Betty Neuman Theory of Nursing

Betty Neuman Theory of NursingThe Betty Neuman Theory of Nursing is known as the Systems Model. The Neuman Systems Model is a unique, open systems-based perspective that provides a unifying focus for approaching a wide range of international health concerns. Being universal in nature, it is open to creative interpretation and is widely used throughout the world as a multidisciplinary, wholistic, and comprehensive guide for excellence in nursing practice, education, research, and administration. Its concepts, processes, and theoretical base are relevant to complement future emerging health care trends and issues.
The Neuman Systems Model provides a comprehensive, flexible, holistic, and sysmtems-based perspective for nursing. This conceptual model of nursing focuses attention on the response of the client sustem to actual or potential environmental stressors, and the use of prumary, secondary, and tertiary nursing prevention interventions for retention, attainment, and maintenan of optimal client system wellness.
- Betty Neuman (1996)
Betty Neuman’s theory incorporated the concept of a whole person and an open system approach. The concept is aimed towards the development of a person in a state of wellness having the capacity to function optimally. The main role of the nurse in her theory is to help a person to adapt with environmental stimuli causing illnesses back to a state of wellness.
Neuman believes that nursing requires a holistic approach, an approach that considers all factors affecting a client’s health. The model sets a structure that depicts the part and subparts of a client as a complete system. This concept provides the nurse to consider that a client’s physical, physiological, pyschological, mental,social,cultural,developmental and spiritual well-being is dynamic. Therefore, a nurse must be able to adjust to meet the individual and unique needs of every client.
Neuman regarded the concept of a person as an individual, family, community or the society. She sees a person as an open system that works together with other parts of its body as it interact with the environment. An open system is characterized presence of an exchange of information and reaction with other factors surrounding a person.
Neuman considers health as dynamic in nature. A person’s health depends upon which state of the health continuum they are in line with, the person maybe in line with the state of wellness or illness. The state of wellness exists when all the part or system of person works harmoniously. Disharmonious system reflects illness as a result of unmet needs of a person. The state of health varies according to the degree of reaction a person has to environmental forces. If a person successfully copes with the environmental influences and is able to maintain adequate level of health, the person can preserve the integrity of all parts of its system.
The environment can be an internal, external and created force that interacts with a person’s state of health. It can alter or improve the systems in which a person exists. These forces are what Neuman termed as the stressors. Stressors are tensions that produce alterations in the normal flow of the environment. These stressors can be:
  • Intrapersonal - occurs within the self and comprises of man as a psychospiritual being
  • Interpersonal – occurs between one or more individual and consists of man as a social being

System Model in Nursing Practice

Client Variables

The clients variables can be one or combination of the following : physiological, sociocultural, developmental and spiritual. These variables function to achieve stability in relation to the environmental stressors experienced by the client.


Lines of Resistance

Lines of Resistance act when the Normal Line of  Defense is invaded by too much stressor, producing alterations in the client’s health. It acts to facilitate coping to overcome the stressors that are present within the individual.


Normal Line of Defense

To achieve the stability of the system, the Normal Line of Defense must act in coordination with the normal wellness state. It must reflect the actual range of response that is normally acted by clients in response to any stressors. It is the baseline in determining the level of wellness of client within the continuum of health.


Flexible Line of Defense

Flexible Line of Defense serve as a boundary for the Normal Line of Defense to adjust to situations that threaten the imbalance within the client’s stability. It expanded the range of normal defense from becoming invaded by the stressors thus increasing its protection.



Stressors are forces that produce tensions, alterations or potential problems causing instability within the client’s system. The importance of identifying the stressors helps nurses to appropriately use actions to address and help solve the produced problem.



Reactions are the outcomes or produced results of certain stressors and actions of the lines resistance of a client. It can be positive or negative depending on the degree of reaction the client produces to adjust and adapt with the situation. Neuman specified these reactions as negentropy or entropy. Negentropy is set towards stability or wellness while Egentropy is set towards disorganizaton of the system producing illness.



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