Betty Neuman (System Model in Nursing Practice)

Betty Neuman
System Model in Nursing Practice
(1924 - present)

“Health is a condition in which all parts and subparts

are in harmony with the whole of the client.”

Life Story

Betty Neuman was born in 1924 on a farm near Lowell, Ohio.

Her father was a farmer and her mother was a home maker. She grew up in the rural Ohio where
she developed love for the land and her compassion for people in need.

1947, Neumans initial nursing education was completed with double honors at People's Hospital
School of Nursing (now General Hospital) in Akron, Ohio.

She then moved to Los Angeles to live with relatives in California, she worked in variety of
nursing roles that include hospital staff and head nurse, school nurse, and industrial nurse.

She was also involved in clinical teaching in University of Southern California Medical Center,
 Los Angeles in the areas of medical surgical, communicable disease and critical care.

She had always been interested in human behavior.

She attended the University of California at Los Angeles (UCLA) with a double major in Public
Health and Psychology. She completed her Baccalaureate Degree with Honors in Nursing in
1957.

A very supportive and loving wife who helped established and managed her husband's medical
practice.

1966, she received her Master's Degree in Mental Health, Public Health Consultation from
UCLA.

1985, She- received a Doctoral Degree in Clinical Psychology from Pacific Western University
in 1985.

Neuman and Donna Aquilina were the first two nurses to develop the nurse counselor role within
Los Angeles based community crisis centers.

She developed her first explicit teaching and practice model for mental health
consultation m the late 1960s before the creation of her systems model. Neuman was a pioneer of
nursing involvement in mental health. She developed taught, and refined a community mental
health program for postmasters level nurses at UCLA.
 Books and Publications

Neuman designed a conceptual model for nursing in 1970 in response to request

from UCLA graduate students who wanted a course emphasizing breadth rather than depth in
understanding the variables in nursing. Initially, the model was developed to integrate students'
understanding of client variables that extend nursing beyond the medical model. The Neuman
model included such behavioral science concepts as problem identification and prevention.

Neuman first published her model in 1972.

She spent the following decade further defining and refining various aspects of the
model in preparation for her book, the Neuman System Model: Application to Nursing Education
and Practice. Further development and revisions of the model are illustrated in the second (1989)
and third (1995) editions. Neuman stated that the fourth edition will offer an integrative review
of use of the model with guidelines for application of the model in practice, research, education
and administration.
 She is a Fellow of the American Association of Marriage and Family Therapy.
She contuse in active, private practice as a licensed clinical marriage and family therapist, with

an emphasis on Christian Counseling. Neuman lives in Ohio

and maintains a leadership role as Director of Neuman Systems Model Trustees Group, Inc. until
2009.
She serves as a consultant internationally for nursing schools theory-based practice.

Theoretical Sources
1. Gestalt theory - homeostasis process.
2. Marx - properties of parts are determined partly by the larger wholes.
3. de Chardin - philosophy of wholeness of life.
4. Han Selye - General Adaptation Syndrome and Stress Theory.
5. Caplan - prevention levels of nursing.
Metaparadigm in Nursing
- the concept of a whole person and an open system approach.

The concept is aimed towards the development of a person in a state of wellness having the
capacity to function optimally by adaptation with environmental stimuli causing illnesses back to
a state of wellness

Nursing
Neuman believes that nursing requires a holistic approach that considers all factors affecting a
client's health—physical, physiological, psychological, mental, social, cultural, developmental
and spiritual well-being.

Person
Neuman regarded the concept of a person as an individual family community or the society.
She sees a person as an open system that works together with other parts of its body as it interact
with the environment.
 Open system is characterized by the presence of an exchange of information and
reaction with other factors surrounding a person.

Health
Neuman considers health as dynamic in nature in which the person’s health is as the level of
health continuum—wellness or illness.

Wellness exists when all the part or system of person works harmoniously.

Environment
The environment can be an internal and external.
Stressors are the forces created by the environment. Stressors are tensions that produce
alterations in the normal flow of the environment. These stressors can be:
1. Intrapersonal - occurs within the self and comprises of man as a psycho-spiritual being
2. Interpersonal - occurs between one or more individual and consists of man as a social being
3. Extrapersonal - occurs outside the individual and may include environmental factors

System Model in Nursing Practice

1. Client Variables
- physiological, sociocultural developmental and spiritual—function to achieve stability in
relation to the environmental stressors experienced by the client.

2. Lines of Resistance
- acts when the Normal Line of Defense is invaded by too much stressor causing alteration in the
normal health pattern to facilitate coping and overcome the stressors that are present within the
individual.

3. Normal Line of Defense

- acts in coordination with the normal wellness state. It is the normal reaction of the client in
response to stress – the baseline determinants of wellness within the health continuum.

4. Flexible Line of Defense

- helps the body to adjust to situations that threaten the imbalance within the client's stability.

5. Stressors
Stressors are forces that produce tensions, alterations or potential problems causing instability
within the clients system.

6. Reaction
Reactions are the outcomes or produced results of certain stressors and actions of the lines
resistance of a client. It can be positive or negative depending on the degree of reaction the client
produces to adjust and adapt with the situation.
a. Negentropy is set towards stability or wellness
b. Egentropy is set towards disorganization of the system producing illness

7. Prevention
Prevention is used to attain balance within the continuum of health

Three Levels of Prevention according to this theory:

A. Primary prevention – focuses on foreseeing the result of an act or situation and preventing its
unnecessary effects as possible. It also aims to strengthen the capacity of a person to maintain an
optimum level of functioning while being interactive with the environment. Ex. health promotion
and disease prevention.

B. Secondary prevention – focuses on helping alleviate the actual existing effects of an action
that altered the balance of health. It aims to reduce environmental influences that cause an
alteration in the stability of the client. Ex. Early diseases detection and prompt treatment.

C. Tertiary prevention – focuses on the actual treatments or adjustments to facilitate

strengthening of person after being exposed to stressor. Aims to prevent regression and
recurrence of the disease. Ex. Rehabilitation

8. Reconstitution
A state of returning back to old health self.

Application
Practice:
1. Holistic approach in the care of the patients.

Education:
1. Effective in conceptual transition among all levels of nursing education.
2. Basis for continuing education after graduation facilitating professional growth.
3. Validate nursing roles and activities and its applicability beyond nursing practice.

Research:
1. Widely used framework used in nursing research that guides enhancement of nursing care.

Analysis
Simplicity
1. It is simple for people especially health/medical related professionals whom can understand
the concepts of health continuum.

Generality
1. Applicable in any health care settings.
2. The theory is comprehensive and adaptable.

Emperical Precision
1. Utilizes empiricism, wherein the theory is testable by mere use of observation.

Clarity
1. Congruent with traditional nursing values.
2. Consistent with other non-nursing theories.

Derivable Consequences
1. Introduction of the nursing process (assessment, nursing diagnosis, planning, implementation
and evaluation)
2. Provides guidelines for professional nurses.