INTRODUCTION:

 Dr. Betty Neuman ,Ph.D., RN, Developed Neuman Systems Models In

1970 At The University Of Calfornia, Los Angeles
 In Betty Neumans Nursing Theory, Patients Are Cared For From A Holistic
Perspective In Order To Ensure They Are Cared For As People And Not
Simply Ailments.
 The Goal Of The Model Was To Provide A Holistic Approach Including All
The Physiological, Psychological, Socio Cultural , And Developmental
Aspects Of Human Beings.
 The Neuman System Model Has Proven Its Validity As A Holistic Global
Perspective For Interdisciplinary Health Care Concerns And Increasingly
Demonstrating Its Relevance And Reliability In A Wide Range Of Clinical
And Educational Setting Throughout The World.

BIOGRAPHY OF BETTY NEUMAN

 Born In Lowel,Ohio, United States In 1924, Betty Neuman Earned Her
Diploma As A Registered Nurse In 1947 From The Peoples Hospitals
Hospital School Of Nursing In Akron, Ohio.
 She Went On To Complete Her Bachelor Of Science In Nursing In 1957 And
Her Master Of Science In Mental Health, Both From The University Of
California-Los Angeles In 1966. She Also Earned A Ph.D. In Clinical
Psychology From Pacific Western University In 1985.
 In 1992, Neuman Was Given An Honorary Of Letters At The Neumann
College In Aston,Pennsylvania.
 Finally, In 1998, The Grand Vally State University In Michigan Gave Her An
Honorary Doctorate Of Science.

CAREER OF BETTY NEUMAN-

 After Earning Her Master’s Degree, Neuman Began Working A Nurse
Specifically She Was A Pioneer In Nursing Involvement In Community
Mental Health.
 While She Was Developing Her Systems Model, She Was Working As A
Lecturer At The University Of California-Los Angeles In Community Health
Nursing.
 Due To Her Work In Nursing, Neuman Was Named As An Honorary Member
Of Fellowship Of The American Academy Of Nursing.
 In 1982-Betty Neuman First Book, The Neuman Systems Model, Was
Published.
 The Book Included Nursing Process Format And Care Plans, And Was A
Total Approach To Client Care. Newer Editions Were Published In
1989,1995,2002 And In 2010.
 After The Publication Of Her Model, Neuman Spent Her Time Educating
Nurses And Professors About Her Work As An Author And Speaker.
DEFINITION BETTY NEUMAN’S THEORY-
 It’s a holistic approach that considers all the factors that affects clients
health, including physical, psychological, social cultural and
developmental aspects.
  It is a unique, systems-based perspective that provides a unifying focus
for approaching a wide range of nursing concerns.
BETTY NEUMAN’S CONTRIBUTION TO NURSING THEORY:
Neuman Systems Model- The neuman’s system model provides a
comprehensive , flexible, holistic and system based perspective for nursing. This
conceptual model of nursing focuses attention on the response of the client
system to actual or potential environmental stressors, and the use of primary,
secondary and tertiary nursing interventions for retention, attainment and
maintenance of optimal client system wellness.

 In 1970 Newman began developing her systems model.

 It was first developed as a graduate course guide and a way to teach
introductory nursing to students by giving them a holistic view of patients
that included the physiological, psychological, sociological and
developmental aspects.
 In 1974, Neuman model was refined and published in conceptual models
for nursing practice.
 It was classified as a systems model, and was titled “ The betty Neuman
health care systems model: a total person approach to patient problems.
 In this publication, the term patient was replaced with the term client.
 The Neuman system is based on the patients relationship to stress,
reaction to it and reconstitution factors that are dynamic.
 The Neuman systems model is universal in nature, which allows it to be
placed to a variety of situations, and to be interpreted in many different
ways.

PURPOSE OF THE MODEL-

 developed to provide unity, or a focal point for student

 provides a comprehensive, flexible, holistic and system based perspective
for nursing
 focuses attention on the response of the client system
 highly recognized and used globally as a conceptual model for nursing

MAJOR CONCEPTS IN BETTY NEUMAN’S SYSTEM MODEL

Wholistic Client Approach-Client’s Are Viewed As Wholes Whose Parts Are In

Dynamic Interaction. The model considers all variables simultaneously affecting
the client system: physiological, psychological, sociocultural, developmental and
spiritual.

Basic structure or central core- this structure consists of basic factors that
are common to all organisms. Neuman offered the following examples of basic
survival factors: normal temperature range, genetic structure, response pattern,
organ strength or weakness, ego structure and knowns or commonalities.
Open System- A system is open when its elements are exchanging information
energy within its complex organization. Viewed the client as an open system
consisting of a basic structure or central core of energy resources which
represent concentric circles. Basic Structure Energy Resources or Central core. It
is made up of the basic survival factors common to all organisms. These include
the following :
Normal temperature range – body temperature regulation ability
Genetic structure – Hair color and bodily features
Response Pattern – Functioning Of Body Systems Homeostatically.
Organ strength or weakness
Ego structure
Known or commonalities– value system.

