Betty Neumans

Systems Model
Health is a condition
in which all parts and
subparts are in
harmony with the
whole of the client.
METAPARADIGM
 Person
an open system that works together with other
parts of its body as it interact with the environment

a dynamic composite of the interrelationship of five

variables: (1.) physiological, (2.) psychological, (3.)
sociocultural, (4.) developmental, and (5.) spiritual

has protective mechanisms for the basic structure,

and maintains clients system stability: (1.) flexible
line of defense, (2.) normal line of defense, and (3.)
lines of resistance
 Flexible Line of Defense

Normal Line of Defense

CORE
CORE Lines of Resistance
 Health
dynamic condition

equated with stability of normal line of

defense

Wellness exists when all the part or

system of person works harmoniously
 Health

ny Sta
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a rm it y
H
Flexible Line of Defense

Normal Line of Defense

CORE
CORE Lines of Resistance
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 Environment
can be internal, external, and created
force (stressors) that interacts with a
persons state of health

has the potential to alter or improve

stability of systems
 Interpersonal S
S
Intrapersonal T
T
Extrapersonal R
R
E
E Flexible Line of Defense
S
S Normal Line of Defense
S
S CORE
CORE
Lines of Resistance
O
Interpersonal
O
R
R Intrapersonal
S
S Extrapersonal
 Nursing
a unique profession hat requires
holistic approach considers all
factors affecting a clients health

aims to promote optimal wellness to

its client through retention,
attainment, or maintenance of the
stability of clients system
 Nursing (cont.)
nurse helps the different levels of
clientele: individual, family, and groups in
achieving and maintaining an optimal
wellness through intervention with the
goal of reducing stress factors and its
adverse effects to the optimal functioning
of an individual in any given situation

nursing consists of intervention

modalities of prevention which can be:
(1.) primary, (2.) secondary, (3.) tertiary
 Health

ny Sta
o bil
a rm it y
H
Flexible Line of Defense
(Primary Prevention)
Normal Line of Defense
(Secondary Prevention)

CORE
CORE Lines of Resistance
(Tertiary Prevention)
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Health s
 Once an individual is exposed to stress,
the flexible line of defense will be alarmed
to protect the normal (solid) line of defense to
keep the system free from stressor reactions.
However, if this individual is continuously
exposed to stress and if the flexible line of
defense is unable anymore to cope up with the
stressors, the normal line of defense will be
altered. If this happens, there will be a threat
to the wall that protects the basic structure of
the individual and therefore causing instability
of the systems and illness develops.
 Flexible Line of Defense

Normal Line of Defense

STRESSORS
CORE
CORE
Lines of Resistance

(Intrapersonal, Interpersonal,
Extrapersonal)

ILLN ESS
 Sample Situation:

Mr. Yoso is a 38 year-old business executive.

His colleagues describe him as hard working,
perfectionist, and very dedicated to work. His
day starts by leaving the house very early from
Laguna to Makati and begins work by delegating
various tasks with firm expectations and
deadlines that somewhat impossible to meet. He
usually responds with pressure and intimidating
remarks for works not perfectly done. He smokes
and drinks alcohol whenever he is stressed.
Recently, the company experienced continuous
dropped in their sells and his bosses started to
put blame to him.
continuation
Mr. Yoso began exhibiting weird mannerisms and
behaviors that appear strange to his family and
people around him. He misses breakfast and lunch
very often and sleeps very late at night while doing
work. He has no time anymore for his family and
focuses to hard on meeting deadlines and his
preconceived objectives. Because of these weird
changes in him, the company decided to temporarily
relieve him from his position as executive manager.
A week later, he started to have periods of mania
and depression. His family becomes worried and
called up the hospital to seek assistance after he
locked himself in the room, refusing to eat, and most
of the time quiet and staring blankly on the wall.
Later, he developed pneumonia.
Using Neumans System Model in the above
situation, the identified possible stressors
that contributed to Mr. Yosos condition
were as follows: work, personality, and
attitude. Mr. Yoso is not anymore able to
handle the stressors and that had caused
the breakdown of his lines of defense.
Without seeking help from his family and
friends, he was not able to maintain his
flexible line of defense and brought
instability to his system. (The diagram on
the next page shows the effect of the
stress in his lines of defense and the
corresponding prevention that might have
or may be done to prevent illness/or
complications from occurring.)
Primary Prevention:
Stress management activities Tertiary Prevention
Relaxation techniques Re-assessing patients ability to
Anger-management techniques independently perform and
Smoking cessation maintain variables of health.
Regular consult to psychologist.
Maintaining clients support
system
Effects on Flexible Line of Defense:
sleeps very late at night
misses breakfast and lunch
responds with pressure and
intimidating remarks for works not
perfectly done Effects on Lines of
smokes and drinks alcohol whenever
he is stressed CORE
CORE Resistance:
weakened immune
response
developed pneumonia
Work-related stressors

Effects on Normal Line of Secondary Prevention

Defense: Medication (to treat
exhibiting weird mannerisms
symptoms)
and behaviors
periods of mania and Opportunities to
depression verbalize feelings and
concerns
Health is a condition
in which all parts and
subparts are in
harmony with the
whole of the client.
Thank you!!!