SYSTEM MODEL BY BETTY NEUMAN

CREDENTIALS & BACKGROUND OF THEORIST Betty Neuman- born in 1924 in Ohio. 1957-She received a BS in public health nursing () 1966-took MS in public health - mental health nursing from the University of California Los Angels.

-In 1985 -granted Ph.D in clinical psychology by Pacific Western University. -Published 3 editions of the Neuman systems model.

The Neuman Systems Model BASIC STRUCTURE ENERGY RESOURCES  Basic factors common to all organisms, i.e.,  Normal temperature range  Genetic structures  Response pattern  Organ strength  Weakness  Ego structure  Knowns or commonalities Stressors  Identified  Classified as to knows or possibilities, i.e.,  Loss  Pain  Sensory deprivation  Cultural change Primary prevention  Reduce possibility of encounter with stressors  Strengthen flexible line of defense Stressor Stressor Flexible Line of Defense Normal line of Defense Intra Inter Personal Extra factors Lines of Resistance BASIC STRUCTURE ENERGY RESOURCES Secondary prevention  Early case-finding and  Treatment of symptoms Degree of Reaction Reaction Reaction  Individual intervening variables, i.e.,  Basic structure Idiosyncrasies  Natural and learned resistance  Time of encounter with stressor Reconstitution Stressors  More than one stressor could occur simultaneously  Same stressors could vary as to impact or reaction  Normal defense line varies with age and development Tertiary prevention  Readaptatio  Reeducation to prevent future occurrences  Maintenance of stability Intra Inter Personal Extra factors Reconstitution  Could begin at any degree or level of reaction  Range of possibility may extend beyond normal line of defense. Interventions  Can occur before or after resistance lines are penetrated in both reaction and reconstitution phases  Intervention phases  Degree of reaction  Resources  Goals  Anticipated outcome Note: Physiological, psychological, sociocultural, developmental and simultaneously in each client concentric circle Intra Inter personal Extra factors

Two major components are stress and the reaction to stress. Client is viewed as an open system in which repeated cycles of input, process, output and feed back constitute a dynamic organizational pattern Both the client and environment may be affected either positively or negatively by each other.

Major concepts Wholistic client approach Open system Client system includes Basic structure Lines of defense Resistance Stressors Degree of reaction

Environment Created environment, wellness and illness Prevention as intervention Reconstitution

Client system Client system consists of a basic or core structure – protected by lines of resistance. The usual level of health is identified as the normal line of defense. That is protected by a flexible line of defense. Stressor – intra, inter and extra personal. Arises from internal, external and created environment.

6. When stressors break through the flexible line of defense, the system is invaded and the lines of resistance are activated and the system is moving to illness. 7. If adequate energy is available the system will be reconstituted, with the normal line of defense, restored at, below or above its previous level. 8. Nursing interventions – Primary prevention, secondary and Tertiary prevention occurs after reconstitution is being established.

BASIC STRUCTURE The inner circle of the diagram represents the basic survival factors or energy sources of the client. The basic structure or central core in made up of those survival factors common to the species. These factors include the system variables, genetic features, and strength and weakness of the system parts.

LINES OF RESISTENCE It is the series of broken rings which surrounds the basic core structure. The internal factor that help the client defend against stressors e.g. Immune response system. The lines of resistance protect the basic structure and become activated when the normal line of defense is invaded by environmental stressors.

NORMAL LINE OF DEFENCE It is the outer solid circle. A stability state for the individual, or system. The adjustments made to stressors and maintained overtime. (Eg) Individual’s usual coping patterns, life style and developmental stage.

FLEXIBLE LINES OF DEFENCE It is the outer broken ring. It is the initial response or the first protective mechanism of the system to stressors. It acts as a protective buffer It prevents the stressors from breaking through the solid line of defense. E.g., loss of sleep. It is important to strengthen this flexible line of defense to prevent a possible reaction.

STRESSORS Stressors are environmental forces that may alter system stability. Intrapersonal forces occurring with in the individual. correlate with internal environment (e.g. conditioned response, auto - immuine response, depression, insomnia, guilt feeling).

Interpersonal stressors - occur between environment and system (e.g role expectation, conflict, social withdrawal)

Extra personal forces Occur outside the individual system boundaries (e.g. financial circumstances, a social policy, shift to new place and lack of social support ). Stressors are stimuli which might penetrate both the clients flexible and normal lines of defense. The potential outcome of an inter action with a stressor may be beneficial, positive or noxious (negative)

WELLNESS It exists when the parts of the client system interacts in harmony. System needs are met. It is the stable condition. ILLNESS Disharmony among the parts of the system is considered as illness in varying degrees. Reflecting unmet needs. It is the state of instability and energy depletion.

DEGREE OF REACTION It is the degree to which there is instability within the system due to the invasion of the normal lines of defense due to the stressors. The reactions may be positive or negative. System movement toward negentropy or entropy.

PREVENTION AS INTERVENTION Prevention is possible before or after their resistance lines are penetrated in both reaction and reconstitution phase. the intervention should begin when the stressors is suspected or identified.

The interventions are based on the possible or actual degree of reaction, resources, goals and the anticipated outcome. Interventions are purposeful actions to help the client retain, attain or maintain system stability.

3 levels of intervention Primary Prevention It is carried out when a stressor is suspected or identified. Occurs prior to system reacting to a stressor, when the degree of risk is known. It includes health promotion and maintenance of wellness, immunization, health education, exercise and life style changes.

Secondary prevention Occurs after the system reacts to a stressor Secondary prevention Occurs after the system reacts to a stressor. It involves intervention or treatment after the symptoms from stress have occurred. To regain optimal system stability and to conserve energy. To strengthen internal lines of resistance, reduce the reaction and increase the resistance factors.

Tertiary prevention It is an intervention that follows secondary prevention or the active treatment. Prevent recurrence of reactions and regression. Maintain wellness, strengthen resistance to stressors. It focuses on readjustment toward optimal client system’s stability.

RECONSTITUTION Return of the system to stability. It is the state of adaptation to stressors in the internal and external environment. It may begin at any level of reaction and may progress To higher or lower level of wellness Stabilize the system or return it to the level that existed before the illness. Nursing is to help the client system attain, maintain or retain system stability.

METAPARADIGM THE HUMAN BEING The client as a whole person is viewed as an open system that interacts with both internal and external environmental forces or stressors. The human is in constant change, moving toward a dynamic state of system stability or toward illness of varying degrees.

ENVIRONMENT It includes internal, external and created environment. Stressors are the concept of the environment, they are the forces interact with the system and alters the stability.

HEALTH OR WELLNESS The condition as degree of system stability A continum from wellness to illness. Stability occurs when the systems parts and sub parts are in balance or harmony When system needs are met, optimal wellness exists. When system needs are not satisfied illness exists. Reconstitution may occur after adaptation to stressors.

NURSING The appropriate action in situation that are stress related or in relation to possible reactions of the client or client system to stressors. Nursing interventions are aimed at helping the system adapt or adjust and to retain, restore or maintain some degree of stability for optimal wellness between and among the client system variables and environmental stressors with a focus on conserving energy

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