Copyright © 2015. F.A. Davis CompanyChapter 7Doroth.docx

Copyright © 2015. F.A. Davis Company
Chapter 7
Dorothy Johnson’s Behavioral System Model and Its
Applications
Developed by Bonnie Pope, and S. Gordon (2010)
Updated by D. Gullett (2014)
*
On completion of this chapter, students will be able to:
Discuss paradigmatic origins of Johnson’s Model
Discuss the five core principles of Dorothy Johnson’s
Behavioral Systems Model.
Identify the eight subsystems of Dorothy Johnson’s Behavioral
Systems Model and discuss their interrelationship.
Describe Johnson’s definition of person, environment, health,
and nursing.
Discuss the role of the Behavioral Systems Model in nursing
practice, administration, research, and education.
*

Introducing the Theorist Dorothy JohnsonBorn August 21, 1919,
in Savannah, GeorgiaServes as faculty member Vanderbilt
University School of NursingUCLA 1949–1978Died in 1999
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EducationEarned an Associates in Arts Degree from Armstrong
Junior College in Savannah, Georgia in 1938 Earned a Bachelor
of Science in Nursing degree from Vanderbilt University in
1942.Earned a Master of Public Health degree from Harvard in
1948
*
Johnson Behavioral System Model (JBSM) OverviewEvolved
from philosophical ideas, theory, and research; her clinical
background; and many years of thought, discussions, and
writing Influences:Florence NightingaleSystems
theoryDevelopmental theory
*

Five Core PrincipalsWholeness and
OrderStabilizationReorganizationHierarchic
InteractionDialectical Contradiction
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Wholeness and Order
Developmental analogy of wholeness and order is continuity
and identity.Continuity and change can exist across the life
span.Continuity is in the relationship of the parts rather than in
their individuality.
*
StabilizationDynamic systems respond to contextual changes by
either a homeostatic or homeorhetic process.Set point
maintained by altering internal conditions to compensate for
changes in external conditions.Nurses act as external
regulators.Monitor patient response, looking for successful
adaptation to occur. Nurses intervene to help patient restore
behavioral system balance.Intervention is not needed if
behavioral system balance returns.
*

Reorganization
Occurs when the behavioral system encounters new experiences
in the environment that cannot be balanced by existing system
mechanismsNurse acts to provide conditions or resources
essential to help the accommodation process:May impose
regulatory or control mechanisms to stimulate or reinforce
certain behaviorsMay attempt to repair structural components
*
Hierarchic Interaction
Hierarchies, or a pattern of relying on particular subsystems,
lead to a degree of stability.
*
Dialectical Contradiction
Motivational force for behavioral changeDrives/responses
developed and modified over time through maturation,
experience, and learningEnvironmental domains that the person
is responding to include the biological, psychological, cultural,
familial, social, and physical setting
*

Dialectical Contradiction (continued)
Faced with illness or the threat of illness, the person needs to
resolve (maintain behavioral system balance of) a cascade of
contradictions between goals related to: Physical status, social
roles, and cognitive status. Nurses’ interventions: Focus on
restoring behavioral system balance Leading to a new level of
development
*
Major Concepts of the ModelPersonSubsystemsHealthNursing
and nursing therapeutics
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PersonViewed as an open system with organized, interrelated,
and interdependent subsystems. The whole of the human
organism (system) is greater than the sum of its parts
(subsystems).Wholes and parts create a system with dual
constraints: Neither has continuity and identity without the
other.Nursing client viewed as a behavioral systemBehavioral
systems are orderly, repetitive, and organized

