TFN: MAAM PALICPIC

Betty Neuman

made the Neuman Systems Model

Betty Neuman

Born in 1924 on a farm near Lowell, Ohio.

Betty Neuman

In 1947, she completed her nursing education with double honors at People’s Hospital School of Nursing (now General Hospital) in Akron, Ohio.

Betty Neuman

As a young nurse, she moved to California and worked in a variety of nursing roles including hospital staff, head nurse, school nurse.

Betty Neuman

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.

Betty Neuman

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.

Betty Neuman

In 1957, she completed her Baccalaureate Degree with Honors in Nursing

Betty Neuman

In 1966, she received her Master’s Degree in Mental Health and Public Health Consultation from the University of California at Los Angeles.

Betty Neuman

In 1985, she completed her Doctor’s Degree in Clinical Psychology from Pacific Western University.

Betty Neuman

A strong/good advocate of Mental Health

Neuman Systems of Model

Neuman first published this model in 1972. Further development and revisions of the model are illustrated in the second (1989) and third (1995) editions. In the fourth edition, it will offer an integrative review of use of the model with guidelines for application of the model in practice, research, education and administration.

1. General System Theory

2. Gestalt Theory

3. Philosophical Views of de Chardin and Marx (One part - three of a whole)

4. Concept of Stressors

5. Levels of Prevention from Caplan’s Conceptual Model

Several Theoretical Sources Neuman took in in her Model

General System Theory

Reflects the nature of living organisms as an open system in interaction with each other and with the environment.

Open system

the interaction with each other, interpersonal, and the interaction with the environment.

Gestalt Theory

Describes homeostasis as the process by which an organism maintains its equilibrium and health under varying conditions.

Gestalt Theory

Focuses on the equilibrium or balance that needs to be maintained, disruption of the balance, illness would come in.

Philosophical Views of de Chardin and Marx (One part - three of a whole)

Anything that happens to the one part affects the whole, if one factor affects the totality of a person other parts of the whole will also not function as well.

Deductive

top-down (paubos)

Inductive

bottom-up (paigbaw)

Concept of Stressors

stress increases the demand for readjustment. This demand is non-specific; it requires adaptation to a problem, irrespective of the nature of the problem.

1. internal

2. external

Stressors can be classified into two

External Stressors

stressors that pertains to the environment

Internal Stressors

stressors that pertains to the problems within the person

Levels of Prevention from Caplan’s Conceptual Model

These stressors can be prevented from occurring and from disrupting the balance or the equilibrium of the open system which is us by the levels of prevention; primary, secondary, and tertiary prevention.

Primary prevention

is used to protect the organism before it encounters a harmful stressor.

Secondary and Tertiary Prevention

are used after the client’s encounter with a harmful stressor.

Primary Level

health promotion and disease prevention

Secondary Level

early detection of disease and treatment

Tertiary Level

health restoration and prevention of the reoccurrence of the disease and prevention of complications.

Client System

composed of variables that function to achieve stability in relation to the environmental stressors experienced by the client, and can be one or a combination of physiological, psychological, sociocultural, developmental, and spiritual variables.

1. physiological

2. psychological

3. sociocultural

4. developmental

5. spiritual

Variables in the Client System

Physiological

a variable that tackles the body structure and function

Psychological

a variable that tackles mental processes in interaction with the environment

Sociocultural

a variable that tackles effects and influences of social and cultural conditions

Developmental

a variable that tackles age-related processes and activities

Spiritual

a variable that tackles beliefs and influences

Neuman Systems Model

Neuman Systems Model

Consists of the basic structure, lines of resistance, normal line of defense, flexible line of defense, the concept of health, stressors, and degree and reaction.

Basic Structure

referred to as the central core which is made up of the basic survival factors common to human beings. These factors include system variables, genetic features, and strengths and weaknesses of the system parts.

Lines of Resistance

act when a Normal Line of Defense is invaded by too many stressors, producing alterations in the clients’ health.

Lines of Resistance

It acts to facilitate coping to overcome the stressors that are present within the individual.

Normal Line of Defense

to achieve the stability of the system, it must act in coordination with the normal wellness state. It must reflect the actual range of responses that is normally acted by clients in response to any stressor.

Normal Line of Defense

It is the baseline in determining the level of wellness of the client within the continuum of health.

Flexible Line of Defense

serves as a boundary for the Normal line of Defense to adjust to situations that threaten the imbalance within the clients’ stability.

Flexible Line of Defense

It expanded the range of normal defense from becoming invaded by the stressors thus increasing its protection.

Health

a continuum of wellness to illness that is dynamic in nature (constantly subject to change).

Optimal wellness

can only exist when the needs of the total system are completely met.

Wellness

exists when all system subparts interact in harmony with the whole system and all system needs are being met.

Illness

occurs at the opposite end of the continuum from wellness and represents a state of instability and energy depletion.

Stressors

external factors/forces that produce tensions, alterations or potential problems causing instability within the client’s system, including intrapersonal, interpersonal, and extrapersonal forces.

1. intrapersonal forces

2. interpersonal forces

3. extrapersonal forces

Stressors may come from the following

Intrapersonal forces

self. It occurs within the individual and correlates with the internal environment.

Example: conditioned responses

Interpersonal forces

person to person. It occur between one or more individuals and outside the client system though at a proximal range.

Example: role expectations

Extrapersonal forces

person to environment. It occur outside the individual or outside the client system at a distal range.

Example: social policy and financial circumstances

Degree of Reaction

The degree of system instability resulting from stressor invasion, which can be positive (negentropy) or negative (egentropy).

