nursing

1. NEUMAN'S THEORY
INTRODUCTION :-The NeumannSystemsModel wasoriginallydevelopedin1970 at the Universityof
California,LosAngeles,byBettyNeuman,Ph.D.,RN.The model wasdevelopedbyDr.Neumanasa way
to teachan introductorynursingcourse tonursingstudents.The goal of the model wastoprovide a
holisticoverview of the physiological,psychological,sociocultural,anddevelopmental aspectsof human
beings.
Credentials:-
 1914- Born inBaltimore,Maryland.
 1930- Receivedherdiplomacertificate of nursinginhospital school of nursing,Washington.
 1939- Bachelorof Science educationfromcatholicuniversityof America.
 1945- Master of science innursingfromsame university.
 1958-1960- curriculumconsultantindepartmentof health,educationandwelfare.
 1959- Assistantprofessorof nursingeducationatcatholicuniversityof America.
 1971- Firstbookof nursing;conceptof nursingwaspublished.
 1976- Receivedhonorarydegree of doctorof science.
 1985- The thirdeditionof nursing;conceptof practice waspublished.
VIEWSOF BETTY NEUMAN:-
WELLNESS :-Itwas equatedwithstabilityof the normal line of defenseandillnessappearedtobe
variancesof wellness.
HEALTH:-Healthisenvisionedasbeingatvarious,changinglevelswithinanormal range,risingor falling
throughoutthe life span
RECONSTITUTION:- Itisthe processof movingfromvariancesfromwellnesstodesiredwellnesslevels
and clientstability.
ASSUMPTIONS:-
Wellnessisadynamiccomposite of
 physical
 psychological
 sociocultural
 developmental
 spiritual
balance to resistdisequilibrium.
CONCEPT OF THIS THEORY:-
There are 4 aspectsof Neuman‘s theory.
 Client/ person aspect
 Health aspect
 Environmental aspect
 Nursing aspect

2. CLIENT/PERSON ASPECT OF THEORY:-
Neumanbelievesthatnursingisconcerned withthe wholepersonincludingthese dimensions:
• Physical/Physiological
• Psychological
• Socio-cultural
• Developmental
• Spiritual
HEALTH ASPECT OF THEORY:-
Healthisthe changinglevelswithinanormal range , risingor fallingthroughoutlifespanbecause of
unsatisfactoryadjustmentstoenvironment.
ENVIRONMENTAL ASPECT OF THEORY:-
The environmentisaforce whichsurroundsa personandwithwhichtheyinteractat anygiventime
that affectstheirwellbeing
NURSING ASPECT OF THEORY:-
The role of the nurse isseenintermsof degreesof reactiontostressors,andthe use of primary,
secondaryandtertiaryinterventions
CHARCTERISTICS OF NEUMANS THEORY:-
1. Theories can inter relate concepts in such a way as to create a different way of
looking at a particular phenomenon.
Thisfocuson nursinginterest inthe total personapproachto the interactionof environmentand
health.The emphasisonwellnessandprimarypreventionisunique tothisframework.
2. Theories must be logical in nature.
In the logical translation of the neuman model, there appear to be incompatible
elements since the model reflects both mechanistic and organismic views of the
relationship of person to environment.
3. Theories should be relatively simple yet generalized
It issimple andstraightforwardinapproach.The termsusedare easilyidentifiableandfor
the most part have definitionsthatare broadlyaccepted.
4. Theories can be the bases for hypothesis that can be test
one area for future considering as a beginning testable theory might be the
concept of prevention as intervention.

3. SIGNIFICANCE OF NEUMANS MODEL
 Nurses provide this care through their assessment, diagnosis, treatment and
education, and evaluation.
 It is used at all levels of nursing education from diploma through doctorate.
 It is used in many clinical areas in institutional and community nursing practice at
national and international sites.
NEUMANS ENVISIONS NURSING PROCESS
ASSESSMENT
 Intake summary =Name, age, sex, marital status
 Interpersonal factors
 Psycho socio cultural factors = attitude, values, behavioral pattern and nature of coping
pattern.
 Development factors = age, factors related to present situation.
 Spiritual belief system = hope
 Inter personal factors = resources and relationship of family, friends or caregivers.
 Extra personal factors = resources and relationship of community facilities, finances,
employment etc.
NURSING DIAGNOSIS
 Variances from wellness [needs and problems] are determined by co-relations and
constraint through synthesis of theory
NURSING GOAL
Maintain client system stability
TERTIARY INTERVENTION
• Motivation
• Education and re-education
• Behavior modification
• Optimal use of internal and external resources.
DRAWBACKS
 Concepts need clearer definitions and further explanations.
 Difficult to evaluate the effect of model on nursing practices.
APPLICATION
NURSING DIAGNOSIS
 Acute pain related to the presence of surgical wound on abdomen secondary to
periampullary carcinoma.
 ASSESSMENT
INTRAPERSONAL FACTORS
INTERPERSONAL FACTORS
EXTRAPERSONAL FACTORS
 DESIRED OUTCOME/GOAL
Patient will get relief from pain as evidenced by a reduction in the pain scale score and
verbalization.

4. NURSING INTERVENTIONS
Primary Prevention
 Assess severity of pain by using a pain scale
 Check the surgical site for any signs of infection or complications
 Support the areas with extra pillow to allow the normal alignment and to prevent strain
 Administer the pain medications as per the prescription by the pain clinics to relieve the
severity of pain.
Secondary Prevention
 Teach the patient about the relaxation techniques and make him to do it
 Do not allow the patient to do strenuous activities. And explain to the patient why those
activities are contraindicated.
 psychological support
Tertiary Prevention
 Educate the client about the importance of cleanliness and encourage him to maintain
good personal hygiene.
 Involve the family members in the care of patient
 Educate the family members about the pain management measures.
 Provide the primary and secondary preventive measures to the client whenever necessary.
EVALUATION
 patient verbalized that the pain got reduced and the pain scale score also was zero. His
facial expression also reveals that he got relief from pain.