System Model

Work Stress Among Nurses

Betty Numan ( 1924 to present )

Presented By :
Nada Al-Furayj
NURS 501:THEORETICAL FOUNDATION OF NURSING
Dr. Ruqayah Alhajji
 SYSTEM MODEL
BETTY NEUMAN
( 1924-PRESENT )

“I believe that theory is vital to the development of an autonomous and accountable nursing
profession...I believe that the model is relevant for the future because of its dynamic and
systemic nature; its concepts and propositions are timeless” (Neuman, 2011, p. 318).
 Contents
 Introduction and objective
 Background of the theorist and theory
Definition of the theory.
Major concepts.
Nursing metaparadigm and assumption.
Application.
References.
 Introduction
• In any healthcare facility, nurse is first responder for the patients.
There are factors which are main reasons to increase stress level
among nurses like Patients, scheduling , work overload ,
environment and lack of support.

• Objective of the study is to assess stress level among nurses who

working at inpatient unit and find prevention ways to decrease
level of stress by using Betty Numan model.
Background of Neuman Theory

• completed her nursing education with

1947 Diploma degree at people hospital
school of nursing

• Earned her
1947 baccalaureate in public
health and psychology

• Developed and published

1960 her first explicit teaching

practice model for mental
health consultation

1966
• Earned master degree in mental
health and public health
consultations from university of
California and Los Angels
Background –cont’d

1967 1985 1985

Developed and Developed nurse Established Neuman

completed a
refined a counselors role system model trusts
Signed a nursing doctoral degree
within the group to protect and
community conceptual in clinical
community crisis perpetuate the integrity
mental health model for psychology at
center in Los of the theory in the
program for students UCLA pacific western
Angeles with future
postmaster level university
Donna Aquilina
1970 1988
 Neuman system model
This model developed to focus on the client or group toward stress and the reaction
to it.

• It is a unique, open system based on perspective and provide a

unifying focus for approaching a wide range of concerns.
• System acts as boundary for a single client, a group or numbers of
groups.
• A system interact with the environment delineates the domain of
nursing concern.
• Neumann’s Model was influenced by several theoretical sources,
Gestalt theory: interaction of person and environment.
Chardin: Philosophy of wholeness or totality of life.
Selye: stress adaptation & interaction with environment.
Von Bertalanffy: general living open system theory.
Caplan: levels of prevention approach.
Lararus: stress and coping.
Major concepts

Wholistic
approach

it is a dynamic, open system approach to client care, developed to provide a unifying focus for defining
nursing problems and for understanding the client in the interaction with the environment.
The model consider all variables affecting client system (physiological , psychological , sociocultural,
developmental and spiritual).
Open system
They are basic components of the open system:

The client as a system exchange energy and information with

Function to process
environment

It is the matter, energy, and information that are exchanged

Input and output
between clients and the environment.
it is system output in the form of matter, energy, and information
Feedback
as feedback for future input to change, enhance or stabilize.
The process of energy conservation that assists system in the
Negentropy
progression toward stability or wellness.
It is the dynamic and desirable state of balance in which energy
Stability exchange can take place without disruption of the character of
the system
Environment:
Defined as internal and external forces surrounding the client, influencing and being
influenced by the client at any point and time.

Created Environment is developed unconsciously by the client to express system

wholeness, the purpose is to provide protection for client system functioning and to
isolate the client from stressors.
 Client system Lines of resistance

Normal line of
defense
Flexible line of defense
Basic
structure

Represent the basic survival factors or energy resources of the

Basic structure client, the core structure consists of basic survival factors
common to human begins.

It is the broken rings represent resources factor that help the

Lines of resistance client defend against stressors and it become activated when
environment stressors invade the normal line.

It represent the adaptational level of health developed over the

Normal line of defense
course of time and reflect an enhance wellness state.

Flexible line of defense It keeps the system free from stressor.

Health:
Health is equated with wellness.
Wellness:
It exists when all system
subparts interact in
harmony with whole
system and all system
needs are being met.

Illness:
It exists the opposite of
wellness and represent
at state of instability and
energy depletion.
Stressors:
It is tension producing stimulate that have the potential to disrupt system stability, leading to an
outcome either positively or negatively.

 Intrapersonal factors: within individual

 Interpresonal factors: between one individual or more
 Extrapersolnal factors: outside the individual

Degree of Reaction :represents system instability that occurs when stressors invade the normal line of defense.
Reconstitution : occurs after treatment for stressor reactions.
 Primary
It used to protect the normal line of defense and it
occur before the system react to stressors

Secondary
Focus on strength of internal lines of resistance,
reducing the reaction of the stressors and increase
resistance factors to prevent the damage.
This occur after the system reacts to stressors
Tertiary
Focus on readaptation, stability, protects or
return to wellness after treatment.
This occur after the system has been treat it

Preventions
Nursing Metaparadigm

Nursing
Unique profession that it is concerned with all variables affecting an individual response to stress.

Person
Open system client interacted with environment, the client may be individual, family, group, community or social issue.

