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WATSONS THEORY

PHILOSOPHY AND SCIENCE OF CARING

Jean Harman Watson was born in southern West Virginia and


grew up during the 1940s and 1950s in the small town of Welch.
After graduating from high school in West Virginia, she attended the
Lewis Gale School of Nursing in Roanoke, Virginia , graduating
in1961. After moving to Colorade , Watson continued her nursing
education and graduate studies at the University of Colorado. She
earned a B.S. in Psychiatric Mental Health Nursing in 1966 at the
Health Sciences campus and a Ph.D. in Educational Psychology
and Counselling in 1973 at the Graduate School , Boulder
campus.After Watson completed her Ph D degree, she joined the
School of Nursing faculty of University of Colorado Health Sciences
Center in Denver.

Dr. Watson has also helped to establish the center for


Human Caring at the University of Colorado.Her publication reflect
the evolution of her theory of caring.

Much of current work began with the 1979publication


Nursing : The Philosophy and Science of Caring .The second major
work Nursing : Human Science and Human care.sciences and the
humanities and culminates in a human care process.

EVOLUTION OF THEORY

The goal is the preservation of human dignity and humanity in the


health care system. Watson believes professional nursing care is
deveolped through a a combined study of the sciences and
humanities and culminates in human care process between nurse
and client that transcends time and space and has spiritual
dimensions.
According to Watson, the goal of nursing is to facilitate
individuals of the garining a higher degree of harmony within the
mind, body, and soul which generates self knowledge , self
reverence, self healing and self care proceses while allowing
increasing diversity.

THEORY OF CARING

Jean Watson stated the following assumption of the science of


caring in Nursing and Primary curative factors.

1. caring can only be effectively demonstrated and practiced


scientifiinterpersonally.
2. Caring consist of curative factors that result in the satisfaction
of certain human needs.
3. Effective caring promotes health and individuals or family
growth .
4. Caring responeses accept a person not only as he or she is
now but on what he or she may become.
5. A caring environment is one that offers the development of
potential while allowing the person to choose the best action
for himself or herself at given point of time.

Watsons says that nursing education and the health care


delivery system must be based on human values and concern for
the welfare of others.Watson bases her theory nursing practice or
the structure for the science of caring is built upon the following
Ten Curative Factors.

1. The formation of humanistic altruistic system of values.


2. The instillation of faith hope.
3. The cultivation of sensitivity to ones self and to others.
4. The deveolpment of helping trust relationship.
5. The promotion and acceptence of the expression of positive
and negative feelings.
6. The systematic use of the scientific problem solving method for
decision making.
7. The promotion of interpersonal teachinglearning.
8. The provision for supportive , protective , and or corrective
mental , physical sociocultural and spiritual environment.
9. Assistance with the gratification of human need.
10. The allowance for existential phenomenological forces.

PARADIGM/ASSUMPTION OF WATSON THEORY

HUMAN BEING

By using nursing heritage ,Watson adopts a view of the human


beings as a valued person in and of him or herself to be
cared for , respected, nurtured, understood and assisted ; in
general philosophical view of a person as a fully functional
integrated self.

HEALTH

Watson acknowledges the WHO definition of Health and


believes that others factors needed to be incluede in health
which includes the adding of following three elements.
A high level of over all ysical , mental and social
functioning.
The General adapting maintenance level of daily
functionning.
The absence of illness .

ENVIRONMENT

Watson states Caring has existed in every society. Every


society has had some people who cared for others a caring
attitued is not transmitted by the culture of the profession as
a unique way of coping with its environment.
NURSING

Nursing is concerned with promoting health, preventing illness


caring for the sick and restoring health.Nursing focus on
health promotion as well as treatment of disease.

Watson define nursing as a human science of person and


human health illness experience that are mediated by
professional , personal , scientific , aesthetic and ethical huma
n care transaction.

