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Neuman Systems Model
Cornelia Campbell (Roline)
Tracy Hill
Roxy Johanning
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Introduce Betty Neuman
Overview of the Neuman Systems
Model (NSM), concepts and
principles
Evaluate the NSM nursing theory
using Fawcett’s criteria
Contrast the NSM with two other
nursing theories
Discuss and analyze the use of the
NSM
Betty Neuman (1924•Born in 1924 on a farm near
Lowell, Ohio.
• After completion of her initial
nursing education, she moved to Los
Angeles to live with relatives.
•Worked in a variety of nursing
roles - always with an interest in
human behavior.
•She attended UCLA; graduated
1957 with a double major in Public
Health and Psychology.
•Helped her husband to establish
and manage his medical practice.
•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.
Career advances (con’t)
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.
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Maintained involvement in variety of professional and international
activities
• Numerous publications
• Paper presentations
• Consultations
• Lectures
• Conferences.
•
Moved back to Ohio and practiced as a licensed clinical marriage and
family therapist.
• Maintains leadership role in the Neuman Systems Model Trustees Group
“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 as keynote speaker at
the University of Maine, Fort Kent,
2004.
- Betty Neuman, 2002
An overview of the
Neuman Systems Model
“ The philosophic base of the Neuman Systems Model
encompasses wholism, a wellness orientation, client
perception and motivation, and a dynamic systems
perspective of energy and variable interaction with
the environment to mitigate possible harm from
internal and external stressors, while caregivers and
clients form a partnership relationship to negotiate
desired outcome goals for optimal health retention,
restoration and maintenance. This philosophic base
pervades all aspects of the model.”
Neuman, 2002
o Wholism
o Wellness orientation
o Client perception and motivation
o Dynamic systems perspective of
energy and variable interaction
with the environment
o Client & caregiver in partnership
Classified according to the applicable metaparadigm forerunner.
Human
Beings
• Client/Client
System
• Interacting
Variables
• Basic Structure
• Flexible line of
Defense
• Normal line of
Defense
• Lines of
Resistance
Environment
• Internal
Environment
• External
Environment
• Created
Environment
• Stressors
Health
• Health/Wellness/
Optimal Client
System Stability
• Variances from
Wellness
• Illness
• Reconstitution
Nursing
• Prevention as
Intervention
Concept: Client / client system
Viewed as open system
 Repeated cycles of input, process, output
& feedback
 Thus a dynamic organizational pattern
 Can be
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Individual
Family
Group
Community
Aggregate
Concept: Interacting Variables
Physiological
Developmental
Present in each type
of client
Psychological
Consider these simultaneously
and comprehensively
Spiritual
Socio-cultural
Concept: Central Core
System
variables
Weaknesses
Basic
survival
factors
Genetic
features
Strengths
Concept: Central Core
System
variables
Weaknesses
Basic
survival
factors
Genetic
features
Strengths
Outer barrier
Accordion-like
Dynamic – can be
altered in relatively
short period of time
Normal line of Defense
Lines of Resistance
Neuman’s Context
Conceptual System
Conceptual Diagram
Small group exercise /
application discussion
Other theories based on NSM
Jacqueline Fawcett on Betty
Neuman’s System Model Theory:
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Neuman System Model Trustee since: 1988
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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.
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Selected Neuman Systems Model Publications:
Fawcett, 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, 231238.
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.
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.
Fawcett’s Criteria to Evaluate
Nursing Theory
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Significance
Internal Consistency
Parsimony
Testability
Empirical Adequacy
Pragmatic Adequacy
Significance - Meets
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All of Neuman’s philosophical claims are addressed:
 Human beings - client as an open system.
 Environment - contains both internal and external
stressors (neutral) and resistance factors (determined by
client to be + or -).
○ client => energy exchange <= environment
 Health – represents a usual dynamic stability state of the
normal line of defense; stressors penetrate normal line of
defense, causing illness.
 Nursing - goal is optimal client system stability or
wellness; perceptual distortions are mutually negotiated
and resolved. Prevention as intervention.

Neuman acknowledged the support of colleagues
and the influence of other scholars on the
development of the NSM, as well as adjunctive
disciplines.
 UCLA
Internal Consistency - Meets
Neuman values a holistic (“wholistic”),
systems-based approach to the care of
clients.
 The basic intent, meaning, and purpose
of the model have been retained.
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Parsimony - Meets
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Is the theory content clearly stated?
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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.
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Testability - Meets
Is there research methodology developed?
Is it congruent with the theory?
 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.
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Empirical Adequacy – Meets in
part?
Are study findings congruent with the
concepts and principles? Are theoretical
assertions congruent with empirical
evidence?
 The content of the NSM is not
completely logically congruent.
 Neuman considers her model to be
appropriate for use by members of all
health-care disciplines.
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Pragmatic Adequacy - Meets
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Special training required? Has it been used in “real world”
practice? Effectiveness measurable? Comparisons in
situations with and without theory use?
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).
Critical Analysis of NSM - Fawcett
Comparison
Rogers
Neuman
Roy
(1970)
(1970)
(1970)
Science of Neuman’s
Roy’s
Unitary
System Adaptation
Human
Model
Model
Beings
Contemporaries of one another
Martha
Rogers
Betty
Neuman
Sister
Callista
Roy
Each Defines:
Person
Health
Environment
Nursing
Used in nursing:
Practice
 Administration
 Education

Meets Fawcett’s criteria eligibility:
Rogers
 Roy?
 Neuman?

Sister Callista Roy
• Grand
theories
and
midrange
theories
based
on
SUHB
Betty Neuman
Martha Rogers
Theories derived from:
Goal of Nursing
Promote human betterment wherever
people are, on the planet or in outer
space.
To facilitate optimal wellness for the
client through retention, attainment,
or maintenance of client system
stability.
Overview
Focus is on unitary, irreducible
human beings and their
environments.
Focus is on wellness of client
system in relation to environmental
stressors and reactions to the
stressors.
Focus is on human adaptive
system responses and
environmental stimuli, which are
constantly changing.
Worldview
Rogers
Roy
Neuman
To Conclude
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