BETTY NEUMAN NURSING THEORY MODEL LECTURE

Type of nursing model

1. BETTY NEUMAN

2. BETTY NEUMAN Developed a model based on the individual’s relationship to stress, the reaction to it and reconstitution factors that are dynamic in nature. Views a client as an open system consisting of a basic structure (physiologic, sociocultural , developmental and spiritual) sorrounded by two concentric boundaries referred to as rings of resistance.

3. BETTY NEUMAN Lines of resistance represent internal factors that help defend against a stressor e.g WBC The inner/ normal line of defense (solid line) represents the person’s state of equilibrium/ adaptation developed and maintained over time. Flexible line (broken line) is dynamic and can be rapidly altered over a short period of time.

4. BETTY NEUMAN Categorizes stressors as Intra-personal – occur within the individual e.g infection. Inter-personal – occur between individuals e.g unrealistic role expectations. Extrapersonal – occur outside the person e.g financial concerns.

5. BETTY NEUMAN Nursing interventions focus on retaining or maintaining system stability. The preventive levels are:- Primary prevention – focuses on protecting the normal line of defense and strengthening the flexible line. Secondary prevention – focuses on strengthening internal lines of resistance, reducing reaction and increasing resistance factors. Tertiary prevention – focuses on re-adaptation and stability and protects reconstitution or return of wellness following treatment.

6. BETTY NEUMAN OUTER LINE: flexible line of defense Mid-line: normal line of defense Inner line: lines of resistance BASIC STRUCTURE

7. Flexible Lines of Defense Is the outer boundary to the normal line of defense, the line of resistance, and the core structure. Keeps the system free from stressors and is dependent on the amount of sleep, nutritional status, as well as the quality and quantity of stress an individual experiences. If the flexible line of defense fails to provide adequate protection to the normal line of defense, the lines of resistance become activated.

8. Normal Line of Defense Represents client’s usual wellness level. Can change over time in response to coping or responding to the environment, which includes intelligence, attitudes, problem solving and coping abilities. Example is skin which is constantly smooth and fair will eventually form callous over times.

9. Lines of Resistance The last boundary that protects the basic structure Protect the basic structure and become activated when environmental stressors invade the normal line of defense. An example: when a certain bacteria enters our system, there is an increase in leukocyte count to combat infection. If the lines of resistance are effective, the system can reconstitute and if the lines of resistance are not effective, the resulting energy loss can result in death.

10. Stressors Are capable of producing either a positive or negative effect on the client system. Is any environmental force which can potentially affect the stability of the system: Intrapersonal - occur within person, example is infection, thoughts and feelings Interpersonal - occur between individuals, e.g. role expectations Extrapersonal - occur outside the individual, e.g. job or finance concerns

11. Stressors A person’s reaction to stressors depends on the strength of the lines of defense. When the lines of defense fails, the resulting reaction depends on the strength of the lines of resistance. As part of the reaction, a person’s system can adapt to a stressor, an effect known as reconstitution

12. KEY CONCEPTS Viewed the client as an open system consisting of a basic structure or central core of energy resources which represent concentric circles Each concentric circle or layer is made up of the five variable areas which are considered and occur simultaneously in each client concentric circles.

13. KEY CONCEPTS These are: Physiological - refers of bodily structure and function. Psychological - refers to mental processes, functioning and emotions. Sociocultural - refers to relationships; and social/cultural functions and activities. Spiritual - refers to the influence of spiritual beliefs. Developmental - refers to life’s developmental processes.

14. Basic Structure Energy Resources This is otherwise known as the central core, which is made up of the basic survival factors common to all organisms. These include the following: Normal temperature range – body temperature regulation ability Genetic structure – Hair color and bodily features Response pattern – functioning of body systems homeostatically Organ strength or weakness Ego structure Knowns or commonalities – value system

15. BETTY NEUMAN PERSON: A client system that is composed of physiologic, psychological, socio-cultural and environmental variables. ENVIRONMENT: internal and external forces surrounding humans at any time. HEALTH: focus is on the reparative process of getting well. NURSING: goal is to place the individual in the best condition for good health care.

16. Assumptions Each client system is unique, a composite of factors and characteristics within a given range of responses contained within a basic structure. Many known, unknown, and universal stressors exist. Each differ in it’s potential for disturbing a client’s usual stability level or normal LOD (Line of Defence ).

17. Assumptions The particular inter-relationships of client variables at any point in time can affect the degree to which a client is protected by the flexible LOD against possible reaction to stressors. Each client/ client system has evolved a normal range of responses to the environment that is referred to as a normal LOD. The normal LOD can be used as a standard from which to measure health deviation.

18. Assumptions When the flexible LOD is no longer capable of protecting the client/ client system against an environmental stressor, the stressor breaks through the normal LOD The client whether in a state of wellness or illness, is a dynamic composite of the inter-relationships of the variables. Wellness is on a continuum of available energy to support the system in an optimal state of system stability. Implicit within each client system are internal resistance factors known as LOR, which function to stabilize and realign the client to the usual wellness state.

19. Assumptions Primary prevention relates to principles applied in client assessment and intervention, in identification and reduction of possible or actual risk factors.  Secondary prevention relates to symptomatology following a reaction to stressor, appropriate ranking of intervention priorities and treatment to reduce their noxious effects.

20. Assumptions Tertiary prevention relates to adjustive processes taking place as reconstitution begins and maintenance factors move the back in circular manner toward primary prevention. The client as a system is in dynamic, constant energy exchange with the environment.