jhonson nursing theory

1. Dorothy Johnsons Theory
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2. Contents
• Objectives
• Introduction
• Purpose
• Theoretical Sources Of The Theorist
• Major Concepts And Definitions
• Theoretical Assertions
• Acceptance By Nursing Community
• Critique
• Strength and limitation
• Summary
• Reference
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3. Objectives
• Knowing the purpose of theory
• Define the behavioral system model
• Understand the concept of behavioral system
model
• Known the assertion of the theory
• Define meta paradigm
• To evaluate the theory
• Understand the limitation and strength of the
theory
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4. Introduction
Back Ground of the Theorist
• Johnson was born August 21, 1919, in Savannah,
Georgia.
• Finished her B. S. N. from Vanderbilt University in
Nashville, Tennessee, in 1942.
• She worked briefly as a public health nurse and in
1944 returned to Vanderbilt as an instructor in
Pediatric Nursing.
• Finished her M.P.H. from Harvard University in
Boston in 1948.
• She retired at January 1, 1978 and remained active in
retirement as a speaker and advocate for nursing
education.
• She died in February 1999.
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5. “Each individual has a predisposition to act, with
reference to the goal, in certain ways rather than in
other ways.”
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6. Purpose
• The purpose of theory is describe, explain and
predict phenomenon of nursing.
• It provides the functions of nursing practices,
to generate further knowledge and indicate
direction that nursing should develop in the
future.
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7. Theoretical sources of the Theorist
Nightingale
• The BSM springs from Nightingale's belief that
nursing's goal is to help individuals prevent or
recover from disease or injury
• Nursing should focus on the individual and not the
disease itself
Talcott Parsons
• Acknowledged in early developmental writing
presenting concepts of then BSM
Systems Theory and Rapoport, Chinn and Buckley
• used their concepts and definitions
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8. Major concepts and definitions
Behavior
• The output of intra-organismic structures and processes as
they are coordinated and articulated by and responsive
to changes in sensory stimulation.
• Johnson focuses on behavior affected by the actual or
implied presence of other social beings that has been
shown to have major adaptive significance.
System
• definition of system, Johnson (1980) stated, “A system is a
whole that which functions as a whole by virtue of the
interdependence of its parts”.
• A person strives to maintain balance in these parts through
adjustments and adaptations to the impinging forces.
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9. Cont…
Equilibrium
• A key concept in nursing’s specific goal.
• It is defined as a stabilized but more or less transitory,
resting state in which the individual is in harmony with
himself and with his environment.
Tension
• A state of being stretched or strained and can be viewed as
an end-product of a disturbance in equilibrium.
Stressor
• Internal or external stimuli that produce tension and result
in a degree of instability.
• Stimuli may be positive in that they are present; or
negative in that something desired is absent.
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10. Behavioral System Model
• Each individual has patterned, purposeful, repetitive
ways of acting that comprise a behavioral system
specific to that individual.
• These ways of behaving form an organized and
integrated functional unit that determines and limits
the interaction between the person and his or her
environment and establishes the relationship of the
person to the objects, events and situations within his
or her environment.
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11. Cont…
• A person as a behavioral system tries to
achieve stability and balance by adjustments
and adaptations that are successful to some
degree for efficient and effective functioning.
• The system is usually flexible enough to
accommodate the influences affecting it.
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12. Cont…
Subsystem
• A mini system with its own particular goal and
function that can be maintained as long as its
relationship to the other subsystems or the
environment is not disturbed.
• The seven subsystems are open, linked, and
interrelated where input and output are components
• Motivational drives direct the activities of these
subsystems, which are continually changing through
maturation, experience and learning.
• The system described appear to exist cross
culturally and are controlled by biological,
psychological, and sociological factors.
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13. The seven (7) identified subsystem
are :-
•
1. Attachment/Afflictive Subsystem
2. Dependency Subsystem
3. Ingestion Subsystem
4. Elimination Subsystem
5. Sexual Subsystem
6. Aggressive/protective Subsystem
7. Achievement Subsystem
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14. Johnson’s Behavioral Subsystem
1. Attachment or affiliative subsystem—serves the
need for security through social inclusion or intimacy
2. Dependency subsystem—behaviors designed to get
attention, recognition, and physical assistance
3. Ingestive subsystem—fulfills the need to supply the
biologic requirements for food and fluids
4. Eliminative subsystem—functions to excrete wastes
5. Sexual subsystem—serves the biologic requirements
of procreation and reproduction
6. Aggressive subsystem—functions in self and social
protection and preservation
7. Achievement system—functions to master and
control the self or the environment
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15. Metaparadigm in Nursing
Nursing
• She defined nursing as “an external regulatory
force which acts to preserve the organization
and integration of the patients behaviors at an
optimum level under those conditions in which
the behaviors constitutes a threat to the
physical or social health, or in which illness is
found”
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16. Cont…
 Based on this definition there are four goals of
nursing are to assist the patient:
1. Whose behavior commensurate with social
demands.
2. Who is able to modify his behavior in ways that
it supports biological imperatives
3. Who is able to benefit to the fullest extent during
illness from the physicians knowledge and skill.
4. Whose behavior does not give evidence of
unnecessary trauma as a consequence of illness.
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17. Cont…
Person
• A person has two major systems: the biological system
and the behavioral system
• Nursing’s focus is the behavioral system
• The person as a behavioral system has patterned,
repetitive, and purposeful ways of behaving that link the
person to the environment
Health
• Is an elusive state that is affected by social,
psychological, biological and physiological factors
• The individual is striving to retain some balance or
equilibrium
• The individual’s goal is to sustain the entire behavioral
system efficiently and effectively.
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18. Cont…
Environment
• Consists of all the factors that are not part of
the individual’s behavior but influence the
system, some of which can be manipulated by
the nurse to achieve the health goal for the
patient.
• The behavioral system attempts to maintain
equilibrium in response to environmental
factors by adjusting and adapting to the forces
that impinge on it.
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19. 11/13/2021 19

