Betty Neuman is a nurse who has developed system for the delivery of holistic health care. The fact that she is both a nurse and a philosopher reflects the thrust of her work and system: the whole patient should be treated rather than just specific symptoms. As such, the spiritual, emotional and general psychological health of the patient needs to be considered rather than merely the clinical symptoms that she presents with. As a site (Patheyman, n.d.) describing the system suggests, "the goal of the model was to provide a holistic overview of the physiological, psychological, socio-cultural and developmental aspects of human beings."
The holistic approach to medicine has, over recent years, received bad publicity because of the extreme claims that some charlatans have made for its successful treatment of disease. Neuman, as a trained and experienced part of traditional modern medicine, does not make these extravagant claims. But her view of the human body as an overall system of which the physical is merely just one part, has been highly influential in the 34 years since her ideas were first published. The basis of her ideas:- that the health of mind and body are closely inter-related, are hardly new: they existed in Classical Greek ideas of medicine that date back to Hippocrates some 3,000 years ago. The manner in which she states these ideas, and the context of a practical nurse and Ph.D. psychologist, gives them a broader range of appeal to and applicability within, the medical community.
Betty Neuman was born near Lowell, Ohio in 1924 and received an RN diploma from a school of nursing in Akron. In her mid-twenties she moved to California and rapidly rose through the ranks of nursing, becoming a head nurse and also a clinical instructor in medical-surgical, critical care and communicable diseases. She received a BS in Nursing from UCLA in 1957, a Master's degree in Mental Health and Public Health Consultation in 1966 from the same university (after which she started to teach her nursing model) and then a Ph.D. in Clinical Psychology in 1985. (Reed, 1993) In 1972 her model was first published in an article titled "Model for Teaching Total Person Approach to Patient Problems". (Neuman, 1972)
This academic biography is key to understanding Neuman's work: the sheer range of her academic development and clinical practice has led to a perhaps unique perspective on healthcare practices. She combines hands-on experience as a nurse with a theoretical and clinical background that make her ideas both practically based and conceptually sophisticated.
The basic concept of the Neuman model is that each person is made up of five different layers, or concentric circles (Neuman, 1972) :
1. Physiological - physiohemical structure and function of the body.
2. Psychological - mental processes and emotions.
3. Sociocultural - relationships, social/cultural expectations and activities.
4. Spiritual - the influence of spiritual beliefs.
5. Developmental - those aspects concerned with lifetime change/development.
These layers need to be considered simultaneously and comprehensively. When a patient first presents himself with a disease, the basic structure, or "central core" (Neuman, 1972) needs to be considered. This core is made up of basic survival factors such as genetic features, the