Applying The Neuman Systems Model to Examine Intrapersonal, Interpersonal, and Extrapersonal Influences on Tuberculosis Treatment Adherence: A Mixed-methods Study

Introduction: Nutrition in old age was recognized as a key determinant of well-being and autonomy. Deficiencies and excesses in nutrition coexisted in older adults, with effects on morbidity, functionality, and quality of life. From a systems perspective, Betty Neuman's model allowed for an understanding of the interaction between the individual and the environment, placing prevention and system stability as goals of care. Within this framework, the aim was to describe the quality of dietary practices and identify their main determinants. Development: The study addressed eating habits as a result of interrelated factors: psychological (emotional state, stress), socioeconomic (income, family support, advertising), environmental (accessibility, portion size, eating in company), and physiological (hunger/satiety, senses, age). The quality of the practice was defined as adherence to specific recommendations and needs, incorporating diversity, balance, safety, and affordability. Critical requirements for older adults were reviewed—high biological value proteins, vitamins B12 and B6, calcium, magnesium, fiber, and water—and malnutrition (undernutrition, overweight/obesity, sarcopenia) was characterized. The nutritional assessment included dietary history and anthropometric and functional indicators. Based on Neuman's model, behavior modification and nutrition education strategies were described, along with community actions to improve access and affordability, and the inclusion of adapted physical activity as an adjunct. Conclusions: It was concluded that intervening in the nutrition of older adults required an integrated, person-centered approach based on Neuman's Systems Model. Prioritizing systematic nutritional screening, protein-micronutrient prescription, continuing education with family support, and improvements in the food environment projected benefits on autonomy and quality of life. It was recommended that cost-effectiveness be evaluated and interventions be adapted to local heterogeneities.

This article illustrates the process of theory-based advanced nursing practice by presenting an exemplar of clinical nurse specialist practice using Neuman's systems model and nursing's taxonomies. A brief explanation of Neuman's systems model is given, and the process of assessment, diagnosis, and planned outcomes/interventions is fully described. A clinical example illustrates the entire process.

Biographical Sketch Neuman's Systems Model Origin Neuman's Systems Model Assumptions and Concepts Neuman's Systems Model Nursing and Prevention as Intervention Application to Practice and Research

Preterm infants have increased morbidity and mortality due to immature physiology and neonatal complications. Necrotizing enterocolitis (NEC) is a devastating gastrointestinal complication that affects morbidity and mortality in preterm infants. The authors present an adaptation of Neuman's systems model called the NEC systems model to explore intrinsic and extrinsic factors leading to NEC in preterm infants. The literature was searched for theoretical models to guide exploration of neonatal disease influenced by the environment. Neuman's Systems Model provides a holistic approach to care of the system, offering a foundation to develop frameworks to examine preterm infants in their environment with associated stressors.

Background: The crisis caused by the child's illness and hospitalization affects all family members. Fear, worry, and anxiety are common issues of hospitalized children’s mothers. Betty Newman's system model plays a vital role in adapting to stress detection and control. Objectives: This study aimed to examine the effect of the behavioral systems model on the concerns of mothers of children admitted to the surgical ward. Methods: This quasi-experimental study was conducted on 60 mothers of children admitted to the surgical ward of the Mousavi Hospital, Gorgan, Iran, in 2020. The participants were selected using convenience sampling and then divided into test and control groups using non-probability sampling. According to Neuman's systems model, participants in the test group received nursing care in 3 - 4 sessions (each lasting 30 - 45 minutes). Participants in the control group received only routine ward care. Data were collected using the Parental Concern Scale and analyzed with IBM SPSS Statistics 21 software using statistical tests (analysis of covariance, unpaired samples t-test, and paired sample test). Results: The mean score of maternal concerns before the intervention was 42.6 ± 3.06 in the control group and 43.21 ± 2.27 in the test group. The results of the independent samples t-test did not show any significant difference between the groups in terms of maternal concerns (P = 0.11). The mean post-intervention maternal concern score was 37.6 ± 2.71 and 41.716 ± 2.55 in the test and control groups, showing a significant difference between the groups as indicated by the t-test results (P < 0.01). However, the paired t-test outcomes showed no difference in the mean maternal concern score in the control group before and after the intervention (P = 0.92). In contrast, there was a significant difference in the mean maternal concern score in the test group before and after the intervention (P < 0.01). Conclusions: Given the effectiveness of Betty Neuman’s systems model, it can be used as a low-cost, effective care method to reduce maternal stress as the model was developed for understanding clients’ and caregivers’ needs and reducing their stress.

