Neuman Systems Model - PowerPoint Presentation

Slide1

Neuman Systems Model

Roline Campbell

Roxy Johanning

Tracy

HillSlide2

Presentation Objectives:

Introduce

Betty

Neuman

Overview of the

Neuman Systems Model (NSM) it’s

concepts and principles

Evaluate the NSM nursing theory using Fawcett’s criteria

Compare the NSM with two other nursing theories

Discuss and analyze the use of the NSM Slide3

Meet Betty Neuman

Born in 1924 on a farm near Lowell, Ohio.

Completed initial nursing education

Then moved to Los Angeles

Worked in a variety of nursing roles - always with an interest in human behavior.

She attended UCLA

1957: Completed

bachelor’s degree with a double major in Public Health & Psychology.

Helped her husband to establish and manage his medical practice.

Slide4

Career advances

1966: Master’s degree in Mental Health, Public Health Consultation from UCLA.

Pioneer of nursing involvement in mental health.

Late

1960’s: Teaching

and practice model for mental health consultation.

Requests from UCLA graduate students prompted the design of a conceptual model for nursing in 1970.

First published in 1972 in an article entitled “A Model for Teaching Total Person Approach to Patient Problems” (Neuman & Young, 1972).

1974 – 2002:

Further

development and refinement of the NSM. (First called “The Neuman Systems Model” in 1985 – retained the same title since then.)

1985: Doctoral degree in Clinical Psychology from PWU.Slide5

Recent years

Maintained involvement in variety of professional and international activities

Moved back to Watertown, Ohio and practiced as a licensed clinical marriage and family therapist.

Founder/Director

of the Neuman Systems Model Trustees Group, Inc.

Holds two Honorary Doctorates

1992: Honorary Doctorate of Letters (Neuman College)

1998: Honorary Doctorate of Science (Grand Valley State University)

Fellow of the American Academy of Nursing (1993)Slide6

“It is important to state that neither was I knowledgeable about nursing models nor had a clear trend yet begun in nursing for developing models. The Neuman Systems Model was developed strictly as a teaching aid”

- Betty Neuman, 2002

Betty Neuman as keynote speaker at the University of Maine, Fort Kent in 2004

.Slide7

An

Overview of the Neuman Systems ModelSlide8

Philosophical Claims

Wholism

Wellness orientation

Client perception and motivation

Dynamic systems perspective of energy & variable interaction with the environment

Client & caregiver in partnershipSlide9

Key Concepts

Classified according to the applicable metaparadigm forerunner. Slide10

Client/Client System

Viewed as open system

Repeated cycles of input, process, output & feedback

Thus a dynamic organizational pattern

Can be

Individual

Family

Group

Community

Aggregate (Social Issue)Slide11

Interacting Variables

Present in

each type of client

Consider these

simultaneously &

comprehensivelySlide12

Central CoreSlide13

Flexible Line of

Defense (FLD)

Outer barrier (protective buffer)

Dynamic – can be altered in relatively short period of time

Prevents stressor invasion of the client systemSlide14

Normal Line of

Defense (NLD)

Client’s normal wellness level

What client has become / evolved into over time

Defines the stability & integrity of client system

Standard from which to measure health deviationSlide15

Lines of Resistance

Protective mechanism

Attempts to stabilize the client system (support return to wellness)

Supports the basic structure & normal line of defense

Contains resource factorsSlide16

Internal Environment

Forces & interactive influences confined within client system

Intrapersonal

StressorsSlide17

External Environment

Forces & interaction influences

existing outside the client system

Extra-personal stressors

Interpersonal

stressorsSlide18

Created Environment

Symbolic

expression of

system wholeness

Unconscious mobilization

of all system variables

Interpersonal

Intrapersonal

Extra-personalSlide19

Wellness and Illness

Optimal WellnessSystem stability

Greatest possible degree of system stability at a given point in time

Illness

State of insufficiency

Disrupting needs are unsatisfied

Excessive expenditure of energy

Variance from Wellness

Varying degrees of system instability

Difference from the normal or usual wellness condition.Slide20

Prevention as Intervention

Basis for health promotion

Nursing is prevention as intervention

Three dimensions

Primary prevention

Secondary prevention

Tertiary preventionSlide21

Primary Prevention

Health promotion & Maintenance of wellness

Occurs before the system reacts to a stressor

Strengthens the client / client system to better deal with stressors

(FLD)

May also try to manipulate the environment to reduce or weaken stressorsSlide22

Secondary Prevention

Focus on preventing damage to the Central Core

Occurs after the system reacts to a stressor

Aims to strengthen the Lines of Resistance

May also try to remove the stressorSlide23

Tertiary Prevention

Occurs after the client/client system has been treated through secondary prevention strategies

Offers support to the client

Attempts to:

add energy to the system or

reduce energy needed in order to facilitate reconstitutionSlide24

Reconstitution

The determined energy increase related to the degree of reaction to a stressorRepresents the return and maintenance of system stability following treatment