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Human Behavior IsOrderly, purposeful, and
predictableFunctionally efficient and effective most of the
timeSufficiently stable and recurrent to be amenable to
description and exploration
*
Subsystems
Are parts of the behavioral system Carry out specialized
tasks/functions needed to maintain the integrity of the whole
system Manage system relationship to the environmentHave a
set of behavioral responses that are developed and modified
through motivation, experience, and learning
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Each Subsystem Is composed of at least four structural
components that interact in a specific
patternGoalSetChoiceAction
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GoalThis is defined as the desired result or consequence of the
behavior. The basis for the goal is a universal drive whose
existence can be supported by scientific research.
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Behavioral SetIs a predisposition to act in a certain way in a
given situation Represents a relatively stable and habitual
behavioral pattern of responses to particular drives or stimuli
Represents learned behavior and is influenced by knowledge,
attitudes, and beliefs
*
Behavioral Set Components
Perseveration Consistent tendency to react to certain stimuli
with the same pattern of behaviorPreparationFunctions to
establish priorities for attending or not attending to various
stimuli
*

Choice
Refers to the individual’s repertoire of alternative behaviors in
a situation that will best meet the goal and attain the desired
outcome. The greater the behavioral repertoire of alternative
behaviors in a situation, the more adaptable the individual.
*
ActionObservable action of the individualConcern is with the
efficiency and effectiveness of the behavior in goal
attainment.Actions are observable responses to stimuli.
*
The Johnson Model ProposesFor behavior to be maintained, it
must be protected, nurtured, and stimulated.Protection from
noxious stimuli that threaten the survival of the behavioral
systemNurturance, which provides adequate input to sustain
behaviorStimulation to continue growth of the behavior and
counteracts stagnation
*

The Johnson Model (continued)Deficiency in any or all of these
functional requirements Threatens the behavioral system as a
whole or the effective functioning of the particular subsystem
with which it is directly involved.
*
Health Behavioral system balance or stabilityDemonstrated by
observed behavior that is purposeful, orderly, and
predictable.Behavior maintained when it is efficient and
effective in managing the person’s relationship to the
environment
*
EnvironmentConsists of all elements that are not a part of the
individual’s behavioral system but influence the system and can
serve as a source of sustenal imperativesManipulated by the
nurse to achieve health
*
External EnvironmentMay include people, objects, and
phenomena that can potentially permeate the boundary of the

behavioral systemExternal stimulus forms an
organized/meaningful pattern that elicits a response from the
individual
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Internal EnvironmentInternalized intervening variables:
Physiology, temperament, ego, age and related
developmental capacities, attitudes, and self-concept General
regulators Variables that influence set, choice, and action Key
areas for nursing assessment
*
Nursing and Nursing Therapeutics
Nursing is “a service that is complementary to that of medicine
and other health professions, but which makes its own
distinctive contribution to the health and well-being of
people.”Nursing views patients as behavioral systems, and
medicine views patients as biological systems.
*
Specific Goal of Nursing Action Is“to restore, maintain, or

attain behavioral system balance and stability at the highest
possible level for the individual” (Johnson, 1980, p 214)
*
Diagnostic ClassificationsInsufficiency: Exists when a
subsystem is not functioning or developed to its fullest capacity
due to inadequacy of functional requirementsDiscrepancy:
Exists when a behavior does not meet the intended conceptual
goal.
*
Diagnostic Classifications (continued)Incompatibility: Exists
when the behaviors of two or more subsystems in the same
situation conflict with each other to the detriment of the
individualDominance: Exists when the behavior of one
subsystem is used more than any other, regardless of the
situation or to the detriment of the other subsystems
*
Nursing Therapeutics Attempt to repair damaged structural units
by altering the individual’s set and choice Impose regulatory