Five client variables: Neuman has identified five variables that are contained
in all client systems: physiological, psychological, sociocultural, developmental
and spiritual. These variables are present in varying degrees of development,
and a wide range of interactive styles and potential. Neuman offers the following
definitions for each variables-

1. Physiological - refers of bodily structure and function.

2. Psychological - refers to mental processes, functioning and emotions.
3. Sociocultural - refers to relationships; and social/cultural functions and
activities.
4. Spiritual - refers to the influence of spiritual beliefs
5. Developmental - refers to life’s developmental processes

Stressors-They are stimuli which might penetrate both the client‘s flexible and
normal lines of defense resulting in a positive or negative effect on the client
system. ---
Intrapersonal - occur within person, example is infection, thoughts and feelings
-Interpersonal - occur between individuals, e.g. role expectations
Extra personal - occur outside the individual, e.g. job or finance

ESSENTIAL CONCEPTS/ NURSING METAPARADIAGRAM

PERSON- Neuman systems model presents the concept of person as a client/

client system that may be an individual, family, group, community, or social
issue.

ENVIRONMENT- it is the sum total of internal and external forces which

surround a person and with which they interact at any given time.

HEALTH- Neuman considers her work work as a wellness model. She views
health as a continuum of wellness to illness that is dynamic in nature constantly
subject to change. The
internal environment exists within the client system. The
external environment exists outside the client system. Created
environment which is an environment that is created

NURSING-Neuman said that nursing as a unique profession that is

concerned with all of the variables which influence the response a person
might have to a stressor.

DESCRIPTION OF BETTY NEUMAN MODEL

Flexible line of defence-it represents the dynamic nature that can rapidly
change over a short time
Normal Line Of Defence-The last boundary that protects the basic structure

Line of resistance- It represent a state of equilibrium of individual or state of

adaptation, or wellness the individual has maintained over time.

In the neuman system model the role of nurse is to keep the system stability by
using three levels of prevention-
Primary prevention
Secondary prevention Tertiary
prevention

Reconstitution - state of adaption to stressors in the int. and ext. envt.

STAGES OF NURSING PROCESS (BY BETTY NEUMAN)

Betty neuman developed nursing process format that consists of three
steps :nursing diagnosis, nursing goals and nursing outcomes.

NURSING DIAGNOSIS-

 It depends on acquisition of appropriate database; the diagnosis identifies,

assesses, classifies, and evaluates the dynamic interaction of the five
variables.

 Variances from wellness (needs and problems) are determined by

correlations and constraints through synthesis of theory and data
base.

NURSING GOALS-

 These must be made as per the diagnose and needs of the patient
and these must be negotiated with the patient, and take account of
patient’s and nurse’s perceptions of variance from wellness.

NURSING OUTCOMES

Nursing outcomes are determined by nursing interventions through the

use of one or more of the three prevention as intervention modes.

CHARACTERISTICS OF A THEORY
 Theories Can Interrelate Concepts In Such A Way As To Create A
Different Way Of Looking At A Particular Phenomenon.
 Theories Must Be Logical In Nature.
 Theories Should Be Relatively Simple Yet Generalizable.
  Theories Can Be Basis For Hypothesis That Can Be Tested.
 Theories Contribute To And Assist In Increasing The General Body Of
Knowledge With In The Discipline Through The Research
Implemented To Validate Them.
 Theories Can Be Utilized By The Practitioners To Guide And Improve
Their Practice.
 Theories Must Be Consistent With Other Validated Theories, Laws,
And Principles But Will Leave Open Unanswered Questions That
Need To Be Investigated.

USES
 It is a comprehensive guide for nursing practice, research, education,
and administration that is open to creative implementation
 IT has the potential for unifying various health-related theories
 It clarifying the relationships of variables in nursing care and role
definitions at various levels of nursing practice.

GLOBAL APPLICATIONS OF THE MODEL:

PRACTICE

 Neuman has developed the neuman‘s nursing process

format to implement the model.
 Developed several instruments to facilitate the utilization of
the system model.
 The Neuman systems model has been applied and adapted to
various specialties include family therapy, public health,
rehabilitation, and hospital nursing.
 Using this conceptual model permits comparison of a nurse’s
interpretation of a problem with that of the patient, so the patient
and nurse do not work on two separate problems.

EDUCATION

 The model has also been widely accepted in academic circles.

 This model has been used widely as a curriculum guide oriented
toward wellness.
 It is used at all levels of nursing education throughout the united
states and in other countries, including Australia, Canada,England ,
Denmark, Holland, Taiwan,korea.
 Neuman college division of nursing was the first school to select the
neuman systems model as its conceptual base for curriculm and
approach to client care in 1976.

