MS.RITIKA SONI ASS. PROF. SNC, SHIMLA

1. Johnson’s Behavior
System Model
Dorothy E. Johnson
Presenter:
Ms. Ritika soni

2. Dorothy E. Johnson
• Behavior System
Model

3. • BIOGRAPHY
• Behavior system model
• Definition & goal of nursing
• Assumptions of the BSM
• Subsystems of the model
• Major concepts
• Sub concepts
• BSM in nursing process
• Characteristics of theory
• Strengths of theory
• Limitations of theory
• Example

4. BIOGRAPHY
• Dorothy Johnson was born on August
21, 1919 in Savannah, Georgia.
• She was the youngest of seven children.
• B. S. N. from Vanderbilt University in
Nashville, Tennessee, in 1942
• She was the top student in her class and
received the prestigious Vanderbilt
Founder’s Medal.
• In 1948, she received her Masters in
public health from Harvard University in
Boston, Massachusetts.

5. Career and Appointments
• After graduation, Dorothy Johnson’s
professional experiences involved mostly
teaching, although she was a staff nurse at
the Chatham-Savannah Health Council from
1943 to 1944.
• She was an instructor and an assistant
professor in pediatric nursing at Vanderbilt
University School of Nursing.
• From 1949 until her retirement in 1978 and
her subsequent move to Key Largo, Florida,
Johnson was an assistant professor of
pediatric nursing, an associate professor of
nursing, and a professor of nursing at the
University of California, Los Angeles.

6. •In 1955 and 1956, Johnson
was a pediatric nursing
advisor assigned to the
Christian Medical College
School of Nursing in Vellore,
South India.
•From 1965 to 1967, she
served as chairperson on the
committee of the California
Nurses Association that
developed a position
statement on specifications
for the clinical specialist.

7. Works
• Dorothy Johnson was a prolific writer on the
subject of nursing theory.
• Johnson’s publications include four books, more
than 30 articles in periodicals, and many papers,
reports, proceedings, and monographs.
• She held a strong conviction that continuing
improvement of care was the ultimate goal of
nursing.
• Her 1968 paper, entitled, One Conceptual Model
of Nursing, is a classic contribution to Nursing
literature.
• Two of the many works written by Johnson
include: Theory Development: What, Why,
How? and Barriers and Hazards in Counseling.

8. Awards and Honors
• Of the many honors she received, Dorothy
Johnson was proudest of the 1975 Faculty
Award from graduate students
• In 1977 ,Lulu Hassenplug Distinguished
Achievement Award from the California
Nurses Association
• and In 1981 Vanderbilt University School of
Nursing Award for Excellence in Nursing.

9. • Death: Dorothy Johnson died in
February 1999 at the age of 80.
• Before she died, she was pleased
that her theory had been found
useful as a model for nursing
practice.

10. Behavior
system model

11. •Dorothy E. Johnson is well-known for
her “Behavioral System Model,” which
was first proposed in 1968.
•Her model was greatly influenced
by Florence Nightingale’s book, Notes on
Nursing.
•It advocates the fostering of efficient
and effective behavioral functioning in
the patient to prevent illness and
stresses the importance of research-
based knowledge about the effect of
nursing care on patients.

12. In her model, The patient is identified as
a behavioral system composed of seven
behavioral subsystems: affiliative,
dependency, ingestive, eliminative, sexual,
aggressive, and achievement.
The three functional requirements for
each subsystem include protection from
noxious influences, provision for a
nurturing environment, and stimulation
for growth.
An imbalance in any of the behavioral
subsystems results in disequilibrium.
It is nursing’s role to assist the client to
return to a state of equilibrium.

14. •Shedefined nursing as “an external regulatory
forcewhichactstopreservetheorganization and
integration of the patients behaviors at an
optimumlevelunder thoseconditionsinwhich
thebehaviorsconstitutes athreattothephysical
or socialhealth,orinwhich illnessisfound”.
•Her nursing model states that “each
individual has patterned, purposeful,
repetitive ways of acting that comprises a
behavioral system specific to that
individual.”

15. GOALS
The goals of nursing according to the
Behavior System Model:
Nursing had an explicit goal of action in patient
welfare.
(1) To assist the patient whose behavior is
proportional to social demands.
(2) To assist the patient who is able to modify his
behavior in ways that it supports biological
imperatives.
(3) To assist the patient who is able to benefit to the
fullest extent during illness from the physician’s
knowledge and skill.
(4) To assist the patient whose behavior does not give
evidence of unnecessary trauma as a
consequence of illness.

16. Assumptions of the
Behavioral System Model

17. The assumptions made by Dorothy
Johnson’s theory are in
THREE CATEGORIES:
1.Assumptions
about system,
2.Assumptions
about structure
3. Assumptions
about functions.

