Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Betty Neuman 2
1.
2. 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
3.
4. 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
5. 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
6. 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
7. 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
8. 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
9. 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
10. 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
11. 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
12. Conceptual Model
“A conceptual model provides a
distinct frame of reference for its
adherents…that tells them how to
observe and interpret the
phenomena of interest to the
discipline.”
(Aligood & Toomey, 2010
15. 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
16. 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
17. 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
18. 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
19. 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
20. 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
21. 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
22. 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
23.
24. NURSING
Nursing concerns
whole person
Perception influences
care
(Aligood & Toomey, 2010
25. PERSON
Open system, reciprocal to environment
Client system always changing
Physiological, psychological, sociocultural,
developmental and spiritual all interrelated
(Aligood & Toomey, 2010
26. HEALTH
Stability of system
important
Wellness model
Stability is associated with
total system needs being
met
(Aligood & Toomey, 2010
27. 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
28. 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
29. SIMPLICITY
Complex yet logical
Some concepts overlap
Usable in variety of
practice settings
(Aligood & Toomey, 2010
30. 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
31. EMPIRICAL PRECISION
Extensive use in nursing research
Continues to be tested and refined
(Aligood & Toomey, 2010
32. DERIVABLE CONSEQUENSES
Guideline for
assessment
Use of nursing process
Implement prevention
Client involvement in
goals
Expansion of scientific
knowledge for nurses
(Aligood & Toomey, 2010
33.
34. Practice
Approach
Goal-Directed
Unified
Wholistic
Multidisciplinary
Prevent fragmentation of care
Flexible
(Aligood & Toomey, 2010
35. Practice
Multidisciplinary
Stressors
Client system
Guidelines
Nursing
Allied services
(Aligood & Toomey, 2010
36. 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
37. Practice
• Hospitals
• Nursing homes
• Rehab centers
• Community-based services
• Multiple countries
– Holland, Malaysia
• Individuals & communities
• Acute care & clinic
(Aligood & Toomey, 2010
38. Education
Curriculum guide
Clinical
learning
Health promotion
Widely accepted in education
(Aligood & Toomey, 2010
39. 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
40. Case Simulation
Barry Stinson
60-year-old male presents to surgical staging
area for bilateral knee replacement surgery.
42. 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. www.neumansystemsmodel.org Last
updated 2011