Introduction
Dr. Betty Neuman developed Neuman's Systems Model as a practical guideline to be used by caregivers and administrators to help those in their charge to manage stressors. The model outlines the guidelines and dynamic scripts to be applied by practitioners worldwide, and it also places massive focus on clients’ individuality by acknowledging their distinct circumstances and background. The theory is generally based on individual’s relationship to stress, and it has been recognized globally by NSM practitioners as a suitable and valid method to create positive client outcome. Despite its various implications for nursing practices, it uses key concepts, such as the central core, the person, prevention, environment, wellness/illness, reconstitution, and stressors. This paper discusses the major concept of Neuman's Systems Model and also looks into its implications in the nursing practices.
Neuman's Systems Model is majorly based on critical assumptions, and the base of Neuman's work is drawn from theoretical foundations outside nursing. Ahmadi and Sadeghi (2017) state that the foundation of Neuman's model is primarily Seleyes stress theory, von Bertalanffy’s general system theory, Caplan's levels of prevention, and Lewis field theory, whose main perspectives supports the idea that holistic view of human is crucial. It is considered a system model, which mainly concentrates on the interrelationship of the parts or subparts within the system. From this perspective, Neuman's model uses the assumption that system is unique, there is the existence of known and unknown stressors, and each patient is unique and has tacit internal resistance factors.
According to Bademli and Duman (2017), the major concept of Neuman’s theory includes content, which are the variables of the person in interaction with internal and external environment comprising of the whole client system. The concept of basic structure or central core is fundamental to this model in understanding the energy resources necessary for defense. The theory argues that the central core consists of basic survival factors, such as normal temperature, range, genetic structure, organ strength or weaknesses, response, and ego structure. In addition, it consists of various energy resources surrounded by multiple lines of resistance that help to defend stressor. For instance, line of resistance represents the internal factors within the system that essentially helps a patient to defend against stressor.
The concept of person is also well presented in Neuman's System Model, which tries to portray man as a total person as a client system. The model views a person from the perspective of an individual, family or group, which is an open system that works in unison with other parts of the body and constantly interacts with the environment. A person is a layered, multidimensional being with each layer consisting of a dynamic composite of five variables and has protective mechanisms for the basic structure to aid in the maintenance of stability (Bademli & Duman, 2017). The five interconnected person’s subsystems are physiological, which are related to the physiochemical structure and function of the body. Physiological represents the mental process and emotions, while sociocultural refers to social and cultural functions, developmental representing development processes of life, and spiritual, which refers to aspects of spiritual beliefs.
Another vital concept presented by this theory is the concept of the environment, which can either be internal or external. Therefore, Bademli and Duman (2017) cite out that stressors, according to this model, are the forces created by the environment, which produce alterations in the thermal flow of the environment. The environment is a fundamental component of the nursing system, and they include both the internal and external forces that surround a person and which they constantly interact with. A person’s normal line of defense and stability are subjected to the effects of forces of the environment, such as interpersonal, intrapersonal, and extrapersonal stressors. The three components of environment include internal, which exists within the client system, external which exists outside the client system and the created which is developed unconsciously by a person (Bademli & Duman, 2017).
Neuman's system model represents the concept of prevention as the primary intervention. Neuman argues that primary intervention is essential and should occur before the patient system reacts to a stressor. The primary aim of prevention is to keep the stressor and the stress response from having a detrimental effect on the body (Demir & Platin, 2017). Primary nursing prevention includes those practices that contribute to health promotion and maintenance of well-being as well as strengthening a person to help him deal with stressors. Conversely, secondary prevention normally occurs following a patient reaction to stressors, and it is usually provided within the existing systems. The main focus of secondary prevention is to mitigate the detrimental effects to the central core by strengthening the internal lines of the stressor or eliminating the stressor.
Furthermore, after the patient has gone through primary and secondary prevention, tertiary prevention is, therefore, necessary to offer support to the patient and enable him to gain or reduce the essential energy required to facilitate reconstitution. Neuman also views nursing as a unique profession, which is concerned with the variables which influence the response a person might have to a stressor (Demir & Platin, 2017). The model defines nursing as an action, which assists an individual, family or groups to achieve the maximum level of wellness through the application of nursing intervention to reduce stressor. Neuman emphasizes that the nurses’ perception must be critically assessed because it crucially influences the care plan being offered to the patient. The role of the nurse is, therefore, important in a patient reaction to stressor and maintenance of wellness.
This model has been applied in a number of areas of nursing practices, such as the education of nursing students, clinical practices research, and administration of health-care services. The framework is effective in giving the adequate education to caregivers and providing necessary support for group interaction. In various hospitals around the world, Neuman's model is being utilized to help the nurses care for patients and to promote the clients' outcome. This nursing framework has been proven to be practical and useful to nurses in their nursing practices. Ahmadi and Sadeghi (2017) argue that nurses can utilize it together with the concept of wellness with terminally ill or healthy individual.
In my area of practice, I have applied Neuman's model to assist me in understanding the environmental forces that impact the client system to offer critical insight into the family coping abilities. I have applied the Neuman's model while caring for the patient with multiple sclerosis (MS). As a result of complexity and unpredictability of MS, it was found suitable to adopt Neuman's model to provide guidelines in dealing with the stressor associated with this unique condition (Ahmadi & Sadeghi, 2017). While collecting the patient’s data, the focus was based on the client and nurse perception of a stressor on the client. However, the model implications included continued monitoring and daily private sessions to between the nurse and patient to capture the overall patient’s feeling. It also requires reevaluation of goals after primary and secondary interventions.
Conclusion
The application of Neuman's System model in nursing practices has shaped the nursing knowledge and nursing theories. It is important for practitioners to utilize this model as a guideline in their practices because the model provides the nurses with the conceptual framework and necessary contributions to provide holistic care. The key concepts of the model include content, the basic or central core, the person, environment, prevention, and wellness or illness. It has significant implication in its application in nursing practices.