Betty Neuman Systems Model - Concepts and Definitions

Question 1

______ occurs after treatment for stressor reactions. It represents return of the
system to stability, which may be at a higher or lower level of wellness than before stressor
invasion.

Answer 1

• Reconstitution

Question 2

Interventions are purposeful actions to help the client retain, attain, or maintain system
stability.
* They can occur before or after protective lines of defense and resistance are penetrated.
* Neuman supports beginning intervention when a stressor is suspected or identified.
* Interventions are based on possible or actual degree of reaction, resources, goals, and
anticipated outcomes.
* Neuman identifies three levels of intervention:
1. Primary Prevention - Primary prevention is used when a stressor is suspected or
identified. A reaction has not yet occurred, but the degree of risk is known. The
purpose is to reduce the possibility of encounter with the stressor or to decrease the
possibility of a reaction.
2. Secondary Prevention- Secondary prevention involves interventions or treatment
initiated after symptoms from stress have occurred. The client’s internal and
external resources are used to strengthen internal lines of resistance, reduce the
reaction, and increase resistance factors
3. Tertiary Prevention- Tertiary prevention occurs after the active treatment or
secondary prevention stage. It focuses on readjustment toward optimal client
system stability. The goal is to maintain optimal wellness by preventing recurrence
of reaction or regression. Tertiary prevention leads back in a circular fashion
toward primary prevention.

Answer 2

Prevention As Intervention

Question 3

The _________ represents system instability that occurs when stressors invade the
normal line of defense

Answer 3

Degree of Reaction

Question 4

_______ are tension-producing stimuli that have the potential to disrupt system stability,
leading to an outcome that may be positive or negative.
* They may arise from the following:
1. Intrapersonal forces occurring within the individual, such as conditioned
responses
2. Interpersonal forces occurring between one or more individuals, such as role
expectations
3. Extrapersonal forces occurring outside the individual, such as financial
circumstances.

Answer 4

Stressors

Question 5

The model’s outer broken ring is called the ____________
* It is perceived as serving as a protective buffer for preventing stressors from breaking
through the usual wellness state as represented by the normal line of defense.
* Situational factors can affect the degree of protection afforded by the flexible line of
defense, both positively and negatively.
* Neuman describes the flexible line of defense as the client system’s first protective
mechanism. “When the flexible line of defense expands, it provides greater short-term
protection against stressor invasion; when it contracts, it provides less protection”.

Answer 5

Flexible Line of Defense

Question 6

The _________ is the model’s outer solid circle.
* It represents the adaptational level of health developed over the course of time and serves
as the standard by which to measure wellness deviation.
* Expansion of the normal line of defense reflects an enhanced wellness state, and
contraction indicates a diminished wellness state.

Answer 6

Normal Line of Defense

Question 7

A series of broken rings surrounding the basic core structure are called the
_________
* These rings represent resource factors that help the client defend against a stressor.
* _________ serve as protection factors that are activated by stressors penetrating
the normal line of defense.

Answer 7

Lines of Resistance

Question 8

The client as a system is composed of central core surrounded by concentric rings. The
inner circle of the diagram represents the basic survival factors or energy resources of the
client.
* This core structure consists of survival factors common to human beings.

Answer 8

Basic Structure

Question 9

The __________ is a composite of five variables (physiological, psychological,
sociocultural, developmental, and spiritual) in interaction with the environment.
* The physiological variable refers to body structure and function.
* The psychological variable refers to mental processes in interaction with the environment.
* The sociocultural variable refers to the effects and influences of social and cultural
conditions.
* The developmental variable refers to age-related processes and activities.
* The spiritual variable refers to spiritual beliefs and influences

Answer 9

Client System

Question 10

The __________ is developed unconsciously by the client to express system
wholeness symbolically.
* Its purpose is to provide protection for client system functioning and to insulate the client
from stressors.

Answer 10

Created Environment

Question 11

As defined by Neuman, “ . . . internal and external forces surrounding the client,
influencing and being influenced by the client, at any point in time”.

Answer 11

Environment

Question 12

a dynamic and desirable state of bal-ance in which energy exchanges can take
place without disruption of the character of the system, which points toward optimal health
and integrity

Answer 12

• Stability

Question 13

The process of energy conservation that assists system in the progression toward stability
or wellness is negentropy.

Answer 13

• Negentropy

Question 14

System output in the form of matter, energy, and information serves as feedback for
future input for corrective action to change, enhance, or stabilize the system.

Answer 14

• Feedback

Question 15

For the client as a system, ____________ are the matter, energy, and information that
are exchanged between the client and the environment

Answer 15

• Input and Output

Question 16

The client as a system exchanges energy, information, and matter with the environment as
well as other parts and subparts of the system as it uses available energy resources to move
toward stability and wholeness.

Answer 16

• Function or Process

Question 17

A system is open when there is a continuous flow of input and processes, output, and
feedback.
* Stress and reaction to stress are basic components of an open system.

Answer 17

Open System

Question 18

The Neuman Systems Model is a dynamic, open, systems approach to client care originally
developed to provide a unifying focus for defining nursing problems and for understanding
the client in interaction with the environment.
* The client as a system may be defined as a person, family, group, community, or social
issue.
* Clients are viewed as wholes whose parts are in dynamic interaction. The model considers
all variables simultaneously affecting the client system: physiological, psychological,
sociocultural, developmental, and spiritual.

Answer 18

Wholistic Approach