NEUMAN’s System

Model
 Betty Neuman

-She was born in 1924 near Lowell, Ohio.

-She grew up on a farm which later encouraged her to help people who
are in need.
-During World War II, she had her first job as an aircraft instrument
technician.
-. In 1947, she received her RN Diploma from Peoples Hospital School of
Nursing, Akron, Ohio.
-She 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.
What is the Neuman Systems
Model?

 -it is based on the person’s relationship to stress, the

response to it, and reconstitution factors that are
progressive in nature.
-it also 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.
 Neuman’s Model was influenced
by:
• Von Bertalanfy and Lazlo on General System
Theory
• Selye on Stress Theory
• Larans on Stress and coping
ASSUMPTIONS or ACCEPTED TRUTHS
ABOUT THE MODEL:

• Each client system is unique, a composite of factors and

characteristics within a given range of responses.
• Many known, unknown, and universal stressors exist. Each
differs in its potential for disturbing a client’s usual stability level
or normal line of defense. The particular interrelationships of
client variables at any point in time can affect the degree to
which a client is protected by the flexible line of defense against
possible reaction to stressors.
• Each client/client system has evolved a normal range of
responses to the environment that is referred to as a normal line
of defense. The normal line of defense can be used as a standard
from which to measure health deviation.
• When the flexible line of defense is no longer capable of
protecting the client/client system against an environmental
stressor, the stressor breaks through the normal line of defense.
• When the flexible line of defense is no longer capable of
protecting the client/client system against an environmental
stressor, the stressor breaks through the normal line of defense.
• The client, whether in a state of wellness or illness, is a dynamic
composite of the interrelationships of the variables. Wellness is on
a continuum of available energy to support the system in an
optimal state of system stability.
• 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 state.
• The client as a system is in dynamic, constant energy exchange
with the environment. (Neuman, 1995)
 Major Concepts of Neuman Systems Model

1. Human being
-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.

2. 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.
3 types of environment
a. 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.
b. external environment exists outside the client system.
c. created environment is unconsciously developed and is used by
the client to support protective coping.
3. 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.

4. 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.
6. Open System
A system in which there is a continuous flow of input and process,
output and feedback. It is a system of organized complexity, where all
elements are in interaction.

7. Basic Stricture and Energy Resources

The basic structure, or central core, is made up of those basic survival
factors common to the species. These factors include the system
variables, genetic features, and strengths and weaknesses of the
system parts.

8. Flexible line of defense

A protective accordion-like mechanism that surrounds and protects the
normal line of defense from invasion by stressors.

9. Normal line of defense

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.

10. Lines of resistance

Protection factors activated when stressors have penetrated the normal
line of defense, causing a reaction synptomatology.
Subconcepts of Neuman Systems Model

1. Stressors
A stressor is any phenomenon that might penetrate both the flexible
and normal lines of defense, resulting in either a positive or negative
outcome.
a. Intrapersonal stressors are those that occur within the client
system boundary and correlate with the internal environment.
b. Interpersonal stressors occur outside the client system
boundary, are proximal to the system, and have an impact on the
system.
c. 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.

2. Stability
A state of balance or harmony requiring energy exchanges as the
client adequately copes with stressors to retain, attain, or maintain an
optimal level of health thus preserving system integrity.
3. Degree of Reaction
The amount of system instability resulting from stressor invasion of
the normal line of defense.

4. Entropy
A process of energy depletion and disorganization moving the system
toward illness or possible death.

5. Negentropy
A process of energy conservation that increases organization and
complexity, moving the system toward stability or a higher degree of
wellness.

6. Input/Output
The matter, energy, and information exchanged between the client
and environment that is entering or leaving the system at any point in
time.

7. Reconstitution
The return and maintenance of system stability, following treatment
of stressor reaction, which may result in a higher or lower level of
wellness.
8. Prevention as Intervention
Intervention modes for nursing action and determinants for entry of both
client and nurse into the health care system.

Primary prevention occurs before the system reacts to a stressor; it

includes health promotion and maintenance of wellness. Primary prevention
focuses on strengthening the flexible line of defense through preventing stress and
reducing risk factors. 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.

Secondary prevention occurs after the system reacts to a stressor and is

provided in terms of existing symptoms. Secondary prevention focuses on
strengthening the internal lines of resistance and, thus, protects the basic structure
through appropriate treatment of symptoms. The intent is to regain optimal system
stability and to conserve energy in doing so. If secondary prevention is
unsuccessful and reconstitution does not occur, the basic structure will be unable
to support the system and its interventions, and death will occur.

Tertiary prevention occurs after the system has been treated through

secondary prevention strategies. Its purpose is to maintain wellness or protect the
client system reconstitution through supporting existing strengths and continuing
to preserve energy. Tertiary prevention may begin at any point after system
stability has begun to be reestablished (reconstitution has begun). Tertiary
prevention tends to lead back to primary prevention. (Neuman, 1995)