Professional Documents
Culture Documents
AMRITA CHHABRA
The Model
The Neumans System Model provides a comprehensive, flexible,
model
is
conceptual
framework,
visual
Person variables
Each layer, or concentric circle, of the Neuman model is
made up of the five person variables. Ideally, each of the
person variables should be considered simultaneously
and comprehensively.
Physiological - refers of the physicochemical structure and
function of the body.
Psychological - refers to mental processes and emotions.
Sociocultural - refers to relationships; and social/cultural
refers
to
those
processes
related
to
Central Core
The basic structure, or central core, is made up of the basic survival factors
that are common to the species (Neuman, 1995, in George, 1996).
These factors include: system variables, genetic features, and the
Lines of Resistance
The lines of resistance protect the basic structure and
Reconstitution
Reconstitution is the increase in energy that
occurs in relation to the degree of reaction to the
stressor.
Reconstitution begins at any point following
initiation of treatment for invasion of stressors.
Reconstitution may expand the normal line of
defense beyond its previous level, stabilize the
system at a lower level, or return it to the level
that existed before the illness.
Stressors
The Neuman Systems Model looks at the impact of stressors on
health and addresses stress and the reduction of stress (in the
form of stressors).
A stressor is any environmental force which can potentially
affect the stability of the system: they may be:
Intrapersonal - occur within person,
e.g. emotions and feelings
Interpersonal
occur
between
individuals, e.g. role expectations
Extra personal - occur outside the
individual, e.g. job or finance pressures
PREVENTION
Prevention is the primary nursing intervention.
Prevention focuses on keeping stressors and the stress response
from having a detrimental effect on the body.
Primary
Primary prevention occurs before the system reacts to a
stressor. Primary prevention includes health promotion
and maintenance of wellness.
Secondary
Secondary prevention occurs after the system reacts
to a stressor and is provided in terms of existing
systems.
Tertiary
Tertiary prevention occurs after the system has
been treated through secondary prevention
strategies.
META PARADIGM
PERSON
The person is a layered multidimensional being. Each layer
consists of five person variables or subsystems:
Physical/P
hysiological
Development
al
Spiritual
Psychological
Sociocultural
Contd
The layers, usually represented by concentric circle, consist of the central
core, lines of resistance, lines of normal defense, and lines of flexible
defense.
Contd
ENVIRONMENT
forces
include
the
intrapersonal,
interpersonal
and
system.
Neuman also identified a created environment which is an
environment that is created and developed unconsciously by the client
HEALTH
Contd
Contd
NURSING
Neuman sees nursing as a unique profession that is concerned with
Nightingale, Leininger
Psychology theorists who influenced her theory of
caring: Hans Selye, Carl Rogers
Carative Factors
Caritas comes from the Latin word meaning to
relationships.
5. The promotion and acceptance of expression of
positive and negative feelings.
6. The systematic use of scientific problem solving
method for decision making.
environment.
9. Assistance with the gratification of Human needs.
10. The allowance for Existential-phenomenologicalspiritual forces.
1.
TYPE OF
NEEDS
Survival Needs
Functional Needs
Integrative Needs
Growth Seeking
Needs
Concepts contd
Transpersonal Caring Relationship
Foundation of the work
Shows concern for inner life world of another fully
embodied person
Goes beyond ego self, reaching to the deeper connections to
spirit & broader universe
Nurse uses caring consciousness to preserve & honor
embodied spirit & heal as experience, perception, and
Concepts contd..
Caring Occasion - Caring Moment
Occurs when nurse & another come together
with unique life histories & phenomenal
fields in a human-to-human transaction
PROPOSITIONS - DIAGRAM
METAPARADIGMS OF
WATSONS THEORY
PERSON (PATIENT)
Is subjective and unique, not objective,
predictable and calculating.
Has distinct human needs, which are
biophysical, psychophysical, psychosocial
and interpersonal.
