Betty Neuman’s Nursing Theory: The Neuman Systems Model
TRENT/FLEMING SCHOOL OF NURSING
Princess Osatohangbon (0845673)
Nurs 1001H – Nursing as a Profession
Rachel Galea
October 14th, 2024
Discussion of Nursing Theory
Betty Neuman is known for her impact on mental health nursing, especially her focus on the influence of stressors on patients (Farah et al., 2021). The Neuman Systems Model is a nursing theory developed by Betty Neuman in 1970. It focuses on the management of stress to promote wellness (Carrol, 2024) considering both the internal and external stressors of a patient. This model’s aim is to increase the knowledge about stressors to create effective nursing interventions and emphasize collaboration between nurse and patient, highlighting a supportive relationship, to strengthen the patient’s defenses against stress (Carrol, 2024). This theory views people as open systems that interact with their environment (Farah et al., 2021). In Neuman’s approach the person is seen as a being that encompasses physiological, psychological, sociocultural, developmental, and spiritual factors (Meleis, 2012). This model acknowledges both universal and individual characteristics, emphasizing that each client has a distinct response pattern influenced by a core structure, as a result she proposes that nurses should focus on identifying and managing stressors (Astle et al., 2019). Neuman categorizes stressors into three types. Intrapersonal stressors originate within an individual and can significantly affect their psychological and physical health, which can manifest in the form of physical disfunction or fear of recurrence. Interpersonal stressors impact a person’s social interactions and emotional well-being, influencing aspects such as family relationships and feelings of loneliness. Finally, extrapersonal stressors affect an individual’s ability to access resources and support by influencing their financial, economic, or environmental circumstances (Choi & Kim, 2022). Additionally, Neuman states that a patient system has three lines of defense which include a flexible line of defense, comprising of adaptive preventive measures against stressors; a normal line of defense, representing the typical state of health and well-being; and a line of resistance, which signifies the mechanisms that aid in recovery from stressors (Vanaki & Rafiei, 2020). In her model, Neuman promotes three levels of prevention. The first is primary prevention, which aims to prevent exposure to stressors. The second is secondary prevention, which deals with stressors once they arise. The third is tertiary prevention, which focuses on readjustment and recovery following treatment (Farah et al., 2021). This theory views health as a spectrum from wellness to illness, where ideal wellness represents stability and fulfillment of needs with the goal being to strengthen and enhance a patient defense lines and coping skills to restore balance and health (Farah et al., 2021). Neuman’s nursing theory is specifically directed at patients and nurses involved in patient care. While the model is comprehensive, it may not be suitable for groups or individuals in acute or critical care settings who require immediate life-saving interventions rather than long-term stress management or prevention. Those not actively involved in their care or with limited understanding of their health status may also not fit into the theoretical framework.
Personal Choice and Reflection
I chose to explore this theory because of its comprehensive nature, which goes beyond just the physiological dimension to include psychological, sociocultural, developmental, and spiritual aspects. I have always had the desire to work in the healthcare field, but I initially selected nursing because of the diversity it offers within the profession. After a few years in the nursing program and gaining valuable placement experiences, I remain committed to pursuing a career in nursing with the goal of making meaningful contributions to the mental health field. I aim to gain expertise and eventually teach young nurses and students. My dedication to this profession is closely tied to Betty Neuman’s nursing theory, which has significantly impacted the mental health area, my chosen specialty. Mental health relies heavily on the development of a therapeutic client-nurse relationship. Neuman’s comprehensive and holistic approach, which considers not only physiological factors but also other dimensions, aligns perfectly with my choice of nursing practice. As a future mental health nurse, I will use this theory to shape my nursing story by applying its principles to my experiences and embracing the model’s emphasis on the diverse dimensions of care. Throughout my journey, this comprehensive framework will enable me to view patients as unique individuals with diverse needs, enhancing my ability to provide and understand patient care. As a self-regulating nurse, this theory will support me in maintaining both autonomy and high professional standards in my practice. It can do this by allowing me to identify and acknowledge patient stressors to implement proactive measures that promote their well-being, empowering me to deliver high-quality, patient-centered care. As well as by aligning my practice with the core values of the Neuman Systems Model, I can enhance my socialization within the nursing profession. This model highlights the significance of interconnectedness and collaboration, encouraging me to consider various stressors in patient management while engaging with colleagues and other healthcare professionals. With a focus on interconnectedness, I will develop a deeper understanding of how to build strong rapport not only with my patients but also with other healthcare workers. Neuman’s theory promotes a supportive environment that enhances teamwork and communication. By embracing these principles, I can contribute to a culture of collaboration that benefits both patients and healthcare providers.
