THEORISTS PEOPLE
Myra Levine A holistic being; wholeness is
integrity and integrity means the
person has a freedom of voice
System of Systems and its
Wholeness expresses the
organization of all contributing
parts.
The life processes is the
process of change
Martha Rogers as an open system in continuous
process with the open system
that is the environment
(integrality)
- Human beings “are not
disembodied entities, nor are
they mechanical aggregates…
Man is a unified whole possessing
his own integrity and manifesting
characteristics that are more than
and different from the sum of his
HEALTH
The pattern of adaptive of change of
the whole being.
(Socially determined by the ability to
function in a reasonably normal
manner)
Return to Self
- Individuals are free and able to
pursue and able to purse interest
within the context of own resources
Rogers uses the term passive health
to symbolize wellness and the
absence of disease and major illness
(Rogers, 1970).
- Later, she wrote that wellness “is a
much better term… because the term
health is very ambiguous”
ENVIRONMENT
Context in which individuals live
their lives. Not a passive backdrop
Includes both Internal and
External
(Internal – physiologic or
pathophysiologic response,
External – has three classifications:
influence of culture, language and
recognition.
1. Operational
➢ Ex: Microorganism
2. Perceptual
➢ Perception or information that is
recorded by sensory of organs
3. Conceptual
➢ Influenced by language, culture,
ideas and cognition
“an irreducible, pan-dimensional
energy field identified by pattern
and manifesting characteristics
different from those of the parts.
Each environmental field is specific
to its given human field. Both
changes continuously and
creatively.
*this enters the role of nurses, that
we are going to participate in the
NURSING
Human interaction
It has a conservative function
Both a profession and scientific
discipline
➢ Uses patient rather than client,
because if we use the client, it is only
receptive and will just abide what the
nurses say. There is effort of patients
to promote and maintain wholeness
that we have.
is a learned profession and is both a
science and art.
Purpose/Goal of nursing – to
participate in the process of change
towards better health
*Is the study unitary, irreducible
indivisible human and environmental
fields
 parts”
Open Self
Unified Whole
Indivisible
Dorothea E. Humans are identified as “men,
women and children cared for
Orem either singly or a social units,”
and are the “material object” and
composed of four aspects. The
person, it can be holistic where
taking care of holistic person,
physical, psychological,
interpersonal, and social as part
of the human being.
Imogene King focuses on the patient.
She defines person as “a
personal system that interacts
with interpersonal and social
systems”
a. Involves every aspect of the
patient’s self
b. Is important for the nurse to
look at the whole person,
including spiritual, emotional,
and financial state
c. This metaparadigm furthers
patient care by understand
the internal and external conditions
that permit self-care needs to be
meet.
*the health condition of your client
*the nurse will set in to perform care
to that client
“Dynamic life experiences of a
human being, which implies
continuous adjustment to stressors
in the internal and external
environment through optimum use
of one’s resources to achieve
maximum potential for daily living.”
This is especially important to King’s environment of human beings
theory of goal-attainment because
to achieve goal attainment one
must also take into consideration
the height at which the patient’s
process of change because there
will be continuous and creative
change both in the human and
environmental field.
*because of the continuous change
in the human and environmental,
there might be disease process or
illness/continuous well-being of
your client.
anything outside or external to the
person that can
positively/negatively affect the
person’s ability to function
“can be both external and
internal”
The external environment is the
context ‘within which humans
being grow, develop and perform
daily activities’; the internal
transforms energy to enable them
to adjust to continuous external
environmental changes”
*Rogers claims that nursing exists to
serve people, and the safe practice of
nursing depends on the nature and
amount of scientific nursing knowledge
the nurse brings to his or her practice.
*In the nursing curriculum, you will
experience hardships because that is
the very reason
it consists of those action to overcome
or prevent self-care deficit Providing
care for someone who is unable to
perform self-care
as “a process of human interactions
with the goal of helping patients
achieve their goal.
• This also is vital to her formulation
of her theory of goal-attainment
 where the patient is coming health can be fulfilled
from and what is most
important to him or her
Health, to the extent possible for
the patient, is the goal for ill and
their nurse alike
The distinction between internal
and external environment is
incredibly important. If the
internal environment is unable to
adjust to the changing external
environment, growth and
development externally will be
inhibited

Betty Neuman
viewed as an “OPEN SYSTEM”
and a “TOTAL PERSON”
(Neuman, 1989). This means
that rather than viewing the
person as comprised of various
parts and each part functioning
individually, the person is
consisted of parts; however,
they function as a whole.
• The many dimensions of a
person, as described by
Nueman, are said to include
physiological, psychological,
sociocultural, developmental
and spiritual variables.
• Neuman’s Model, the
concepts of lines of defense and
resistance comprise the person
and both of these are affected
by the various stressors that
• These environments include
stressors that can be intrapersonal,
interpersonal or extra personal;
each of these affects the
environment and its stability.
• The internal environment is
comprised of forces that create and
effect the defined client system,
while with the external
environment would include both
inter- and extra personal stressors
that are external to the client
system.
• The internal environment exists
within the client system. All forces
and interactive influences that are
solely within boundaries of the
client system make up this
environment.
• The external environment exists
outside the client system.
seen as the “degree of client
wellness that exists at any point
in time, ranging from an optimal
wellness condition, with available
energy at its maximum to death,
which represents total energy
depletion.