Environment
All the internal and external factors that surround and influence the client system.
Open system client interacted with environment, the client may be individual, family, group, community or social issue.

Health
Optimal wellness or stability indicates that total system needs and reduce in wellness result in unmet system needs.
 Assumptions or “accepted truths”
made by Neuman’s Systems 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.

flexible line of defense against possible reaction to stressors.

Each client/client system has evolved a normal range of responses to the environment 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.
Assumptions or “accepted truths” –cont’d

Primary prevention relates to general knowledge applied in client assessment and intervention in
identifying and reducing or mitigating possible or actual risk factors associated with environmental
stressors to prevent a possible reaction.

Secondary prevention relates to symptomatology following a reaction to stressors, an appropriate

ranking of intervention priorities, and treatment to reduce their noxious effects.

Tertiary prevention relates to the adjustive processes 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)
Theory Evaluation analysis
NEUMAN SYSTEM MODEL
Brief Critique of the Neuman systems model
The model had a constructive beginning as it began as a hypothetical model and
intends to build a more complex picture of clients and their surrounding systems.

A Comprehensive conceptual model that clearly operationalizes the concept that are
relevant to nursing.

The scope of model is broad and easy use for the research and practice by individuals
and groups communities.
 Consistency
The definitions of the concepts fit their use in the propositions.
such as with the definition of the flexible line of defense accordion-like effect a protective,
accordion like mechanism that surrounds and protects the normal LOD from invasion by
stressors.
increases the utility of the model.

Complexity
The model is complex; therefore, it cannot be described as being simple, yet nurses using the model
describe it as easy to understand and it is used across cultures and in a wide variety of practice settings.
Logical adequacy of the theory
energy sources in her model as part of the basic structure, new nursing interventions as to the
provision of needed energy of the client can be conceptualized.

• Neuman Systems ; use of the concept of entropy is inconsistent with the characteristics of
entropy which is closed, rather than an open system.
 Clarity
 Neuman presents abstract concepts that are congruent with
tIn reality, the individual resists stressors with internal and
external reflexes which were made complicated with the
formulation of different levels of resistance in the open
systems model of Neuman.

Testability
used as a conceptual framework extensively in nursing research, and aspects of the
model have been empirically tested.
The Neuman Systems Model's major
strength&weaknesses:
The Neuman Systems Model’s major strength is its flexibility for use in all areas of nursing
administration, education, and practice(is logically consistent)

The emphasis on primary prevention, including health promotion, is specific to this model.

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

Practice
Used by Anderson, McFarland and Helton in 1985, for
community health needs assessment in which they identified
violence toward women.
(Nursing diagnosis, goals and outcome)

Education Research
Used with nursing students at a community Used by nursing researches as conceptual framework
center to teach them how they can promote like studies of post traumatic stress disorder
health of communities. symptoms in emergency.
Summary and Conclusion

• The NSM’s moderate clarity, consistency, and rationale give it the

feasibility to be used within multiple populations and contexts. within
the nursing discipline supports its future impact on nursing research,
practice, education, and administration .
• The Neuman Systems Model Perspective of Nurse-Led Interprofessional
Collaborative Practice.
• While it provides adequate guidance for applying theoretical thinking to
clinical nursing situations, it also allows for opportunities to be creative
when finding solutions to broader problems.
• It provides the conceptual framework for nurses to advance and improve
their practice.
 References
• Ahmadi, Z., & Sadeghi, T. (2017). Application of the betty Neuman systems model in the nursing care of patients/clients with multiple
sclerosis. Multiple Sclerosis Journal - Experimental, Translational and Clinical, 3(3), 205521731772679
• . https://doi.org/10.1177/2055217317726798
• Joshi, P., Kumari, V., & Kumar, A. (2020, September 14). Application of Betty Neuman Systems Model in nursing care
...https://www.jscimedcentral.com/Nursing/nursing-7-1116.pdf. Retrieved April 1, 2022,
• from https://www.jscimedcentral.com/Nursing/nursing-7-1116.pdf
• says:, R. lily G., says:, J., says:, B., says:, L. S., says:, E., & says:, P. (2021, March 5). Betty Neuman: Neuman Systems Model (Nursing Theory
Guide). Nurseslabs. Retrieved April 2, 2022,
• from https://nurseslabs.com/betty-Neuman-systems-model-nursing-theory/
• Ø Sultan, B. (2018). Application of Betty Neuman theory in care of stroke patient. https://www.jscimedcentral.com/Nursing/nursing-5-
1092.pdf. Retrieved April 2, 2022,
• from https://www.jscimedcentral.com/Nursing/nursing-5-1092.pdf

• Montano, A.-R. (2021). Neuman Systems Model with Nurse-Led Interprofessional Collaborative Practice. Nursing Science Quarterly, 34(1),
45–53.
• from https://doi.org/10.1177/0894318420965219
• Betty Neuman’s System Model. (n.d.). Currentnursing.com. Retrieved October 11, 2023,
• from https://currentnursing.com/nursing_theory/Neuman.html
Any Questions?

Thank you