Reactions

are the outcomes/produced results of certain stressors and actions of the lines resistance of a client.

Reactions

It can be positive or negative depending on the degree of reaction the client produces to adjust and adapt with the situation.

1. negentropy

2. egentropy

Neuman specified reactions as:

Negentropy

set towards stability or wellness.

Egentropy

set towards disorganization of the system producing illness.

Intervention

purposeful action to help the client, retain, attain, and maintain system stability.

Prevention

used to attain balance within the continuum of health. These are actions that generate good results or are aimed towards hindering negative outcomes.

1. Primary Prevention

2. Secondary Prevention

3. Tertiary Prevention

Three Levels of Prevention

Primary prevention

focuses on foreseeing the result of an act or situation and preventing its unnecessary effects as possible.

Primary prevention

It also aims to strengthen the capacity of a person to maintain an optimum level of functioning while being interactive with the environment.

Primary prevention

Example: health promotion and disease prevention

Secondary prevention

focuses on helping alleviate the actual existing effects of an action that altered that balance of health of a person.

Secondary prevention

It aims to reduce environmental influences that lead to the decline of the level of functioning of a person and strengthening or restoring a person's resistance after the illness exposure.

Secondary prevention

Involves the treatment of symptoms following a reaction to stressors.

Secondary prevention

Example: early detection of disease and prompt treatment

Tertiary prevention

focuses on actual treatments or adjustments to facilitate the strengthening of a person after being exposed to a certain disease or illness.

Tertiary prevention

It aims to prevent the regression or reoccurrence of the illness in the manner of rehabilitation.

Tertiary prevention

involves the maintenance of optimal wellness following treatment.

Tertiary prevention

Example: disability avoidance and physical therapy.

Reconstitution

the adjustment state from the degree of reaction.

Reconstitution

It is the state of going back to the actual state of health before illness occurred.

1. Nursing

2. person

3. health

4. environment

Metaparadigm or the key concepts in Neuman's model.

Nursing

Neuman believes that it is concerned with the whole person.

Nursing

She views it as “a unique profession in that it is concerned with all the variables affecting the individual’s response to stress.”

Person

Neuman regarded the concept of it as an individual, family, community, or the society.

Person

She sees it as an ‘open system’ that works together with other parts of its body as it interacts 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 views it as a continuum from wellness to illness that is dynamic in nature.

Environment

Neuman defines it as the “internal and external forces surrounding the client, influencing and being influenced by the client.” It can alter or improve the systems in which the person exists

Practice (The Neuman Systems Model)

• unified and holistic approach

• multidisciplinary as nurses use the nursing process format and prevention as an intervention to collaborate with the healthcare team

• Addressing the problem of an individual, family, community, or society in a different practice setting is really helpful.

• it is very much applicable to the hospital, clinic, nursing home, rehab, and even in birthing centers.

• It is also applicable for clients experiencing complex stressors.

• Help nurses to formulate an approach that can prevent and alleviate the client's condition.

• Applicable in organizing a framework to plan care

Education (The Neuman Systems Model)

• Been widely used both by nursing students and educators

• the model demonstrated effectiveness and conceptual transition among levels of nursing education

• it has formed a basis for continuing study after graduation

• This model provides a direction to validate nursing roles and activities setting its applicability beyond nursing practice.

Research (The Neuman Systems Model)

• Incorporated the use of testing the efficacy and usefulness of the model in different areas and scope of the nursing practice

• the model has been most widely used frameworks used in nursing research as it guides the enhancement of nursing care

Clarity (The Neuman Systems Model)

• Neuman's model is initially clear as to its conceptual description wherein its structure shows itself as a central nucleus wrapped by normal and defensive lines.

• It presented information congruent with traditional nursing values

• It's consistent with other non-nursing theories

Simplicity (The Neuman Systems Model)

Neuman's Systems Model is viewed to have contradicting reactions. Others say that her model was not simple enough but others believe that it can be easily understood and used.

Simple because:

• Used to understand the help of a person

• Identify the related stressors and possible reactions

• Have prevention and restoration activities

Generality (The Neuman Systems Model)

• Her theory was comprehensive and adaptable for the nurse to use in the different practice settings.

• Its applicability is congruent with the social, physical, physiological, psychological, spiritual aspects of a person which is very holistic.

Accessibility (The Neuman Systems Model)

• Some critics believe that the use of Neman's model increases the collection of empiricism within the scope of nursing practice.

• Therefore, it is predicted that the enhancement of the theory has an increasing chance.

Importance (The Neuman Systems Model)

• Neuman's theory provides guidelines for a professional nurse to have an accurate assessment, planning, implementation, and evaluation of the planned care for their clients.

• This model also serves as a guide for them that can be useful for further research.

Sister Callista Roy

Born on October 14, 1939 in Los Angeles, California

Sister Callista Roy

A sister or a member of St. Joseph of Carondelet

Sister Callista Roy

A nurse theorist and a professor at the William F. Connell School of Nursing at Boston College, Massachusetts

Sister Callista Roy

Earned her Bachelor of Science in Nursing in1963, from Mount Saint Mary College, LA

Sister Callista Roy

Finished her Masters degree in Pediatric Nursing in 1966

Sister Callista Roy

Doctorate in Sociology was conferred to her in 1977 from the University of California, LA

Sister Callista Roy

She was Post-Doctoral Fellow and Robert Wood Johnson clinical nurse scholar at University of California, LA

Roy's Adaption Model

Focuses on the concept of adaptation of the person and is both deductive and inductive in nature.