces and interactive
influences that are solely within boundaries of the client system make up this energy needed to support life is not available, death occurs.
environment.
• The external environment exists outside the client system.
• The created environment is unconsciously developed and is used by the client to
support protective coping.
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Major Concepts of Neuman System Model Major Concepts of Neuman System Model
Nursing Open System Basic Stricture and Energy
• The primary concern of nursing is to define the appropriate action in situations • A system in which there is a Resources
that are stress-related or in relation to possible reactions of the client or client continuous flow of input and • The basic structure, or central core,
system to stressors. process, output and feedback. It is is made up of those basic survival
• Nursing interventions are aimed at helping the system adapt or adjust and to a system of organized complexity, factors common to the species.
where all elements are in
retain, restore, or maintain some degree of stability between and among the
interaction. • These factors include the system
client system variables and environmental stressors with a focus on conserving variables, genetic features, and
energy. strengths and weaknesses of the
system parts.
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Major Concepts of the Conservation Theory Major Concepts of Neuman System Model
Flexible line of defense
Client Variables
• A protective accordion-like mechanism that surrounds and
• Neuman views the individual client holistically and considers the variables protects the normal line of defense from invasion by stressors.
simultaneously and comprehensively.
Normal line of defense
• The physiological variable refers to the structure and functions of the
body. • An adaptational level of health developed over time and
• The psychological variable refers to mental processes and relationships. considered normal for a particular individual client or system; it
becomes a standard for wellness-deviance determination.
• The sociocultural variable refers to system functions that relate to social
and culturalexpectations and activities. Lines of resistance
• The developmental variable refers to those processes related to • Protection factors activated when stressors have penetrated the
development over the lifespan. normal line of defense, causing a reaction synptomatology.
• The spiritual variable refers to the influence of spiritual beliefs.
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Sub-concepts Sub-concepts
Stressors Stability Degree of Reaction
A stressor is any phenomenon that might penetrate both the • A state of balance or harmony • The amount of system instability
flexible and normal lines of defense, resulting in either a
positive or negative outcome.
requiring energy exchanges as the resulting from stressor invasion of
client adequately copes with the normal line of defense.
1. Intrapersonal stressors are those that occur within the stressors to retain, attain, or
client system boundary and correlate with the internal
environment. maintain an optimal level of health
thus preserving system integrity.
2. Interpersonal stressors occur outside the client system
boundary, are proximal to the system, and have an impact
on the system.
3. Extrapersonal stressors also occur outside the client
system boundaries but are at a greater distance from the
system that are interpersonal stressors. An example is
social policy. Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
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Sub-concepts Sub-concepts
Entropy Negentropy Input/Output Reconstitution
• A process of energy depletion • A process of energy • The matter, energy, and • The return and maintenance of
and disorganization moving conservation that increases information exchanged between system stability, following
the client and environment that is treatment of stressor reaction,
the system toward illness or organization and complexity, entering or leaving the system at which may result in a higher or
possible death. moving the system toward any point in time. lower level of wellness.
stability or a higher degree of
wellness.
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Sub-concepts Prevention as Intervention

Prevention as Intervention • Primary prevention occurs before the system reacts to a
• Intervention modes for nursing action and determinants for stressor; it includes health promotion and maintenance of
entry of both client and nurse into the health care system. wellness.
1. Primary Intervention • Primary prevention focuses on strengthening the flexible line of
2. Secondary Intervention defense through preventing stress and reducing risk factors.
3. Tertiary Intervention • This intervention occurs when the risk or hazard is identified but
before a reaction occurs.
• Strategies that might be used include immunization, health
education, exercise, and lifestyle changes.
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Assumptions Assumptions
• Secondary prevention occurs after the system reacts to a • Tertiary prevention occurs after the system has been treated
stressor and is provided in terms of existing symptoms. through secondary prevention strategies.
• Secondary prevention focuses on strengthening the internal • Its purpose is to maintain wellness or protect the client system
lines of resistance and, thus, protects the basic structure through reconstitution through supporting existing strengths and
appropriate treatment of symptoms. continuing to preserve energy.
• The intent is to regain optimal system stability and to conserve • Tertiary prevention may begin at any point after system stability
energy in doing so. has begun to be reestablished (reconstitution has begun).
• If secondary prevention is unsuccessful and reconstitution does Tertiary prevention tends to lead back to primary prevention.
not occur, the basic structure will be unable to support the (Neuman, 1995)
system and its interventions, and death will occur.
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Strengths Strengths
• Betty Neuman reports her nursing model was designed for • The major strength of the Neuman Systems Model is its flexibility for
nursing but can be used by other health disciplines, which both use in all areas of nursing – administration, education, and practice.
has pros and cons. • Neuman has presented a view of the client that is equally applicable
to an individual, a family, a group, a community, or any other
• As a strength, if multiple health disciplines use the Neuman’s aggregate.
System Model, a consistent approach to client care would be • The Neuman Systems Model, particularly presented in the model
facilitated. diagram, is logically consistent.
• As a con, if the model is useful to a variety of disciplines, it is not • The emphasis on primary prevention, including health promotion, is
specific to nursing and thus may not differentiate the practice of specific to this model.
nursing from that of other disciplines. • Once understood, the Neuman Systems Model is relatively simple,
and has readily acceptable definitions of its components.
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Weaknesses Weaknesses
• With such, new nursing interventions as to the • The delineation of Neuman’s three defense
provision of needed energy of the client can be
conceptualized. lines were not clearly explained.
• The holistic and comprehensive view of the • In reality, the individual resists stressors
client system is associated with an open with internal and external reflexes which
system. were made complicated with the
• Health and illness are presented on a formulation of different levels of resistance
continuum with movement toward health in the open systems model of Neuman.
described as negentropic and toward illness as
entropic. • Neuman made mention of energy sources
• Her use of the concept of entropy is in her model as part of the basic structure.
inconsistent with the characteristics of entropy It can be more of help when Neuman has
which is closed, rather than an open system. enumerated all sources of energy that she is
pertaining to.
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Strengths References
• The major strength of the Neuman Systems Model 1. Alligood, M. R. (2013). Nursing Theory-E-Book: Utilization & Application. Elsevier Health
is its flexibility for use in all areas of nursing – Sciences.
administration, education, and practice.
2. Neuman, B. (1996). The Neuman systems model in research and practice.Nursing Science
• Neuman has presented a view of the client that is Quarterly, 9(2), 67-70. [Link]
equally applicable to an individual, a family, a group,
a community, or any other aggregate. 3. Neuman, B. (1995). The neuman systems model (3rd ed.). In McEwen, M. and Wills, E.
(Ed.). Theoretical basis for nursing. USA: Lippincott Williams & Wilkins.
• The Neuman Systems Model, particularly presented
in the model diagram, is logically consistent.
• The emphasis on primary prevention, including
health promotion, is specific to this model.
• Once understood, the Neuman Systems Model is
relatively simple, and has readily acceptable
definitions of its components.
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26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Betty Neuman’s Nursing Theory

Betty Neuman’s Nursing Theory Betty Neuman’s Nursing Theory

Betty Neuman’s Nursing Theory Betty Neuman’s Nursing Theory

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Assumptions Major Concepts of Neuman System Model

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Sub-concepts Prevention as Intervention

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

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