• Thus, according to Neuman, the
levels of energy within the client
system will determine whether
one is ‘well’. So, it can be
concluded that wellness would be
associated with energy levels that
are high, rather than low levels
hence, the client would not be in
a state of wellness.
“unique profession” that focuses on
the person as a whole, and the
variables, that affect the response to
stressors.
• According to Neuman, retaining
and attaining stability in the client
system to reduce stressors is the
most important goal of nursing.
• Neuman made it clear that, because
care provided will be influenced by
the nurse’s perceptions, nurses must
assess their own perceptions in
addition to assessing the clients.
• Primary, secondary, and tertiary
preventions are the nursing
interventions that are emphasized in
this model and allow for flexible lines
may be present.
• Because the normal line of
defense represents the ‘normal’
level of wellness in a person,
when stressors of everyday life
are placed on an individual, the
ability to adjust to it will be
displayed through this line of
defense.
• The flexible line of defense
acts as a protective barrier for
the normal line of defense and
being used when stressors are
present in the client system.
• In contrary, the line of
resistance would be responsible
for creating a balance in the
system and stabilizing the
person after a reaction to a
stressor.
• The terminology “person” is
considered to include the
individual, the family, group and
even the community, therefore,
the person can refer to a large
population not only consisting
of one being according to
Neuman’s model. The idea that
the person is seen as always
being in constant change with
• The created environment is
unconsciously developed and is
used by the client to support
protective coping.
• Since the normal line of
defense displays the usual level of
wellness, when there is stressors
placed on a system, due to unmet
needs, the wellness level
decreases.
of defense and resistance.
• Depending on the type of
intervention that would be used, the
nurse’s role would change
• However, if system had reacted to
the stressor (secondary prevention),
then the nurse would focus on
removing the stressor and protecting
and preventing damage to the system
as well as strengthening the lines of
resistance.
• In this case that the client was
experiencing symptoms (tertiary
prevention), clearly the stressors have
impacted the system greatly and
nursing interventions would focus on
limiting the effects of the stressors on
the system, as well as reducing the
amount of energy needed to limit the
use of energy and preserve the
amount available in the system.
 its environment is another key
idea according to Neuman.
SR. Callista
• “Human systems have thinking
Roy and feeling capacities, rooted in
consciousness and meaning, by
which they adjust effectively to
changes in the environment and,
in turn, affect the environment.”
• Based on Roy, humans are
holistic beings that are in
constant interaction with their
environment. Humans use a
system of adaptation, both innate
and acquired, to respond to the
environmental stimuli they
experience. Human systems can
be individuals or groups, such as
families, organizations, and the
whole global community.
• “Health is not freedom from the
inevitability of death, disease,
unhappiness, and stress, but the
ability to cope with them in a
competent way.”
• Health is defined as the state where
humans can continually adapt to
stimuli, and because illness is a part
of life, health is the result of a
process where health and illness can
coexist.
• If a human can continue to adapt
holistically, they will be able to
maintain health to reach
completeness and unity within
themselves.
• If they cannot adapt accordingly,
the integrity of the person can be
affected negatively.
• “The conditions, circumstances • “The goal of nursing is] the promotion
and influences surrounding and of adaptation for individuals and
affecting the development and groups in each of the four adaptive
behavior of persons or groups, with modes, thus contributing to health,
particular consideration of the quality of life, and dying with dignity.”
mutuality of person and health
resources that includes focal, • In Adaptation Model, nurses are
contextual and residual stimuli.” facilitators of adaptation. They assess
the patient’s behaviors for adaptation,
• The environment is defined as promote positive adaptation by
conditions, circumstances, and enhancing environment interactions
influences that affect the and helping patients react positively to
development and behavior of stimuli. Nurses eliminate ineffective
humans as an adaptive system. coping mechanisms and eventually lead
• The environment is a stimulus or to better outcomes.
input that requires a person to
adapt and these stimuli can be
positive or negative.
• Roy categorized these stimuli as
focal, contextual, and residual.
o Focal stimuli are that which
confronts the human system and
requires the most attention.
o Contextual stimuli are
characterized as the rest of the
stimuli that present with the focal
stimuli and contribute to its effect.
o Residual stimuli are the

Dorothy
• Johnson views human beings as
Johnson having two major systems: the
biological system and the
behavioral system. It is the role of
medicine to focus on the
biological system, whereas
nursing’s focus is the behavioral
system.
The concept of PERSON was
defined as a behavioral system
that strives to make continual
adjustments to achieve, maintain
or regain balance to a steady-
state that is adaptation.
Health is seen as the opposite of
illness, and Johnson defines it as
“some degree of regularity and
constancy in behavior, the behavioral
system reflects adjustments and
adaptations that are successful in
some way and to some degree,
adaptation is functionally efficient
and effective.”
additional environmental factors
present within the situation, but
whose effect is unclear. This can
include previous experience with
certain stimuli.
Environment is not directly defined,
but it is implied to include all
elements of the surroundings of
the human system and includes
interior stressors.
Nursing is seen as “an external
regulatory force which acts to preserve
the organization and integration of the
patient’s behavior at an optimal level
under those conditions in which the
behavior constitutes a threat to
physical or social health, or in which
illness is found.”