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CHAPTER 16 Betty Neuman 291

The Neuman Systems Model Trustee Group was states that the concepts can be separated for analysis,
established in 1988 to preserve, protect, and perpetu- specific goal setting, and interventions (B. Neuman,
ate the integrity of the model for the future of nursing personal communication, June 21, 1992). This model
(Neuman, 2011d). Its international members, person- can be used to explain the client’s dynamic state of equi-
ally selected by Neuman, are dedicated professionals. librium and the reaction or possible reaction to stress-
The Neuman Systems Model Research Institute has ors. The concept of prevention as intervention can
been organized to generate and test middle-range be used to describe or predict nursing phenomena.
theories derived from the model. Preliminary work The model is complex; therefore, it cannot be described
that has been completed includes assembling as being simple, yet nurses using the model describe it
resources, identifying concepts and the relationships as easy to understand and it is used across cultures and
among them, and synthesizing existing research in a wide variety of practice settings.
based on Neuman Systems Model concepts (Gigliotti,
2003). The Research Institute offers grants and fellow- Generality
ships to deserving researchers in an effort to promote The Neuman Systems Model has been used in a wide
the use of the model and work in generating middle- variety of nursing situations; it is both comprehensive
range theories from the model, and also offers consul- and adaptable. Some concepts are broad and represent
tation services regarding the use of the model in the phenomenon of “client,” which may be one person
nursing research (Gigliotti, 2011). or a larger system. Other concepts are more definitive
and identify specific modes of action, such as primary
prevention. The model’s systematic broad scope allows
Critique it to be useful to nurses and to other health care pro-
Neuman developed a comprehensive conceptual model fessionals in working with individuals, families,
that operationalizes systems concepts that are relevant groups, or communities in all health care settings.
to the breadth of nursing phenomena. The model’s Health professionals beyond nursing use the model
wholistic perspective allows for a wide range of creativ- as a framework for care because its wholistic perspec-
ity in its use. It remains relevant for use by nursing and tive accommodates varied approaches to client assess-
by other health care professions in the future. ment and care. Its systems approach and its emphasis
on involving the client as an active participant fit well
Clarity with contemporary health care values such as preven-
Neuman presents abstract concepts that are familiar tion and interdisciplinary care management.
to nurses. The model’s essential concepts of client,
environment, health, and nursing are congruent with Accessibility
traditional understanding of the nursing metapara- The model has been tested and is used extensively to
digm. Concepts defined by Neuman and those bor- guide nursing research. Early work (Hoffman, 1982;
rowed from other disciplines are used consistently Louis and Koertvelyessy, 1989) provided initial docu-
throughout the model. However, the model’s clarity mentation of empirical support. Continued testing
has been criticized in that concepts need to be defined and refinement through the work of the Research
more completely (August-Brady, 2000; Heyman & Institute and independent nurse researchers increase
Wolfe, 2000). the model’s empirical precision as research continues
and findings from multiple studies are synthesized
Simplicity (Gigliotti, 1999, 2003, 2011; Skalski, DiGerolamo, &
The model concepts are organized in a complex yet Gigliotti, 2006).
systematically logical manner. Multiple interrelation-
ships exist among concepts, and variables overlap to Importance
some degree. Distinctions between concepts tend to Neuman’s conceptual model includes guidelines for the
blur at several points, but loss of theoretical meaning professional nurse for assessment of the client system,
would occur if they were separated completely. Neuman utilization of the nursing process, and implementation