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Science Quarterly

A Neuman Systems Model Perspective on Nursing in 2050

Betty Neuman and Karen S. Reed
Nurs Sci Q 2007 20: 111
DOI: 10.1177/0894318407299847

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 Theoretical Concerns 111

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A Neuman Systems Model Perspective

on Nursing in 2050

Betty Neuman, RN; PhD; FAAN

Consultant, Watertown, Ohio

Karen S. Reed, RN; PhD

Associate Professor & Director, Graduate Program in Nursing, Malone College, Canton, Ohio

Ilisted
deas in this column were contributed by the authors spiritual variable to recovery of health. The Neuman systems
model proposed that the spiritual variable is a moderating one
as well as Lois Lowry, Jacqueline Fawcett, and Sarah
Beckman. In order to predict the future of nursing theory, it that “empowers the client toward wellbeing by directing spir-
is important to remember the vision and values that spawned itual energy” (Neuman, 1995, p. 48). Thus, the model is on
the development of conceptual models. The Neuman systems the forefront of what is being proposed in medicine.
model was originally designed in 1970 to be a healthcare sys- The current literature reflects that the conceptualizations of
tems model, implying that many professionals could benefit Neuman continue to be most relevant. In a world of accelerat-
through its use. The system perspective provides a universal ing change and increasing complexity, it is important to
language linking parts and wholes into a unifying framework. remember our roots. The dynamic nature of the Neuman sys-
The concept of client wholeness, the goal of optimal health and tems model supports creative interpretations of the proposi-
utilization of primary prevention strategies to maintain well- tions expressed in the model. The language of the model
ness, and popular thinking in the lay literature all catapulted the concepts is understandable to those in other cultures, enabling
Neuman systems model into acceptance by the nursing profes- them to make inference to healthcare situations specific to
sion. These same values are very much alive in today’s world. them. Nurses in different countries have published their appli-
If anything, there is more emphasis on wholistic health and cations of the model in education and service settings. Nursing
wholistic nursing today than there was 37 years ago. homes and hospitals seeking magnet status are the latest set-
In 1989 the spiritual variable was added to the definition of tings expressing interest in using the Neuman systems model.
client in the Neuman systems model (Neuman, 1989). The These organizations claim that the breadth of the model plus
inclusion of the spiritual variable added a new dimension to the specificity of the process of delivering nursing care are
nursing care, always needed, but rarely acknowledged. Today helpful to nurses by unifying their approach to implementation.
there is an explosion of interest in spirituality and its effect on
health. Kliewer and Saultz (2006) present a systems approach Responses to Questions
to integrating spiritual issues into the process of healthcare for
medicine. Although a new approach for medicine, nursing has Question 1
integrated spiritual care into nursing since the days of How do you see the values and beliefs of your theory
Nightingale. Research is demonstrating the importance of the emerging through new conceptualizations that are relevant
DOI: 10.1177/0894318407299847 to the health and quality of life of persons in 2050?

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112 Nursing Science Quarterly, 20:2, April 2007

Response Special consideration will be given to client intra- and inter-

personal needs to offset depersonalization from technological
The Neuman systems model has withstood the test of
aspects of care. Increased isolation related to healthcare deliv-
time in a great variety of worldwide applications. Its proven
ery methods will result in a potentially disenfranchised popu-
cultural relevancy and interdisciplinary use as well as its
lation. Because of the need for individualized attention,
broad, flexible structure assures its continued adaptability
particularly to vulnerable populations, caregivers will enter
for evolving healthcare needs.
into bonding partnerships with clients and families to provide
The value of the model is its wholistic perspective, which
specific education, compassionate care, and encouragement.
is timeless and expansive in being adaptable to all client care
Evidence-based care continuity will become a reality sup-
situations. The key components: a client system comprised of
porting middle-range theory development. As best care prac-
five variables that interact with the internal and external envi-
tices are identified and refined, the knowledge will need to
ronment, and the three prevention levels, provide a mecha-
be organized and integrated to provide a “comprehensive
nism to attain optimal client wellness. These concepts and
description of practice that allows for critique and interpreta-
processes are markers (Chaska, 2000) that give specific
tion of evidence” (Fawcett, Watson, Neuman, Hinton-Walker,
directions for relevant goal planning and interventions. The
& Fitzpatrick, 2001/2006, p. 262). Theory-based care activi-
model principles remain the same for care of one client or a
ties will scientifically validate a science of nursing, helping
larger system; for example, direct care agency or curricular
close the gap between practice and education.
programming, policy shaping, and scientific evaluation.
The Neuman nursing process is designed to implement the
Question 3
model through use of the theoretical concepts and scientific
processes. It considers the client’s perceptions of needs and What would need to happen to get there?
encourages partnership with caregivers to retain, attain, and
maintain the wholistic goal of client system optimal wellness. Response
The Neuman systems model acts as a comprehensive Requirements for 21st century professional care-giving
wholistic care guide for 21st century intervention, nursing include:
research, education, practice, and administration (Neuman &
Fawcett, 2002) to include interdisciplinary sharing and cul- 1. Using both inductive and deductive processes, assessment of
tural care efficacy. The model is designed to organize and client system needs and the subsequent interventions will be
integrated into a larger conceptual model.
direct care-giving activities with the client as central focus. 2. Changing theoretical knowledge will be appropriately uti-
This leads to the development of high-level scholarship for lized in client healthcare situations.
responsible and creative leadership activities. The model fos- 3. Changing natural health/wellness care modalities (for
ters client care partnerships and a spirit of community with example, dietary supplementation) will be used within the
other health caregivers. The ideal nurse role will continue to theory of prevention as intervention to prevent illness, treat
symptoms, and support reconstitution of client systems.
be one of coordinating client healthcare toward optimal well- 4. Considering issues such as social change, care access, health
ness within an identified interactive client system. disparity, and select client/client system education needs to
The model theoretical concepts and scientific processes provide relevant healthcare.
are the glue that consistently holds together interdisciplinary 5. Requiring high levels of caregiver knowledge, commitment,
experiences in both education and practice settings, thus clos- and skill to foster client/caregiver partnerships for mutual
care planning and implementation. It will be imperative that
ing the gap between the two. The wholistic Neuman perspec- nurses consider intrapersonal and cultural concerns.
tive will remain adaptive and relevant to changing healthcare 6. Requiring a common knowledge/skill core for education of
needs up to and including the year 2050. Since 1970, the healthcare professionals, based on systemic principles,
model has both preceded and followed the increasing trend which allow each discipline to identify its own uniqueness.
toward wholistic systemic thinking. Its social utility will 7. Coordinating all client/client system healthcare activities to
optimize wellness through select use of resources, care con-
remain high. tinuities, and scientific validation of the processes used.
Question 2
In summary, rapid development of health knowledge and
How will those conceptualizations be expressed in that
care technology requires that nursing and other health disci-
world?
plines use scientific processes for relevant care planning and
implementation. A case is made for using systems perspec-
Response
tives that will adapt to future changes up to and beyond the
Greater emphasis will be given to in-depth assessment of year 2050. A systems care approach will meet the relevant
client needs for appropriate interventions. The increase in planning and implementation needs to serve one client as a
the amount of data available will require that an organizing system or many; thus, it is adaptable to a wide range of care
framework be used to categorize and highlight gaps in programming needs. In addition, systems terminology, con-
knowledge, as well as maintain continuity of care over mul- cepts, and processes are easily understood by all caregiving
tiple venues and disciplines. disciplines and cultures. A great need exists for unification,

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