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Betty Neuman: Systems Model

Presented by: Antonietta Carriero

NURS 608 – PHILOSOPHICAL FOUNDATIONS OF NURSING

Dr. APRIL MANUEL

November 4, 2018

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Objectives

Objectives

After reading this presentation, participants will:

  • Obtain knowledge about Betty Neuman and her background
  • Define the Neuman Systems Model
  • Understand the client systems (Line of defenses, variables)
  • Understand how stressors (intrapersonal, interpersonal, and extra personal)impact the client system
  • Identify client environment (internal, external, and created)
  • Show an understanding of the Neuman Sytems Model Nursing Process.

Betty Neuman

Was born in Ohio in 1924

Background

Educational background

Educational Background

1947- Diploma: Registered Nurse

Peoples Hospital School

Akron, Ohio

1957- Masters of Science in Mental Health

University of California

Los Angeles, California

1985- Ph D. in Clinical Psychology

Encino, California.

(Bushra, 2018)

Models Timeline

Systems Model timeline

Retrieved from www.img1.imagesbn.com/p/9780135142776_p0_v1_s260x420.JPG

1970- Neuman first developed the Systems Model as a teaching tool for students at UCLA.

1972- Neuman's Model was first published.

1982- The first edition of The Neuman Systems Model: Application to Nursing Education and Practice was published.

1989, 1995, 2002, & 2011- The model was further developed and revised.

(Raile-Alligood, 2014)

Theorist that influenced Neuman

Theorists that influenced Neuman

Neuman drew from several exsisting models and theories to create and develop her own

  • Gestalt's Theory: whole thats perceived as more than the sum of its parts.
  • DeChardin, Marxist; Cornu: Wholeness System
  • Selye's: Stress Theory
  • Caplan: Concepts of levels of prevention

Who uses this model

2.bp.blogspot.com/-Vbhf0ptvnYI/UG37cK9qwII/AAAAAAAAAIE/D9-vWWRTL-E/s1600/flags-of-the-world.jpg

  • The model is widely used in the United States, Canada, and Holland.
  • The model has been used in other countries also (Australia, Brazil, Egypt, England etc.).
  • The model is easily transferable from academia, to practice and to research.
  • Although it was originally developed for nursing, the model can be adapted to other health care disciplines.

Systems Model

Major concepts

Definition

Retrieved from:https://csinsocal.com/wp-content/uploads/2012/12/120-FIYQ45WJ1.jpg

  • The Neuman Systems model is based on a general system theory and reflects the nature of living organism as open systems in interaction with each other and with the environment
  • Use of the Neuman Systems Model for nursing facilitates goal-oriented, unified, wholistic approaches to client care
  • The primary aim of nursing is the stability of the client system. This is achieved through nursing intervention to reduce the stressors.
  • This nursing model considers the occurrence of stressors, and the reaction of the person to stressors, in relation to the outcome of wellness .
  • It is highly significant to the discipline of nursing as it provides a conceptual framework for nursing practice, reseach, and education.

Definition

(Raile-Alligood, 2014)

An Open System

A system is open when there is continuous flow of input and process, output, and feedback. Stress and reaction to stress are basic components of an open system (Raile-Alligood, 2014).

Open system

Stressors

Stressors are tension-producing stimuli that have the potential to disrupt system stability, leading to an outcome that may be positive or negative(Raile-Alligood, 2014). Stressors can be intrapersonal, interpersonal or extrapersonal.

Intrapersonal stressors

Intrapersonal

Intrapersonal forces occurring within the individual, such as conditioning responses.

Raile-Alligood, 2014

Interpersonal stressors

Interpersonal forces occurring between one or more individuals, such as role expectations

Interpersonal

Raile-Alligood, 2014

Extrapersonal stressors

Extrapersonal forces occurring outside the individual, such as financial circumstances.

Extrapersonal

Raile-Alligood, 2014

The Neuman Systems Model Diagram

The conceptual model diagram was developed to explain the client-client system as an individual person for the discipline of nursing

The Neuman Systems Model Diagram

The Neuman Systems Model Diagram

Metaparadigm

Using nursing's Metaparadigm along with general systems theory helps identify this model as a holistic and useful approach to nursing care (Neuman, 1982).

Client

Retrieved from https://www.imagenesmy.com/imagenes/betty-neuman-model-diagram-7e.html

  • The client is seen as a unique whole person which is characterized by several variables: Physiological, psychological, socio-cultural, spiritual and developmental.
  • The client is in a dynamic constant energy exchange with the environment.
  • Environmental Stressors can disrupt the client’s usual stability or line of defense, prevention as interventions are purposeful actions to help the client retain, attain, or maintain system stability.
  • The client can refer to the patient, the family, or even the community.

Client

(Smith, 2015,Raile-Alligood, 2014).

Variables

Variables that characterize the human being

  • Physiological: Body structure and function
  • Psychological: Mental processes in interaction with the environment
  • Socio-cultural: Effects and influences of social and cultural conditions
  • Spiritual: Spiritual beliefs and influences
  • Developmental: age- related processes and activities

(Zakieh & Tabandeh, 2017)

Client-system

Retrieved from https://www.imagenesmy.com/imagenes/betty-neuman-model-diagram-7e.html

o Basic Structure:

The core of the system represents the basic survival factors common to the human being, such as innate or genetic features.

o Lines of resistance:

The lines of resistance help clients defend themselves from stressors. They serve as protection factors that are activated by stressors penetrating the normal line of defense.

o Normal line of defense:

It represents the adaptational level of health developed over the course of time and serves as a standard by which to measure wellness deviation, in other words it’s the level of acceptable wellness as determined by the client.

o Flexible line of defense:

This line represents a protective buffer for preventing stressors from breaking through the usual wellness state as represented by the normal line of defense.