Analysis of Theory
While Neuman’s model is holistic and comprehensive, it may need adjustments to align with the evolving nursing knowledge, particularly in areas like technology integration, research, and interdisciplinary collaboration. As technology increasingly shapes healthcare, Neuman’s focus on the therapeutic relationship between the client and nurse may pose challenges for some healthcare professionals, particularly those in fast-paced clinical environments. To enhance the model’s relevance and ease of implementation, it could be beneficial to integrate into its framework modern technologies, such as telehealth and electronic health records, or incorporate ways technology can be used to enhance client-nurse relationships. In their article, Vanaki and Rafiei note that while Neuman’s theory has been valuable in various clinical settings, especially in the wound care of pressure injuries in stroke patients, its application remains limited. Conducting more research studies could further support and enhance the theory, providing evidence-based proof for its effectiveness across different nursing areas. Another consideration is that the model primarily focuses on the client-nurse relationship, often overlooking the contributions of other healthcare professionals involved in patient care. By expanding the theory to recognize and include these collaborators, we could improve both the model and overall patient care. Additional limitations in applying the model include the subjective nature of stressors, resource constraints, and the specific dynamics of clinical settings. Since stressors vary from person to person, assessments of these by different nurses may lead to diverse interpretation and model applications, leading to inconsistencies in care. Furthermore, the time and resources required for the implementation of these assessments may exceed what some healthcare environments can offer. Finally, implementing the model can be particularly challenging in high-pressure settings, such as ICUs or emergency departments, where the rapid pace of care and patients’ varying levels of awareness can complicate the application of Neuman’s framework.
Neuman’s theory provides a holistic approach by taking into account multiple dimensions of care (Choi & Kim, 2022). It highlights the importance of preserving and enhancing quality of life during rehabilitation through preventive measures that address stressors that can disturb an individual’s system (Choi & Kim, 2022). As stated by Vanaki and Rafiei (2020), this theory emphasizes prevention, encouraging nurses to focus on addressing stressors before they negatively impact patients. These strengths can be effectively integrated into nursing practice by taking them into account during the development of care strategies to meet patients’ needs. For instance, Choi and Kim illustrate how Neuman’s model can be used to manage stressors in stroke patients by creating care plans that address both their physical and psychosocial requirements. Additionally, Vanaki and Rafiei point out that this model provides a strong framework for developing comprehensive strategies, demonstrating that its application in stroke care can significantly enhance overall quality of life for patients. These principles of Neuman’s theory can be used to foster a more effective patient-centered approach that prioritizes the well-being of patients.
Applying Neuman’s Systems Model will influence my nursing practice by allowing me to consider the patient as a whole, recognize the stressors they face and implement preventive measures when developing care plans and strategies. This theory will improve my ability to deliver comprehensive, compassionate, and patient-centered care by fostering a deeper understanding of everyone’s unique circumstances and needs. In the end, Neuman’s model can enhance my ability to build meaningful therapeutic relationships with patients, ensuring that their care is effective and empathetic.
References
Astle, B. J., Duggleby, W., Potter, P. A., Stockert, P. A., Perry, A. G., & Hall, A. M. (Eds.). (2019). Canadian fundamentals of nursing (6th ed.). Elsevier.
Meleis, A. I. (2012). Theoretical Nursing: Development and Progress. Lippincott Williams & Wilkins.
Neuman, B. (1982). The Neuman Systems Model. Nursing Science Quarterly, 2(4), 175-182.
Carroll, K. (2024). Truth for the Moment and Importance to Nursing. Nursing Science Quarterly, 37(2), 1 16–117. https://doi.org/10.1177/08943184231224424
Choi, E. J., & Kim, H. Y. (2022). Relationship between multidimensional stressors and quality of life in people with stroke. Nursing & Health Sciences, 24(3), 764–773. https://doi.org/10.1111/nhs.12976
Vanaki, Z., & Rafiei, H. (2020). Application of Betty Neuman System Theory in Management of Pressure Injury in Patients Following Stroke. Medsurg Nursing, 29(2), 129–133.
FARAH, W., SUMERA, Z., & ANILA, F. (2021). A COMPARISON AND INTEGRATION OF TWO NURSING THEORIES INTO CLINICAL PRACTICE: BETTY NEUMAN AND HILDEGARD PEPLAU. I-Manager’s Journal on Nursing, 11(3), 48-. https://doi.org/10.26634/jnur.11.3.17881
