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Person

The person is a layered multidimensional being. Each layer consists of five person variables or subsystems:

  • Physical/Physiological
  • Psychological
  • Socio-cultural
  • Developmental
  • Spiritual

The layers, usually represented by concentric circle, consist of the central core, lines of resistance, lines of normal defense, and lines of flexible defense. The basic core structure is comprised of survival mechanisms including: organ function, temperature control, genetic structure, response patterns, ego, and what Neuman terms knowns and commonalities. Lines of resistance and two lines of defense protect this core. The person may in fact be an individual, a family, a group, or a community in Neuman's model. The person, with a core of basic structures, is seen as being in constant, dynamic interaction with the environment. Around the basic core structures are lines of defense and resistance (shown diagrammatically as concentric circles, with the lines of resistance nearer to the core. The person is seen as being in a state of constant change and-as an open system-in reciprocal interaction with the environment (i.e. affecting, and being affected by it).

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 extrapersonal stressors which can affect the person's normal line of defense and so can affect the stability of the system.

  • The internal environment exists within the client system.
  • The external environment exists outside the client system.
  • Neuman also identified a created environment which is an environment that is created and developed unconsicously 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)". As the person is in a constant interaction with the environment, the state of wellness (and by implication any other state) is in dynamic equilibrium, rather than in any kind of steady state. Neuman proposes a wellness-illness continuum, with the person's position on that continuum being influenced by their interaction with the variables and the stressors they encounter. The client system moves toward illness and death when more energy is needed than is available. The client system moves 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 actions 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 nurse's perception will influence the care given, then not only must the patient/client's perceptions be assessed, but so must those of the caregiver (nurse). The role of the nurse is seen in terms of degrees of reaction to stressors, and the use of primary, secondary and tertiary interventions.

Neuman envisions a 3-stage nursing process:

  1. Nursing Diagnosis - based of necessity in a thorough assessment, and with consideration given to five variables in three stressor areas.
  2. Nursing Goals - these must be negotiated with the patient, and take account of patient's and nurse's perceptions of variance from wellness
  3. Nursing Outcomes - considered in relation to five variables, and achieved through primary, secondary and tertiary interventions.



Neumans System's Model, written and presented by Patrick Heyman and Sandra Wolfe, University of Florida, April 2000