untitled

284 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration

Stressors

Identified

Classified as knowns

or possibilities, i.e.,

Loss

Pain

Sensory deprivation

Cultural change

Inter

Intra

Extra

Personal

factors

Stressors

More than one stressor

could occur

simultaneously*

Same stressors could vary

as to impact or reaction

Normal defense line varies

with age and development

Basic structure

Basic factors common to

all organisms, i.e,

Normal temperature

range

Genetic structure

Response pattern

Organ strength or

weakness

Ego structure

Knowns or commonalities

Stressor Stressor

Reaction

BASIC

STRUCTURE

ENERGY

RESOURCES

Reconstitution

Could begin at any degree

or level of reaction

Range of possibility may

extend beyond normal line

of defense

Primary prevention

Reduce possibility of

encounter with stressors

Strengthen flexible line

of defense

Inter

Intra

Extra

Personal

factors

Inter

Intra

Extra

Personal

factors

Secondary prevention

Early case-finding and

Treatment of symptoms

Tertiary prevention

Readaptation

Reeducation to prevent

future occurrences

Maintenance of stability

Reaction

Individual intervening

variables, i.e.

Basic structure

idiosyncrasies

Natural and learned

resistance

Time of encounter

with stressor

*Physiological, psychological,

sociocultural, developmental, and

spiritual variables are considered

simultaneously in each client

concentric circle

NOTE:

Interventions

Can occur before or after resistance

lines are penetrated in both reaction

and reconstitution phases

Interventions are based on:

Degree of reaction

Resources

Goals

Anticipated outcome

Flexibl

eLineofDefe

nse

Norm

alLineofDefen

se

Lines

ofResista

nce

Degree of

Reaction

Reconstitu

tion

FIGURE 18–1 The Neuman Systems Model. Original diagram copyright 1970 by Betty Neuman. A holistic view of a dynamic open
client-client system interacting with environmental stressors, along with client and caregiver collaborative participation in promoting an
optimum state of wellness. From Neuman, 1995, p. 17, with permission.