NURSING PROCESS AND WATSON

NURSING SCIENTIFIC RESEARCH PROCESS


PROCESS
Assessment assessment involve observation ,
identification and review of problem , use
of the applicable
knowledge in literature
it includes conceptual knowledge for the
formulation and conceptualization of a
framework in which to view and assess the
problem.
it also include the formulation of
hypothesis about relationship and factors
that influence problem.
assessment also include defining variable
that will be examined in solving measured.
plan the plan helps to determine how variable
will be examined or measured.
it inclued a conceptual approach or design
for solving problems that is referred to as
the nursing care plan.
it also includes determining what data will
be collected and on what person and how
data will be collected.
Intervention interventions direct action and
implementation of the plan
it includes the collection of data.
Evaluation evaluation is the method of and the
process of analyzing data as well as the
examinationof the effect of intervention
based on the date.
it includes interpertation of the results ,
the degree to which a positive outcome
occurred and whether the results can be
generalized beyond that situation.
in addition evalton also enerates addional
hpothesis or pssbly even lad to the
generation of horsing theory based on the
problems studied by solution.

CHARACTERISTICS OF THEORY AND WATSON WORK

A theory is an tive groupingof knowledge ideas and experience


that are represented symbolically and seek to illuminate given
phenomenon. Her work has been developed within the
traditional contact and can be compared to the characteristics
of theory.

1. The use of term caring is not unique in Watson what is


unique in her basic assumptions for the structure for this
concept.
2. Watson work is logical in that curative factors are based on
the board assumption that provides a supportive
fframework.
3. Watson theory is relatively simple, because it does use
theories from others disciplines that are familier to nurses.
4. Watson work can be used to guide ans improve practice.
5. Watson suggested that the best method of testing her theory
is through field study. For eg. ,her work in area of loss and
caring that place in Western Australia and involved tribe of
aborigines after analysis.

EVALUATION OF THEORY

1. Watson theory is easily read and uses nontechnical


language that provides calrity.
2. Watson draws on a number of disciplines to formulate her
theory.
3. The theory seeks to provide a moral and philosophical basis
for nurses.
4. The theory does not lend itself to research conducted using
traditional scientific methodologies.
5. Although further testing is necessary Watson theory
continues to provide a useful and improtant metaphysical
orientation for the delivery of nursing care.

CRITIQUE :

CLARITY : Watsons theory is easily read and uses nontechnique


language that provides clarity . In Nursing Science and Human
Care , Wetson expands the Philosophical nature of her theory.

SIMPLICITY : Watson draws on a number of disciplines of


formulate her theory. The reader must have an understanding of a
variety of subject matters to understand the theory as it is
presented. It is seen as complex when considering the existential
phenomenologicaol nature of her work, due in the limited liberal
arts background of many nurses and the limitated integration of
liberal arts in baccalaureate nursing curricula.

GENERALITY : The theory seeks to provide a moral and


philoshophical basis for nursing. The scope of the framework
encompasses all aspects of the health-illness continuum. In
addition , the theory addresses aspects of preventing illness and
experiencing a peaceful death , thereby increasing its generality .

EMPIRICAL PRECISION : Although the framework is difficult to


study empirically, Watson draws heavily on widely accepted work
from other disciplines. The theory dose not lend itself to research
conducted with traditional scientific methodologies . The
methodologies relevant to studying transpersonal caring and
developing nursing as a human science and art can be classified as
qualitative , naturalistic or phenomenological.

DERIVABLE CONSEQUENCES : Watsons theory continue to


provide a useful and important metaphysical orientation for the
delivery of nursing care. Watson concepts, such as use of self ,
client- identified needs, the caring process, and the spiritual sense
of being human , may help nurses and their clients find meaning
and harmony in a period of increasing complexity .

