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290 UNIT III Nursing Conceptual Models

Model is used frequently by nurse researchers as a con- adolescent depression (Sinsiri, 2009). Research pre-
ceptual framework, as it lends itself to both quantitative sented at the thirteenth symposium included studies
and qualitative methods. Recent examples of qualitative on the exploration of spirituality and spiritual care in
studies include studies of post-traumatic stress disorder a baccalaureate nursing program in South Carolina
symptoms in emergency nurses (Lavoie, Talbot, & (South, 2011), role stress and eating behaviors among
Mathieu, 2011) and experiences of patients following clergy (Kavanagh-Mannister, 2011), the relationship
mastectomy (Alves, Mourão, Galvão, et al, 2010). between shift work, sleep quality, and body mass
Examples of quantitative studies include investigations index in nurses (Huth, 2011), and colon cancer aware-
on the effect of back massage on relaxation (Walton, ness (Boxer 2011).
2009), the effects of nurse facilitated family participa- Research projects that were reported at previous
tion in the psychological care of critically ill patients symposia (1993 through 2007) are cited in previous
(Black, Boore, & Parahoo, 2011), perceived wellness editions of this chapter.
and stress in early adolescents (Yarcheski, Mahon, The Neuman Systems Model is used extensively to
Yarcheski, et al., 2010), and the effects of coping and provide the conceptual framework for research projects
support groups for reduction of burnout among nurses in the United States and in other countries. Acceptance
(Günüşen & ūstün, 2010). by the nursing research community is clearly evident.
Graduate students frequently use the model for
dissertations and theses. Recent examples include
studies on created environment of registered nursing Further Development
students in Nevada (Elmore, 2010), acculturation and When published initially, the Neuman Systems Model
birth outcomes in Mexican and Mexican-American was described as being at a very early stage of theory
women (Chaponniere, 2010), the relationship be- development (Walker & Avant, 1983). Although the
tween nursing student stress and the perception of diagram itself has remained unchanged, the model has
clinical nurse educator caring (Roe, 2009), neonatal been refined based on its use and further developed
sepsis from peripherally inserted central catheters in subsequent publications (Fawcett, 2001). At least
(Clem, 2010), and the association of various factors of two components have been supported and further
persons undergoing methadone maintenance therapy developed since 2000. Major developments include
(Paicentine, 2010). spirituality (Beckman, Boxley-Harges, Bruick-Sorge,
Earlier research studies using the Neuman Systems et al., 2007; DiJoseph & Cavendish, 2005; Lee, 2005;
Model are reported in previous editions of this chapter. Lowry, 2002) and the concept of created environment
Additional studies using this model are listed in the (Hemphill, 2006).
bibliography at the end of this chapter. Establishing full credibility of the model depends
The Biennial Neuman Systems Model Symposium on extending the development and testing of middle-
provides a rich forum for presentation of research range theory from it. Neuman and Koertvelyessy
(completed and in progress). At the twelfth (2009) identified two theories generated from the model:
and thirteenth (2011) symposia, nurses from the (1) the theory of optimal client system stability, and
United States, Canada, Holland, Thailand, and China (2) the theory of prevention as intervention (Fawcett,
reported on numerous studies that used the model. 1995b). Gigliotti (2011) reports that additional middle-
Research presented at the twelfth symposium in- range theories continue to be derived from the
cluded studies on participation in online support Neuman Systems Model, including the Theory of Ado-
groups by women with peripartum cardiomyopathy lescent Vulnerability to Risk Behaviors, Theory of
(Weinland & Hess, 2009), stressors and coping strate- Well-being, Theory of Maternal Role Stress, and the
gies in adolescents with scoliosis prior to and follow- Theory of Dialysis Decision Making. Further research
ing surgical correction (Zhou, Ye, Zhang, et al., 2009), based on the Neuman Systems Model is needed to
the utility of the Neuman Systems Model as a guide validate the relationship between model concepts and
for psychiatric nursing practice in Holland (Merks, research outcomes (Fawcett & Giangrande, 2002;
van Tilburg, & Lowry, 2009), and factors influencing Gigliotti, 2011).