The Nueman

BETTY NEUMAN

System Model
 History &
⚬ Betty Neuman was born in 1924 in
Background
Ohio
⚬ Received RN diploma from Peoples
Hospital, SON in Ohio, 1947
⚬ Baccalaureate degree in Public
Health and Psychology in 1957
⚬ Master’s degree in Mental Health,
Public Health Consultation in 1966
from UCLA
⚬ Doctoral degree in Clinical Psychology
Betty Neuman from Pacific West University in 1985
⚬ In 1998 received a second Honorary
 Neuman’s System
Model
• Neuman’s system model goal was to provide a wholistic
overview of the physiological, psychological, sociocultural,
and developmental aspect of human being.
• Viewed as an open system in which repeated cycles of
input, process, output, feedback, consitute a dynamic
organizational pattern.
• Clients may be an individual, a group, a family, and a
community.
 Major Concepts
Wholistic approach - Clients are viewed as whole parts of
Open System
dynamic - There is a continuous flow of input and
interaction.
process, output, and feedback and Stress and Reaction to stress
Function
are basic of Process
components - Thesystem.
of an open client as a system
Input and Output - Client as a system, input and output are
exchanges
“the matter, energy, and information that are exchanged
between
Feedback client and the
- System environment”
output in the form of “matter, energy, and
information serves as feedback
Negentropy - A process of energy conservation that increases
organization and complexity, moving the system toward stability
at a higher degree of wellness
Stability - A dynamic and “desirable state of balance in which
energy exchanges can take place without disruption of the
character of the system,” which points toward optimal health.
 Major Concepts
Environment - The environment of both internal and external forces
Created
surrounding theEnvironment
client. - Developed unconsciously by the client
to express system wholeness symbolically.
Client System - Composed of five variables — Physiological,
Psychological, Sociocultural, Development, and Spiritual in
interaction with the environment.
Basic Structure - Composed of a central core surrounded by
concentric rings. The inner circle represents the basic survival
factors
Line ofor energy resources
Resistance of the
- A series client rings surrounding the
of broken
basic core structure is called the lines of resistance. Represents
resource factors that help the client defend against a stressor
 Major Concepts
Normal Line of Defense - It is the model’s outer solid circle. That
represents the
“adaptational level of health developed
over the course of time and
serves
Flexible Line of Defense - The model’s outerasbroken
the standard bycalled
ring is which to
measure wellness
the flexible line of deviation
determination.”
defense. Perceived as serving as a
protective buffer for
preventing stressors from breaking
through the usual wellness
state, as represented by the
normal line of defense.
 Major Concepts
Health - “Health is a continuum of wellness to illness that is dynamic in
nature. Optimal wellness exists when the total system needs are being
Wellness
completely met”- “Wellness exists when all system subparts interact in
harmony with the whole system and all system needs are being met”
Illness - “Illness exists at the opposite end of continuum for wellness
and represents a state of instability and energy depletion”

Stressor - Tension-producing stimuli “that have the potential or

disrupt system stability, leading to an outcome that may be positive
or negative” they may arise from the following: Intrapersonal
forces, Interpersonal forces, Extrapersonal forces .
 Major Concepts
Degree of Reaction - Represents system instability that occurs when
stressors invade the normal line of defense.
Illness - “Illness exists at the opposite end of continuum for wellness
and represents a state of instability and energy depletion”

Prevention as Intervention - Interventions are purposeful actions

to help the client retain, attain, or maintain system stability. Neuman
Primary
identifies Prevention
3 levels - Used when a stressor is suspected or
of intervention:
identified. “A reaction has not yet occurred,” but the degree of risk is
Secondary Prevention - Intervention or treatment initiated after
known.
symptoms from stress have occurred.
Tertiary Prevention - It occurs after the active treatment or
secondary prevention stage. Focuses on readjustment toward optimal
client system stability.
Reconstruction - Occurs after treatment for stressor reactions.
 Core Elements
I. Person Variable
• 5 PERSON VARIABLE: Physiological variable, Psychological Variable,
Developmental Variable, Sociocultural Variable, and Spiritual Variable.
II. Central Core
• The basic structure or central core is made up of the basic “survival
factor”
• The person’s system is an open system and therefore is dynamic and
constantly changing, and evolving. Stability or homeostasis occurs
when the amount of energy that is available exceeds that being used
III. Flexible Line of Defense
by the system.
• The outer barrier or cushion to the normal line of defense, the line of
resistance and the core structure.
 Core Elements
IV. Normal Line of Defense
• Represents system stability over time.

