Betty Neuman 2


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Betty Neuman 2

  1. 1. Objectives Explore credentials, theoretical sources, and historical perspective of Betty Neuman Review concepts/definitions and concept map Critique theory Examine the Neuman Systems Model’s acceptance by the nursing community Demonstrate NSM’s use through case
  2. 2. Background Credentials Born: 1924 Ohio 1947: RN from Peoples Hospital School of Nursing Akron, OH.  Received double honors Moved to California  Variety of Nursing Roles  Hospital nurse, School Nurse, Industrial Nurse and clinical instructor at University of Southern California (Aligood & Toomey, 2010
  3. 3. Background Credentials 1957- Bachelors degree in public health & psychology - honors 1966- Masters degree in mental health & public health consultation - UCLA 1985- Doctoral Degree in clinical psychology - Pacific Western University. 1998- Honorary doctorate - Grand Valley State University, Allendale, MI. (Aligood & Toomey, 2010
  4. 4. Theory Development Neuman System Model (NSM) developed in 1970 and published in 1972  Firstpublished as “Model for teaching total person approach to patient problems” in Nursing Research. (Aligood & Toomey, 2010
  5. 5. Theoretical Sources General System Theory Reflects the nature of living organisms as open systems in interaction with each other and with environment (Aligood & Toomey, 2010
  6. 6. Theoretical Sources Gestalt Theory Describes homeostasis as the process by which an organism maintains equilibrium, and consequently its health, under varying conditions. (Aligood & Toomey, 2010
  7. 7. Theoretical Sources Marx  Philosophy“suggests properties of parts are determined partly by the larger wholes within a dynamically organized systems.” de Chardin  Philosophy of the wholeness of life (Aligood & Toomey, 2010
  8. 8. Theoretical Sources Selye’s  Caplan definition of  Adapted levels stress: of prevention  Any tension  Primary producing stimuli  Secondary that causes a response  Tertiary  Canbe positive or negative. (Aligood & Toomey, 2010
  9. 9. Historical Perspective Time of great historical development in nursing 1970’s- Nursing Research concluded a lack in conceptual connection and theoretical frameworks.  Leading to two major findings: 1. Standardization of nursing curricula 2. Doctoral education for nurses should be in nursing. (Aligood & Toomey, 2010
  10. 10. Conceptual Model“A conceptual model provides adistinct frame of reference for itsadherents…that tells them how toobserve and interpret thephenomena of interest to thediscipline.” (Aligood & Toomey, 2010
  11. 11. Betty Neuman, Cedar Crest College, October 22, 2008
  12. 12. Major Concepts and Definitions WHOLISTIC APPROACH  Client viewed as “whole”  Person, family, group, community, or social issue 5 person variable  Physiological  Psychological  Sociocultural  Developmental  Spiritual (Aligood & Toomey, 2010
  13. 13. Major Concepts and Definitions OPEN SYSTEM  Function or Process  Client as a system exchanges energy, information and matter with the environment as it uses available energy resources to move toward stability and wholeness  Input or Output  Matter, energy, and information that are exchanged between the client and the environment  Feedback  System output in the form of matter, energy, and information for corrective action to change, enhance or stabilize the system (Aligood & Toomey, 2010
  14. 14. Major Concepts and Definitions  Negentropy  Defined by Neuman as a process of energy conservation utilization that assists system profession toward stability or wellness  Stability  Dynamic and desired state of balance  Copes with stressors to maintain an optimal level of health and integrity (Aligood & Toomey, 2010
  15. 15. Major Concepts and Definitions ENVIRONMENT  Created Environment CLIENT SYSTEM  Basic Client Structure  Composed of a central core surrounded by concentric rings  Lines of Resistance (Aligood & Toomey, 2010
  16. 16. Major Concepts and Definitions  Normal Lines of Defense  Model’s outer solid circle  Represents stability for the individual or system  Maintained over time and serves to assess deviations from client’s usual wellness  Flexible Lines of Defense  Model’s outer broken ring  Can be altered over time; Protective buffer for preventing stressors from breaking through usual wellness state  According to Neuman, “When the flexible line of defense expands, it provides greater short-term protection against stressor invasion; when it contracts, it provides less protection.” (Alligood and Tomey, 2010) (Aligood & Toomey, 2010
