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284 UNIT III Nursing Conceptual Models

MAJOR CONCEPTS & DEFINITIONS—cont’d

Created Environment time and serves as the standard by which to measure
The created environment is developed uncon- wellness deviation. (Neuman, 2011c, p. 328; see also
sciously by the client to express system wholeness Neuman, 1982, 1989, 1995). Expansion of the nor-
symbolically. Its purpose is to provide protection for mal line of defense reflects an enhanced wellness
client system functioning and to insulate the client state, and contraction indicates a diminished well-
from stressors (Neuman, 2011c, p. 327; see also ness state (Neuman, 2001, p. 322).
Neuman, 1982, 1989, 1995, 2002a).
Flexible Line of Defense
Client System The model’s outer broken ring is called the flexible
The client system is a composite of five variables (phys- line of defense (see Figure 16–1). It is perceived as
iological, psychological, sociocultural, developmental, serving as a protective buffer for preventing stress-
and spiritual) in interaction with the environment. ors from breaking through the usual wellness state
The physiological variable refers to body structure and as represented by the normal line of defense. Situa-
function. The psychological variable refers to mental tional factors can affect the degree of protection
processes in interaction with the environment. The afforded by the flexible line of defense, both posi-
sociocultural variable refers to the effects and influences tively and negatively (Neuman, 2011c, p. 327; see
of social and cultural conditions. The developmental also Neuman, 1982, 1989, 1995, 2002a).
variable refers to age-related processes and activities. Neuman describes the flexible line of defense
The spiritual variable refers to spiritual beliefs and influ- as the client system’s first protective mechanism.
ences (Neuman, 2011c, p. 327; see also Neuman, 1982, “When the flexible line of defense expands, it pro-
1989, 1995, 2002a). vides greater short-term protection against stressor
invasion; when it contracts, it provides less protec-
Basic Structure tion” (Neuman, 2011, p. 322).
The client as a system is composed of a central core
surrounded by concentric rings. The inner circle of Health
the diagram (see Figure 16–1) represents the basic Health is a continuum of wellness to illness that is
survival factors or energy resources of the client. dynamic in nature. Optimal wellness exists when
This core structure “ . . . consists of basic survival the total system needs are being completely met
factors common to human beings,” such as innate or (Neuman, 2011c, p. 328).
genetic features (Neuman, 2011c, p. 327; see also
Neuman, 1982, 1989, 1995, 2002a). Wellness
Wellness exists when all system subparts interact in
Lines of Resistance harmony with the whole system and all system
A series of broken rings surrounding the basic core needs are being met (Neuman, 2011c, p. 329; see
structure are called the lines of resistance. These also Neuman, 1982, 1989, 1995, 2002b).
rings represent resource factors that help the client
defend against a stressor (see Figure 16–1). Lines of Illness
resistance serve as protection factors that are acti- Illness exists at the opposite end of the continuum
vated by stressors penetrating the normal line of from wellness and represents a state of instability
defense (Neuman, 2011c, p. 328). and energy depletion (Neuman, 2011c, p. 329; see
also Neuman, 1982, 1989, 1995, 2002b).
Normal Line of Defense
The normal line of defense is the model’s outer solid Stressors
circle (see Figure 16–1). It represents the adapta- Stressors are tension-producing stimuli that have
tional level of health developed over the course of the potential to disrupt system stability, leading to