betty neumann's theory

mahesh kumar sharma

1. BETTY NEUMANN’S theory Moderator Mr. L. Gopichandranan lecturer CON AIIMS PRESENTATED BY MR. MAHESH KUMAR SHARMA M.SC. NURSING 1 ST YEAR CON AIIMS

2. BETTY NEUMANN’S SYSTEM MODEL Betty Neumann’s system model provides a comprehensive, flexible, holistic and system based perspective for nursing. It focuses attention on the response of the client system to actual or potential environmental stressors.

3. BETTY NEUMANN’S SYSTEM MODEL The use of primary, secondary and tertiary nursing prevention intervention for retention, attainment, and maintenance of optimal client system wellness.

4. Back ground and history of theory

5. HISTORY AND BACKGROUND OF THE THEORIST Betty Neumann was born in 1924, in Lowel , Ohio. Completed B.Sc. nursing in 1957, and M.S. in Mental Health Public health consultation, from UCLA in 1966. She holds a Ph.D. in clinical psychology.

6. HISTORY AND BACKGROUND OF THE THEORIST A pioneer in the community mental health movement in the late 1960s. Began developing her health system model, while a lecturer in community health nursing at University of California, Los Angeles.

7. HISTORY AND BACKGROUND OF THE THEORIST The models was initially developed, in response to graduate nursing students expression of a need for course content, that would expose them to breadth of nursing problems, prior to focusing on specific nursing problem areas.

8. HISTORY AND BACKGROUND OF THE THEORIST The model was published in 1972 as “ A Model for Teaching Total Person Approach to Patient Problems ” in Nursing Research. It was refined, and subsequently published in the first edition of Conceptual Models for Nursing Practice, in 1974, and in the second edition in 1980.

9. DEVELOPMENT OF THE MODEL Neumann’s model was influenced by a variety of sources. The philosophy writers de Chardin and cornu (on wholeness in system). Von Bertalanfy , and Lazlo on general system theory. Selye on stress theory. Lararus on stress and coping.

10. NEUMANN’S WORK & THE CHARACTERISTICS OF A THEORY Theories can be the bases for hypotheses, that can be tested. Theories contribute to and assist in, increasing the general body of knowledge within the discipline, through the research implemented to validate them.

11. NEUMANN’S WORK & THE CHARACTERISTICS OF A THEORY Theories connects the  interrelated concepts in such a way, as to create a different way of looking at a particular phenomenon. Theories must be logical in nature . Theories should be relatively simple yet generalizable.

12. NEUMANN’S WORK & THE CHARACTERISTICS OF A THEORY Theories can be utilized by the practitioner, to guide and improve their practice. Theories must be consistent with other validated theories, laws and principles but will leave open unanswered questions, that need to be investigated.

13. BASIC ASSUMPTIONS OF NEUMANN’S THEORY Sunday, February 12, 2017 13

14. BASIC ASSUMPTIONS 1. Each client system is unique, a composite of factors and characteristics within a given range of responses contained within a basic structure. I am unique

15. BASIC ASSUMPTIONS 2. Many known, unknown and universal stressors exist. Each differ in it’s potential for disturbing a client’s usual stability level or normal Line of Defense.

16. 3. Stressors both universal and known; some are unique to the client. They have potential to disturb equilibrium, thus causing a change in priority of needs at any given moment. BASIC ASSUMPTIONS Stressors disturbs the normal equilibrium

17. BASIC ASSUMPTIONS 4. Man is a composite of the interrelationship of the four variables ( biological, psychological, socio-cultural and developmental) which are at all times present.

18. BASIC ASSUMPTIONS 5. Each client/ client system has evolved a normal range of responses to the environment that is referred to as a normal Line of Defense. The normal Line of Defense can be used as a standard from which to measure health deviation.

19. BASIC ASSUMPTIONS 6. When the flexible Line of Defense is no longer capable of protecting the client/ client system, against an environmental stressor, the stressor breaks through the normal Line of Defense.

20. BASIC ASSUMPTIONS

21. 8.Primary prevention relates to general knowledge applied to clients assessment to identify stressors before they occur. 9.Secondary prevention relates to symptomatology. These are interventions generally initiated after an encounter with a stressor. 10.Tertiary prevention relates to the adaptive process, as reconstitution begins and moves back towards primary prevention. These are the interventions initiated after treatment. BASIC ASSUMPTIONS

22. MAJOR CONCEPTS OF NEUMANN'S THEORY

23. FOUR MAJOR CONCEPTS

24. 1.Person Each layer consists of five person variable or subsystems: Physiological - Refer to the physiochemical structure and function of the body. Psychological - Refers to mental processes and emotions. Socio-cultural - Refers to relationships; and social/cultural expectations and activities. Spiritual - Refers to the influence of spiritual beliefs. Developmental - Refers to those processes related to development over the lifespan.

25. 2.Environment The internal environment exists within the client system. The external environment exists outside the client system. A created environment which is an environment that is created and developed unconsciously by the client and is symbolic of system wholeness.

26. 3.Health Neuman sees health as being equated with wellness. She defines health/wellness as “ the condition in which all parts and subparts (variables) are in harmony with the whole of the client (Neumann, 1995)”.

27. 3.Health The client system moved toward wellness when more energy is available than is needed. The client system moves toward illness and death when more energy is needed than is available. .

28. 4. Nursing Neuman sees nursing as a unique profession that is concerned with all of the variables, which influence the response a person might have to a stressor. The person is seen as a whole, and it is the task of nursing to address the whole person.

29. 4. Nursing Neuman defines nursing as “action which assist individuals, families and groups to maintain a maximum level of wellness, and the primary aim is stability of the patient/client system, through nursing interventions to reduce stressors.’’

30. 4. Nursing The role of the nurse is seen in terms of degree of reaction to stressors, and the use of primary, secondary and tertiary interventions.

31. Primary prevention Secondary prevention Tertiary prevention Stressors Reaction Interventions Reconstitution Stressors Stressors Basic structure and Line of Defense The Neuman System Model (3 rd edition, 1995)

32. STAGES OF NURSING PROCESS (BY NEUMAN)

33. STAGES OF NURSING PROCESS (BY NEUMAN) 1. NURSING DIAGNOSIS It depends on acquisition of appropriate database; the diagnosis identifies, assesses, classifies, and evaluates the dynamic interaction of the five variables. Variances from wellness (needs and problems) are determined by correlations and constraints through synthesis of theory and data base. Broad hypothetical interventions are determined, i.e. maintain flexible line of defense.

34. STAGES OF NURSING PROCESS (BY NEUMAN) 2. NURSING GOALS These must be negotiated with the patient, and take account of patient’s and nurse’s perceptions of variance from wellness. 3. NURSING OUTCOMES Nursing intervention using one or more preventive modes. Confirmation of prescriptive change or reformulation of nursing goals. Short term goal outcomes influence determination of intermediate and long – term goals. A client outcome validates nursing process.

35. Neumann’s SYSTEM MODEL FORMAT

36. ACCEPTANCE BY THE NURSING COMMUNITY PRACTICE EDUCATION RESEARCH ADMINISTRATION

37. As a curriculum guide for a conceptual framework oriented more toward wellness than toward a medical model and has been used at various levels of nursing education. Developing a frame of reference centered on holistic care. EDUCATION

38. NEUMAN’S SYSTEM MODEL CONCEPT MAP:

39. Summary Introduction of theory History and background of theorist Development of model Characteristics of theory Basic assumptions Major concepts Applications in nursing practice