and control measures Supply or help the client find his or her
own supplies of essential functional requirements
*
The Nurse May ProvideNurturance Stimulation Protection
*
The Nurse-Client RelationshipThe nurse and the client negotiate
the treatment plan.
*
References
Johnson, D. E. (1980). The behavioral system model for
nursing. In: J. P. Riehl & C. Roy (Eds.), Conceptual models for
nursing practice (2nd ed., pp. 207–216). New York, NY:
Appleton-Century-Crofts.
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CJ 550 Final Project Milestone One Guidelines and Rubric
Overview: Understanding the structure of a criminal justice
organization is the foundation of organizational assessment.
This will allo w you to accurately assess
whether or not an organization is fulfilling its mission
statement. Once assessment is determined, inter departmental
dissemination will be streamlined due to
familiarity with the structure of the organization.
Prompt: Submit a draft of the structure (Section II) of your final
project. Start with an outline of the organization as a whole
entity. Once the st ructure has been
determined, begin to analyze how departments interact to
maximize efficiency in meeting the standards of the
organization. Be sure to address all of the critical
elements as outlined below.
Specifically the following critical elements must be addressed:
II. Structure: In this section, you will analyze the overall
structure of the organization to set the stage for your
performance assessment. For the purposes
of this project, you will select a subdivision of the agency on
which to focus your performance assessment.
A. What are the departments or subdivisions into which your
selected organization is divided, and how do these subdivisions
work together as a
whole in relation to the mission of the organization? In other
words, each department or su bdivision has its own goals, but
how do all the

departments or subdivisions work together to achieve the
organization’s mission?
B. Describe your selected subdivision, and outline the specific
goals and responsibilities of the subdivision, describing how the
y align with the
overall mission of the agency. Consider how the goals of the
selected subdivision align with the mission of the agency.
C. Describe the key policies in place that run your selected
subdivision of the organization, explaining how these polici es
align with the mission of
the subdivision. For example, the subdivision might have
specific rules and regulations within its operating procedures
and laws that ensure the
subdivision meets its established goals.
Guidelines for Submission: Your paper must be submitted as a
2- to 3-page Microsoft Word document with double spacing, 12-
point Times New Roman font,
one-inch margins, and at least three sources cited in APA
format.
Critical Elements Proficient (100%) Needs Improvement (80%)
Not Evident (0%) Value
Structure:
Departments or
Subdivisions
Outl i nes the departments or s ubdi vi s ions
of the organi zati on and expl ai ns how the

s ubdi vi s ions work together as a whol e i n
rel ati on to the mi s s i on of the organi zation
Outl i nes the departments or s ubdi vi s ions
of the organi zati on and expl ai ns how the
s ubdi vi s ions work together as a whol e i n
rel ati on to the mi s s i on of the
organi zati on, but wi th gaps i n detai l or
accuracy
Does not outl i ne the departments or
s ubdi vi s ions of the organi zati on and does
not expl ai n how the s ubdi vi s ions work
together as a whol e i n rel ati on to the
mi s s i on of the organi zati on
30
Structure:
Subdivision
Des cri bes the s el ected s ubdi vi sion,
outl i ni ng the s peci fi c goal s and
res pons i bi liti es, des cri bing how they al i gn
wi th the overal l mi s s ion of the agency
Des cri bes the s el ected s ubdi vi sion,
outl i ni ng the s peci fi c goal s and
res pons i bi liti es, des cri bing how they al i gn

wi th the overal l mi s s ion of the agency,
but wi th gaps i n detai l or accura cy
Does not des cri be the s el ected
s ubdi vi s ion
30
Structure: Policies Des cri bes the key pol i ci es i n pl ace that
run the s el ected s ubdi vi s ion of the
organi zati on, expl ai ning how thes e
pol i ci es align wi th the mi s s i on of the
s ubdi vi s ion
Des cri bes the key pol i ci es i n pl ace that
run the s el ected s ubdi vi s ion of the
organi zati on, expl ai ning how thes e
s ubdi vi s ion, but wi th gaps i n detai l ,
accuracy, or l ogi c
Does not des cri be the key pol i ci es i n
pl ace that run the s el ected s ubdi vi s ion of
the organi zati on, expl ai ning how thes e
s ubdi vi s ion
30
Articulation of
Response
Submi s s i on has no major errors rel ated to

ci tati ons , grammar, s pel l i ng, s yntax, or
organi zati on
Submi s s i on has major errors rel ated to
organi zati on that negati vel y i mpact
readabi l ity and arti culation of mai n i deas
Submi s s i on has criti cal errors rel ated to
organi zati on that prevent unders tandi ng
of i deas
10
Total 100%
Chapter 9
Imogene King’s Theory of Goal Attainment
Developed by S. Gordon (2010)