  17. 17. Major Concepts and Definitions HEALTH  Wellness  Illness STRESSORS  Tension producting stimuli that have the potential to disrupt system stability DEGREE OF REACTION  Represents system instability that occurs when stressors invade normal line of defense (Aligood & Toomey, 2010
  18. 18. Major Concepts and Definitions PREVENTION AS INTERVENTION  Purposeful actions to help client maintain system stability  Levels of Prevention: Primary, Secondary, Tertiary  Primary: Used when stressor is suspected or identified; Degree of risk in known  Secondary: Involves interventions or treatment initiated after symptoms occurred  Tertiary: Occurs after active treatment; maintenance RECONSTITUTION  Occurs after treatment for stressor reaction (Aligood & Toomey, 2010
  19. 19. Empirical Evidence Neuman took the lead to hypothesize her theory along with other theories to create the model Evaluated the use of model by using graduate nursing students at UCLA (Aligood & Toomey, 2010
  20. 20. NURSING  Nursing concerns whole person  Perception influences care (Aligood & Toomey, 2010
  21. 21. PERSON Open system, reciprocal to environment Client system always changing Physiological, psychological, sociocultural, developmental and spiritual all interrelated (Aligood & Toomey, 2010
  22. 22. HEALTH Stability of system important Wellness model Stability is associated with total system needs being met (Aligood & Toomey, 2010
  23. 23. ENVIRONMENT Seen as internal and external influences Stressors can threaten stability Three environments  Internal=allinteraction in client  External=all factors outside client  Created=unconscious, coping (Aligood & Toomey, 2010
  24. 24. THEORETICAL ASSERTIONS  Nurse and client interact  Nurse concerned with variables that affect response to stressors  Copes by flexing environment  Either changes himself to stressors or adjusts stressors to himself (Aligood & Toomey, 2010
  25. 25. SIMPLICITY Complex yet logical Some concepts overlap Usable in variety of practice settings (Aligood & Toomey, 2010
  26. 26. GENERALITY Comprehensive and adaptable Broad scope, useful in applying theory to all healthcare settings Wholistic approach, client participation works well in today’s views of prevention and interdisciplinary care (Aligood & Toomey, 2010
  27. 27. EMPIRICAL PRECISION  Extensive use in nursing research  Continues to be tested and refined (Aligood & Toomey, 2010
  28. 28. DERIVABLE CONSEQUENSES Guideline for assessment Use of nursing process Implement prevention Client involvement in goals Expansion of scientific knowledge for nurses (Aligood & Toomey, 2010
  29. 29. Practice Approach  Goal-Directed  Unified  Wholistic Multidisciplinary  Prevent fragmentation of care  Flexible (Aligood & Toomey, 2010
  30. 30. Practice Multidisciplinary  Stressors  Client system Guidelines  Nursing  Allied services (Aligood & Toomey, 2010
  31. 31. Practice• Neuman Nursing Process Format – Nursing diagnosis • Data base  variance from wellness – Nursing goals • Negotiation btw client and caregiver  desired changes – Nursing outcomes • Prevention-as-intervention • Evaluation• when used by other disciplines, nursing is changed accordingly (Aligood & Toomey, 2010
  32. 32. Practice• Hospitals• Nursing homes• Rehab centers• Community-based services• Multiple countries – Holland, Malaysia• Individuals & communities• Acute care & clinic (Aligood & Toomey, 2010
  33. 33. Education Curriculum guide  Clinical learning  Health promotion Widely accepted in education (Aligood & Toomey, 2010
  34. 34. Research Used as framework in nearly 100 studies between 1989 – 1993 (per 3rd edition) Qualitative and Quantitative Multiple cultures Pragmatic Extension to middle range theory (Aligood & Toomey, 2010
  35. 35. Case Simulation Barry Stinson 60-year-old male presents to surgical staging area for bilateral knee replacement surgery.
  36. 36. Case Simulation SQ
  37. 37. References Alligood, M.R. & Tomey, A.M. (2010). Nursing Theorists and Their Work 7th Edition. Maryland Heights, Missouri: Mosby Inc. Photo and diagram courtesy of Neuman Systems Model Inc. Last updated 2011