CONCLUSION : Watson provides many useful concepts for the


practice of nursing.She ties together many theories commonly used
in nursing education and does so in a manner helpful to
practioners of the art and science of nursing.The detailed
descriptions of the carative factors can give guidance to those who
wish to employ them in practice or research. Using her theory can
add a dimension to practice that is both satisfying and challenging.
BIBLIOGRAPHY :

1. Timber BK. Fundamental skills and concepts in Patient Care,


7th edition, LWW, N
2. George B. Julia , Nursing Theories- The base for professional
Nursing Practice , 3rd ed. Norwalk, Appleton & Lange.
3. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for
Nursing Philadelphia. Lippincott Williams& wilkins.
4. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development
& Progress 3rd ed. Philadelphia, Lippincott.
5. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing
Care 4th ed. Philadelphia, Lippincott.
6. Potter A Patricia, Perry G Anne (1992) Fundamentals Of
Nursing Concepts Process & Practice 3rd ed. London Mosby
Year Book.
7. Ann Marriner Tomey,Nursing Theorists And Their Work, 4th
Edition 1998 by Mosby, 142-156
ROY ADAPTATION MODEL

Sister Callista Roy, a member of the Sister of Saint Joseph of


Carondeler , was born October 14 , 1939, in Los Angeles, California.
She received a Bachelor of Arts in Nursing in 1963 from Mount
Saint Marys College in Los Angeles and a Master of Science in
Nursing from the University of California at Los Angles in1966.

Roy began her education in sociolgy , receiving both an MA in


sociology in 1973 and a Ph.D. in sociology in 1977 from the
University of California. Roy was an associate professor and
chairperson of the Department of Nursing at Mount Saint Marys
College until 1982.

EVOLUTION OF THEORY

Roys Adaptation Model for Nursing was derived in 1946 from Harry
Helsons Adaptation Theory, adaptive responses are a functin of the
incoming stimulus and the adaptive level.

The adaptive level is made up of the pooled effect of three classes of


stimuli (i) focal (ii) contextual stimuli, which are all other stimuli
present (iii) residual stimuli. Roy combines Helsons work with
Rapports definition of system and views the person as an adaptive
system.

Roy is developing the humanism value base of her model. According


to Roy, Humanism in nursing is the belief in the persons own
creative ower or the belief that the persons own coping abilities will
enhance wellness . Roys holistic approach to nursing is grounded
in humanism.
As an open living system the person receive inputs or stimuli from
both the environment and the self.The adaptation level is
determined by the combined effect of the focal, contextual and
residual stimuli. Adaptation occurs when the person responds
posivively to environmental changes.

CONCEPT USED BY ROY

System

Asustem is a set of units so related or connect as to form a uniry


or whole and characerised bu inputs, outputsand control and
feedback processes.

Adaptation Level

A persons adaptation level is a constantly changing point ,made


up of focal, contexual , and residual stimuli, which represent the
persons own standard of the range of stimuli to which one can
respond with ordinary adaptive responses.

Adaptation Problems

Adaptation problems are the occurrences of situation of inadequate


responses to need deficits or excesses.

Focal Stimulus

A focal stimulus is the degree of change or stimulus most


immediately confronting the person and the one to which the
person must make an adaptive response , that is the factor theat
precipitates the behaviour.

Residual Stimuli

Residual stimuli are factors that may be affecting behavior but


whose effects are not validated.
Regulator

A regulator is a subsystem coping mechanism which responds


automatically through neural chemical endocrine processes.

Cognator

A cognator is a subsystem coping mechanism which responds


through complex processes of perception and information
processing learning judgement and emotion.

Adaptive Modes

Adaptive or effectors modes are a classification of ways of coping


that manifest regulator and cognator activity ,that is, phusiology ,
self concept , role function and interdependence.

ASSUMPTIONS FROM SYSTEM THEORY

Holism : A system is a set of units so related or connected


as to form a unity or whole.
Interdepence : A system is a whole that functions on a whole
by virtue of the interdependence of its parts.
Control processes: A system have inputs, output, and control
and feedback processes.
Information feedback : Inputs, in the form of a standard or
feedback often is referred to as information.
Complexity of living system: Living system are more complex
than mechanical systems and have standards and feedback to
direct their functioning as a whole.