*
Describe the evolution of King’s theory from her personal
writings.
Identify and discuss a variety of literature related to King’s
theory.
Describe various settings and populations in which King’s
Conceptual System (KCS) and middle range theory have been
applied.
Discuss future applications of KCS and middle range theory as
it relates to an evidence based practice.
*
Theory of Goal Attainment Initial IdeasProblems and prospect
of knowledge development in nursingLack of professional
nursing languageAtheoretical nursing phenomenaLimited
concept development
*

Original Levels of InteractionHuman being (or individual or
person)PerceptionCommunicationInterpersonal
relationsHealthSocial institutions
*
Philosophical UnderpinningVon Bertalanffy’s General Systems
TheoryRefutes logical positivism and reductionismProposes
isomorphism and perspectivism in knowledge
developmentWholeness, systems in interactionOrganized
complexity as whole systems
*
Conceptual SystemA concept is an organization of reference
pointsProvides structure for organizing multiple ideas into
meaningful wholesShows unity and relationships among
conceptsConsists of individual systems, interpersonal systems,
and social systems
*

Developing a Concept
1) Review, analyze, and synthesize research literature related
to concept.
2) From the review, identify the characteristics (attributes) of
the concept.
3) From the characteristics, write a conceptual definition.
4) Review literature to select an instrument or develop an
instrument.
*
Developing a Concept (continued)
5) Design a study to measure the characteristic or concept.
6) Select the population to be sampled.
7) Collect data.
8) Analyze and interpret data.
9) Write results of findings and conclusions.
10) State implications for adding to nursing knowledge.
*
King’s Conceptual System Personal SystemSelf
PerceptionTime Growth and development
Body image
Learning

Personal spaceSubstantive knowledge about human beings
*
King’s Conceptual System Interpersonal Systems
Related to small
groupsInteractionCommunicationRoleTransactionsStress
*
King’s Conceptual System Social SystemRelated to large
groupsDecision makingOrganizationPowerStatusAuthority
*
Theory of Goal AttainmentDerived from the goal of
nursing:Help individuals maintain or regain health (King,
1990)Uses the following concepts:Self, perception,
communication, interaction, transaction, role, growth and
development, stress, time, personal space

*
Transaction Process ModelDescribes a human process that can
be observed when two or more people interact.Information is
exchanged, goals are set, and transactions are made during the
process.Nurses should document their conversations and
determine if goals were met.
*
Documentation System
Implements the nurse-patient transaction process leading to
goal attainmentMethod used is generally nursing process:
Assess, diagnose, implement, and evaluateNurse and patient
agree to goals, means, and evaluation : Entered into patient’s
chart Eliminates need for multiple formsDocuments patient
involvement in care decisions
*
Instrument Development Goal Attainment Scale (King,

1989b)Nurse Performance Goal Attainment (NPGA) (Kameoka,
Funashima & Sugimori, 2007)
*
Examples of Practice Applications
Development of Middle-Range Theories from:
King’s Interacting Systems Framework
Theory of Perceptual Awareness (Brooks & Thomas, 1997)
Interpersonal System
Family Health Theory (Doornbos, 2007)
Model for collaboration through reciprocation in heath care
organizations (Thomason & Lagowski, 2008)
*
Examples of Practice Applications (cont)
Development of Middle-Range Theories from:
Interpersonal Systems
Theory of Group Empowerment within Organizations (Sieloff &
Bularzik (2011).

*
Examples of Practice ApplicationsMidrange theory used in
several categoriesUsed across the life spanUsed in different
client systemsFocus on phenomena of concern to clients
*
Examples of Practice ApplicationsUsed with different nursing
specialties Used in varied work settingsMulticultural
applicationsEvidence based practice
*
References
Brooks, E. M., & Thomas, S. (1997). The perception and
judgment of senior baccalaureate student nurses in
clinical decision making. Advances in Nursing Science,
19(3), 50–69.

