BEHAVIORAL SYSTEM MODEL

DOROTHY E. JOHNSON

OBJECTIVES

At the end of the lecture, the students will be able to:

a. determine the life and works of Dorothy Johnson.

b. comprehend the Behavioral System Model.

c. scrutinize Johnson’s Behavioral System Model in relation to Nursing's Metaparadigm.

d. verify the application of the theory to the nursing process

e. summarize Johnson’s Behavioral System Model

DOROTHY E. JOHNSON

DOROTHY E. JOHNSON

Born in Savannah, Georgia, in 1919 Finish BSN at Vanderbilt University,

Nashville, Tennessee MPH from Harvard Most of her teaching career was in

Pediatric Nursing at the UCLA She retired as Professor Emeritus,

January 1978

DOROTHY E. JOHNSON

She believed nursing had a body of knowledge reflecting both the science and art

1959 – proposed that knowledge of the science of nursing necessary for effective nursing can included a synthesis of key concepts drawn from basic and applied sciences.

DOROTHY E. JOHNSON

1961 – Johnson proposed that nursing care facilitated the client’s maintenance of a state of equilibrium

She proposed that client’s were “stressed” by a stimulus of either an external or internal nature.

DOROTHY E. JOHNSON

1968 – Johnson first proposed her model of nursing care as the fostering of the “efficient way and effective behavioral functioning in the patient to present illness”

DEFINITION OF NURSING

1980 – developed her Behavioral System Model for nursing from a philosophical perspective “supported by a rich, sound, and rapidly expanding body of empirical and theoretical knowledge”

She defined nursing as “an external regulatory force which acts to preserve the organization and integration of the patient’s behavior at an optimal level under those conditions in which the behavior constitutes a threat to physical or social health or in which illness is found”

4 GOALS OF NURSING

1. Whose behavior is commensurate with social demands

2. Who is able to modify his behavior in ways that support biologic imperatives

3. Who is able to benefit to the fullest extent during illness from the physician’s knowledge and skill

4. Whose behavior does not give evidence of unnecessary trauma

ASSUMPTIONS OF THE BEHAVIORAL SYSTEM

MODEL

1st Assumption– In constructing a behavioral

system, the assumption is made that there is “organization, interaction, interdependency, and integration of the parts and elements of behavior that go to make up the system”

ASSUMPTIONS OF THE BEHAVIORAL SYSTEM

MODEL

2nd Assumption– A system “tends to achieve a balance

among the various forces operating within and upon it, and that man strives continually to maintain a behavioral system balance and steady states by more or less automatic adjustments and adaptations to the natural forces impinging upon him”

ASSUMPTIONS OF THE BEHAVIORAL SYSTEM

MODEL

3rd Assumption– A behavioral system , “which

both requires and results in some degree of regularity and constancy in behavior, is essential to man”

ASSUMPTIONS OF THE BEHAVIORAL SYSTEM

MODEL

4th Assumption– The behavioral system is that the

“system balance reflects adjustments and adaptations that are successful in some way and to some degree”

JOHNSON’S 7 BEHAVIORALSUBSYSTEM

1. Attachment – or affiliative is identified as the first response system to develop in the individual.

allows “social inclusion, intimacy and the formation and maintenance of a strong social bond”

JOHNSON’S 7 BEHAVIORALSUBSYSTEM

2. Dependency –are “succoring” behaviors that precipitate murturing behaviors from other individuals in the environment

result: “approval, attention or recognition, and physical assistance”

JOHNSON’S 7 BEHAVIORALSUBSYSTEM

3. Ingestive – relates to the behaviors surrounding the intake of food

-related to the biological system

4. Eliminative – relates to behaviors surrounding the excretion of waste products from the body

JOHNSON’S 7 BEHAVIORALSUBSYSTEM

5. Sexual – reflects behaviors relate to procreation

6. Aggressive – relates to behaviors concerned with protection and self-preservation-as one that generates defensive responses from the individual when life or territory is threatened.

