Betty Neuman was born in the year 1924 in Lowel, Ohio. Neuman received an RN Diploma from the Peoples Hospital School of Nursing in Akron, Ohio. Later on, she moved to the state of California where she gained a lot of experience working as a hospital staff and later on as a head nurse, an industrial nurse, a school nurse and later as a clinical instructor in critical care, communicable disease and medical surgical nursing.
Neuman enrolled at the University of California, Lo Angeles (UCLA) where she majored in public health and psychology. She received her Bachelor of Science in Nursing and in 1966; she received a Masters degree in Mental Health and public Health Consultation from the same institution. Dr Neumann received her Clinical Psychology doctorate in 1985 from the Pacific Western University. The Grand Valley State University awarded Betty Neumann an honorary degree in 1998.
Dr. Neuman is considered as one of the pioneers in the field of nursing involving community mental health. She is particularly known for the Neumann systems model. She began developing this model while she was a lecturer of community mental health at the University of California (UCLA). Neumann developed the model as an introductory teaching course to the nursing students (Neuman 1982). The goal or aim of this model was to present a holistic overview of the psychological, physiological, developmental and sociocultural aspects of the human race. The model was published in Nursing Research in 1972 after a two year evaluation as a “model for educating a total person approach to problems faced by patients”.
Concepts of the Model
The Neuman systems model views a client as an open system that essentially responds to the various stressors present in the environment. In this system, recurring cycles of input, procedure, output and finally feedback are coordinated to constitute an organization pattern that is very dynamic. According to this model or theory, nursing essentially requires an approach that takes into consideration all the factors that affect a client’s health including physical, psychological, physiological, mental, cultural, social, spiritual and developmental well- being (Neuman 1982). In regard to health, the model considers health as a dynamic aspect in which an individual’s health is in a state of continuum of either wellness or illness. Neumann systems model categorizes the environment into two parts: internal and external.
Each concentric circle or layer of Neuman’s Model is comprised of the person variables that are five in number (International Nursing Symposium 1988).
- Physiological- refers to the body function as well as its physicochemical structure
- Sociocultural- This aspect refers to cultural and social expectations, activities and relationships
- Spiritual- this is the spiritual beliefs influence
- Psychological- this refers to emotions and mental processes
- Developmental- The processes associated with lifespan development
The central core also referred to as the basic structure is comprised of the basic survival factors common to the human species. Some of the factors in this category include genetic features, system variables, the strengths as well as the illnesses of the parts of the system. Common examples include, the ability of the body to regulate temperature, homeostatic functioning of body systems, physical strength and cognitive ability (Reed 1993).
A person’s system is said to be an open system that is dynamic and is therefore constantly evolving and changing. Homeostatic or stability takes place when energy amount available than the one used by the person’s system (Neuman 1982). A body system that is in a homeostatic state achieves a state of balance because it is in a continuous dynamic process that includes input, output, compensation and feedback.
Flexible Lines of Defense
This line of defense usually serves as a cushion or an outer barrier to the normal defense line, the resistance line and the basic or core structure. If this line of defense fails to provide sufficient protection to the normal defense lines, the resistance lines become activated. The line of defense that is flexible contracts closer or expands away from the normal line of defense. In simple terms, the flexible line of defense assists the body to make adequate responses to the various situations that intimidate the imbalance in the client’s stability.
Normal Line of Defense
This works in dexterity with the normal wellness state. This is usually the client’s normal reaction or response to stressors. This line of defense is prone to changes over time due to the response displayed when coping to environmental dynamics. A perfect example is skin which is fairly constant and stable but can actually thicken to form a callus over a given period of time (Reed 1993).
Line of Resistance
This usually acts in situations where the Normal Line of Defense is under too much invasion by a specific stressor therefore causing a change or alteration in the normal pattern of health that facilitates coping or overcoming of stressors present in a person. An example is immune response activation after a microorganism invasion. Effective lines of resistance in such a situation can reconstitute but if they are not, the energy loss resulting from this can lead to death (Neuman 1982).
This is the energy increase that happens in relation to reaction degree to the stressing element or simply the stressor. A reconstitution essentially starts at the point where treatment for a stressor is initiated.
According to the model, stressors are essentially the tensions or trains that bring about alterations in the environmental normal flow. The stressors can be divided into the following parts:
- Intrapersonal-these occur within an individual’s self and views man as a psycho-spiritual creature
- Interpersonal- Takes place between two or more individuals and man is seen as social being
- Extra personal- Takes place outside a person and may even include some environmental factors
At any given time, an individual has a certain reaction degree to any stressor. However, the nature of this reaction is dependent to some level on the lines of defense and the lines of resistance strengths. By using various interventions, the nurse to restore or maintain the system’s stability.
This is concerned with keeping stressors and their consequent response from placing a harmful effect on the body. There are three levels of prevention that include
- Primary- which occurs the system makes a response to the specific stressor
- Secondary- Takes place after the reaction of a system to a stressor and is usually provided using existing systems. It focuses on protecting the central core by eliminating the stressor. It strengthens an individual to enable him to be able to deal in a better way with stressors (Neuman 1982).
- Tertiary- This usually takes place after the treatment of the system using secondary prevention strategies. This prevention offers support to a client and tries to add or remove energy that is required to facilitate the process of reconstitution.
Some of the philosophical underpinnings that influenced this theorist (Betty Neuman) include the application of this system model to the adult’s mental health nursing so that it can actually help them to deal with the stressors which have rendered the adjustment to these life experiences unsuccessful. Another philosophical underpinning of this model or theory was that its structure was very consistent with the practice and research of the nursing students nursing needs (Tomey et al 2008). The model also offers a wide approach to the evaluation of developmental, spiritual, physiological, psychological, cultural and social interacting variables which are important for holistic care. The other philosophical underpinning is the use of theories and concepts from different disciplines by Neuman to develop her theory, for example Chardin and Cornu (wholeness of systems) and Selye (stress memory).
Impact of this model on nursing today
Betty Neuman model has had a humongous impact on nursing today. It has particularly found high application in nursing education and practice. It has assisted in guiding nursing practice with an aspiration to manage patient care in medicine, surgery community pediatric nursing amongst others (Tomey et al 2008). Parts of the model have found use in the direction nursing research, for example, the flexible line of defense has been tested using the multiple role stress of women.
Betty Neuman Systems model is indeed very unique because it provides a very unique spotlight for looking into a large variety of international health issues and concerns.
Indeed, this model will come in handy in the future as it will help in solving the emerging health issues and trends.
Tomey, Ann Marriner, PhD, RN, FAAN & Alligood, Martha Raile, PhD, (2008) RN Sixth Edition: Nursing Theorists and Their Work
International Nursing Symposium, N., & Neumann College, N. (1988). Neuman Systems Model: As related to research, education and clinical practice. Aston, Pa: Neumann College, Nursing Program.
Neuman, B. M. (1982). The Neuman systems model: Application to nursing education and practice. Norwalk, Conn: Appleton-Century-Crofts.
Reed, K. S. (1993). Betty Neuman: The Neuman systems model. Newbury Park, Calif: Sage Publications.