Doornbos, M. M. (2007). King’s conceptual system and family
health theory in the families of adults with persistent mental
illness—An evolving conceptualization. In C. L. Sieloff & M.
A. Frey (Eds.), Middle range theory development using
King’s conceptual system (pp. 31-49). New York: Springer.
Kameoka, T., Funashima, N., & Sugimori, M. (2007). If goals
are attained, satisfaction will occur in nurse- patient
interaction: An empirical test. In C. L. Sieloff & M. A. Frey
(Eds.), Middle Range Theory Development Using King’s
Conceptual System (pp. 261-272). New York: Springer.
*
References
King, I. M. (1989b). King’s systems framework for nursing
administration. In B. Henry (Ed.), Dimensions of nursing
administration: Theory, research, education (p. 35). Cambridge,
UK: Blackwell Scientific.
King, I. M. (1990). Health as a goal for nursing. Nursing
Science Quarterly, 3, 123–128.
Sieloff, C. L., & Bularzik, A. M. (2011). Group power through
the lens of the 21st century and beyond: further validation of
the Sieloff-King Assessment of Group Power within
Organizations. Journal Of Nursing Management, 19(8),
1020-1027. doi:10.1111/j.1365- 2834.2011.01314.x
Thomason, D., & Lagowski, L. (2008, December). Business and
leadership. Sustaining a healthy work force in the 21st
century -- a model for collaborating through reciprocation.

AAOHN Journal, 56(12), 503-513.
*
Chapter 8
Dorothea Orem’s Self-Care Deficit Theory
Developed by S. Gordon and C. Kain (2010)
*
Describe Orem’s Theory of Self-Care Deficit.
Identify the proper object of nursing identified in Orem’s
Theory of Self-Care Deficit.
List the abilities of humans to affect their health as identified
by Orem.
Compare and contrast self-care agency and dependent-care
agency.
Identify and describe major constructs of the Self-Care Deficit
Nursing Theory.

Describe the theoretical linkages between the Theory of Self-
Care, Theory of Dependent Care, Theory of Self-Care Deficit,
and Theory of Nursing Systems.
*
Chapter PurposeDiscuss the integration of views of humankind
within views of nursingDiscuss the differentiate individual and
generally held nurse-specific views of human beings as part of
developing viable nursing scienceProvide insight into model
building and theory development using exemplars from the Self-
Care Deficit Nursing Theory
*
Nursing is Commonly Viewed as:Human health serviceImplies
two categories of human beings:Those who need nursing
serviceThose who produce nursing service
*
Nursing as a Human Health ServiceService implies nursing is a

helpful activityHealth indicates that the thrust of the service is
the structural and functional integrity of persons served
*
General Theories of NursingGives names and roles to the two
categories of human beingsAttributes distinct potential and
actual human powers, properties and actions of each
humanIdentifies the interactions among the types of human
beings and their powers, properties and actionsSpecifies the
broad structural features of the processes that produce nursing
*
Integration of Views of Human BeingsGeneral viewsYou can
study and think about human beings and their situations without
thinking about nursing.Nurse-specific viewsYou cannot study
and think about nursing without incorporating nursing-specific
views of human beings.
*

Nursing ScienceKnowing and seeking to extend and deepen
knowing by:Understanding both the structure of the processes of
nursing Understanding the internal structure, constitution,
powers, properties, and nature of those who require nursing
*
Comprehensive General Nursing Theories AddressWhat nurses
doWhy they do itWho does whatHow they do it
*
Valid General Nursing TheoriesSet forth nursing’s professional-
technical features specific to the production of nursingProvides
articulation with interpersonal features of nursing and sets
standards for safe effective interpersonal systemsPoint to the
legitimacy of, or the need for change in, societal-contractual
systems
*