ASSUMPTION FROM ADAPTION LEVEL THEORY

Behavior as adaptive: Human behavior represents adaptation


to environment and organism forces.
Adaptive as a function of stimuli and adaption level :
adaptive behavior is a function of the stimulus and adaptation
level , that is, the pooled effect of the focal contextual and
residual stimuli.
Individual , dymanic adaption level: Adaptation is a process
of responding positively to environment changes.this positive
response decrease the responces necessary to cope with the
stimuli and increases the sensitivity to respond to other
stimuli.
Positive and active process of responding: Responces
reflects the state of the organism as well as the properties of
stimuli, and hence , are regarded as active processes.

PHYLOSOPHICAL ASSUMPTIONS

Roy 1988 addressed the thoughtful explication of eight


philosophical assumptions. Four based on the philosophisical
principle of Humanism and four based on the philosophical
principle of veritivity.

ASSUMPTION FROM HUMANISM

Creativity Persons have their own creative power and shares


in creative power.
Purposefulness- A persons behaviour is purposeful and not
merely a cause and effect.
Holism- Person in holistic that is individual possesses
intrinsic holism.
Interpersonal Process- A person strive to maintain integrity
and to realise the need for relationship through individuals
options and view points are of value in the interpersonal
relationship is significant.

ELEMENTS OF THE ROYS ADAPTATION MODEL

The four essential elements of the RAM are the following

The person who is recipient of nursing care.


The concept of environment.
The concept of health.
Nursing.

NURSING PROCESS AND ROYS ADAPTATION MODEL

Assessment of stimuli

After behavioural assessment , the nurse analyses the emerging


themes and patterns of client behaviour to identify ineffective
responses or adaptive responses requiring nurse support. When
ineffective behaviour or adaptive behaviours requiring support are
present, the nurse makes an assessment of inernal and external
stimuli that may be affecting behaviiour.

Nursing Diagnosis

Roy describe three methods of making a nursing diagnosis. One


method is to use a typology fo diagnoses developed by Roy and
related to the four adaptive modes.

The second method is to make a diagnodes by stating the observed


response within one mode along with the most influential stimuli.

The third method summarizes responses in one or more adaptive


modes related to the same stimuli.For eg. If the persong
experiencing chest pain is a farmer working outside in hot weather
is necessary for success in his or her work. In this case, an
appropriate diagnosis might be :Role failure associated with limited
physical ability to work in hot weather.

Planning

Goals are the end point behaviours that the person is to achieve.
The are recorded ad client behaviours indicative of resolution of the
adaptation problem. The goal statement includes the behaviour, the
change expected, and a time frame. Long term goals reflet
resolution of adaptive problems and the availability of energy to
meet other goals ,growth , reproduction and short term goal identify
expected client behaviours that indicate cognator or regulator
coping.

Implementation

Nursing intervention are planned with the purpose of altering or


managing the focal or contextual stimuli. Implementation may also
focus on broadening the persons coping ability or adaptation level ,
so that the total stimuli fall within that persons ability to adapt.

Evaluation

The nursing process is completed by evaluation . Goal behaviours


are compared to the persons output responses, and movement
toward or away from goal achievement is determined.

ROY WORK AND THE CHARACTERISTICS OF A THEORY

1. Theories can interrelate concepts in such a way as to create a


different way of looking at a particular phenomenon. The Roy
model does interrelate concept in such a way as to present a
new view of the phenomenon being studies.
2. Theories must be logical in nature . The sequence of concepts
the Roy model follows logically. In the presentation of each of
the key concepts into there is the recurring idea of adaptation
to maintain integrity.
3. Theories should be relatively simple yet generalizable. The
concepts of the Roy model are stated in realtively simple
terms.
4. Theories can be the bases for hypotheses that can be tested or
for theory to be expanded.
5. Theories contribute to and assist in increasing the general
body of knowledge of a discipline through the research
implemnted to validate them.
6. Theories can be used by practitioners to guide and improve
their practice.

