untitled

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

Inter

Intra

Extra

Personal

factors

Primary prevention

Reduce possibility of

encounter with stressors

Strengthen flexible line

of defense

Secondary prevention

Early case-finding and

Treatment of symptoms

Tertiary prevention

Readaptation

Reeducation to prevent

future occurrences

Maintenance of stability

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

Stressors

Identified

Classified as knowns

or possibilities, i.e.,

Loss

Pain

Sensory deprivation

Cultural change

Inter

Intra

Extra

Personal

factors

Stressor Stressor

Line

sofResistan

ce

Nor

malLineofDefens

e

Flexibl

eLineofDefe

nse

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

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

ENERGY

RESOURCES

FIGURE 18–3 Environment. Internal and external factors surrounding the client-client system. From Neuman, 1995, p. 27, with permission.

FIGURE 18–4 Nursing. Accurately as-

sessing the effects and possible effects

of environmental stressors (inter-, intra-,

and extrapersonal factors) and using

appropriate prevention by interventions

to assist with client adjustments for an

optimal level of wellness. From

Neuman, 1995, p. 29, with permission.