Enfermeria

Betty Neuman's System Model

This page was last updated on January 28, 2012

INTRODUCTION

• Theorist - Betty Neuman - born in 1924, in Lowel, Ohio.

• BS in nursing in 1957; MS in Mental Health Public health consultation, from UCLA in 1966; Ph.D. in clinical psychology

• Theory was publlished in:

o “A Model for Teaching Total Person Approach to Patient Problems” in Nursing Research - 1972.

o "Conceptual Models for Nursing Practice", first edition in 1974, and second edition in 1980.

• Betty Neuman’s system model provides a comprehensive flexible holistic and system based perspective for nursing.

DEVELOPMENT OF THE MODEL

Neuman’s model was influenced by:

• The philosophy writers deChardin and Cornu (on wholeness in system).

• Von Bertalanfy, and Lazlo on general system theory.

• Selye on stress theory.

• Lararus on stress and coping.

BASIC ASSUMPTIONS

• Each client system is unique, a composite of factors and characteristics within a given range of responses contained within a basic structure.

• Many known, unknown, and universal stressors exist. Each differ in it’s potential for disturbing a client’s usual stability level or normal LOD (Line of Defence).

• The particular inter-relationships of client variables at any point in time can affect the degree to which a client is protected by the flexible LOD against possible reaction to stressors.

• Each client/ client system has evolved a normal range of responses to the environment that is referred to as a normal LOD. The normal LOD can be used as a standard from which to measure health deviation.

• When the flexible LOD is no longer capable of protecting the client/ client system against an environmental stressor, the stressor breaks through the normal LOD

• The client whether in a state of wellness or illness, is a dynamic composite of the inter-relationships of the variables. Wellness is on a continuum of available energy to support the system in an optimal state of system stability.

• Implicit within each client system are internal resistance factors known as LOR, which function to stabilize and realign the client to the usual wellness state.

• Primary prevention relates to G.K. that is applied in client assessment and intervention, in identification and reduction of possible or actual risk factors.

• Secondary prevention relates to symptomatology following a reaction to stressor, appropriate ranking of intervention priorities and treatment to reduce their noxious effects.

• Tertiary prevention relates to adjustive processes taking place as reconstitution begins and maintenance factors move the back in circular manner toward primary prevention.

• The client as a system is in dynamic, constant energy exchange with the environment.

MAJOR CONCEPTS (Neuman, 2002)

Content

• the variables of the person in interaction with the internal and external environment comprise the whole client system

Basic structure/Central core

• The common client survival factors in unique individual characteristics representing basic system energy resources.

• The basis structure, or central core, is made up of the basic survival factors which include: normal temp. range, genetic structure.- response pattern. organ strength or weakness, ego structure.

• Stability, or homeostasis, occurs when the amount of energy that is available exceeds that being used by the system.

• A homeostatic body system is constantly in a dynamic process of input, output, feedback, and compensation, which leads to a state of balance.

Degree to reaction

• the amount of system instability resulting from stressor invasion of the normal LOD.

Entropy

• a process of energy depletion and disorganization moving the system toward illness or possible death.

Flexible LOD

• a protective, accordion like mechanism that surrounds and protects the normal LOD from invasion by stressors.

Normal LOD

• It represents what the client has become over time, or the usual state of wellness. It is considered dynamic because it can expand or contract over time.

Line of Resistance-LOR

• The series of concentric circles that surrounds the basic structure.

• Protection factors activated when stressors have penetrated the normal LOD, causing a reaction symptomatology. E.g. mobilization of WBC and activation of immune system mechanism

Input- output

• The matter, energy, and information exchanged between client and environment that is entering or leaving the system at any point in time.

Negentropy

• A process of energy conservation that increase organization and complexity, moving the system toward stability or a higher degree of wellness.

Open system

• A system in which there is continuous flow of input and process, output and feedback. It is a system of organized complexity where all elements are in interaction.

Prevention as intervention

• Interventions modes for nursing action and determinants for entry of both client and nurse in to health care system.

Reconstitution

• The return and maintenance of system stability, following treatment for stressor reaction, which may result in a higher or lower level of wellness.

Stability

• A state of balance of harmony requiring energy exchanges as the client adequately copes with stressors to retain, attain, or maintain an optimal level of health thus preserving system integrity.

Stressors

• environmental factors, intra (emotion, feeling), inter (role expectation), and extra personal

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