CRITIQUE :

1. CLARITY :according toChinn and Jacob clarity requires the


semantic and structural organization of goals , assumption ,
concepts, definition , relationships ,and structure into a
logically coherent whole . Duldt and Giffin state that Roys
arrangement of concept is logic but that the development of
definitions is inadequate related to her original formate. Terms
and concepts borrowed from other disciplines are not
redefined for nursing .
2. SIMPLICITY : the roy model include the concepts of nursing ,
person, health illness, environment , adaptation and nursing
activities . It is also includes the subconcepts of regulator,
cognator , and the four effector mdes of physiological , self
concept , role function , and independence. Because this
theory has several major concept and subconcepts and
numerous relational statements, it is complex.
3. GENERALITY : Roys defines her model as drawn from
multiple middle range theories and advocate multiple middle
range theory for use in nursing. Middle range theories are
testable but have sufficient generality to be scientifically
interesting. Roy s model is generalizable to all setting in
nursing practice but is limited in scope because it primarily
addressed the concept of person-environment adaptation and
focuses primarily on the client ;information on the nurse
implied .
4. EMPIRICAL PRECISION : Increasing complexity within
theories often helps increases empirical precision . when
subcomponents are designated within the theory , the
empirical precision increases , assuming the broad concepts
are based in reality. Because Roys broad concepts stem from
theory in physiological , psychology, sociology , and nursing
empirical data indicate that this general theory base has
substance.

EVALUATION OF THE THEORY

According to Chinn and Jacobs Clarity requires the semantic and


structural organization of goals, assumptins ,concepts, definitions,
ralationships,and structure into a logically coherent whole.

Roys assumptions can also be analysed to determine what type of


statements they are. The eight assumptions of the Adaptation
Model of Nursing are as follows.

1. The person is a biopsychosocial being.


2. The person is in constant interaction with a changing
environment.
3. To cope with a changing world , the person uses both innate
and acquired mechanism ,which are biological ,psychological
and sociological in origin.
4. Health and illness are one inevitable dimension of the persons
life.
5. To respond positively to environmental changes , the person
must adapt.
6. The persons adaptation level is such that it comprises a zone
indicating the range of stimulation that will lead to a positive
response.
7. The persons adaptation is a function of the stimulus he is
exposed to and his adaptation level.
8. The person is conceptualised as having four mides of
adaptation : physiological needs, self concept ,role
function,and interdependence relations.

CONCLUSION :

Meleis asserts that there are three types of nursing theorists; those
who focuses who focuses on out come . Roys Adaptation Modle is
classified as an outcome theory , defined by this author as a well
articulated conception of men as a nursing client and of nursing
as an regulatory mechanism. Roy, in applying the concepts of
system and adaptation to man as a client of nursing , has
presented her articulation of man for nurses to use as a tool in
practice, education ,and research.
BIBLIOGRAPHY :

1. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development


& Progress 3rd ed. Philadelphia, Lippincott.
2. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing
Care 4th ed. Philadelphia, Lippincott.
3. Potter A Patricia, Perry G Anne (1992) Fundamentals Of
Nursing Concepts Process & Practice 3rd ed. London Mosby
Year Book.
4. Vandemark L.M. Awareness of self & expanding
consciousness: using Nursing theories to prepare nurse
therapists Ment Health Nurs. 2006 Jul; 27(6) : 605-15
5. Reed PG, The force of nursing theory guided- practice. Nurs
Sci Q. 2006 Jul;19(3):225
6. Ann Marriner Tomey,Nursing Theorists And Their Work, 4th
Edition 1998 by Mosby, 243-247

BETTY NEUMAN THEORY


SYSTEMS MODEL

Betty neuman was born in 1924 on a farm near Lowell, Ohio. Her
father and Mother ahomemaker. She developed a love the land
while growing up in rural Ohio, and this rural background
developed her compassion for people in need. Neumans initial
nursing education was completed with double honors at People
Hospital School of Nursing ( now General Hospital ). In California
she held various positions, including Hospital staff and head
nursing , school nursing and industrial nursing. She was also
involved in clinical teaching in what is now the USC Medical
Center,Los Angeles, in the area of Medical Surgical , Communicable
disease, and critical care.

The models was initially developed in response to graduate nursing


students expression of a need for course content that would expose
them to breadth of nursing problems prior to focusing on specific
nursing problem areas.

