Betty Neuman’s Biography

1924-  Born near Lowell, Ohio

1947 -  Received RN Diploma from Peoples Hospital School of Nursing, Akron, Ohio.
 Moved to California and gained experience as a hospital, staff and head nurse school
nurse and industrial Nurse and as a clinical instructor in medical-surgical, critical
care and communicable disease nursing.
 Attended University of California at Los Angels (UCLA) with double major in
psychology and public health.
1966 -  Received Masters degree in Mental Health, public Health Consultation form UCLA.
 Recognized as pioneer in the field of nursing involvement in community mental
health.  Began developing her model while lecturing in community mental health at UCLA.

1972 -  Her model was first published as a Model for teaching total person approach to patient
problems in Nursing Research.
1985 -  Received doctorate in clinical Psychology from Pacific Western University.
1998 -  Received second honorary doctorate- this one from Grand Valley State University,
Michigan
Betty Neuman’s Nursing Theory
A nursing theory developed by Betty Neuman is based on the person’s relationship to stress, the
response to it, and reconstitution factors that are progressive in nature. The Neuman Systems
Model presents a broad, holistic and system-based method to nursing that maintains a factor of
flexibility. It focuses on the response of the patient system to actual or potential environmental
stressors and the maintenance of the client system’s stability through primary, secondary, and
tertiary nursing prevention intervention to reduce stressors.

Betty Neuman’s System Model

Neuman’s work focuses on the wellness of the client system in relation to environmental
stressors and reactions to stressors. The goal of this model is to facilitate optimal wellness for the
client through retention, attainment, or maintenance of client system stability. It focuses on the
wellness of the Personal system in relation to environmental stress, reactions to stress, and
reconstitution to it. The Neuman System Model is universal and can be adapted to a variety of
different situations it also can be interpreted in many different ways. Neuman sees health as
being equated with wellness. She defines health/wellness as the condition in which all parts and
subparts which are variables are in harmony.

NEUMAN’S PERSPECTIVE IN NURSING

METAPRADIGMS
In this section states the concept of a whole person and an open system approach.
The concept is aimed towards the development of a person in a state of wellness having the
capacity to function optimally by adaptation with environmental stimuli causing illnesses back to
a state of wellness.

NURSING
The primary concern of nursing is to define the appropriate action in situations that are
stress-related or in relation to possible reactions of the client or client system to stressors.
Nursing interventions are aimed at helping the system adapt or adjust and to retain,
restore, or maintain some degree of stability between and among the client system
variables and environmental stressors with a focus on conserving energy.
(summary)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
Human being is viewed as an open system that interacts with both internal and external
environment forces or stressors. The human is in constant change, moving toward a dynamic
state of system stability or toward illness of varying degrees.
(summary) 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
In Neuman’s nursing theory, Health is defined as the condition or degree of system stability
and is viewed as a continuum from wellness to illness. When system needs are met,
optimal wellness exists. When needs are not satisfied, illness exists. When the energy
needed to support life is not available, death occurs.
(Summary) Neuman considers health as dynamic in nature in which the person’s health is as the
level of health continuum—wellness or illness.

ENVIRONMENT
The environment is a vital arena that is germane to the system and its function. The
environment may be viewed as all factors that affect and are affected by the system. In
Neuman Systems Model identifies three relevant environments: (1) internal, (2) external,
and (3) created:

 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 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.

SYSTEM MODEL IN NURSING PRACTICE

1. Client Variables
- physiological, sociocultural, developmental, psychological and spiritual—This variables
functions to achieve stability in relation to the environmental stressors experienced by the client.

 The physiological variable refers to the structure and functions of the body.

 The psychological variable refers to mental processes and relationships.
 The sociocultural variable refers to system functions that relate to social and cultural
expectations and activities.
 The developmental variable refers to those processes related to development over the
lifespan.
 The spiritual variable refers to the influence of spiritual beliefs.

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.
- Protection factors activated when stressors have penetrated the normal line of defense, causing
a reaction symptomatology.
-Symptomatology - the set of symptoms characteristic of a medical condition or exhibited by a
patient.

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.
- An adaptational level of health developed over time and considered normal for a particular
individual client or system; it becomes a standard for wellness-deviance determination.

4. Flexible Line of Defense

- helps the body to adjust to situations that threaten the imbalance within the client's stability.
- A protective accordion-like mechanism that surrounds and protects the normal line of defense
from invasion by stressors.

5. Stressors
Stressors are forces that produce tensions, alterations or potential problems causing instability
within the client’s 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.

9. Stressors
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

Strengths and Weaknesses

Betty Neuman reports her nursing model was designed for nursing but can be used
by other health disciplines, which both has pros and cons. As a strength, if multiple
health disciplines use the Neuman’s System Model, a consistent approach to client
care would be facilitated. As a con, if the model is useful to a variety of disciplines, it
is not specific to nursing and thus may not differentiate the practice of nursing
from that of other disciplines.

Strengths

 The major strength of the Neuman Systems Model is its flexibility for use
in all areas of nursing – administration, education, and practice.
 Neuman has presented a view of the client that is equally applicable to an
individual, a family, a group, a community, or any other aggregate.
 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.

Weaknesses

 The major weakness of the model is the need for further clarification of
terms used.
 Interpersonal and extrapersonal stressors need to be more clearly
differentiated.

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.

GROUP 2/ BSN – 1/ BLOCK 7

Baby Jane Del Rosario
Carlo M. De Vera
Carl Angelo Cuison
Janella Dela Cruz
Lyka Gomez De Vera
Marla Deppas
Veronica Dominguez