Enfermeria

INTRODUCTION
* Theorist - Betty Neuman - born in 1924, in Lowel, Ohio.
* BS in nursing in 1957; MS in Mental Health Public health consultation, from UCLA in 1966; Ph.D. in clinical psychology
* Theory was publlished in:
* “A Model for Teaching Total Person Approach to Patient Problems” in Nursing Research - 1972.
* "Conceptual Models for Nursing Practice", firstedition in 1974, and second edition in 1980.
* Betty Neuman’s system model provides a comprehensive flexible holistic and system based perspective for nursing.
DEVELOPMENT OF THE MODEL
Neuman’s model was influenced by:
* 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.
BASIC ASSUMPTIONS
* Each client system is unique, a composite of factors and characteristics within a given range of responses contained within a basic structure.
* Many known, unknown, and universal stressors exist. Each differ in it’s potential for disturbing a client’s usual stability level or normal LOD (Line of Defence).
* The particularinter-relationships of client variables at any point in time can affect the degree to which a client is protected by the flexible LOD against possible reaction to stressors.
* Each client/ client system has evolved a normal range of responses to the environment that is referred to as a normal LOD. The normal LOD can be used as a standard from which to measure health deviation.
* When the flexible LODis no longer capable of protecting the client/ client system against an environmental stressor, the stressor breaks through the normal LOD
* The client whether in a state of wellness or illness, is a dynamic composite of the inter-relationships of the variables. Wellness is on a continuum of available energy to support the system in an optimal state of system stability.
* Implicit withineach client system are internal resistance factors known as LOR, which function to stabilize and realign the client to the usual wellness state.
* Primary prevention relates to G.K. that is applied in client assessment and intervention, in identification and reduction of possible or actual risk factors.
* Secondary prevention relates to symptomatology following a reaction to stressor,appropriate ranking of intervention priorities and treatment to reduce their noxious effects.
* Tertiary prevention relates to adjustive processes taking place as reconstitution begins and maintenance factors move the back in circular manner toward primary prevention.
* The client as a system is in dynamic, constant energy exchange with the environment.
MAJOR CONCEPTS (Neuman, 2002)Content
* the variables of the person in interaction with the internal and external environment comprise the whole client system
Basic structure/Central core
* The common client survival factors in unique individual characteristics representing basic system energy resources.
* The basis structure, or central core, is made up of the basic survival factors which include: normal temp.range, genetic structure.- response pattern. organ strength or weakness, ego structure.
* Stability, or homeostasis, occurs when the amount of energy that is available exceeds that being used by the system.
* A homeostatic body system is constantly in a dynamic process of input, output, feedback, and compensation, which leads to a state of balance.
Degree to reaction
* the amountof system instability resulting from stressor invasion of the normal LOD.
Entropy
* a process of energy depletion and disorganization moving the system toward illness or possible death.
Flexible LOD
* a protective, accordion like mechanism that surrounds and protects the normal LOD from invasion by stressors.
Normal LOD
* It represents what the client has become over time, or...