May be viewed as feedback from the input/output of secondary prevention

Complete reconstitution may occur

Level beyond the initial Normal Line of Defense

Same level of wellness prior to illness

Lower level where system stability is re-definedSlide25

Jacqueline Fawcett and Betty Neuman at the 8

th Neuman Systems Model Symposium- Salt Lake City, 2001

Evaluation

of the

Neuman Systems

ModelSlide26

Jacqueline Fawcett on Betty

Neuman’s System Model Theory:Neuman System Model Trustee since: 1988

Areas

of Consultation with the Neuman Systems Model:

Serve as a mentor and consultant for students, post-doctoral fellows, faculty, and clinicians interested in using nursing models and theories to guide their research and practice, including the Neuman Systems Model. Slide27

Selected Neuman Systems Model

PublicationsFawcett, J.,

Carpenito

, L. J.,

Efinger

, J.,

Goldblum‑Graff

, D., Groesbeck, M. J., Lowry, L. W., McCreary, C. S., & Wolf, Z. R. (1982). A framework for analysis and evaluation of conceptual models of nursing with an analysis and evaluation of the Neuman Systems Model. In B. Neuman (Ed.), The Neuman Systems Model. Application to nursing education and practice (pp. 30‑43). New York:

Appleton‑Century‑Crofts

.

Fawcett

, J. (1989). Analysis and evaluation of

Neuman's

systems model. In B. Neuman (Ed.), The Neuman Systems Model. Application to nursing education and practice (2nd ed., pp. 65-92). Norwalk, CT: Appleton and Lange.

Fawcett,

J. (1995). Constructing conceptual-theoretical-empirical structures for research: Future implications for use of the Neuman systems model. In B. Neuman, The Neuman Systems Model (3rd ed., pp. 459-471). Norwalk, CT: Appleton and Lange.

Beynon

, C.E., Chadwick, P.L., Chang, N.J., Craig, D.M., Fawcett, J.,

Freese

, B.T., Hinton-Walker, P., & Neuman, B. (1997). The Neuman systems model: Reflections and projections. Nursing Science Quarterly, 10, 18-21.

Fawcett

, J. (2001). The nurse theorists: 21st century updates—Betty Neuman. Nursing Science Quarterly, 14, 211-214.

Fawcett, J., &

Giangrande

, S.K. (2001). Neuman Systems Model-based research: An integrative review project. Nursing Science Quarterly, 14, 231-238.

  Fawcett, J., &

Gigliotti

, E. (2001). Using conceptual models of nursing to guide nursing research: The case of the Neuman Systems Model. Nursing Science Quarterly, 14, 339-345. Slide28

Selected Neuman Systems Model

Publications (cont.)

Neuman

, B.,

Aylward

, P.D.,

Beynon

, C., Breckenridge, D.M., Fawcett, J., Fields, A., Lowry, L.,

Memmott

, R.J., & Toot, J. (2001). The Neuman systems model: A futuristic care perspective. In N. L. Chaska (Ed.), The nursing profession: Tomorrow and beyond (pp. 321-330). Thousand Oaks, CA: Sage.

Neuman

, B., & Fawcett, J. (Eds.). (2002). The Neuman systems model (4th ed.). Upper Saddle River, NJ: Prentice Hall.

Freese

, B.T., Neuman, B., & Fawcett, J. (2002). Guidelines for Neuman systems model-based clinical practice. In B. Neuman & J. Fawcett (Eds.), The Neuman systems model (4th ed., pp. 37-42). Upper Saddle River, NJ: Prentice Hall.

Louis

, M., Neuman, B., & Fawcett, J. (2002). Guidelines for Neuman systems model-based nursing research. In B. Neuman & J. Fawcett (Eds.), The Neuman systems model (4th ed., pp. 113-119). Upper Saddle River, NJ: Prentice Hall.

Fawcett

, J., &

Giangrande

, S.K. (2002). The Neuman systems model and research: An integrative review. In B. Neuman & J. Fawcett (Eds.), The Neuman systems model (4th ed., pp. 120-149). Upper Saddle River, NJ: Prentice Hall.

Gigliotti

, E., & Fawcett, J. (2002). The Neuman systems model and research instruments. In B. Neuman & J. Fawcett (Eds.). The Neuman systems model (4th ed., pp. 150-175). Upper Saddle River, NJ: Prentice Hall.

Newman

, D.M.L., Neuman, B., & Fawcett, J. (2002). Guidelines for Neuman systems model-based education for the health professions. In B. Neuman & J. Fawcett (Eds.), The Neuman systems model (4th ed., pp. 193-215). Upper Saddle River, NJ: Prentice Hall.

