Betty Neuman's Systems Model PDF

BETTY NEUMAN SYSTEMS MODEL/ HEALTH CARE z SYSTEM MODEL z BETTY NEUMAN, RN, BSN, MS, PhD, PLC, FAAN (September 11, 1924; 95 years old) ▪ The philosophic base of the Neuman Systems Model encompasses wholism, a wellness orientation, client perception and...

BETTY NEUMAN SYSTEMS MODEL/ HEALTH CARE z SYSTEM MODEL z BETTY NEUMAN, RN, BSN, MS, PhD, PLC, FAAN (September 11, 1924; 95 years old) ▪ The philosophic base of the Neuman Systems Model encompasses wholism, a wellness orientation, client perception and motivation, and a dynamic systems perspective of energy and variable interaction with the environment to mitigate possible harm from internal and external stressors, while caregivers and clients form a partnership relationship to negotiate desired outcome goals for optimal health retention, restoration and maintenance.  z OVERVIEW The Neuman Systems Model is based on the patient’s relationship to stress, reaction to it, and reconstitution factors that are dynamic. It is universal in nature, which allows it to be adapted to a variety of situations, and to be interpreted in many different ways. z The central philosophy of several lines of resistance, which represent the internal factors helping Neuman’s the patient fight against a stressor; z nursing theory the normal line of defense, which consists of represents the patient’s equilibrium; energy and resources that the flexible line of defense, which represents the dynamic nature that are surrounded can rapidly change over a short time. by three things: z In the Neuman Systems Model, the nurse’s role is to keep the system’s stability by using three levels of prevention. PRIMARY PREVENTION, which protects the normal line and strengthens the flexible line of defense. SECONDARY PREVENTION is used to strengthen the internal lines of resistance, which reduces the reaction and increases resistance factors. TERTIARY PREVENTION readapts, stabilizes, and protects the patient’s return to wellness after treatment. Stress reduction is a goal of system model of nursing practice. Nursing actions are in primary, secondary or tertiary level of prevention. To address the effects of stress and reactions to it on the development and maintenance of health. The concern of nursing is to prevent stress invasion, to protect the client’s basic structure and to obtain or maintain a maximum level of wellness. The nurse helps the client, through primary, secondary, and tertiary prevention modes, to adjust to environmental stressors and maintain client stability. z System is invaded and the lines of resistance are activated System is described as moving into illness on a wellness-illness continuum. If adequate energy is available.. System will be reconstituted with the normal line of defense Restored = below, or above its previous level. The aim of the Neuman model “is to set forth a structure that depicts the parts and subparts and their interrelationship for the whole of the client as a complete system” (Neuman, 2011, p. 12). z SYSTEMS MODEL CLIENT / CLIENT SYSTEM is conceptualized as: Individual Family Group / aggregate Community  z INTERACTING VARIABLES PHYSIOLOGICAL VARIABLE Neuman views the individual the structure and functions of the body. client holistically and considers the variables simultaneously and comprehensively. PSYCHOLOGICAL VARIABLE mental processes and relationships. SOCIOCULTURAL VARIABLE system functions that relate to social and cultural expectations and activities. DEVELOPMENTAL VARIABLE processes related to development over the lifespan. SPIRITUAL VARIABLE influence of spiritual beliefs.  z INTERNAL ENVIRONMENT. exists within the client system. All forces and interactive influences that are solely within boundaries of the client system make up this environment. ENVIRONMENTS EXTERNAL ENVIRONMENT. The environment is a vital arena that is germane to the system and its exists outside the client function. The environment may be system. viewed as all factors that affect and are affected by the system. CREATED ENVIRONMENT. unconsciously developed and is used by the client to support protective coping.  z INTRA-PERSONAL STRESSORS STRESSORS any phenomenon that are those that occur within the client system might penetrate both the boundary and correlate with the internal flexible and normal lines environment. of defense, resulting in either a positive or negative outcome. INTER-PERSONAL STRESSORS occur outside the client system boundary, are proximal to the system, and have an impact on the system EXTRA-PERSONAL STRESSORS also occur outside the client system boundaries but are at a greater distance from the system that are interpersonal stressors. An example is social policy. z When stressors break through the flexible line of defense Views the client as an open system that responds to stressors in the environment The usual level of health is identified as the normal line of defense