to assist with model implementation. The nature of
stressors and their threat to the client-client system
are first determined for each type of prevention
before any other nursing actions are initiated.
Global Applications of the Model
Because the model is flexible and adaptable to a
wide range of groups and situations, people have
used the model globally and for more than two
decades. Neuman’s first book,The Neuman Systems
Model: Application to Nursing Education and
Practice,was published in 1982 as a response to re-
quests for data and support in applying the model.
The third edition was published in 1995 in re-
sponse to expanded use of the model globally and
includes applications of the Neuman Systems
Model to nursing education, practice, administra-
tion, and research. This edition is used as a primary
resource for global applications highlighted in this
chapter (Neuman, 1995).
APPLICATION OF THE NEUMAN SYSTEMS
MODEL TO NURSING EDUCATION
Lowry, Walker, and Mirenda (1995) pointed out
that in the 1980s, exploration and use of Neuman’s
model greatly accelerated in education at all levels
of practice and in varied settings. These settings in-
clude the United States and locations such as
Canada, Europe, Australia, and the Far East.
Many schools of nursing in the United States
have chosen to use the Neuman Systems Model as a
curriculum framework or for selected courses.
Most schools surveyed indicated reasons they chose
the Neuman model. These include consistency with
the school’s beliefs; philosophy; and concepts of
humans, health, nursing, and environment. Sixteen
community college and university nursing pro-
grams have used the model. Associate degree nurs-
ing programs that have used the model include
Athens Area Technical Institute, Athens, Georgia;
Cecil Community College, North East, Maryland;
Central Florida Community College, Ocala,
Florida; Los Angeles County Medical Center
School of Nursing, Los Angeles Valley College, Van
Nuys, California; Santa Fe Community College,
Gainesville, Florida; and Yakima Valley Community
College, Yakima, Washington. Baccalaureate nurs-
ing programs that have used the model include
California State University, Fresno; Indiana
University, Indianapolis; Purdue University, Fort
Wayne, Indiana; University of Tennessee; and the
University of Texas, Tyler. Gustavus Adolphus
College and St. Peter and St. Olaf College,
Northfield, Minnesota, also have used the model
(Glazebrook, 1995; Hilton & Grafton, 1995; Klotz,
1995; Lowry & Newsome, 1995; Stittich, Flores, &
Nuttall, 1995; Strickland-Seng, 1995).
Educational programs in the United States re-
ported benefits with using the model. The model
(1) facilitated cultural considerations in the cur-
riculum related to the populations the schools and
graduates served (Stittich, Flores, & Nuttall, 1995),
(2) provided a nursing focus as opposed to medical
focus (Lowry & Newsome, 1995), (3) included the
concept of clients as holistic beings (Lowry &
Newsome, 1995), (4) allowed flexibility in arrange-
ment of content and conceptualization of program
needs (Lowry & Newsome, 1995), (5) was compre-
hensive and facilitated seeing the person as com-
posites of the five variables, (6) provided a
framework to study individual illness and reaction
to stressors, (7) was broad enough to allow educa-
tional programs to consider family as the context
within which individuals live or as the unit of care,
and (8) considered the created environment.
Education programs have developed evaluation
instruments to determine the effects of using the
model as a framework for nursing knowledge. The
curriculum evaluation instrument cited in the liter-
ature is the Lowry-Jopp Neuman Model Evaluation
Instrument. This instrument was developed to ex-
amine the efficacy of using the model at Cecil
Community College (Lowry & Newsome, 1995).
The results of a five-year longitudinal study showed
that the graduates used the model most of the time
when fulfilling roles of care provider and teacher.
All classes in the study claimed colleagues rarely
knew, accepted, or encouraged model use. Therefore,
colleagues in work settings tended to have a nega-
tive effect on the use of models.
The model is also being used internationally.
Craig (1995b) reported on the experiences of 10
educational institutions in Canada in six Canadian
provinces. These institutions include the University
of Saskatchewan, University of Prince Edward
Island, University of Calgary, Brandon University
of New Brunswick, Université de Moncton,
University of Western Ontario, University of
Windsor, Okanagan College, University of Toronto,290 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration