Theoretical Foundation of Nursing

1. By Group 2

2. • Clearly understand Imogene King and
Betty Neuman’s Biography
• Be able to identify different concepts of
their theory; the Goal Attainment Theory
and Neuman’s System Model
• Know the significance and application of
their theories.

3. • Imogene Martina King was born on Jan. 30, 1923, in West Point, Iowa.
• Imogene King died on December 24, 2007, two days after suffering from a
stroke.
• In 1945, she received a nursing diploma from St. John’s Hospital School of
Nursing in St. Louis, Missouri.
• In 1957, she received a Master of Science in Nursing from St. Louis University.
• From 1947 to 1958, she worked as an instructor in Medical-Surgical nursing
and was an assistant director at St. John’s Hospital School of Nursing.
• Imogene King’s Theory of Goal Attainment was first introduced in the 1960s.
BIBLIOGRAPHY

4. • Toward a Theory for Nursing: General Concepts of
Human Behavior in 1971 and A Theory for Nursing:
Systems, Concepts, Process in 1981
• In 1981, the manuscript for her second book, A Theory for
Nursing: Systems, Concepts, Process, was published.
• A third book, Curriculum and Instruction in Nursing:
Concepts and Process, was published in 1986.
WORKS

5. • Induction into the American Nurses Association (ANA) Hall
of Fame
• Honorary Doctorate Degrees
• Researcher Hall of Fame Award
• Distinguished Contributions to Nursing Science Award
• Sigma Theta Tau International (STTI) Honor Society
• Imogene King Award
AWARDS AND HONORS

6. The Theory of Goal Attainment was developed
by Imogene King in the early 1960s. It describes
a dynamic, interpersonal relationship in which a
patient grows and develops to attain certain life
goals. The theory explains that factors which
can affect the attainment of goals are roles,
stress, space, and time.

7. Nursing:
Nursing is a process of action, reaction, and
interaction whereby nurse and client share
information about their perceptions in the
nursing situation. The nurse and client share
specific goals, problems, and concerns and
explore how to achieve a goal.

8. Health:
Health is a dynamic life experience of a human
being, which implies continuous adjustment to
stressors in the internal and external
environment through optimum use of one’s
resources to achieve maximum daily living
potential.

9. Individual:
Individuals are social beings who are rational and
sentient. Humans communicate their thoughts,
actions, customs, and beliefs through language.
Persons exhibit common characteristics such as the
ability to perceive, think, feel, choose between
alternative courses of action, set goals, select the
means to achieve goals, and make decisions.

10. Environment:
The environment is the background for human
interactions. It is both external to, and internal
to, the individual.

11. Action:
Action is defined as a sequence of behaviors
involving mental and physical activity. The
sequence is first mental action to recognize the
presenting conditions; then physical action to
begin activities related to those conditions; and
finally, mental action to exert control over the
situation, combined with physical action
seeking to achieve goals.

12. Reaction:
The reaction is not specifically defined but
might be considered in the sequence of
behaviors described in action.

13. • Roles
• Stress
• Space
• Time

14. The personal system refers to the individual
receiving nursing care, such as the patient or client.
It includes their perceptions, feelings, thoughts, and
beliefs about their health and well-being. Each
person has unique goals and values, which influence
their behavior and decisions related to health and
treatment.
PERSONAL SYSTEM
The interpersonal system focuses on the interactions
and relationships between the nurse and the
patient. It involves communication, understanding,
and mutual goal-setting between the nurse and the
individual seeking care. The nurse's role is to help the
patient clarify their goals, understand their health
needs, and work collaboratively to achieve those
goals.
INTERPERSONAL SYSTEM

15. The social system encompasses the broader social
context in which the nurse-patient interaction
occurs. It includes the family, community, and
healthcare organizations that influence the delivery
of care and the patient's health outcomes.
Understanding the social system is essential for
tailoring care to the patient's specific needs and
ensuring the support of the patient's social network
in the goal attainment process.
SOCIAL SYSTEM

16. These three systems are interconnected
and constantly interact with each other. The
Theory of Goal Attainment helps nurses and
healthcare providers to understand these
interactions and plan appropriate
interventions to facilitate the achievement
of the patient's health-related goals.

