Page 304 - alligood 8th edition_Neat

CHAPTER 16 Betty Neuman 285

MAJOR CONCEPTS & DEFINITIONS—cont’d
an outcome that may be positive or negative. They but the degree of risk is known. The purpose is to
may arise from the following: reduce the possibility of encounter with the stressor
n Intrapersonal forces occurring within the indi- or to decrease the possibility of a reaction (Neuman,
vidual, such as conditioned responses 1982, p. 15; 2011c, p. 328)
n Interpersonal forces occurring between one or
more individuals, such as role expectations Secondary Prevention
n Extrapersonal forces occurring outside the indi- Secondary prevention involves interventions or
vidual, such as financial circumstances (Neuman, treatment initiated after symptoms from stress have
2002b, p. 324; see also Neuman, 1982, 1989, 1995). occurred. The client’s internal and external resources
are used to strengthen internal lines of resistance,
Degree of Reaction reduce the reaction, and increase resistance factors
The degree of reaction represents system instability (Neuman, 1982, p. 15; see also Neuman, 2011c,
that occurs when stressors invade the normal line of p. 328).
defense (Neuman, 2011c, p. 327; see also Neuman,
1982, 1989, 1995, 2002a). Tertiary Prevention
Tertiary prevention occurs after the active treat-
Prevention As Intervention ment or secondary prevention stage. It focuses on
Interventions are purposeful actions to help the cli- readjustment toward optimal client system stabil-
ent retain, attain, or maintain system stability. They ity. The goal is to maintain optimal wellness by
can occur before or after protective lines of defense preventing recurrence of reaction or regression.
and resistance are penetrated. Neuman supports Tertiary prevention leads back in a circular fash-
beginning intervention when a stressor is suspected ion toward primary prevention (Neuman, 2011c,
or identified. Interventions are based on possible or p. 328; see also Neuman, 1982).
actual degree of reaction, resources, goals, and an-
ticipated outcomes. Neuman identifies three levels Reconstitution
of intervention: (1) primary, (2) secondary, and (3) Reconstitution occurs after treatment for stressor
tertiary (Neuman, 2011, p. 328; see also Neuman, reactions. It represents return of the system to sta-
1982, 1989, 1995). bility, which may be at a higher or lower level of
wellness than before stressor invasion (Neuman,
Primary Prevention 2011c, p. 328).
Primary prevention is used when a stressor is sus-
pected or identified. A reaction has not yet occurred,

has produced sound empirical evidence in support of Neuman (1995) states that the perceptual field of the
the Neuman Systems Model (Figure 16–1). caregiver and the client must be assessed.
Person
Major Assumptions
Neuman presents the concept of person as an open
Nursing client system in reciprocal interaction with the envi-
Neuman (1982) believes that nursing is concerned with ronment. The client may be an individual, family,
the whole person. She views nursing as a “unique pro- group, community, or social issue. The client system is
fession in that it is concerned with all of the variables a dynamic composite of interrelationships among
affecting an individual’s response to stress” (p. 14). The physiological, psychological, sociocultural, develop-
nurse’s perception influences the care given; therefore, mental, and spiritual factors (Neuman, 2011b, p. 15).