Theoretical Model Framework
The Neuman Systems Model delivers an approach that is comprehensive, holistic, and system-based (Smith & Parker, 2015). The theory places emphasis on actual or potential environmental stressors and the response of the patient system by primary, secondary, and tertiary nursing prevention intervention (Petiprin, 2016). Interventions focus on patient system wellness retention, attainment, and maintenance. Identification and lessening possible or actual risk factors occurs in primary prevention. Appropriate prioritization of interventions, and reducing the noxious effects of an invading stressor occurs in secondary prevention. Adjustive processes for reconstitution and maintenance factors occurs in tertiary prevention.
The major concepts of the Neuman Systems Model include the human being, environment, health, wellness, illness, basic stricture and energy resources, client variables, flexible line of defense, normal line of defense, and lines of resistance. The human being is considered an open system that has interactions with internal and external forces and stressors of the environment (Gonzalo, 2011). The human is in continuous change shifting towards a dynamic state of system steadiness or towards varying degrees of illness. Factors that affect and are affected by the system is the environment which is a vital arena appropriate to the system and its function. Client variables include the physiological, sociocultural, developmental, spiritual, and developmental and are considered simultaneously and comprehensively in the client system (Smith & Parker, 2015). The flexible line of defense is a protective line that surrounds the normal line of defense. The normal line of defense is developed over time and is an adaptational level of health considered normal for an individual or system. Lines of resistance are activated when stressors enter the normal line of defense and are protection factors (Reed, 1993).
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Specific research approaches that are appropriate for use in this project involve the concept of wellness and the client variables. In this project, psychological factors are greatly considered as being relevant in the individual’s coping and energy preservation. This comprises of lifestyle (motivation, goals, needs, expectation), personality type, coping ability and use of existing resources. In this project, it is comparable to the factors present that can affect degree of burnout. The Neuman Systems model considers the surrounding environment, the need to assess the environment, and the effects of increasing or decreasing stressors. This consideration can result in recognizing the stressful factors leading to nurse burnout and how to remove them appropriately. The Neuman Systems Model focuses on primary prevention of potential health problems. This recognizes preventing possible complications of nurse burnout. In use of secondary prevention for this project, strengthening lines of resistance includes strategies in this project of stress reduction classes; recognition and reward; mentor and buddy programs; and improvement of management and working environment. Tertiary prevention in this project aligns with returning to state of wellbeing following treatment of nurse burnout.
The Neuman Systems Model is centered on an individual’s relationship to stress, response to stress, and reconstitution factors. As the model studies thoughts and feelings of participants, the appropriate method of research is qualitative. Qualitative research seeks answers to a question, systematically uses set of procedures to answer a question, and collects evidence. This method is effective in obtaining specific information relating to culture about values, opinions, behaviors in social context. The goal of the researcher in this method include efforts to access the participants’ feelings thoughts. Qualitative research seeks to recognize why people have feelings or thoughts that might affect behavior (Sutton & Austin, 2015). An appropriate qualitative method for this model is ethnography. Ethnography is the study of behaviors, social interactions, and perception within groups, organizations, teams, and communities (Reeves, Huper, & Hodges, 2008). The goal in ethnography is to provide holistic insights of people views and actions. Additional qualitative method for this model include participant observation, in-depth observation, and focus group. Participant observation allows researchers to assess nonverbal expression of feelings thus facilitates a better understanding of behaviors and activities (Kawulich, 2005). In depth interviews collect data on individual’s personal histories. Focus groups help generate broad overviews of concerned issues of a group.
The Neuman Systems Model may be used to evaluate this project of nurse burnout by use of the three lines of defense as indicators. The goal is to prevent participants from reaching the line of resistance which is activated during invasion of a stressor by primary prevention. Evaluation of the project by the Neuman Systems Model may also be completed by use of primary, secondary, and tertiary prevention interventions as indicators. The use of tertiary prevention suggests that secondary prevention interventions have been done to treat present symptoms of burnout. This may show if primary and secondary prevention interventions are effective or ineffective in burnout.
In critiquing how well the Neuman Systems Model fits the project, it is thought as suitable due to as its holistic view point and basis on protecting the environmental factors in relation to state of wellness. The Neuman Systems Model allows prevention and protective interventions to be studied. Flexibility of this model allows consideration of the many areas in nursing. This model can be applied to administrative nurses, hospital nurses, clinic nurses, etc. In addition to that, it is possible to consider the many different factors that lead to burnout. This is achievable by use of the model’s client variables of physiological, sociocultural, developmental and spiritual variables. The aspect of viewing the individual as an open system that responds to stressors in the environment supports the presence of stressors that may lead to burnout. To conclude, the Neuman Systems Model is applicable in this study of interventions to reduce burnout in nurses.
Kawulich, B. (2005). Forum: Qualitative Social Research. Participant Observation as a Data Collection Method Barbara B. Kawulich,6(2).
Petiprin, A. (2016). Systems Theory. Retrieved May 15, 2019, from http://www.nursing-theory.org/theories-and-models/neuman-systems-model.php
Gonzalo, A. (2011). Betty Neuman. Retrieved May 16, 2019, from https://nursingtheories.weebly.com/betty-neuman.html
Reed, K. S. (1993). Betty Neuman: The Neuman systems model. Newbury Park, Calif: Sage Publications.
Reeves, S., Kuper, A., & Hodges, B. D. (2008). Qualitative research methodologies: Ethnography. Bmj,337(Aug07 3). doi:10.1136/bmj.a1020
Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice (Fourth edition.). Philadelphia, PA: F.A. Davis Company.
Sutton, J., & Austin, Z. (2015). Qualitative Research: Data Collection, Analysis, and Management. The Canadian journal of hospital pharmacy, 68(3), 226–231.
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