BETTY NEUMAN CREDENTIALS AND BACKGROUND born in 1924 on a farm near Lowell, Ohio.

. Her father was a farmer and her mother a homemaker. Neuman's initial nursing education was completed with double honors at Peoples Hospital School (now General Hospital), Akron, Ohio in 1947 In California, she worked in variety of nursing roles that included hospital staff and head nurse, school nurse, and industrial nurse. She was also involved in clinical teaching in waht is now the University of Southern California Medical Center, LA, in the areas of medical-surgical, communicable disease, and critical care. She had always been interested in human behavior; therefore she attended the University of California at Los Angeles (UCLA) with a double major in public health and psychology. She completed her baccalaureate degree with honors in nursing in 1957 and then helped establish and manage her husband's medical practice. In 1966, she received her master's degree in Mental Health, Public Health Consultation, from UCLA. She received a doctoral degree in clinical psychology from Pacific Western University in 1985. Neuman was a pioneer of nursing involvement in mental health. Neuman and Donna Aquilina were the first two nurses to develop he nurse counselor role within Los Angeles-based community crisis center. She developed her first explicit teaching and practice model for mental health consultation in 1960s, before the creation of her systems model. This teaching and practice model is cited in her first book publication, Consultation and Community Organization Mental Health Nursing in 1971. Neuman designed a conceptual model for nursing in 1970 in response to requests from UCLA graduate students. Neuman first published her model in 1972. She spent the following decade further defining and refining various aspects of the model in preparation for her book, The Neuman Systems Model: Application to Nursing Education and Practice. THEORETICAL SOURCES The Neuman Systems Model is based in general system theory and reflects the nature of living organisms as open system. General system theory states that all elements in a complex organization are in interaction. Within the model, Neuman synthesizes knowledge from several disciplines and incorporates her own philosophical beliefs and clinical nursing expertise, particularlyin mental health nursing. The model draws from Gestalt Theory which describes homeostasis as the process by which an organism maintains its equilibrium, and consequently its health, under varying conditions. Neuman describes adjustment as the process by which the organism satisfies its needs. Many needs exist and each adjustment process is dynamic and continuous. The model is also derives from the philosophical views of deChardin and Marx. Marxist philosophy suggests that the properties of parts are determined partly by the larger wholes within dynamically organized system. With this view,

Neuman confirms that the patterns of the whole influence awareness of the part, which is drawn from deChardin's philosophy of the wholeness of life. Neuman used Selye's definition of stress, which is the nonspecific response of the bosy to any demand made on it. Stress increases the demand for readjustment. This demand is nonspecific; it requires adaptation to a problem, irrespective of the nature of the problem. Therefore, the essence of stress is nonspecific demand for activity. Stressors are the tension - producing stimuli that result in stress; they may be positive or negative. Neuman adapts the concept of levels of prevention from Caplan's conceptual model and relates these prevention levels to nursing. Primary prevention is used to protect the organism before it encounters a harmful stressor. Primary prevention reducing the possibility of encountering the stressor or strengthening the organism to decrease its reaction to the stressor. Seondary and tertiary prevention are used following the organism's encounter with a harmful stressor. Secondary prevention attempts to reduce the effect or possible effect of stressors through early diagnosis and effective treatment or illness symptoms. Tertiary prevention attempts to reduce the residual stressor effects after treatment.

HEALTH CARE SYSTEMS MODEL The model is based on the Persons Relationship to Stress, his Reaction to it and Reconstitution factors that are dynamic in nature. The concern of nursing is to PREVENT STRESS INVASION Person is viewed as an Open System composed of Basic Structure of Energy Resources which includes: Physiologic Psychologic Sociocultural Developmental Spiritual Basic Structure/Central Core -surrounded by 2 concentric boundaries or Rings called Lines Of Resistance which represents the internal factors that AID the person Defend against a Stressor. Lines of Resistance further surrounded by 2 lines of Defense 1. Normal Line of Defense 2. Flexible Line of Defense 1. Normal Line of Defense- persons state of equilibrium or the state of adaptation developed & maintained over time and which is considered normal for the person 2. Flexible Line of Defense- dynamic and can be readily and rapidly changed over a short period of time. - adjusts to situations that threatens the imbalance w/in the clients stability Stressors: Intrapersonal Interpersonal

Extrapersonal FOCUS of Nursing Interventions - keeping or maintaining the stability of the open system which can be carried out on three levels of prevention APPLICATION Very comprehensive model of nsg that outlines the way how Nurses provide HOLISTIC NURSING CARE to pts. Emphasis is on the management of Stress thru adequate understanding of the complex client system. Strong Advocate of Prevention Interventions which is congruent to the aims of modern-day nsg & Hxcare services. It is a MUST that Nurses perform thorough & comprehensive assessment that includes ALL aspects of the Ct.