Introduction The University of California, San Francisco (UCSF) School of Nursing created Systems Management Theory (SMT) in 1994. The conceptualization at that time was based on models developed by nurses such as Orem's self-care model (Humpreys, 2008). There are three dimensions that make up SMT which include symptom experience, symptom management strategies, and symptom status outcomes (Newcomb, 2010). These dimensions are interrelated and integrated into the underlying nursing domains (Newcomb, 2010). According to the author, with appropriate modifications, this theory could be adapted to the pediatric population. Evidence-based practice was used to strengthen the original theory in 2001 and make it relevant to pediatrics. SMT is constantly being revised to include components tested and proven effective to achieve the best possible patient outcomes. Three Dimensions and Modifications Originally, traditional theory consisted of symptom experience, symptom management strategies, and symptom state findings. Perceiving, evaluating, and responding are integral and initial components of the system experience. Dimensions are linear with the previous dimension directing the next one. While this approach was effective for adult populations, it was too basic when applied to pediatric populations. Improvements were needed because “…the current SMT model…does not capture the idea that psychological, social, emotional, spiritual, or physical growth occurs in every significant event in a child's life.” (Newcomb, 2010) Noncompliance on the part of children and their caregivers is another weakness. Management strategies cannot be evaluated for effectiveness and adapted appropriately to achieve optimal outcomes. Additionally, com...... half of document ......imate communication between children, parents or caregivers, and healthcare providers to validate symptom experiences and ensure the best outcomes for patients. Ideally, patient and healthcare provider education is a crucial aspect of treatment. The author compares the SMT to a spiral to illustrate how these three dimensions evolve with each other through additional concepts. ReferencesHumphreys, J., Lee, K.A., Carrieri-Kohlman, V., Puntillo, K., Faucett, J. (2008). Symptom management theory. Medical Sciences - Nursing and Nursing, 8, 1-9. Linder, L. (2010). UCSF Symptom Management Theory Review: Implications for Pediatric Oncology Nursing. Journal of Pediatric Oncology Nursing, (27), 316-324.Newcomb, P. (2010). Using symptom management theory to explain how nurses care for children with asthma. Journal of theory building and testing , 14(2), 40-44.