18. • Betty Neuman was born on September 11, 1924 and died on May 28, 2022.
• 1947, she received her RN Diploma from Peoples Hospital School of Nursing,
Akron, Ohio.
• 1957, she received a baccalaureate degree in public health and psychology
with honors.
• 1966, She earned a master’s degree in mental health, public health
consultation from the University of California, Los Angeles (UCLA).
• 1967-1973 she developed the first community mental health program for
graduate students in the LA.
• 1970, Betty Neuman designed a nursing conceptual model to expand
students’ understanding of client variables beyond the medical model.
• 1985, Betty Neuman concluded a doctoral degree in clinical psychology

19. Betty Neuman is a nursing theorist and educator who
developed the Neuman Systems Model, a comprehensive
conceptual framework for nursing practice. She began her
nursing career in the 1950s, working in various clinical
settings and earning a Bachelor's degree in nursing from
UCLA in 1957. She went on to earn a Master's degree in
mental health from UCLA in 1966 and a PhD in clinical
psychology from Pacific Western University in 1985.

20. Neuman's model emphasizes the importance of considering
the whole person and their environment in nursing practice.
It includes five variables: physiological, psychological,
sociocultural, developmental, and spiritual. The model also
incorporates concepts such as stress and adaptation, which
Neuman believed were key to understanding human
behavior and health.

21. Throughout her career, Neuman has published numerous
articles and books on nursing theory and practice and has
been recognized with numerous awards and honors. She
has also served as a consultant and lecturer on nursing and
healthcare issues around the world.

22. As a nurse, Betty Neuman had a diverse and accomplished nursing
career. While specific details about her clinical practice are not
widely available, her contributions to the nursing field as an
educator, author, and nursing theorist are well documented.

23. 1. Clinical Practice: Betty Neuman worked as a staff nurse
early in her career, gaining valuable experience in direct
patient care and understanding the challenges and needs
of patients.
2. Nursing Education: Neuman's passion for nursing
education led her to become a clinical instructor, where
she shared her knowledge and skills with aspiring nurses.
She also held various teaching positions at different
educational institutions.

24. 3. Development of the Neuman Systems Model: One of the most significant
aspects of her nursing career is the development of the Neuman Systems
Model. The model was first published in 1972 and has since become one of
the most widely used nursing theories globally. It has shaped the way
nurses assess and provide care to patients, focusing on prevention,
stressors, and maintaining stability.
4. . Authorship: Betty Neuman authored several influential nursing textbooks
and research articles throughout her career. Her work helped disseminate
the Neuman Systems Model and its application in nursing practice.
5. Research and Consultation: Neuman engaged in research related to her
model and its application in various healthcare settings. She also provided
consultation and training on the Neuman Systems Model to healthcare
institutions and professionals.

25. 6. Recognition and Legacy: Betty Neuman's contributions
to nursing theory and practice have been recognized with
numerous awards and honors. Her model continues to be
taught in nursing programs worldwide, and its impact on
nursing care remains significant.

26. Stress is typically described using three words: unavoidable, painful,
and escalating. It is typically subjective and might be viewed as scary
and out of their control events. Betty Neuman's nursing theory is
founded on a person's relationship to stress, reaction, and
reconstitution variables that are progressive in nature.
The Neuman Systems Model of Nursing gives a comprehensive,
holistic, and system-based approach to nursing that retains a degree
of flexibility. It focuses on the patient system's response to real or
anticipated external stresses and maintains client system stability
through primary, secondary, and tertiary nursing stress reduction
treatments.