To present guidelines for a community needs assessment for a Sexual Assault Nurse Examiner (SANE) program using Neuman's Systems Model. The guidelines provide advanced practice nurses with a holistic, systematic means to conduct an assessment prior to the implementation of a SANE program and facilitate collaborative work with other disciplines and agencies. Selected research-based articles on sexual assault, classic texts and writings on Neuman's Systems Model, and community assessment models and programs. Sexual assault is a problem faced by almost every community. A thorough community assessment is an important first step in establishing programs that adequately meet a community's needs. Guidelines for conducting such an assessment related to implementation of a SANE program are rare, and guidelines using a nursing model were not found in the literature. One program that has been successful in meeting community needs is the SANE program. A concise and organized assessment guide can reduce the necessary time and money allocated for a community assessment and can provide a basis for evaluation and research.

The purpose of this study was to explore the structure of variables in studies related to unmarried mothers (UMs) based on Neuman's systems model, and the stressors and stress responses of UMs. Whittemore and Knafl's methodology for integrative reviews was applied. The literature was searched using five electronic databases (KISS, KMbase, KoreaMed, NDSL, and RISS) and a total of 99 variables were collected from 15 studies published between 2009 and 2019. The main stressors for UMs were a sense of loss and burden caused by childbirth and childrearing. The main stress responses were parenting stress and depression, respectively. Within the basic structure of variables related to UMs, self-esteem played a crucial role by helping UMs adapt to their situation. Meanwhile, social support of UMs was significantly correlated with parenting stress, depression, and self-esteem. In order to understand UMs' stress, is necessary to explore their sense of loss, burden, and self-esteem. Furthermore, it is important to assess the level of parenting stress and depression of UMs and to provide effective interventions to alleviate these stressors. The results of this study provide useful knowledge that can be applied to nursing assessment and interventions for stress management in UMs.

Children with medical complexity are an increasing population with frequent use of intensive care services within hospitals. As children's health improves, they are often transferred to a general unit before being discharged to home. This transition often leads to an acute decline in health, resulting in emergent interventions. Betty Neuman's systems model provides the foundation to guide prevention interventions on stress mitigation to promote stability. An evidence-based transition bundle of care may be a valuable tool to prevent stress at the time of transfer from the intensive care unit and prevent deterioration.

The University of Tennessee, Knoxville has established a masters and PhD in nursing with a concentration in homeland security degree to meet the need of advanced nursing expertise to provide nursing care in mass casualty incidents related to natural disasters, accidental exposure to toxic agents, war and terrorism or other threats to the homeland. Homeland security nurses will prepare and execute comprehensive plans for major public health emergencies. Utilizing Neuman's Systems Model, the nursing process and goals of the Department of Homeland Security are compared and contrasted to form the theoretical and practice base for homeland security nursing. An application of homeland security nursing utilizing Neuman's Systems Model is provided.

BackgroundPatients’ beliefs are a major factor affecting tuberculosis (TB) treatment adherence. However, there has been little use of Health Belief Model (HBM) in determining the pathway effect of patients’ sociodemographic characteristics and beliefs on TB treatment adherence. Therefore, this study was aimed at determining the effect of sociodemographic characteristics and patients’ health beliefs on TB treatment adherence based on the HBM concept in Ethiopia.MethodsA cross-sectional study was conducted in Addis Ababa, Ethiopia among TB patients undertaking treatment. Thirty health centres were randomly selected and one hospital was purposely chosen. Six hundred and ninety-eight TB patients who had been on treatment for 1–2 month, were aged 18 years or above, and had the mental capability to provide consent were enrolled consecutively with non-probability sampling technique from the TB registration book until required sample size achieved. Structured questionnaires were used to collect data. Structural equation modelling was employed to assess the pathway relationship between sociodemographic characteristics, patients’ beliefs, and treatment adherence.ResultsOf the 698 enrolled participants, 401 (57.4%) were male and 490 (70.2%) were aged 35 years and below. The mean age of participants was 32 (± 11.7) and the age range was 18–90 years. Perceived barrier/benefit was shown to be a significant direct negative effect on TB treatment adherence (ß = −0.124, P = 0.032). In addition, cue to action (ß = −0.68, P ≤ 0.001) and psychological distress (ß = 0.08, P < 0.001) were shown significant indirect effects on TB treatment adherence through perceived barrier/benefit.ConclusionsInterventions intended to decrease perceived barriers and maximize perceived benefits should be implemented to enhance TB treatment adherence. In addition, it is crucial that counselling is incorporated with the regular directly observed therapy program. Motivators (cue to actions) such as friends, family, healthcare workers, and the media could be used to promote TB treatment adherence.