ENVIRONMENT
Is crucial to the holistic healing (mental, physical, social,
emotional,
spiritual,
developmental,
protective,
supportive
HEALTH
Is viewed holistically, as the unity
between the physical, social, mental
and
spiritual
self,
with
all
parts
social
environment.
conditions
and
NURSING
Is a caring, meaningful and
harmonic connective bond that is
shared between the nurse and the
patient.
Is providing care, professional
and thoughtful interactions to
restore and promote holistic
health and to prevent illness.
Is a holistic practice that is
complementary to medicine.
EDUCATIONAL BACKGROUND
1945 Nursing diploma from St. Johns Hospital of Nursing, St. Louis,
Missouri
WORK EXPERIENCES
Administrator (Ohio State University)
Educator (St. Johns Hospital School of Nursing; Loyola
University; University of South Florida)
ACHIEVEMENTS
Founder of King International Nursing
Group (KING) (1998)
Jessie M. Scott award (ANA convention)
Award presented to a registered nurse whose
accomplishments in a field of practice, education,
or research with significance for the improvement
of nursing and health care.
HER STORY
1963.. challenged by her philosophy
professors with a question, Have you or any
other nurses defined the nursing act?
1972.. reading course work led King to the
Literature Systems analysis and General
Systems Theory and hence to another set of
questions
PERSON
social beings who are rational
and sentient
communicate their thoughts,
actions, customs, and beliefs
through language
exhibit common characteristics
like ability to perceive, to think, to
feel, to choose between alternative
courses of action, to set goals, to
select means to achieve goals, and
to make decisions
NURSING
a process of action,
reaction, and interaction
whereby nurse and client
share information about
their perceptions in the
nursing situation
nurse and patient share
goals, problems, and
concerns and explore
means to achieve a goal.
NURSING
Goal of nurse: To help
individuals to maintain their
health so they can function in
their roles.
Domain of nurse: Includes
promoting, maintaining, and
restoring health, and caring for
the sick, injured and dying.
Function of professional
nurse: To interpret information
in nursing process to plan,
implement and evaluate nursing
care.
NURSING
ACTION
Mental
Action
Recognize
the
presenting
conditions.
Physical
Action
Mental
Action
Physical
Action
Begin
activities
related to
those
conditions.
Effort to
exert
control
over the
situation.
Seeking
to
achieve
goals.
HEALTH
dynamic life experience of a human being
which implies continuous adjustment to
stressors in the external and internal
environment through optimum use of ones
resources to achieve maximum potential for daily
living.
She discusses health as a functional state and
illness as an interference with that functional
state.
ENVIRONMENT
the background for human actions
ENVIRONMENT
Internal environment:
transforms energy to
enable person to adjust to
continuous
external
environmental changes
External environment:
involves
formal
and
informal organizations.
Nurse is a part of the
patients environment.
Three
systems
in
conceptual framework:
the
Contd.
Body Image; Personal & subjective; acquired or learned; dynamic and changing. Includes how
person sees self & others reactions to ones appearance.
Space; Exist in all directions, is the same everywhere, and is defined by the physical area
known as territory and by the behaviors of those who occupy it.
Time; A duration between one event and another as uniquely experienced by each human
being.
Role; Nurses role is interacting with one or more others in a nursing situation to
identify goals and help others to achieve the goals.
Decision Making; A dynamic and systematic process by which goaldirected choice of perceived alternatives is made and acted upon by individuals
or groups to attain a goal.
Nurse and client communicate information, set goal mutually and then
act to attain those goals
Perception
Judgment
Action
Reaction
Interaction
Judgment
Patient
Action
Reaction
Perception
Feedbac
k
Transaction
the
environment
to
maintain
balance
for
growth,
territory.
Defined by the behaviors of a person
who occupy it.
Introduction to Theorist
Health Promotion model was developed by Nola
J. Pender in early 1980. Pender was born on
August 16, 1946 in Lansing, Michigan. She
received her nursing diploma in 1962. In 1964,
Pender completed her baccalaureate.
