Betty Neuman was born in 1924, in Lowel, Ohio. She completed BS in nursing in 1957 and MS in Mental Health Public health consultation, from UCLA in 1966. She holds a Ph.D. in clinical psychology. Betty Neuman started work on her health system model while she was a lecturer in community health nursing at University of California, Los Angeles. The model was initially 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, 1974, and in the second edition in 1980.
Theory’s definition of elements of nursing
Persons/Clients: Neuman’s model defines each human being as a total person as a client system and the person is a layered multidimensional being. Each layer has five variables:
Ideally the five variables function harmoniously or are stable in relation to internal and external environmental stressor influences” (Neuman, 2002).
Health/Well Being: Neuman sees health as being related 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 (Neuman, 1995).
Environments: The environment is seen to be the totality of the internal and external forces which surround a person and with which they interact at any given time.
The internal environment exists within the client system.
The external environment exists outside the client system.
Neuman also identified a created environment which is an environment that is created and developed unconsciously by the client and is symbolic of system wholeness.
Nursing: Neuman defines nursing as action which assists 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. Neuman states that, because the nurse’s perception will influence the care given, then not only must the patient/client’s perception be assessed, but so must those of the caregiver (nurse).
Theory’s definition of relationship between elements of nursing
The interrelationships between the concepts of person, health, nursing and society/environment are repeatedly mentioned throughout the Neuman model. Neuman’s model, organized around stress reduction, is concerned primarily with dealing with stress and the reactions to stress that affect the development and maintenance of health. Stressors are tension-producing stimuli that disturb a person’s normal line of defense or the person’s “usual steady state.” It is the way in which an individual usually deals with stressors. Stressors may be of three types:
- Intrapersonal: forces arising from within the person
- Interpersonal: forces arising between persons
- Extrapersonal: forces arising from outside the person
A flexible line of defense resists stressors which is a dynamic protective buffer made up of all variables affecting a person at any time the person’s resistance to any stressors. If the flexible line of defense fails to protect the person against a stressor, the stressor disturbs the person’s equilibrium, and invokes a reaction. The reaction may lead toward restoration of balance or toward death. Neuman intends for the nurse to “assist clients to retain, attain, or maintain optimal system stability” (Neuman, 1996). Thus, health (wellness) seems to be related to changing equilibrium of the normal line of defense, where stressors are overcome or avoided by the flexible line of defense. Neuman defines illness as “a state of insufficiency with disrupting needs unsatisfied” (Neuman, 2002).
Research studies directed
Neuman’s model is simple and direct in approach. The terms used are easily understandable have broadly accepted definitions. The multiple use of the model in varied nursing situations (practice, curriculum, and administration) is testimony in itself to its broad applicability. It covers the persons of varied age and gender as it is general in nature. The potential use of this model by other health care disciplines also attests to its generalization for use in practice. The model has provided clear, comprehensive guidelines for nursing education and practice in a variety of settings. The concept within the guidelines is clearly explicated and many applications of the theory have been published. The guidelines have provided a practical resource for many nursingpractitioners and have been used extensively in a variety of setting in nursing practice, education and administration.
Identify the nursing theory that is most congruent with your beliefs
The nursing theory that I find most congruent with my beliefs as a health practitioner is the second theory that I have discussed namely Margaret Newman’s Health as expanding consciousness theory. Her theory is based on treating the person and not the illness which is what I believe being a nutritional counselor I have come to belief that the problem is not the illness but the person’s attitude towards the illness.
Nutrition problems of patients are usually unconsciousness of problematic health patterns in their daily diet. Helping the patients recognize and realize the health patterns causing problems and choosing better suited diet options can lead to higher level of consciousness of the patient.
As noted by Newman, health and illness are both part of the patients environment. The patient has to gain consciousness of his bad health patterns and identify more suitable patterns that may lead to healthy life. I as a nutrition counselor believe in the same rule and therefore during my consultation I try to discover the environmental, social and psychological patterns in the patient’s life that are leading him to illness. Then through discussion I lead the patient to self realization and recognition of unsuitable health patterns in terms of nutrition. Once the problematic patterns are identified, I discuss the more healthy diet choices with the patient and help him develop new patterns of healthy diet for him. In this way I apply the Newman’s theory to my practice and see the success results of many of my patients.