27. The nurse's job in the Neuman Systems Model
is to maintain system stability through three layers
of prevention. The first is primary prevention, which
protects the usual line of defense while
strengthening the flexible line. Secondary
prevention is utilized to enhance internal lines of
resistance, reducing response and increasing
resistance elements. Finally, tertiary prevention
readjusts, stabilizes, and preserves the patient's
post-treatment return to well-being.

28. Ÿ an open system that works together with
other parts of its body as it interact with the
environment
Ÿ a dynamic composite of the interrelationship
of five variables: (1.) physiological, (2.) psychological,
(3.) sociocultural, (4.) developmental, and (5.)
spiritual
Ÿ has protective mechanisms for the basic
structure, and maintains client’s system stability: (1.)
flexible line of defense, (2.) normal line of defense,
and (3.) lines of resistance

29. The Core: Include system variable genetic features,
and the strengths and weaknesses of the system
parts
-Made up of basic survival factors that include: the
body's ability to regulate temperature, cognitive
ability, physical strength, values and hair and eye
color

30. The last boundary protecting the central core is
involuntary activated when a stressor invades the
normal line of defense. It attempts to stabilize the
client system and foster a return to the normal line
of defense.
ex. Bacteria enters our system, there is an increase
in leukocyte count to combat infection.

31. Is the middle ring that represents the Person's
normal or usual wellness state. Is Dynamic and
unique to the individual.
Composed of 5 structures
1. Physiological
2. Psychological
3. Sociocultural
4. Spiritual
5. Developmental

32. The outermost boundary
• Keeps the system free from stressors and is
dependent on several factors unique to the
individual such as
-Nutritional status
-Quality & quantity of stress
-Amount of sleep
-Individual experiences

33. Neuman defines the main concern of nursing as
preventing stress invasion •
1. Primary - protects NLD and strengthensthe
FLD
2. Secondary-strengthens internal lines of
resistance, reducing reaction of the stressor,
and increasing resistance factors
3. Tertiary- readaptation and stability, protects
reconstitution or return to wellness after
treatment

34. The human being is an open system that interacts with internal and external
environment forces or stressors. The human is constantly changing, moving toward a
dynamic state of system stability or illness of varying degrees.
HUMAN BEING
ENVIRONMENT
The environment is a vital arena that is germane to the system and its function. The
environment may be viewed as all factors that affect and are affected by the system.
Which includes the Three Relevant Environments:
• The internal
• External
• Created

35. ENVIRONMENT
• The internal environment exists within the client system. All forces and interactive
influences that are solely within the client system’s boundaries make up this
environment.
• The external environment exists outside the client system.
• The created environment is unconsciously developed and is used by the client to
support protective coping.
HEALTH
In Neuman’s nursing theory, Health is defined as the condition or degree of system
stability and is viewed as a continuum from wellness to illness.

36. NURSING
Nursing’s primary concern is to define the appropriate action in situations
that are stress-related or concerning possible reactions of the client or
client system to stressors.

38. A stressor is any phenomenon that might penetrate both
the flexible and normal lines of defense, resulting in
either a positive or negative outcome.
INTRAPERSONAL STRESSORS
INTERPERSONAL STRESSORS
EXTRAPERSONAL STRESSORS

39. PRIMARY PREVENTION
SECONDARY PREVENTION
TERTIARY PREVENTION

41. • Provides a holistic view of health and
wellness, taking into account the physical,
emotional, social, and spiritual aspects of an
individual's life.
• Emphasizes the importance of prevention
and early intervention rather than simply
treating symptoms or illnesses after they
have already developed.
• Encourages collaboration and
communication among healthcare
providers, patients, and families, leading to
more effective and efficient care.

42. • Provides a holistic view of health and
wellness, taking into account the physical,
emotional, social, and spiritual aspects of an
individual's life.
• Emphasizes the importance of prevention
and early intervention rather than simply
treating symptoms or illnesses after they
have already developed.
• Encourages collaboration and
communication among healthcare
providers, patients, and families, leading to
more effective and efficient care.