Introduction to Model
The initial version of health
promotion model appeared
in early 1980s and focused
on
health
promoting
behaviors
rather
than
health protection or illness
prevention .
Assumptions:
Persons seek to create conditions of living through which
they can express their unique human health potential.
Persons have the capacity for reflective self-awareness,
including assessment of their own competencies.
Persons value growth in directions viewed as positive and
attempt to achieve a personally acceptable balance
between change and stability.
Cont..
Individuals seek to actively regulate their own
behavior.
Individual in all their biopsychosocial complexity
interact
with
transforming
the
environment,
the
environment
progressively
and
being
Cont..
Health professionals constitute a part of the
interpersonal
environment,
which
exert
reconfiguration
of
person-
Cont
Personal
psychological
factors:
personal
competence,
Personal
socio-cultural
factors:
is
considered
to
be
major
motivational
anticipated
Cont..
Perceived barriers to action: A
persons perceptions about
action.
Cont..
Perceived Self efficacy: Judgment
behavior.
Cont..
Activity related Affect: Subjective positive or
negative feeling that occur before, during and
following behavior based on the stimulus properties
of
the
behavior
itself.
Activity-related
affect
Cont
Interpersonal Influences:
Interpersonal influences are a persons
perceptions concerning the behaviors,
beliefs, or attitudes of others. Family,
peers, and health care providers are the
source of interpersonal influences. It
includes
expectations
of
significant
Cont..
Situational Influences:
Behavioural Outcome
Health promoting behavior is the outcome of
Health Promotion Model, is directing toward
attaining positive health outcomes for the
client.
Health promoting behavior should results in
Commitment to a Plan of
Action
It is a concept of commitment and identification
of a planned strategy leads to implementing and
reinforcing the health behavior.
are environmental
contingencies such as work or
family care responsibilities.
Cont..
Competing preferences
are alternative behavior over which
individuals exert relatively high control,
such as choice of ice cream or apple for
a snack.
INTRODUCTION
History and Orientation
behaviors
and
the
transmission
of
INDIVIDUAL PERCEPTIONS
Perceived susceptibility (What are the
chances that this could happen to me?)
Cont.
Perceived seriousness - (How serious could it
be if it did happen to me?)
Concern about the spread of acquired immune
deficiency syndrome reflects the general publics
perception of the seriousness of this illness.
Cont.
Perceived threat perceived susceptibility &
perceived seriousness combine to determine the
total perceived threat of an illness to a specific
individual. E.g. a person who perceives that many
of
seriousness
the
combined
susceptibility
&
MODIFYING FACTORS
Demographic variables Age, sex, race ethnicity
etc. eg an infant does not perceive the
importance of healthy diet. An adolescent may
MODIFYING FACTORS
Sociopsychological variables social pressure or
influence from peers or other reference groups
MODIFYING FACTORS
Sociopsychological variables social pressure or
influence from peers or other reference groups
MODIFYING FACTORS
Structural variables presumed to influence
preventive behavior or knowledge about the
had
frequent
occurences of Asthma
ear
infections
&
Likelihood of action
It depends on the perceived benefits of the
action minus the perceived barriers to the
action.
Perceived benefits of the action - refraining from
smoking to prevent lung cancer, and eating
nutritious foods and avoiding snacks to maintain
weight.
Perceived Susceptability
to Disease X
Perceived Seriousness
(Severity) of Disease X
MODIFYING FACTORS
LIKELIHOOD OF
Demographic variables
(age, sex, race,
ethnicity, etc.)
Perceived benefits of
preventive action
Sociopsychological variables
Perceived barriers to
preventive action
Perceived Threat of
Disease X
minus
Likelihood of Taking
Recommended
Preventive Health Action
Cues to Action
Mass media campaigns
Advice from others
Reminder postcard from physician/dentist
Illness of family member or friend
Newspaper or magazine article