Shambaugh

, B.F., Neuman, B., & Fawcett, J. (2002). Guidelines for Neuman systems model-based administration of health care services. In B. Neuman & J. Fawcett (Eds.), The Neuman systems model (4th ed., pp. 265-270). Upper Saddle River, NJ: Prentice Hall. Slide29

Fawcett’s Criteria to Evaluate Nursing Theory

SignificanceInternal ConsistencyParsimonyTestability

Empirical Adequacy

Pragmatic AdequacySlide30

Significance - Meets

Metaparadigm concepts & propositions are explicitly stated

All philosophical

claims are

addressed

Support of

colleagues and the influence of other scholars

& adjunctive disciplines are acknowledged

(Psychology & Philosophy)

Special contributions made by NSM to discipline of nursing are identified

Usefulness in Education, Research, Practice & Administration of Health Care ServicesSlide31

Internal Consistency - Meets

Neuman values a holistic (“wholistic”), systems-based approach to the care of clients.

Revisions and refinements indicates Neuman’s responsiveness to critiques.

The basic intent, meaning, and purpose of the model have been retained.Slide32

Parsimony - Meets

NSM is sufficiently comprehensive with regard to depth of content. The revisions and refinements in Neuman’s (2002d) current version have clarified several areas of confusion found in earlier versions and have improved the adequacy of concept definitions and descriptions (Fawcett, 2005).

Confusion still remains in the Family, Community, and Social Issue dimensions of the Client/Client System – these dimensions require definitions or descriptions that go beyond being described as kinds of groups.Slide33

Testability - Meets

The guidelines for research based on NSM are clearly defined and are congruent with the theory (Optimal Client System Stability).Research and practice are linked: Problems encountered in practice give rise to new research questions (Fawcett, 2005).

NSM based research continues to increase.Slide34

Empirical

Adequacy – Partially met

The

content of the

NSM

is not completely logically congruent.

Additional research is clearly warranted (Varying statistical significance).

Neuman considers her model to be appropriate for use by members of all health-care disciplines.Slide35

Pragmatic Adequacy - Meets

Extensive study of the concepts of the NSM and relevant theories from nursing and adjunctive disciplines is required before knowledgeable application in nursing research, education, administration, and practice.

The content of the NSM comprises many terms, but most are familiar words; therefore, use of the model does not require mastery of an extensive vocabulary.

The success of the NSM as a guide for nursing curricula and for delivery of nursing services is documented in several reports (Fawcett, 2005

).

Slide36

Comparison of NSM with two other nursing theories / modelsSlide37
Slide38

Contemporaries of one anotherSlide39

Each Define the Metaparadigm Concepts:

PersonEnvironmentHealth

NursingSlide40

Each Used

in Nursing:PracticeAdministrationEducationSlide41

Theories derived from:Slide42

Goal of NursingSlide43

OverviewSlide44

WorldviewSlide45

Reciprocal Interaction Worldview

This worldview is a synthesis of elements from the organismic, simultaneity, totality, change, persistence and interactive-integrative world views:Human beings are holistic; parts are viewed on the context of the whole

Human beings are active, and interactions between human beings and their environments are reciprocal

Change is a function of multiple antecedent factors, and may be continuous or may be only for survival

Reality is multidimensional, context dependent, and relative

(

Fawcett, 2005, p.12-13)Slide46

Simultaneous Action World View

This world view combines elements of theorganismic, simultaneity, change and unitary-transformative world views:Unitary human beings are identified by pattern

Human beings are in mutual rhythmical interchange with their environments

Human beings change continuously, unpredictably and in the direction of more complex self-organization

The phenomena of interest are personal knowledge and pattern recognition

(

Fawcett, 2005,

p.

13)Slide47

Meets Fawcett’s

Criteria for Evaluation of Nursing ModelsRogers

Roy

Neuman

(Fawcett 2005, p. 57-58)Slide48

Selection RationaleSlide49

Discussion of the Nurse as the Client

Galloway (1993) offered an informative NSM-based self-analysis of her practice with a mentally and physically impaired infant. She stated:“Through analyzing my role as a student nurse in a difficult clinical situation, I learned that I not only adapted well but also experienced personal growth. I did not avoid the reality of my situation; rather, I worked within the difficulties it presented. Understanding the importance of identifying and expressing emotions, I did not deny my positive and negative feelings. By using effective coping mechanisms and introducing alternative methods as necessary to deal with stressors, I achieved a positive result. Although my flexible line of defense contracted slightly due to the influence of specific negative variables, it buffered effectively so that my underlying normal line of defense was not penetrated (p. 36).”

(Fawcett, 2005, p. 206)Slide50

Discussion PointsSlide51

Steps taken to ensure the Continued Evolution of the NSM

Establishment of the NSM Trustees GroupSupport & promote the NSM through scholarly work & professional forums

Establisment

of the NSM Archives at Neumann College in Aston, Pennsylvania

Facilitates access to important documents

Establishment of the Neuman Institute

Enhance continuation of NSM-based scholarly work