18. 1.Assumptions about system
(1) There is “organization, interaction, interdependency and
integration of the parts and elements of behaviors that go
to make up the system.”
(2) A system “tends to achieve a balance among the various
forces operating within and upon it, and that man strive
continually to maintain a behavioral system balance and
steady state by more or less automatic adjustments and
adaptations to the natural forces Impinging upon him.”
(3) A behavioral system, which requires and results in some
degree of regularity and constancy in behavior, is essential
to man. It is functionally significant because it serves a
useful purpose in social life as well as for the individual.
(4) “System balance reflects adjustments and adaptations
that are successful in some way and to some degree.”

19. 2.Assumptions about structure
The four assumptions about structure and function of each
subsystem are that:
(1) “From the form the behavior takes and the
consequences it achieves can be inferred what ‘drive’
has been stimulated or what ‘goal’ is being sought.”
(2) Each individual person has a “predisposition to act
with reference to the goal, in certain ways rather than
the other ways.” This predisposition is called a “set.”
(3) Each subsystem has a repertoire of choices called a
“scope of action.”
(4) The individual patient’s behavior produces an outcome
that can be observed.

20. 3. Assumptions about functions.
• There are three functional
requirements for the subsystems:
(1) The system must be Protected from
toxic influences with which the
system cannot cope.
(2) Each system has to be Nurtured
through the input of appropriate
supplies from the environment.
(3) The system must be Stimulated for
use to enhance growth and prevent
stagnation.

21. NURTURANCE SIMULATION
PROTECTION

22. Subsystems of the Behavior System
Model
• Johnson identifies seven subsystems in the
Behavioral System Model.
• They are:

24. 1. Attachment or affiliative
subsystem
Attachment or affiliative subsystem is
the “social inclusion intimacy and the
formation and attachment of a strong
social bond.”
It forms the basis for all social
organization. On a general level, it
provides survival and security.

25. 2. Dependency subsystem
• Dependency subsystem is the “approval,
attention or recognition and physical
assistance.”
• It promotes helping behavior that calls for a
nurturing response.
• A certain amount of interdependence is
essential for the survival of social groups.

26. 3. Ingestive subsystem
• Ingestive subsystem is the “emphasis on the
meaning and structures of the social events
surrounding the occasion when the food is
eaten.”
• The ingestive subsystem “has to do with
when, how, what, how much, and under what
conditions we eat.”
• All subsystems are distinct subsystems with
their own input and output mechanisms.

27. 4. Eliminative subsystem
• Eliminative subsystem states that “human
cultures have defined different socially
acceptable behaviors for excretion of waste,
but the existence of such a pattern remains
different from culture to culture.”
• It addresses “when, how, and under what
conditions we eliminate.”

28. 5. Sexual subsystem
• Sexual subsystem is both a biological and
social factor that affects behavior. It has the dual
functions of procreation and gratification.
• courting and mating, this response system
begins with the development of gender role
identity

29. 6. Aggressive subsystem
• Aggressive subsystem relates to the
behaviors concerning protection and self-
preservation, generating a defense response
when there is a threat to life or territory. Its
function is protection and preservation.

30. 7. Achievement subsystem
• Achievement subsystem provokes behavior
that tries to control the environment. It
attempts to manipulate the environment.
• Areas of achievement behavior include
intellectual, physical, creative, mechanical,
and social skills.

31. Representation of Johnson's Model
Goal ----- Set --- Choice of Behavior --- Behavior
• Affiliation
• Dependency
• Sexuality
• Aggression
• Elimination
• Ingestion
• Achievement

33. MAJOR CONCEPTS

34. Major Concepts
• The following are the major concepts
and definitions of the Johnson’s nursing
model including the definition for its
nursing metaparadigms:
1. Human Beings
• Johnson views human beings as having
two major systems: the biological
system and the behavioral system. It is
the role of medicine to focus on the
biological system, whereas nursing’s
focus is the behavioral system.
• The concept of human being was
defined as a behavioral system that
strives to make continual adjustments to
achieve, maintain, or regain balance to
the steady-state that is adaptation.

35. 2. Environment
• Environment is not directly defined, but it is
implied to include all elements of the
surroundings of the human system and
includes interior stressors.

36. 3. Health
• Johnson defines it as “some degree of
regularity and constancy in behavior, the
behavioral system reflects adjustments and
adaptations that are successful in some way
and to some degree… adaptation is
functionally efficient and effective.”

37. 4. Nursing
• Nursing is seen 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.”

40. 5. Behavioral system
Man is a system that indicates the state of the
system through behaviors.
6. System
That which functions as a whole by virtue of
organized independent interaction of its parts.
7. Subsystem
A mini system maintained in relationship to
the entire system when it or the environment
is not disturbed.

41. Sub concepts
1. Structure
The parts of the system that make up the
whole.
2. Variables
Factors outside the system that influence the
system’s behavior, but which the system lacks
power to change.
3. Boundaries
The point that differentiates the interior of the
system from the exterior.

42. 4. Homeostasis
Process of maintaining stability.
5. Stability
Balance or steady-state in maintaining balance of
behavior within an acceptable range.
6. Stressor
A stimulus from the internal or external world
that results in stress or instability.
7. Tension
The system’s adjustment to demands, change or
growth, or to actual disruptions.
8. Instability
State in which the system output of energy
depletes the energy needed to maintain stability.