As dehydration is related to negative health outcomes in the elderly, including an increased risk of disability and death, prevention may help improve health, functional status, and quality of life. Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous. Numerous etiologies place the elderly at an increased risk. The role of the community health nurse (CHN) derives from the responsibilities attached to her, and the Betty Neuman's Systems Model of health care with three levels of protection is usually applied to the CHN. In this mini-review, we try to integrate the Betty Neuman's Systems Model with the results of identified articles. This study includes a literature search of reputable international databases such as SpringerLink, PubMed, Embase, and Wanfang, particularly for the period 2005 to the present. Ten articles that met the qualifying criteria were included in this study. The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.

Neuman's Systems Model was used as a guide to the assessment and intervention for a dysfunctional family. The model gave direction to the selection of family therapy as the appropriate and successful intervention. The case example illustrates the application and use of Neuman's model in child and adolescent nursing practice.

Tuberculosis (TB) remains a major public health issue in Indonesia. Treatment adherence among TB patients is essential and influenced not only by medical conditions but also psychological, social, and environmental factors. This study aimed to identify factors affecting treatment adherence in TB patients at Dr. Yos Sudarso Hospital, Padang. A quantitative, cross-sectional design was used, involving 50 purposively selected patients. Data were collected through structured questionnaires covering demographics, TB knowledge, family support, patient-health worker relationships, drug side effects, and medication adherence levels. Bivariate and multivariate analyses were conducted to determine significant influencing factors. Results showed that most respondents (60%) were aged 26–45 years, had secondary education, and 70% adhered to treatment. Multivariate analysis revealed that good patient knowledge about TB (OR = 4.10; p = 0.018) and strong family support (OR = 3.25; p = 0.032) were significantly associated with better adherence. Drug side effects were noted as a key barrier to consistent medication use. In conclusion, TB treatment adherence at Dr. Yos Sudarso Hospital is shaped not only by individual patient factors but also by family support, treatment experiences, and interactions with healthcare providers. Improving adherence requires continuous, tailored education based on patient literacy levels, involving families as treatment companions, and effectively managing side effects.

Necrotizing fasciitis (NF) is a rare yet life-altering infection. Disfigurement and death ensue without accurate diagnosis and treatment. Educational awareness can assist nurses to advocate for differential diagnosis, immediate treatment, and plan of care. This article examines the experience of a mother with NF, application of Neuman's Systems Model (NSM) to address her healing needs, and nursing practice guided by one's personal worldview. NSM was chosen because it is holistic and concise and can be utilized from a Christian perspective.

Tuberculosis (TB) is a major cause of morbidity globally. Regardless of the efforts to combat the disease, poor treatment adherence has resulted in treatment failure. As such, there is increased community transmission of TB, resulting in a persistently high burden of disease. In this baseline cross-sectional study, the aim was to determine the level of TB treatment adherence and the effect of family support on adherence. Adherence was assessed using a 6-item Medication Adherence Rating Scale (MARS). A total of 147 TB patients were enrolled. Two in three (65.3%, 95% CI 57.6–73.0) of the patients had a high level of adherence. Forms of actual family support, including medication reminders, encouragement, and emotional support, were significantly associated with adherence (p < 0.05). Having no caregivers and missing refill appointments were associated with poor average adherence scores (p < 0.0001). The level of perceived family support moderated the effect of actual family support on adherence (p < 0.05). The findings underscore the significance of both tangible and perceived family support in improving TB treatment adherence. There is a high need to integrate the family support dimensions into TB care. Patients’ perceptions regarding family support should inform the design and implementation of adherence-promoting interventions.