Model Building and Theory DevelopmentNursing-specific views
of human beings are necessary for understanding and
identifying(1) When and why individuals need and can be
helped through nursing(2) The structure of the processes
through which the nursing help needed is determined and
produced
*
Self-Care Deficit Nursing Theory (SCDNT)Began with
formulations about the reasons why individuals (the
patient)Need nursing and Can be helped through nursing
*
Central IdeaMature human beings have learned and continue to
learn to meet some or all components of their own TSCDs and
the TSCDs of their dependents (those for whom the dependent
care agent assumes or has responsibility for meeting
TSCDs).Self-care and dependent care (i.e., care delivered by
someone other than the individual for the individual) are time-
specific entities produced by individuals.

*
Self-Care Deficit Nursing TheoryHuman properties and
powers:Individuals have a continuing demand for self-
careTherapeutic Self-Care Demand (TSCD)Care for self that
must be learned and deliberately performed
*
Theory of Self-CareIndividuals have the human power to
develop and exercise capabilities to know and meet Therapeutic
Self-Care Demands using Self-Care Agency (SCA)First,
investigate or identify what can or should to be done.Second,
decide what can be done.Third, produce the care.
*
Theory of Dependent Care Assumptions relate to the nature of
interpersonal action systems and social dependency.
*

Nursing Is Needed:When Therapeutic Self-Care Demands
exceed an individual’s Self-Care Agency because of health state
or health-care–related conditions Self-Care Deficit (SCD)TSCD
> SCA = SCD = Nursing Required
*
TSCD and SCAVary qualitatively and quantitatively over
timeIdentified as patient variablesReal or potential existence of
a health-related care deficit relationship between care demand
and the power of agency is the reason nursing is required
*
Nurse AgencyCritical power operative in nursing The power of
nurses to think about, design and produce nursing care for
othersInvestigation of Nurse Agency and the capabilities and
conditions for its exercise are critical components of nursing
science

*
Nurses Must Have Knowledge and SkillsInvestigating and
calculating individual’s TSCDDetermining degrees and
development of SCAEstimating potential for regulation of the
exercise or development of SCAIdentify, perform, and support
an individual’s SCD when indicated
*
Nursing Triad of Interrelated Action SystemsProfessional-
TechnicalNecessary for the production of nursing–dependent on
the interpersonal systemInterpersonal Interaction and
communication necessary for design and production of
nursingSocietalEstablished by the specifying contracting parties
and their legitimate relationshipsSocietal-contractual system
*
Broader Views of Human BeingsNurse-specific views of human
beings fit within broader views of human beings.Orem identifies
five broad views of human beings that support the development
of the constructs of Self-Care Deficit Nursing Theory.Broader

views come into play when nurses think about and produce
nursing.
*
View of PersonHuman beings are:Embodied with inherent
rightsAt once a self and a personPerson-as-agentCentral to
understanding and integrating the other views of human
beingsSubsumes all other viewsEssential to understanding
nursing as a triad of systems
*
View of User of SymbolsIndividual human beings are persons
who use symbols to:Stand for thingsAttach meaning to
themFormulate and express ideasCommunicate ideas and
information to othersEssential to understanding the nursing
interpersonal systemNecessary for nurse-patient communication
*

View of OrganismIndividuals viewed as unitary living beings
who grow and develop biological characteristics of homo
sapiens during known stages of the human life cycle.Requires
knowledge of biology, psychology, human physiology,
environmental physiology, pathology, and other sciences.
*
View of ObjectHuman beings are viewed as having the status of
object subject to physical forces whenever they act to protect
themselves against such forces.Requirement for protective
nursing care.Taken when nurses provide care for infants, young
children, or adults unable to control their positions and
movements in space and contend with environmental physical
forces.
*
ConclusionNursing-specific views of human beings are
differentiated from general views of human beings.General
views (human beings as energy fields, living health, or culture-
oriented or as caring beings) are helpful in understanding
humankind but do not and cannot support viable nursing
science.

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