43. 9. Set
The predisposition to act. It implies that
despite having only a few alternatives from
which to select a behavioral response, the
individual will rank those options and choose
the option considered most desirable.
10. Function
Consequences or purposes of action.

44. Behavioral System Model and The
Nursing Process
 Assessment
 Diagnosis
 Planning and implementation
 Evaluation

45. Assessment
• Grubbs developed an assessment tool based on
Johnson’s seven subsystems plus a subsystem she
labeled as restorative which focused on activities of
daily living.
• Affiliation
• Dependency
• Sexuality
• Aggression
• Elimination
• Ingestion
• Achievement
• Restorative
• assessment also based on drive, set behavior,
repertoire, and observable behavior

46. Diagnosis
• Diagnosis tends to be general to the system.
Grubb has proposed 4 categories of nursing
diagnosis derived from Johnson's behavioral
system model:
• Insufficiency
• Discrepancy
• Incompatibility
• Dominance

47. Planning and implementation
• Implementation of the nursing care related to the
diagnosis may be difficult because of lack of
clients input in to the plan.
• the plan will focus on nurses actions to modify
clients behavior, these plan then have a goal ,to
bring about homeostasis in a subsystem
• based on nursing assessment of the individuals
drive, set behavior, repertoire, and observable
behavior.
• The plan may include protection, nurturance or
stimulation of the identified subsystem.

48. Evaluation
• Based on the balance of the subsystems.
• Johnson’s Behavioral System Model is best
applied in the evaluation phase, during which
time, the nurse can determine whether or not
there is balance in the subsystems of the patient.
• If a nurse helps a patient maintain an equilibrium
of the behavioral system through an illness in the
biological system, he or she has been successful
in the role.

49. Johnson’s and Characteristics of a
theory
• Interrelate concepts to create a different way of viewing a
phenomenon - Concepts in Johnson's theory are interrelated.
• Theories must be logical in nature- Johnson's theory is logical in
nature.
• Theories must be simple yet generalizable - The theory is simple.
• Theories can be bases of hypothesis that can be tested - Research
studies are conducted applying Johnson's theory.
• Theories contribute to and assist in increasing the body of
knowledge within the discipline through the research implemented
to validate them.
• Theories can be utilized by practitioners to guide and improve their
practice- utilized
• Theories must be consistent with other validated theories, laws and
principles but will leave unanswered questions that need to be
investigated- theory is consistent

50. Strengths
• Dorothy Johnson’s theory guides nursing practice,
education, and research; generates new ideas about
nursing; and differentiates nursing from other health
professions.
• It has been used in inpatient, outpatient, and community
settings as well as in nursing administration.
• It has always been useful to nursing education and has
been used in practice in educational institutions in different
parts of the world.
• Another advantage of the theory is that Johnson provided a
frame of reference for nurses concerned with specific client
behaviors.
• The theory also has potential for continued utility in
nursing to achieve valued nursing goals.

51. Limitation
• The theory is potentially complex because Johnson
does not clearly interrelate her concepts of subsystems
comprising the behavioral system model.
• It is difficult to test Johnson's model by development of
hypothesis.
• Though the seven subsystems identified by Johnson
are said to be open, linked, and interrelated, there is a
lack of clear definitions for the interrelationships
among them which makes it difficult to view the entire
behavioral system as an entity.
• The model is very individual oriented so the nurses
working with the group have difficulty in its
implementation.
• Johnson’s behavioral system model is not flexible.

52. EXAMPLE
Johnny smith, age 6 weeks, brought into the clinic for a
routine check up. He presents with no weight gain since his
check up. At age 2 weeks. His mother states she feeds him
but he doesn't seem to eat much. He sleeps 4-5 hours
between feedings. His mother holds him in her arms
without making trunk to trunk contact. As the assessment
is made the nursing officer notes that Mrs. Smith never
looks at Johnny and never speaks to him. She states he was
a planned baby but that she never “realized how much
work an infant could be.” she says her mother told her she
was not a good mother because Johnny is not gaining
weight like she should. She states she had not called the
nursing office when she knew Johnny was not gaining
weight because she thought the nursing staff would think
she was a “bad mother” just like her own mother thought
she was a “bad mother”.
 Apply the BSM in nursing process.

53. SUMMARY
• Johnson’s Behavioral system model is a model of nursing
care that advocates the fostering of efficient and effective
behavioral functioning in the patient to prevent illness. The
patient is defined as behavioral system composed of 7
behavioral subsystems. Each subsystem composed of four
structural characteristics i.e. drives, set, choices and
observable behavior.
• Three functional requirement of each subsystem includes
(1) Protection from noxious influences,
(2) Provision for the nurturing environment, and
(3) stimulation for growth.
• Any imbalance in each system results in disequilibrium .it is
nursing role to assist the client to return to the state of
equilibrium.