that is protected by a flexible line of defense. z CENTRAL CORE (core structure) Consist of basic survival factors normal temp range genetic structure response pattern organ strength/weakness ego structure  z FLEXIBLE LINE OF DEFENSE (FLD) Forms the outer boundary of the defined client system [individual/ family/ group/ community] (Neuman, 2002) Acts as a protective buffer system for the client’s normal line of defense or wellness state Prevents stressor invasion of the client system  z NORMAL LINE OF DEFENSE (NLD) The client / client system’s normal or usual wellness level This line represents what the client has become/evolved over time (Neuman, 2002) The NLD defines the stability and integrity of the client system, its ability to maintain stability and integrity This normal defense line is the standard against determining any variance from wellness  z LINES OF RESISTANCE (LOR) A protective mechanism that attempts to stabilize the client system and foster a return to the usual wellness LOR contain certain known and unknown internal and external resource factors that support the client’s basic structure and NLD (mobilize WBC, activate immune system mechanisms) Protection factors activated when stressors have penetrated the normal line of defense, causing a reaction symptomatology. z OPTIMAL SYSTEM STABILITY Optimal wellness is the greater possible degree of system stability at a given point in time (Neuman, 2002). Optimal client system stability means the highest possible health condition achievable at given point in time (Neuman, 2002). z VARIANCE FROM WELLNESS Varying degrees of system instability The difference from (Neuman, 2002). the normal or usual wellness condition (Neuman, 2002)  ILLNESS Illness is a state of insufficiency with disrupting needs unsatisfied (Neuman,2002). Illness is an excessive expenditure of energy… when more energy is used by the system in its state of disorganization than is built and stored, the outcome may be death (Neuman, 2002). z RECONSTITUTION Complete reconstitution may occur beyond the previously determined NLD or usual wellness state, may stabilize the May be viewed as system to a lower level, feedback from the or return to the level of input/output of secondary wellness prior to illness. intervention Is the determined energy increase related to the degree of reaction to a stressor, and represents the return and maintenance of system stability following treatment for stressor reactions (Neuman, 2002) z PREVENTION AS INTERVENTION (basis for health promotion) ▪ Nursing is prevention as intervention encompass three dimensions: Primary Prevention Secondary Prevention Tertiary Prevention  In Neuman’s Systems Model nursing process, there are six steps, each with specific zcategories of data about the patient. z NEUMAN’S NURSING PROCESS ASSESSMENT OF THE PATIENT, which looks at: actual and potential stressors; condition and strength of basic factors and energy sources; characteristics of flexible and normal lines of defense, lines of resistance, degree of reaction and potential for reconstitution; interaction between the patient and his or her environment; life process and coping factors for optimal wellness; and the perceptual difference between the care giver and the patient. The nurse makes a DIAGNOSIS by interpreting the data collected. The data includes health-seeking behaviors, activity intolerance, ineffective coping, and ineffective thermoregulation. SET GOALS. The ultimate goal is to keep the client system stable. From the goals, a PLAN is created, which focuses on strengthening lines of defense and resistance. That plan is implemented using primary, secondary, and tertiary preventions. Finally, the nursing process is EVALUATED to determine whether or not balance was restored, and a stable state maintained.  z METAPARADIGMS Human being is viewed as an open system that interacts with both internal and external environment forces or stressors. HUMAN BEING The human is in constant change, moving toward a dynamic state of system stability or toward illness of varying degrees. The primary concern of nursing is to define the appropriate action in situations that are stress-related or in relation to possible reactions of the client or client system to NURSING stressors. Nursing interventions are aimed at helping the system adapt or adjust and to retain, restore, or maintain some degree of stability between and among the client system variables and environmental stressors with a focus on conserving energy. condition or degree of system stability and is viewed as a continuum from wellness to illness. When system needs are met, optimal wellness exists. HEALTH When needs are not satisfied, illness exists. When the energy needed to support life is not available, death occurs. Seen to be the totality of the internal and external forces which surround a ENVIRONMENT person and with which they interact at any given time