(Raile-Alligood, 2014)

Line of defense

Environment

Retieved from:https://sites.google.com/site/neumanmodel/a-closer-look/environment%20venn.jpg?attredirects=0

Environment

The environment is broadly defined by Neuman as all internal and external factors or influences surrounding the identified client or client system (Smith, 2015), she identifies three relevant environments: internal, external, and created environments.

Internal environment

Internal

Consists of all forces or interactive influences contained within the boundaries of the client, for example age, values, range of body function (Smith & Parker, 2015).

External environment

External

Consists of all forces existing outside of the client, for example the relationship with family, finances, employment (Smith & Parker, 2015).

Created environment

Created

Created environment is unconsciously developed and is used by the client to support protective coping (Zakieh & Tabandeh, 2017), denial is an example of a created environment.

Health

https://tulasstory.files.wordpress.com/2012/02/fermented-foods-illness-health.jpg

Health

According to Neuman health is a continuum of wellness to illness that is dynamic in nature and is constantly changing , health is equated with optimal system stability, the degree of wellness depends on the amount of energy required to return and maintain system stability (Smith, 2015). A reduced state of wellness is the result of unmet systemic needs.

(Smith, 2015,Raile-Alligood, 2014).

Wellness

Optimal wellness exists when the total system needs are completely met (Zakieh & Tabandeh, 2017).

Illness

Illness represents a state of instability and energy depletion (Zakieh & Tabandeh, 2017).

Nursing

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Nursing

  • Neuman (1982) views nursing as a unique profession in that it is concerned with all the variables affecting an individual’s response to stress.
  • The primary aim of nursing is the stability of the client system. This is achieved through nursing intervention to reduce the stressors.
  • Neumans nursing process is divided in three parts: Nursing diagnosis, nursing goals, and nursing outcomes.
  • Three levels of prevention as interventions are identified: Primary, secondary and tertiary.
  • Interventions are purposeful actions to help the client retain, attain, or maintain system stability.

(Raile-Alligood, 2014, Zakieh & Tabandeh, 2017)

Prevention

Primary: The primary prevention takes place even before the client system can respond to a stressor; its purpose is to reduce the possibility of encountering a stressor.

Secondary: This prevention happens once a stressor as occurred, and there are signs of illness.

Tertiary: Tertiary prevention strategies are instituted through support and education so that the client can readapt and resume the road to healthy functioning.

Prevention as interventions

(Ume-Nwagbo, DeWan, & Lowry, 2006, Zakieh & Tabandeh, 2017)

Nursing Diagnosis

Variables

Nursing

Goals

Nursing Process

Levels

of

Prevention

Interventions

Neuman's Systems Model Nursing Process

Nursing Outcomes

Evaluation

Nursing diagnosis

Diagnosis

In order to make a nursing diagnosis nurses must collect comprehensive and holistic data, they must consider all the variables, determine the environmental stressors, and validate the data collected.

(Bushra , 2018)

Nursing goal

Goals

Nursing goal refers to the expected outcomes or the planned interventions determined by the nurse, both the client and the nurse need to agree on the goal and intervention, this will help achieve patient wellness.

(Bushra , 2018., Zakieh & Tabandeh, 2017)

Nursing outcomes

Outcomes

Refers to the evaluation of the goals and interventions, by analyzing the clients response, determining if the set goals are attained, and reformulating goals if needed.

(Bushra , 2018., Zakieh & Tabandeh, 2017)

Theory critiques

Theory critiques

  • It can be complicated to navigate the multitudes of variables in the model (Lines of defense, variable, stressors, preventions as intervention, etc.)
  • The model can be seen as reactive and not pro-active
  • Not all patients are willing to participate in their own decisions making

(Haggart, 1993)

References

References

Bushra, S. (2018). Application of the Betty Neuman theory in care of stroke patient. Annals of Nursig and Practice, 5(1), 1-4.

Haggart, M. (1993). A critical analysis of Neuman's systems model in relation to public health nursing. Journal Of Advanced Nursing, 18, 1917-1922.

Hayden, S. (2012). The NeumanSystemsModel (5th ed.). By B.Neuman and J.Fawcett (Upper Saddle River, NJ:Pearson, 2011). Nursing Science Quarterly, 25(4), pp. 378-380. doi:10.1177/0894318412457067

Neuman, B. (1982). The NeumanSystems Model: Application to nusring education and practice. Norwalk, Connecticut: Appleton-Century-Crofts.

Raile-Alligood, M. (2014). Nursing Theorists and Their Work (eighth ed.). St-Louis, Missouri: Elsevier, Mosby.

Smith, M. C., & Parker, M. E. (2015). Nursing Theories and Nursing Practice (Fourth ed.). Philadelphia, PA: F.A.Davis Company.

Ume-Nwagbo, P. N., DeWan, S. A., & Lowry, L. W. (2006). Using the Neuman Systems Model for Best Practices. Nursing Science Quarterly, 19(1), pp. 31-35. doi:10.1177/0894318405284125

Yarcheski, T. j., Mahon, N. E., Yarcheski, A., & Hanks, M. M. (2010). Perceived stress and wellness in early adolescents using the Neuman Systems Model. The Journal of School of Nursing, 26(3), 230-237. doi:10.1177/1059840509358073

Zakieh, A., & Tabandeh, S. (2017, July-September). Application of the Betty Neuman Systems Model in nursing care of patients/clients with multiple sclerosis. Multiple Sclerosis Journal, 1-8. doi:10.1177/205521737726798

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