Application of Betty Neuman
Theory
Presented by:
“Neuman’s
conceptual model of
nursing, the system
model, focuses on
the wellness of the
client system in
relation to
environmental stress
& reactions to stress.”
NURSING
Nusing is to define the appropriate action in
suitations that are stress releated or in relation
to possible reactions of client system to the
stress.
The major concern of nursing is to help the
client system attain, maintain or retain system
stability.
Theory applied to management of patient
care
Medicine
Surgery
Mental health
Women’s health
Pediatric nursing
Community as client
An Assessment and
Intervention Tool
A. Intake Summary
1.Name _______________
Age _________________
Gender
__________________
Marital Status __________
2. Referral source and related
information_______________
Cont….
B. Stressors as Perceived by Client
C. Stressors as Perceived by Caregiver
D. Intrapersonal Factors
E. Interpersonal Factors
F. Extrapersonal Factors
G. Formulation of a Comprehensive Nursing
Diagnosis
Stressors as perceived by client
What do you consider your major stress areas ?
How do present circumstances differ from usual life
pattern?
Have you ever experienced the similar problem? If so,
what was the problem and how did you handle it?
Were you successful?
What do you anticipate for future as consequence of
your present situation?
What can you do to help your self?
What do you expect caregivers, family,f riends or
others to do for you?
Stressors as perceived by caregiver
What do you consider to be major concern areas ?
How do present circumstances seem to differ from the
client’s usual life pattern?
Has the client ever experienced a similar problem? If
so, how would you evaluate? What the client did?
What do you anticipate for future as consequence of
your present situation?
What can a client do to her self?
What do you think the client expect from caregivers,
family,f riends or others to do for you?
Intrapersonal Factors
1. Physical
2. Psycho-socio cultural
3. Developmental
4. Spiritual belief system
Interpersonal Factors – occurs between one or more
individual and consist of man as social being
Extra personal Factors – occurs outside the individual
and may include environmental factors
Based on through assessment and with
●
Diagnosis consideration given to five variables in three
stressor areas
Caregiver – clients negotiation of intervention
●
Goals strategies to retain, attain or maintain system
stability
In relation to five variables and achieved
●
Implementation through primary, secondary and tertiary
interventions
The anticipated or desired change has
●
Evaluation occurred if it not met goals are reformed
Case Study Using the
Neuman Systems Model
Intake Summary
Name: Simran
Gender:35 years
Sex: Female
Marital Status: Married
Referral Source: Self-
referred
A. Stressors as Perceived by
Client
1. Major stress areas or areas of concern:
a. Found out 2 weeks ago is 2 months pregnant – here
for prenatal visit
b. First child is 11 months old, wants another child,
ambivalent about the timing of this pregnancy
2. Life-style patterns
a. Cares for home and daughter
b. Active in Temple
c. Participates in community groups related to
parenting
d. Has supportive family and friends
e. What is different now? – experiencing nausea and
fatigue
3. Ever experienced similar
problem?
a.The nausea and fatigue are similar to the first
pregnancy
b. What helped then – crackers and lying down helped
some; primarily just suffered through it
4. Anticipators for the future
a. Concerns about how to maintain a healthy
pregnancy and care for an active toddler
b. Also anticipating the demands of caring for two
children under the age of two
5. What is she doing to help herself?
a. Talking with friends and family about their
experiences
b. Reading articles and books on childbearing and
childrearing
c. “I need to lower my expectations of myself and try
not to do so much – for me that’s HARD!”
6. What is expected of others?
a. Family is visiting around the time the baby is due
and will help with the children and the house
b. Husband is doing more of the cooking and helping
keep the house clean
B. Stressors as Perceived by
Caregiver
1. Major stess area
a. History of premature delivery
b. Type A personality who has difficulty relaxing
2. Present circumstances differing
from usual pattern of living
a. Fatigue and nausea of pregnancy
b. Dealing with anticipation concerns about
expanding family
3. Client’s past experience with similar situation?
a. Experienced with nausea and fatigue of pregnancy
b. Not experienced in having 2 children under 2
4. Future anticipations
a. Client is capable of handling the situation – will
need support and encouragement to do so
5 What client can do to help
herself?.
a. Use her support systems
b. Concentrate on getting needed rest
c. Remember that goal is a healthy child and things
can be done later
6. Clients expectations of family,
friends, and caregivers
a. Accurate information
b. Support and encouragement
c. A listening ear
C. Intrapersonal Factor
1. Physical
2. Psycho-sociocultural
3. Developmental
4. Spiritual belief system
1. Physical
a. Height: 5 feet, 5 inches
b. Weight: 55 kg (no change from pregnancy weight)
c. TPR 98.4 F, 76, 12
d. B/P 118/76
e. Urine negative for sugar and albumin
f. Care – perform all activities of daily living for self
and toddler
Physical cont….
g. Is current with all immunizations
h. Sleeps 7 to 8 hours per night
i. Does not smoke or ingest alcohol
j. Follows a low fat, balanced diet; usually 3 meals per
day
k. Reports experiencing nausea and fatigue – a major
stressor at this time
2. Psycho-socio cultural
a. 35-year-old female, married
b. Caucasian
c. Holds a masters degree in communications
d. Sometimes concerned about feeling isolated – likes
to have lots of friends and best friend will be moving
in 6 to 12 months
Psycho-sociocultural
e. Lives in own home
f. Fluent in English and Spanish
3. Developmental
a. “I have demonstrated my ability to be a good
mother – that is reassuring that I can meet this new
challenge.”
b. “How am I going to find the time to do everything?”
4. Spiritual belief system
a.This is an area of support, not an area of concern
b. Active at temple, regular attendance is important
c. Has personal holly book study daily
D. Interpersonal Factors
1. Has supportive family and friends
2. Often speaks on the phone to family and friends,
has lunch with friends regularly
3. Shares toddler play days with friends
4. Concerned about having 2 children under 2 in the
house
D. Interpersonal Factors
5. Is working on a project at church to improve the
nursery program
6. Cannot rest at with toddler at home – this is
different than with first pregnancy so previous coping
responses are not as effective
7. Will try to interests toddler in quiet activities on the
days she is really tired
8. Husband can work at home some days and help
with the toddler
E. Extrapersonal Factors
1. Community lacks good day care programs/facilities
for toddlers so there is no real community support for
when she needs a respite from child care
2. Health care for all family members is readily
available
F. Formulation of a Comprehensive
Nursing Diagnosis:
1. Nursing Diagnoses
a. Nausea and fatigue related to pregnancy
b. Lack of knowledge related to parenting two under
the age of two
2. Goals (desired outcomes)
a. Manage nausea and fatigue
i. Primary – Normal line of defense has been invaded
– is having symptoms
ii. Secondary – Plan daily activities to include rest
periods when toddler naps; explore types of foods and
eating patterns that decrease nausea
iii. Tertiary – Continue to encourage rest whenever
possible; husband helps out as he can; plan daily
intake of appropriate nutrients; keep a journal listing
daily plans to demonstrate ability to plan less for each
day
b. Lack of knowledge about parenting
two under two
i. Primary – Discuss current parenting strategies with
husband, friends, family, caregiver and explore how
these strategies may be adapted caregiver encourages
discussion with friend who has two small children and
works full time
ii. Secondary and Tertiary – Not needed as yet; flexible
and normal lines of defense have functioned
effectively
4. Evaluation
simran delivered a healthy 3 kg boy at 38-weeks
gestation after a pregnancy she described as “much
better than I thought it would be.”
Husband/father and older daughter are delighted with
the new baby.
THANK YOU
