Betty Neuman’s Systems Model in Nursing


The Neuman systems model proposed by Betty Neuman outlines the system of factors predictive of people’s attitudes and reactions to stressors. The researcher earned her Ph.D. degree in clinical psychology in 1985 and received honorary doctorate degrees from three educational institutions (Neuman Systems Model, Inc., n.d.). Since the start of her career, Neuman has tried different professional roles in research, education, and counseling (Neuman Systems Model, Inc., n.d.). In the 1970s, inspiration from other theories and her own research efforts led to the creation of the Neuman systems model that is still popular today (Neuman Systems Model, Inc., n.d.). By placing the general systems theory in the context of nursing, the model provides valuable ideas concerning wellness promotion.

Theory Analysis

Among the basic concepts that Neuman introduces are stressors or external stimuli that cause negative reactions. Stressors are not the same for different clients, which explains why patient cases should be analyzed individually (Fawcett & Foust, 2017; Lowry & Aylward, 2015). The next concept, a normal line of defense, can be defined as a “normal range of response to external stressors,” helping to distinguish between typical and abnormal reactions to stressors (Lowry & Aylward, 2015, p. 167). This component often acts as the standard of patient wellness, and it can change over time due to the influence of everyday situations (Fawcett & Foust, 2017). Therefore, the model touches upon a broad range of processes that take place when a person is impacted by unwanted events.

The author tries to model a well-developed system in the theory. Thus, in her model, Neuman also introduces the notion of the lines of resistance. They are specific factors that prevent a person from overreacting to stressors, and their key function is to help an individual to maintain emotional stability (Lowry & Aylward, 2015). Then, there is a flexible line of defense that protects and supports the normal line of defense and reduces stress factors’ ability to destabilize the system (Memmott, Marett, Bott, & Duke, 2017).

Apart from that, attention should be paid to the so-called central core, one of the basic components of the model. It can be described as a complex of factors that facilitate survival and provide an individual with energy needed to handle different stressful events (Memmott et al., 2017). As is clear from the way that the term is formulated, the researcher puts a deep meaning in it and structures the entire system around the component.

Apart from the definitions of particular terms coined by Neuman, it is pivotal to consider interactions between the abovementioned components of the system responsible for coping with stress. Based on Neuman’s graphic representation of her model, the mechanism consists of four interdependent elements. The resources of energy at the core of the system are followed by multiple lines of resistance that prevent the misuse of these resources (Fawcett & Foust, 2017; Lowry & Aylward, 2015).

In their turn, these lines are surrounded by the normal defense line that sets limits and displays common and normal reactions to particular stress events (Lowry & Aylward, 2015). The latter is protected and surrounded by the next layer of the system – the flexible line of defense. It cushions the impact of stressors on the entire client system and prevents abrupt changes affecting the normal line of defense (Lowry & Aylward, 2015). Wellness can be achieved when all components work properly and there is no imbalance between the available and required resources.


Judging from the researcher’s biography, the theory is partially relevant to her experience. As a young girl, she understood the importance of nurses since her father had severe health problems and was hospitalized multiple times (Lowry & Aylward, 2015). She studied a lot and developed her own theory to make nursing care more wellness-oriented and effective (Lowry & Aylward, 2015). Thus, basically, the Neuman systems model can be called the researcher’s contribution to improvement in nursing practice.

The discussed model is also relevant to modern healthcare; for instance, Neuman’s theory explains the need for three types of interventions promoting wellness. Primary prevention interventions are needed to maintain the stability of the client system by strengthening the flexible defense line before the emergence of significant stress factors (Fawcett & Foust, 2017). Interventions at the secondary level are required to prevent destabilization following the impact of these stressors (Fawcett & Foust, 2017). They should be followed by tertiary prevention interventions that maintain the previously made progress and help clients to achieve wellness after treatment under professional supervision. Therefore, Neuman’s perspectives align with the goals and philosophy of modern healthcare.

In reference to the patient, the model is extremely significant since it recognizes the diversity of responses to stress. Neuman claims that her theory can be used to construct a client-centered approach to care that addresses a person’s unique experience and reactions to stress (Turner & Kaylor, 2015). According to the first basic perspective presented by Neuman, “each client system is unique” and presents a “composite of innate characteristics” (Lowry & Aylward, 2015, p. 167). Therefore, if the model is applied properly, the selected strategies and interventions will be reflective of the client’s individual problems and difficulties.

The theory is widely discussed in modern research with reference to the ways to adapt it to clients’ specific goals. For instance, in their project, Fawcett and Foust (2017) explore the model’s potential in geriatric nursing with the help of the case study method. According to their conclusions and results, the model promotes optimal aging in different social groups (Fawcett & Foust, 2017). As for practical implications, the researchers state that nurses can use the model to promote wellness when working with older adults without reference to the presence of chronic health issues (Fawcett & Foust, 2017). With that in mind, although the model is not applied universally, its ability to improve the quality of care is recognized by multiple specialists.

As is clear from modern research, Neuman’s theory can lead to positive patient outcomes in populations suffering from severe and long-term diseases. In their clinical study, Ahmadi and Sadeghi (2017) use Neuman’s model to provide a group of patients suffering from multiple sclerosis with nursing care. As for the reported results, the use of nursing interventions constructed with reference to Neuman’s recommendations helped the researchers to consider patients’ individual care needs (Ahmadi & Sadeghi, 2017). Consequently, the researchers recommend the use of the model as a framework for care, especially to help people with poor health (Ahmadi & Sadeghi, 2017). Thus, it can be concluded that the theory has significant potential when it comes to individuals with disabling diseases.


To sum up, the Neuman systems model successfully applies the systems theory to nursing care. Its strong sides include the thoroughly described connections between different components of the client system and consideration given to people’s uniqueness. More than that, the theory can be called practice-oriented since the researcher pays close attention to the role of nursing interventions in patient outcomes. Speaking about its potential limitations, the definitions of some components of the client can be considered ambiguous. It may give rise to questions concerning the objective need for particular components.


Ahmadi, Z., & Sadeghi, T. (2017). Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis. Multiple Sclerosis Journal – Experimental, Translational and Clinical, 3(3), 1-8.

Fawcett, J., & Foust, J. B. (2017). Optimal aging: A Neuman systems model perspective. Nursing Science Quarterly, 30(3), 269-276.

Lowry, L. W., & Aylward, P. D. (2015). Betty Neuman’s systems model. In M. C. Smith & M. E. Parker (Eds.), Nursing theories and nursing practice (4th ed., pp. 165-184). Philadelphia, PA: F. A. Davis Company.

Memmott, R. J., Marett, K. M., Bott, R. L., & Duke, L. (2017). Use of the Neuman systems model for interdisciplinary teams. Online Journal of Rural Nursing and Health Care, 1(2), 58-73.

Neuman Systems Model, Inc. (n.d.). Betty M. Neuman, RN, BSN, MS, PhD, PLC, FAAN. Web.

Turner, S. B., & Kaylor, S. D. (2015). Neuman systems model as a conceptual framework for nurse resilience. Nursing Science Quarterly, 28(3), 213-217.

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NursingBird. "Betty Neuman's Systems Model in Nursing." July 19, 2023.