Application of Neuman’s Systems Model Theory

The article “Application of Neuman’s system model on the management of a patient with

asthma” effectively applies Neuman’s system model to a case study of a patient with asthma. It

discussed the model’s focus on holistic care in terms of primary, secondary and tertiary

prevention to maintain a system of balance within the patient “system.” It combined the levels of

prevention with Neuman’s model and the body’s response toward stress and stressors and the

lines of defense the body maintains to protect the system from attacks of stress.

In this article Neuman’s system model was applied to facilitate asthma attack prevention.

The article demonstrates the effectiveness of the model in the prevention and nursing

management of a patient dealing with frequent exacerbations of asthma. Neuman’s system model

when applied to a case study of an asthmatic patient “allows intervention to be implemented at

the different stages of the disease: when the patient is well (primary prevention), during and

immediately after an episode of the disease (secondary prevention), and during recovery (tertiary

prevention)” (Lee, 2014). The article was broken down into the levels of prevention and

interventions were provided for the patient (system) as appropriate for each prevention level to

holistically treat all five factors of the system (biological, mental, interactive environmental

social-cultural, developmental and spiritual) according to Neuman’s model (Lee, 2014).

The article clearly demonstrated that the model facilitates nurses to manage patients with

asthma in a holistic manner, leading to better patient outcomes. By using the model, the nurses in

the case study were able to identify interventions required for the different stages of disease

management.

By approaching the interventions in the case study by level of prevention is allows the

nurse to tailor interventions to patient’s needs based on the different stages of the disease
process. As each patient is unique so are their lines of defense, so the interventions required will

vary for different patients. Primary prevention is applied in the patient assessment and helps to

set individualized interventions. The patient studied, “Miss L,” received interventions based on

all three levels of prevention while hospitalized. Primary prevention for her requires that she

understand her disease because she cannot reduce encounters with stressors or strengthen lines of

defense to stressors unless she understands what those stressors are. Much teaching is required

for Miss L so that she can improve her care at home. She needs follow up with nurses who can

help her increase her knowledge of the disease. Miss L also needs information regarding

strengthening her lines of defense. Many of her comorbidities, if treated or controlled properly,

could reduce asthma encounters by strengthening her lines of defense. For example, losing

weight could help with reducing airway obstruction and hypersensitivity, increase elastic load on

respiratory muscle, relive GERD symptoms and possibly resolve obstructive sleep apnea.

Because Miss L does not know the benefits of weight loss related to asthma she cannot

strengthen her lines of defense. With counseling and increased knowledge, she can make the

decision to tackle weight issues and see improvements in all the areas listed above. If patients do

not have the education to assume responsibility of primary preventions it is the job of the nurse

to make sure they receive it as well as understand it.

Secondary prevention deals with making sure Miss L’s health does not further

deteriorate, as well as restoring her to optimal health. This targets the patient’s lines of resistance

and flexible lines of resistance as well as treating the patient’s signs and symptoms of both the

physical and psychological illness. Any medication treatment as well as close monitoring of the

patient falls into this category. It is important to remember that as with all disease asthmatics are

at risk of developing mental illness such as depression and anxiety after exacerbations. While it
is important to stabilize the patient medically, nurses must remember to treat them emotionally

as well.

Tertiary prevention for Miss L deals with reconstructing the patient’s normal line of

defense. This level allows the patient to re-adapt to the illness and re-learn about it as well.

Education is necessary to prevent relapse. The normal line of defense is rebuilt and the flexible

line of defense may be widened. Miss L will receive education prior to discharge from the

hospital to make sure she has the knowledge base to control her asthma at home. Follow up for

Miss L should be arranged at the asthma clinic. She should receive assessment of her use of

inhalers and education regarding medications to take at home.

I personally found this article extremely useful to further my understanding of

Neuman’s system model. I liked how it broke the disease process down into primary, secondary

and tertiary interventions because it helped me to understand exactly where each level of

prevention works into the equation. It also helped me to understand the lines of defense and how

you can widen them and build them up if given the knowledge to know your personal stressors.

Doing so helps to keep your human system in balance and helps ward off sickness before it

starts. I really enjoyed this article and definitely would recommend it to anyone trying to

understand how the Neuman Systems Model is applicable in real life. Most nurses use it every

day when treating patients without even knowing they are doing so. By understanding how it

applies to the disease process it helps one to treat the whole person and not let any of the little

steps or details slip through the cracks so to speak. Thorough

References
Lee, Q. (2014). Application of Neuman’s system model on the management of a patient with

asthma. Singapore Nursing Journal, 41(1), 20-25.