Betty Neumann’s system

model
Maj Aswathy Ganesh
MSc I year
CON ,AFMC
History
• Betty Neumann was born in 1924, in Lowel Ohio
• She lost her father at 11 years of age –CKD
• Praise for nurses, influenced Neuman’s view of nursing
• Mother-Rural midwife
History and Background

1947-RN
1966-MS in
diploma from
Mental Health
Peoples 1957- BS in 1985-Phd in
and Public
Hospital nursing from clinical
Health
School of UCLA psychology
consultation
Nursing ,Akron
from UCLA
,OHIO
History

• Her model originally developed in 1970’s at University of

Calfornia LosAngeles
• She developed this model while working as lecture in
Community Health Nursing
• The model was published in response to graduate nursing
student expression of a need for course content that would
expose them to breadth of nursing problem prior to focusing on
specific problems
History of Model Devolpment
• The model was published in 1972 as “ A model for teaching total
person approach to patient problems “ in Nursing Research
• It was refined and subsequently published in the first edition of
conceptual models for nursing practice in 1974
• 1974-Betty Neuman’s Health Care System
• 1985-The Neuman System Model
• Published 3 editions of Neuman’s system model
• The Neuman’s system Model Truste Group was established in
1988
Influences
• Pierre De Chardin
• Berenard Marx
• Gestalt theory
• General adaptation syndrome
• General systems theory
• Caplans level of prevention
Influences
Pierre De Chardin
• Was a Catholic priest and scientist who is credited with first
proposing the idea of spiritual evolution
• He believed that spiritually humans are evolving toward an
ultimate perfection that he called the Omega point
• He is most often associated with the idea of a mind ,the
interconnectedness of human, spirit, and mind
Influences
Bernard Marx
• Marxist philosophy suggests that the properties of parts are
determined partly by the larger wholes within dynamically
organized system.
• Human activities is the product of a particular social and
economic environment
• Societies should be reorganized in a more equitable way to
eliminate poverty
Influences
General adaptation theory
• It postulate that there is nonspecific response to stress involving
three stages
alarm
resistance
exhaustion
Influences
General Systems Theory
• Grew out of field of thermodynamics
• Posits that world is made up of systems that are interconnected
and are influenced by each other
• Energy is needed to maintain high organizational state, and that
a dysfunction in one system will affect other.
Basic assumptions

• Based on stress and the reaction / potential reaction to stress

with a philosophical basis in wholeness,wellness, client

perception, and ,motivation, energy and environmental

interaction(Neuman,2002)
Basic assumptions

• It focuses on the response of the patient system to actual or

potential environmental stressors and the maintanence of

clients ability through primary, secondary, teritiary nursing

prevention intervention to reduce stressors

Basic assumptions
• Each client system is unique
• Many known, unknown universal stressors exists
• Each stressors differ in its potential for disturbing a clients usual
stability level or normal line of defense
• Each client system has evolved a normal range of responses to
environment that is reffered to as normal LOD
• The normal LOD can be used as a standard from which to
measure health deviation
Basic assumptions
• The particular inter relationship of clients variable at any point in
time can affect the degree to which client is protected by the
flexible line of defense against possible reaction to stressors
• When flexible LOD is no longer capable of protecting the client
or client system , against environmental stressor the stressor
break normal LOD
Basic assumptions
• Wellness is a dynamic composite of the interrelationship of the
five client variables and represent a continuum of variable
system energy
• Following a stressor reaction internal resistance lines attempt to
stabilize the client by returning to normal or enhanced wellness
state
Basic assumptions
• Primary Prevention assessment and intervention identifies and
allays risk factors associated with stressors
• Secondary prevention relates to symptom identification and
implementation of prevention to deal with system dysruptions
• Teritiary prevention assists client adjustment as reconstitrution
is initiated and maintanence factors move the client back toward
primary prevention
Concepts
• Content –the variables of the person in interaction with the
internal and external environment comprise the whole system
• Basic structure/Central core –common client survival factors in
unique individual characteristics
• Degree to reaction-the amount of system instability resulting
from stressor invasion of the normal line of defense
• Entrophy – a process of energy depletion and disorganization
moving the system towards illness or possible death
Concepts
• Negentrophy – a process of energy conservation that increase
organization and complexity, moving the system towards
stability or a higher degree of wellness
• Open system –a system in which there is continuous flow of
input and process,output and feedback.
• Prevention as intervention – intervention modes for nursing
action and determinants for entry of both client and nurse into
health care system
 Concepts

• Reconstitution – the return and maintanence of system stability

following treatment for stressor reaction
• Stability –a state of balance of harmony requiring energy
exchanges as the client adequately copes with stressors to
retain, attain, or maintain an optimal level of health, thus
preventing system integrity
• Stressors – a stressors is any phenomenon that might
penetrate both the flexible line of defense resulting a positive or
negative outcome
Concepts
• Wellness-wellness is a condition in which all system parts and
subparts are in harmony with the whole system of client
• Illness-is an excessive expenditure of energy when more
energy is used by the system in its state of disorganization
• Prevention- according to Neuman’s model prevention is the
primary nursing intervention
Concepts
• Primary Prevention – occurs before the system reacts to a
stressor, it strengthens the flexible line of defense to enable him
to better deal with stressors
• Secondary prevention- occurs after system reacts to a stressor.
It focusses on preventing damage to the central core by
strengthening the internal lines of resistance
• Teritary prevention –occurs when system has been treated
through secondary prevention. It offers support to client
attempts to add energy to system
Neuman System Model
Nursing Metaparadigm
Person
• Layered multidimensional being
• Each layer consist of five person variable or subsystem
physiological
psychological
spiritual
developmental
Nursing Metaparadigm
Enviroment
• Totality of internal and external forces
• Surrounds a person with which they interact at any given time
• Internal environment exists within client system
• External exists outside the systdem
Nursing Metaparadigm
Health
• Defines health/wellness as the condition in which all parts and
subparts (variables) are in harmony with whole of client
• The clients system move towards wellness when more energy
is available than needed
• The clients system move towards illness and death when more
energy is needed than available
Nursing Metaparadigm
Nursing
• Neumann defines nursing as unique profession that is
concerned with all variables which influence the response , a
person might have to a stressor . The person is seen as whole
and is task of nursing to address whole person
• Defines nursing as action which assist individuals, families, and
groups to maintain a maximum level of wellness, and the
primary aim is stability of the patient, or client system ,through
nursing intervention to reduce stressors
Application

Assessment
• Potential and actual stressors
• Strength of basic factors
• Chracteristics of flexible LOD,normal LOD, LOR
• Interaction between client and environment
• Life process and coping factors
• Perceptual difference between care giver and client
Application
Nursing diagnosis
• Health seeking behavior
• Activity intolerance
• Ineffective coping
• Ineffective thermoregulation
Goal
• To keep client system stable
Application
Planning
• Focused on strengthening line of defense and resistance
• Implementation
• Primary prevention- retain stability
• Secondary prevention-attain stability
• Teritiary prevention maintain stability
Evaluation
• Whether equilibrium is maintained or restored
Acceptance by Nursing Community
• Neumann’s model has been described as a grand nursing
theory by Walker and Avant
• Grand theories can provide a comprehensive perspective of
nursing practice,education and research
Characteristics of Theory
• Different way of looking at particular phenomenon
• Must be logic in nature
• Relatively simple yet generalizable
• Bases for hypothesis that can be tested
• Contribute to increasing general body of knowledge
• Can be utilized for practitioner to guide improve their practice
• Consistent with other validated theory
???
Thank you