RESEARCH
  A study was published by Riehl and Roy to test the usefulness of the
Neuman model in nursing practice.
 Acceptance by the nursing community for research applying this
model is positive.
PROJECTIONS FOR THE USE OF THE MODEL IN TWENTY-FIRST
CENTUARY-
Neuman believes her model is”both concept and process Relevant As A
Directive Toward Nursing And Other Health Care Activities In The
Challenging 1st Centuary”(Betty Neuman, Personal Communication,
January 10, 1999). This Model Has Been Used To Make Projections About
The Future Of Nursing And Health Care. Procter And Cheek (1995) And
Tomilinson And Anderson (1995) Provided Two Examples Of This Use.
Procter And Cheek Used The Model To Project The Role Of The Nurse In
World Catastrophic Events, And Tomlinson And Anderson Used The Model
To Project Family Health As A System. Procter And Cheek Studied
Experiences Of Serbian Australians At The Time Of Civil War In The
Former Yugoslavia Using The Neuman Systems Model To Understand The
Experiences. As A Result Of Study, The Researches Came Up With
Implications For The Role Of Nursing In World Catastrophic Events. The
Researchers Suggested The Goal Of Nursing In Such Worldwide Events
Should Be To Assist Individuals And Communities To Retain Maximum
Wellness And System Stability As They Strive For A Sense Of Inner Peace
And Contentment Against Impossible Odds.
Tomlinson And Anderson(1995) Recognized That There Is An Increasing
Focus On The Family System As A Health Entry. The Acknowledged,
However, That There Is Not A Universally Accepted Definition Of Family
Health As A Systems Phenomenon. Tomlinson And Anderson Proposed
That Are The Nurse Who Uses The Broad Concepts Of The Neuman Model
Along With A Shared Family Health Systems Perspective , In Which The
Whole Family Is The Client In The Health Promotion Enterprise, Will Be
Well Prepared To Meet Future Nursing Challenges.
Neuman Systems Model Institute Awards-The aim of the
Neuman Systems Model Institute is to further the development of the
NSM as a research model. To facilitate this aim, the NSM Institute is
funding two awards named in honor of two past NSM Trustees: Dr.
Patricia Chadwick and Dr. John Crawford.

 The Patricia Chadwick NSM Research Grant is a $1000 biennial

award. Its purpose is to support a novice researcher whose work will
lead to the development of new nursing knowledge framed within
the NSM.

 The John Crawford NSM Research Fellow Award funds up to 5

biennial $100 awards. The purpose of this award is to recognize an
outstanding contribution to use of the NSM as a research model.

Research Articles
  “Leadership scholarship integration:using
the neuman systems model for 21st =centuary
professional nursing practice.”This article
describes leadership and scholarship from
the neuman systems model as requisite for a
true practice model necessary for 21st
centuary scientific professional nursing. A
rationale for the integration of leadership
and scholarship is provided along with
markers to guide the leadership-scholarship
protocol, which can be viewed as scholarly
research process. An example from a
community nursing center demonstrating the
application of the integration of leadership-
scholarship is presented to support the
proposed integration.

The Betty Neuman Systems Model applied to practice: a client with

multiple sclerosis.
Knight JB.,Source :School of Nursing, University of Ottawa, Canada.

Abstract

The importance of nursing theories and models for the growth and development
of the profession of nursing is widely acknowledged. The variety of nursing
phenomena and situations demands some flexibility in the choice of specific
conceptualizations to be used. This paper demonstrates the goodness of fit of
the Betty Neuman Systems Model to the care of clients with multiple sclerosis.
An adapted assessment tool, based on Neuman's tool, but more useful in the
acute care medical setting, is used to gather data related to a woman with
recently diagnosed multiple sclerosis. A nursing care plan illustrating the use of
Neuman's model is generated, implemented and evaluated. The Neuman Model
is demonstrated to be useful and effective in the implementation of the nursing
process in this case

BETTY NEUMAN’S NURSING PROCESS FORMAT

ASSESSMENT

 Potential and actual stressors.

 Condition and strength of basic structure factors and energy
sources.
 Characteristics of flexible and normal line of defenses, lines of
resistance, degree of reaction and potential for reconstitution.
 Interaction between client and environment.
  Life process and coping factors (past, present and future) actual and
potential stressors (internal and external) for optimal wellness
external.
 Perceptual difference between care giver and the client.

NURSING DIAGNOSIS

 The data collected are then interpreted to condition and formulate

the Nursing diagnosis.
 Health seeking behaviors.
 Activity intolerance.
 Ineffective coping.
 Ineffective thermoregulation.

GOAL

 These must be negotiated with the patient, and take account of patient’s
and nurse’s perceptions of variance from wellness.

PLANNING

 Planning is focused on strengthening the lines of defense and

resistance.

IMPLEMENTATION

The goal of stabilizing the client system is achieved through three modes
of prevention

 Primary prevention : actions taken to retain stability

 Secondary prevention : actions taken to attain stability
 Tertiary prevention : actions taken to maintain stability

EVALUATION -The nursing process is evaluated to determine whether

equilibrium is restored and a steady state maintained.