JOHNSON’S 7 BEHAVIORALSUBSYSTEM

7. Achievement – provokes behavior that attempt to control the environment.

- recognizes intellectual, physical, creative, mechanically and social skills

JOHNSON’S BEHAVIORAL SYSTEM MODEL

Forces Effective

Behavioral and functioning

disorder sress and

adaptation

Ineffective

Feedback

Attachment & affiliation

Elimination

Ingestion

Achievement

Dependency

Sexuality

Aggression

3 FUNCTIONAL REQUIREMENT

“Protected from noxious influences with which the system cannot cope”

“Nurtured through the input of appropriate supplies from the environment”

“Stimulated for use to enhance growth and prevent stagnation”

NURSING’S METAPARADIGM

HUMAN BEINGS

Two major systems:– Biological System –

medicine’s focus– Behavioral System –

nursing’s focus

NURSING’S METAPARADIGM

SOCIETY– Relates to the environment in which the

individual exists.– Influenced by all events in the environment

HEALTH – supports the idea that the individual is attempting to maintain some balance or equilibrium.

NURSING’S METAPARADIGM

NURSING– Primary goal is to foster equilibrium

within the individual, which allows for the practice with individuals at any point in the health-illness continuum

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

Johnson’s Behavioral System easily fits the nursing process model.

Grubbs developed an assessment tool based on Johnson’s seven subsystem, plus a subsystem she labeled “restorative”

JOHNSON’S BEHAVIORAL SYSTEM AND THE NURSING

PROCESS

In assessment phase, questions are related to specific subsystems are developed.

An assessment based on the behavioral subsystems does not easily permit the nurse to gather detailed information about the biological system.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

A diagnosis can be made related to insufficiencies or discrepancies within a subsystems or between subsystems.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

Diagnosis– Insufficiency – a state which exists

when a particular subsystem is not functioning or developed to its fullest capacity due to inadequacy.

– Discrepancy – a behavior that does not meet the intended goal.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

– Incompatibility – the goals or behaviors of two subsystem in the same situation conflict with each other to the detriment of the individual.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

– Dominance – the behavior in one subsystem is used more than any other subsystem regardless of the situation or to the detriment of the other subsystems.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

Planning for the implementation of nursing care should start at the subsystem level with the ultimate outcome of effective behavioral functioning of the entire system.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

Implementations by the nurse present to the client an external force for the manipulation of the subsystem to the state of equilibrium.

JOHNSON’S BEHAVIORAL SYSTEM AND THE

NURSING PROCESS

Evaluation of the result of this implementation is readily possible if the state of balance that is the outcome has been defined during the planning phase before the implementation.

CRITIQUE

1. What is the historical context of the theory?

-Past observational studies and general system theory influenced Dorothy Johnson in the development of her Behavioral System Model.

2. What are the basic concepts and relationships presented by the theory?

-7 behavioral subsystem

-3 functional requirements

CRITIQUE

3. What major phenomena of concern to nursing are presented?-The major phenomenon of concern in Johnson’s work is behavior.

4. To whom does this theory apply? In what situations? In what way?-can be generalized across the lifespan and across cultures

CRITIQUE

5. By what method or methods can this theory be tested?

-It is difficult to test Johnson’s model by the development of hypotheses

6. Does this theory direct critical thinking in nursing practice?

-Decision making for nursing practice using the Johnson’s model would involve critical thinking.

CRITIQUE

7. Does this theory direct therapeutic nursing interventions?

-does not clearly define the expected outcomes when one of the subsystems is being affected by nursing interventions.

8. Does this theory direct communication in nursing practice?

-refers to communication rather than directing

CRITIQUE

9. How contagious is this theory?

-has limited following when compared to Callista Roy and Martha Rogers.

-there is a limited body of literature on the use of the Behavioral System Model in the clinical practice or to provide framework for nursing research.

REFERENCES

-Nursing theories: The Base for Professional Nursing Practice, 5th Edition by Julia George

-Nursing Theorist and Their Work by Aligood

-www.nursingtheory.net