theory

2. 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.

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

4. Primary prevention
 Reduce possibility of
encounter with
stressors
 Strengthen flexible
line of defense
Stressors
 Identified
 Classified as to knows or
possibilities, i.e.,
 Loss
 Pain
 Sensory deprivation
 Cultural change
Secondary prevention
 Early case-finding
and
 Treatment of
symptoms
Tertiary prevention
 Readaptatio
 Reeducation to
prevent future
occurrences
 Maintenance of
stability
Reaction
 Individual intervening
variables, i.e.,
 Basic structure
Idiosyncrasies
 Natural and learned
resistance
 Time of encounter
with stressor
Intra
Inter Personal
Extra factors
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
Basic Structure
 Basic factors common to
all organisms, i.e.,
 Normal temperature
range
 Genetic structures
 Response pattern
 Organ strength
 Weakness
 Ego structure
 Knowns or
commonalities
BASIC
STRUCTURE
ENERGY
RESOURCE
S
Intra
Inter Personal
Extra factors
Stressor
Stressor
Reaction
Degree of
Reaction
Reconstitution
 Could begin at any degree or
level of reaction
 Range of possibility may
extend beyond normal line of
defense.
Intra
Inter personal
Extra factors
The Neuman Systems Model
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
Note:
Physiological, psychological,
sociocultural, developmental
and simultaneously in each
client concentric circle

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

6. Major concepts
I. Wholistic client approach
II. Open system
Client system includes
 Basic structure
 Lines of defense
 Resistance
 Stressors
 Degree of reaction

7.  Environment
 Created environment, wellness and illness
 Prevention as intervention
 Reconstitution

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

9. 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.

10. 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.

11. 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.

12. 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.

13. 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.

14. 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).

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

16. 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)

17. 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.

18. 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.

19. 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.

20.  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.

21. 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.

22. 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.

23. 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.

24. 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.

25. 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.

26. 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.

27. 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.

28. 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