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Holistic Touch: The Neuman System Model TheoryResearch Paper

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¶ … Betty Neuman's Systems Model, middle-range theory

Betty Neuman was born in Lowel, Ohio in 1924 (Nursing Theory, 2013; Current Nursing, 2012). In 1947, she first earned a diploma as registered nurse from the People's Hospital School in Akron, Ohio. This was followed by a Bachelor of Nursing degree in 1957 and a Master of Science in Mental Health in 1966, both at the University of California in Los Angeles, and a PhD in clinical psychology at the Pacific Western University in 1985. She was further decorated with an honorary Doctorate of Letters at the Neuman College in Aston, Pennsylvania and anoher honorary doctorate, this time, of science at the Grand Valley State University in Michigan in 1998 (Nursing Theory, Current Nursing).

Neuman's first job was as a pioneering nurse in community mental health (Nursing Theory, 2013; Current Nursing, 2012). She also worked as a lecturer at the University of California in Los Angeles while developing her systems model, her masterwork. This model was the subject of her first book, entitled The Neuman Systems Model, published in 1982. Its major contents were a nursing process format and care plans, by itself a comprehensive approach to patient care.

She lectured and wrote about this Model to both nurses and professors (Nursing Theory, Current Nursing).

B. Theory Description

1. Reasoning: Inductive, Deductive or Retroductive -- Inductive -- If an ill or injured person is viewed and dealt with as a complete person, instead of, and despite, his or her condition, he or she tends to cooperate better with his or her treatment and recovery. The general idea is that every patient or person is a complete entity and must be viewed this way before any specific dealings can succeed with him or her. In the case of healthcare, the patient or client needs and wants to be viewed as a person who happens to be ill and needing specific care.

2. Major Concepts, Consistency in their Use -- The Model, on the whole, focuses on the patient's response to stress and the factors, which trigger it (Gigliotti, 2011; Nursing Theory, 2013; Current Nursing, 2012; Gonzalo, 2011). It was readily accepted and earned popularity for its universal appeal and applicability to most situations as well as interpretability in many forms. Neuman's Model philosophy rests on energy resources, which sustain three different and progressive lines of defense. The first consists of lines of resistance, composed in turn of internal factors, which attempt to throw off or defeat a stressor. The second is the person's equilibrium or normal line of defense. And the third and last is a flexible and time-dependent, changeable line of defense that sets in when the first two lines of defense are unable to deal with the stressor effectively (Gigliotti, Nursing Theory, Current Nursing, Gonzalo).

The Systems Model content deals with the dynamics of the patient's interaction with factors and circumstances within his internal and external environment, representing the entire client system (Current Nursing, 2012; Gigliotti, 2003). Basic to it are survival factors or a person's basic energy resources. These are physiological and psychological in nature. They include normal body temperature range, genetic makeup, pattern of response to stimuli, strength or weakness of the person's physiological organs, and ego structure. The person is in a stable state, also called homeostatis, when the combination of available physical and emotional or psychic energy exceeds that which is being used by the system. In a reverse condition, injury, sickness or disorder of the body or mind occurs (Current Nursing, Gigliotti).

3. Implicit or Explicit Definition of the Concepts, Relationships among Major Concepts - The three levels of defense represent the system's response to stimuli, which it perceives and affect it within his internal and/or external environment (Gonzalo, 2001; Current Nursing, 2012; Nursing Theory, 2013). When a stimulus appears or is perceived by the client or system, it responds to it either positively or negatively. If the response is positive, it accepts the effects of the stimulus. If negative, its first line of defense rejects and throws it out of its environment. Its function is to protect the equilibrium and integrity of the person or system by filtering off what it considers harmful or unpleasant. At the same time, this first line reinforces the flexibility of the last or third line of defense. The secondary line of defense fortifies internal lines of resistance in the event that the disturbing or harmful stimulus breaks down the protective mechanism of the first line and penetrates the second line. The secondary line or level of defense continues the fight by reducing the system's adverse reaction and increase or strengthens resistance factors. But when the stimulus is able to break through the secondary level or line, the tertiary level takes over and readapts, stabilizes, installs and protects the system's recovery following therapy (Current Nursing, Nursing Theory).

C. Evaluation

1. Explicit ad Implicit Assumptions of the Theory - Every person is a unique dynamic system (Current Nursing, 2012, Gonzalo, 2011). That system consists of factors and characteristics, which determine the person's responses. The interaction between a stimulus and these factors and characteristics occurs within the system or client's internal and/or external environment. Many known and unknown universal stressors exist and affect every individual differently. The interrelation among the variables in a person's system determines the degree of the protection extended by his first and third flexible lines of defense against stressors. Every system has a structured normal range of responses to the environment in reacting to stressors. Because of the universal nature of its applicability, the normal line of defense is usable as a standard in measuring mental or emotional deviations. The theory offers a mechanism for diagnosis and treatment of injury, disease or disorder in a system or person (Current Nursing, Gonzalo).

As already explained earlier, a person is a dynamic system of interrelated variables within an internal and external physical and psychological or psychic environment (Current Nursing, 2012; Gonzalo, 2011). He is considered well when available supportive energy is continuous and in an optimal state of stability. Internal resistance factors, called lines of resistance, implicitly stabilize and realign the person into a stable state of wellness. Also implied are the three levels of protection within the person's system. The first protects or prevents a stressor from damaging the person's equilibrium and state of stable wellness. The stressor and the risk factors are identified for the purpose of reducing or eliminating them. The second strengthens his many internal lines of defenses when a stressor manages to breach the first line of defense. At this point, interventions and treatment are decided for the purpose of eliminating the stressor and its effects or at least reducing these effects. And the tertiary line of defense is triggered when the damaged or affected system reconstructs its equilibrium and reinstates primary prevention. This dynamism illustrates that the person or client system is engaged in a constant energy exchange with his internal and external environment (Current Nursing, Gonzalo).

2. Four Metaparadigm Concepts of Nursing? How Explained or Relevant Elements - The four nursing meta-paradigm of nursing applies to the Model or Theory Current Nursing, 012; Gonzalo, 2011). These four as we know it are the person, the environment, health, and nursing. It sees the person or system as a complex but composite entity of physical, psychological, socio-cultural, and developmental characteristics and factors. It also consists of sub-types. The Model sees the environment as the overall composition of internal and external forces, changes and phenomena with which the person or system interacts at any given time and way. And health or wellness represents the condition of optimal and harmonious balance and functioning of all the parts and sub-parts of the client or system. It is present when the client or system has more available energy for survival and a variety or responses to stimuli than the amount of energy already in use. But when the response depletes the energy level and more is used than is available, injury, sickness or disorder develops or leads to death. And the fourth and last concept, nursing is the unique profession dedicated to the promotion and maintenance of the optimal stability of all the variables of the client system. Successful nursing care depends on the positive and optimal response of the client or system to the harmful stressor. Nursing consists of a regimented set of actions meant to help the client or system, families and other groups achieve, maintain or restore the optimum level of wellness or health. These actions are also called interventions. The nurse assesses the person's condition according to the degree of his harmful response or reaction to a stressor. Then she applies the three levels of intervention with the singular goal of eliminating or defeating the stressor with the cooperation of the client during therapy (Current Nursing, Gonzalo).

3. Lucidity and Consistency -- The Model's concepts, assumptions and meta-paradigm are clear and consistent.

D. Application

1. How It Guides Nursing Actions - The Model or… [END OF PREVIEW]

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