The model was 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.

DEVELOPMENT OF THE MODEL

Neumans model was influenced by a variety of sources.


The philosophy writers deChardin and cornu (on wholeness in
system).
Von Bertalanfy, and Lazlo on general system theory.
Selye on stress theory.
Lararus on stress and coping.

PREVENTION
According to Neumans model, prevention is the primary
nursing intervention. Prevention focuses on keeping stressors
and the stress response from having a detrimental effect on
the body.

PRIMARY PREVENTION

Primary prevention occurs before the system reacts to a


stressor. On the one hand, it strengthens the person (primary
the flexible LOD) to enable him to better deal with stressors
On the other hand manipulates the environment to reduce or
weaken stressors.
Primary prevention includes health promotion and
maintenance of wellness.

SECONDARY PREVENTION

Secondary prevention occurs after the system reacts to a


stressor and is provided in terms of existing system.
Secondary prevention focuses on preventing damage to the
central core by strengthening the internal lines of resistance
and/or removing the stressor.

TERTIARY PREVENTION

Tertiary prevention occurs after the system has been treated


through secondary prevention strategies.
Tertiary prevention offers support to the client and attempts to
add energy to the system or reduce energy needed in order to
facilitate reconstitution.

FOUR MAJOR CONCEPTS

PERSON

The focus of the Neuman model is based on the philosophy


that each human being is a total person as a client system and
the person is a layered multidimensional being.
Each layer consists of five person variable or subsystems:
o Physiological- Refer of the physicochemical structure
and function of the body.
o Psychological- Refers to mental processes and emotions.
o Socio-cultural- Refers to relationships; and
social/cultural expectations and activities.
o Spiritual- Refers to the influence of spiritual beliefs.
o Developmental- Refers to those processes related to
development over the lifespan.

ENVIRONMENT

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.
These forces include the intrapersonal, interpersonal and
extra-personal stressors which can affect the persons normal
line of defense and so can affect the stability of the system.
o The internal environment exists within the client
system.
o The external environment exists outside the client
system.
o 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.

HEALTH

Neuman sees health as being equated 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).
The client system moves toward illness and death when more
energy is needed than is available. The client system moved
toward wellness when more energy is available than is needed

NURSING
Neuman sees nursing as a unique profession that is concerned
with all of the variables which influence the response a person
might have to a stressor.
The person is seen as a whole, and it is the task of nursing to
address the whole person.
Neuman defines nursing as action which assist 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 nurses perception will
influence the care given, then not only must the
patient/clients perception be assessed, but so must those of
the caregiver (nurse).
The role of the nurse is seen in terms of degree of reaction to
stressors, and the use of primary, secondary and tertiary
interventions

STAGES OF NURSING PROCESS (BY NEUMAN)

NURSING DIAGNOSIS

It depends on acquisition of appropriate database; the


diagnosis identifies, assesses, classifies, and evaluates the
dynamic interaction of the five variables.
Variances from wellness (needs and problems) are determined
by correlations and constraints through synthesis of theory
and data base.
Broad hypothetical interventions are determined, i.e. maintain
flexible line of defense.

NURSING GOALS

These must be negotiated with the patient, and take account


of patients and nurses perceptions of variance from wellness.

NURSING OUTCOMES

Nursing intervention using one or more preventive modes.


Confirmation of prescriptive change or reformulation of
nursing goals.
Short term goal outcomes influence determination of
intermediate and long term goals.
A client outcome validates nursing process.

NeumanS SYSTEM MODEL FORMAT


Neumans nursing process format designates the following
categories of data about the client system as the major areas of
assessment.

ASSESSMENT

Potential and actual stressors.


Condition and strength of basic structure factors and energy
sources.
Characteristics of flexible and normal line of defenses, lines of
resistance, degree of reaction and potential for reconstitution.
Interaction between client and environment.
Life process and coping factors (past, present and future)
actual and potential stressors (internal and external) for
optimal wellness external.
Perceptual difference between care giver and the client.