V. Line of Resistance
• Protects the basic structure and become activated when
environmental stressor invade the normal line of defense.
VI. Reconstitution
• Increase in energy that occurs in relation to the degree of reaction to
the stressor.
 Core Elements
VII. Stressor
• Neuman system model focuses on the impact of stressor on health
and addresses stress and the reduction of stress.
• They may be Intrapersonal, Interpersonal, or Extrapersonal

VIII. Prevention
• Neuman defines prevention as the primary nursing intervention.
• 3 Preventions: Primary, Secondary, and Tertiary Prevention
The Neuman Systems Model
The Neuman Systems Model of
Client Sys
 Major Assumptions
Human Beings (Person/Client)
• The layered multidimensional being. Each layer consists of the
person variables Physical/Physiological, Psychological,
Socio-cultural, Developmental, Spiritual
• Neuman defines the client as “an unlimited entity with an active
personality system whose evolution follows principles,
symbolism, and systematic organization. It is not always possible
to see the potential expansions of the entity and the
Health
ramifications of its actions.”
• Nueman see health as being equated with wellness.
• Defines health/wellness as “the condition in which all parts and
subparts (variables) are in harmony with the whole of the
client”.
 Major Assumptions
Environment
• Neuman defines environment as all the internal and external
factors that surround and influence the client system.
• Stressor are significant to the concept of environment and are
described as environmental forces that interacts with any
potentially alter system stability.
• Neuman identifies three relevant environment: (1) internal, (2)
external,
Nursing and (3) created
• Neuman see nursing as a “ unique profession that is concerned
with all of the variables which influence the response a person
might have to a stressor”
• Neuman states that because the nurse’s perception will
influence the care given, not only must the patient/client
 Acceptance by the Nursing
Community
• Practice - nursing practice facilitated goal-directed, unified,
wholistic approaches to client care. It is also appropriate for
multi-disciplinary use to prevent fragmentation of client care.

• Education - the model is well accepted in academia and is used

widely as a curriculum guide, has been used throughout the US
and in many other countries. It is equally well to guide clinical
learning, i.e., in community, nursing centers, maternity clinical
settings.

• Research - often used by nurse researchers as a conceptual

framework because it lends itself to both quantitative and
qualitative methods.
 Critique:Neuman’s System Model
• Clarity - Neuman presents abstract concepts that are
familiar to nurses
• Simplicity - concepts are organized in a complex, yet
systematically logical manner. However, Neuman states
that concepts can be separated completely. She
contends that concepts can be separated for analysis,
specific goal setting, and interventions.
• Generality - used in a wide variety of nursing
situations; both comprehensive and adaptable.
• Accessibility (Empirical Precision) - has been tested
and is used extensively to guide nursing research.
• Importance (Derivable Consequences) - considered
APPLICATION OF NEUMAN’S
SYSTEM MODEL
 WRAP-UP
• Betty Neuman developed a wholistic systems-based model to guide
nursing practice, research, and education.
• The model views the client as an open system constantly interacting with
the environment, influenced by stressors.
Key components:
⚬ Lines of defense and resistance that protect the central core of survival
factors.
⚬ Stressors (intrapersonal, interpersonal, extrapersonal) that challenge
system stability.
⚬ Health continuum from wellness to illness, depending on balance and
energy.

• Nursing interventions focus on prevention (primary, secondary, tertiary) to

maintain or restore stability.
Thank
You