NURSING DIAGNOSIS

The data collected are then interpreted to condition and


formulate the Nursing diagnosis.
Health seeking behaviors.
Activity intolerance.
Ineffective coping.
Ineffective thermoregulation.

GOAL

In Neumans systems model the goal is to keep the client


system stable.

PLANNING
Planning is focused on strengthening the lines of defense and
resistance.

IMPLEMENTATION

The goal of stabilizing the client system is achieved through three


modes of prevention

Primary prevention : actions taken to retain stability


Secondary prevention : actions taken to attain stability
Tertiary prevention : actions taken to maintain stability

EVALUATION

The nursing process is evaluated to determine whether


equilibrium is restored and a steady state maintained.

ACCEPTANCE BY THE NURSING COMMUNITY

Neumans model has been described as a grand nursing


theory by walker and Avant.
Grand theories can provide a comprehensive perspective for
nursing practice, education, and research and Neumans
model does.

PRACTICE

The Neuman systems model has been applied and adapted to


various specialties include family therapy, public health,
rehabilitation, and hospital nursing.
The sub specialties include pulmonary, renal, critical care,
and hospital medical units. One of the models strengths is
that it can be used in a variety of settings
Using this conceptual model permits comparison of a nurses
interpretation of a problem with that of the patient, so the
patient and nurse do not work on two separate problems.
The role of the nurse in the model is to work with the patient
to move him as far as possible along a continuum toward
wellness.
Because this model requires individual interaction with the
total health care system, it is indicative of the futuristic
direction the nursing profession is taking.
The patient is being relabeled as a consumer with individual
needs and wants.

EDUCATION

The model has also been widely accepted in academic circles.


It has often been selected as a curriculum guide for a
conceptual framework oriented more toward wellness than
toward a medical model and has been used at various levels of
nursing education.
In the associate degree program at Indiana University.
One of the objectives for nursing graduate is to demonstrate
ability to use the Neuman health care system in nursing
practice. This helps prepare the students for developing a
frame of reference centered on holistic care.
At northwestern State University in Shreveport, Louisiana, the
faculty determined that a systems model approach was
preferred for their masters program because of the
universality framework.
Acceptance by the nursing community for education therefore
is evident.

RESEARCH

A study was published by Riehl and Roy to test the usefulness


of the Neuman model in nursing practice.
There were two major objectives of the study.
o To test the model/assessment tool for its usefulness as a
unifying method of collecting and analyzing data for
identifying client problems.
o To test the assessment tool for its usefulness in the
identification of congruence between the clients
perception of stressors and the care givers perception of
client stressors.
Results indicated that the model can help categorize data for
assessing and planning care and for guiding decision making.
Neumans model can easily generate nursing research.
It does this by providing a framework to develop goals for
desired outcomes. Acceptance by the nursing community for
research applying this model is in the beginning stages and
positive.

NeumanS AND THE CHARACTERISTICS OF A THEORY

Theories connects the interrelated concepts in such a


way as to create a different way of looking at a particular
phenomenon.

The Neuman model represents a focus on nursing interest in


the total person approach to the interaction of environment
and health.
The interrelationships between the concepts of person, health,
nursing and society/environment are repeatedly mentioned
throughout the Neuman model and are considered to be
basically adequate according to the criteria.

Theories must be logical in nature


1. Neumans model in general presents itself as logically
consistent.
2. There is a logical sequence in the process of nursing
wherein emphasis on the importance of accurate data
assessment is basic to the sequential steps of the nursing
process.
Theories should be relatively simple yet generalizable.
1. Neumans model is fairly simple and straightforward in
approach.
2. The terms used are easily identifiable and for the most
part have definitions that are broadly accepted.
3. The multiple use of the model in varied nursing
situations (practice, curriculum, and administration) is
testimony in itself to its broad applicability.
4. The potential use of this model by other health care
disciplines also attests to its generalizability for use ion
practice.
5. One drawback in relation to simplicity is the diagrammed
model since it presents over 35 variables and tends to be
awesome to the viewer.
Theories can be the bases for hypotheses that can be
tested.
1. Neumans model, due to its high level and breadth of
abstraction, lends itself to theory development.
2. One are for future consideration as a beginning testable
theory might be the concept of prevention as
intervention, subsequent to basis concept refinement in
the Neuman model.
Theories contribute to and assist in increasing the general
body of knowledge within the discipline through the
research implemented to validate them.
1. The model has provided clear, comprehensive guidelines
for nursing education and practice in a variety of
settings; this is its primary contribution to nursing
knowledge.
2. The concept within the guidelines is clearly explicated
and many applications of the theory have been
published, little research explicitly derived from this
model has been published to date.
Theories can be utilized by the practitioner to guide and
improve their practice.
1. One of the most significant attributes of the Neuman
model is the assessment/intervention instrument
together with comprehensive guidelines for its use with
the nursing process.
2. These guidelines have provided a practical resource for
many nursing practitioners and have been used
extensively in a variety of setting in nursing practice,
education and administration.
Theories must be consistent with other validated theories,
laws and principles but will leave open unanswered
questions that need to be investigated.
1. In general, there is no direct conflict with other theories.
There is, however, a lack of specificity in systems
concepts such as boundaries which are indirectly
addressed throughout the model.

CRITIQUES :
1. CLARITY : neumans presents abstract concepts that are
familiar to nursing . the model s concepts of client,
environment , health, and nursing are congruent with
traditional values.
2. SIMPLICITY : Multiple interactions and interrelationships
comprise this broad systems based model ;they are
organized in a complex yet logical manner, and variables tends
to overlap to some degree. The concepts coalesce , but a loss of
theoretical meaning would occurs if they were completely
separated. The model can be used to delineate further the
system concept for nursing and also to describe various other
health care system.
3. GENERALITY : The Neumans system model has been used in
a wide variety of nursing situation; it isreadily adaptable and
comprehensive enough to be useful in all health care setting,
including administration and research .other related health
fields can use this framework because of its systemic nature
and its emphasis on the client system as a whole .
4. EMPIRICAL PRECISION : Although the model has not been
completely tested to date, nursing scientists are demonstrating
major interest in and use of the model to guide nursing
research . early work by Hoffman described a list of variables
and selected operational definition that were derived from the
model.
5. DERIVABLE CONSEQUENCES : Neumans conceptual model
provide the professional nurse with important guidelines for
assessment of the client system , utilization of the nursing
process , and implementation of preventive intervention . the
focus on the primary prevention and interdisplinary care
facilities improved quality of care and is futuristic.

CONCLUSION : Dr. Neuman as a way to teach an introductory


nursing course to nursing students. The goal of the model was to
provide a wholistic overview of the physiological, psychological,
sociocultural, and developmental aspects of human beings. After a
two-year evaluation of the model, it was published in Nursing
Research (Neuman & Young, 1972).
The Neuman Systems Model is a unique, systems-based perspective
that provides a unifying focus for approaching a wide range of
nursing concerns. The Neuman Systems Model is a comprehensive
guide for nursing practice, research, education, and administration
that is open to creative implementation(and) has the potential for
unifying various health-related theories, clarifying the relationships
of variables in nursing care and role definitions at various levels of
nursing practice. The multidimensionality and wholistic systemic
perspective of the Neuman Systems Model is increasingly
demonstrating its relevance and reliability in a wide variety of
clinical and educational settings throughout the world. (Betty
Neuman, 2002)
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Timber BK. Fundamental skills and concepts in Patient Care,
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George B. Julia , Nursing Theories- The base for professional
Nursing Practice , 3rd ed. Norwalk, Appleton and Lange.
Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for
Nursing Philadelphia. Lippincott Williams& wilkins.
Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development
& Progress 3rd ed. Philadelphia, Lippincott.
Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing
Care 4th ed. Philadelphia, Lippincott.
Potter A Patricia, Perry G Anne (1992) Fundamentals Of
Nursing Concepts Process & Practice 3rd ed. London Mosby
Year Book.