20. Theoretical Assertions
• The theory addresses two major components:
1. the patient and
2. nursing.
• The patient is a behavioral system with seven
interrelated subsystems.
• o Each subsystem can be described and
analyzed in terms of structure and functional
requirements.
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21. Cont…
• The four structural elements that have been
identified include:
1. drive or goal - motivation for the behaviors
2. set - normal behavior a client prefers to meet
goal; predisposition to act;
3. choice - available options a person has to meet
goals; alternatives for action;
4. behavior - it will produce an observable
outcome which is the individuals behavior
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22. Cont…
• Each of the subsystems has the same three
functional requirements:
1. Protection – protection from unwanted stimuli
2. Nurturance - through appropriate input of “supplies”
from the environment
3. Stimulation - by experiences, behaviors that
“enhance growth and prevent stagnation
The system and subsystems tend to be self-
maintaining and self-perpetuating as long as
internal and external conditions remain orderly and
predictable.

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23. Acceptance by the Nursing
Community
• Practice
 The BSM was used to develop a self-report and observational instrument
to be carried out with the nursing process.
1. Grubbs (1980) – developed an assessment tool and a nursing process
sheet based on Johnson’s seven subsystems.
2. Holaday (1980) – used the theory to develop an assessment tool when
caring for children. This tool allowed the nurse to objectively describe
the child’s behavior and to guide nursing action
3. Derdiarian (1990) – investigated the effects of using two system
assessment instruments on patient and nurse satisfaction.
 The implementation of the instrument provided a more
comprehensive and organized step to assessment and intervention,
thereby increasing patient and nurse satisfaction with care.
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24. Cont…
• Education
o A core curriculum based on a person as a
behavioral system would have definite goals and
clear course planning.
o The study would center on the patient as a
behavioral system and its dysfunction, which
would necessitate the use of the nursing process.
• Research
Nursing research is vital to explain and identify
behavioral system disorders which rise in
relation with illness, and develop good reasoning
for the means of management.
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25. Cont…
The theory resulting form the BSM influences
to the
• researcher to choose between two options.
1. Examine the functioning of the system and
subsystems by focusing on the Basic Sciences
2. Investigating methods of gathering diagnostic
data or problem solving activities as these
influences the behavioral system.
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26. Critique (Analysis)
Purpose
• This theory guides nursing practice, education and
research
Concept
• BSM theory has major concepts which are the
base of the theory
Definition
• Definition of concepts are not clearly define.
They are open and difficult to apply in to practice
which needs more explanation.
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27. Cont…
Relationship
• In this theory nurse patient has good
relationship and also patient environment
interacted well.
Structure
• The theory is grand theory. Not well
structured because some concepts and nursing
paradigms are over lap so there is redundancy
of ideas.
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28. Cont…
Assumptions
• Johnson made different assumptions that leads
her to develop major concepts for the theory.
• This assumptions show the health environment
interaction.
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29. Cont…
Clarity
• Johnson’s theory is comprehensive and broad
enough to include all areas of nursing practice and
provide guidelines for research and education.
Simplicity
– The theory is potentially complex because there is a
number of a possible interrelationship among the
behavioral system, its subsystems, and the
environment.
– Potential relationship have been explored, but more
empirical work is needed (Brown, 2006)
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30. Cont..
Generality
• Relatively unlimited when applied to sick individuals,
but it has not been used as much with well individuals,
families or groups.
• Perceives a person as a behavioral system composed
of seven subsystems, aggregates of interactive
behavioral systems.
• She stated, “Nursing’s special responsibility for
health is derived from its unique social mission.
Nursing needs to concentrate on developing
preventive nursing to fulfill its social obligations”
(Johson,1992,p26.)
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31. Cont…
Accessibility (Empirical precision )
• Is achieved by identifying empirical indicators for
the abstract concept of model.
• Empirical precision improves when the sub
concepts and the relationships between and
among the sub concepts become better defined
and empirical indicators are introduced to the
science.
• The units and the relationships between the
units in Johnson’s theory are consistently
defined and used.
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32. Strength
• 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 Jonhson’s
theory.
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33. Cont…
• 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.
• Theories must be consistent with other validated
theories, laws and principles but will leave unanswered
questions that need to be investigated.
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34. limitation
• Johnson does not clearly interrelate her concepts of
subsystems comprising the behavioral system model.
• The definition of concept is so abstract that they are
difficult to use.
• It is difficult to test Johnson’s model by development of
hypothesis.
• The focus on the behavioral system makes it difficult for
nurses to work with physically impaired individual to
use this theory.
• The model is very individual oriented so the nurses
working with the group have difficulty in its
implementation.
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35. Cont…
• The model is very individual oriented so the
family of the client is only considered as an
environment.
• Johnson does not define the expected outcomes
when one of the system is affected by the
nursing implementation an implicit expectation
is made that all human in all cultures will attain
same outcome –homeostasis.
• Johnson’s behavioral system model is not
flexible.
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36. 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 seven
(7) behavioral subsystems. Each subsystem composed of
four (4) structural characteristics i.e. drives, set, choices
and observable behavior.
 Three (3) 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.
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37. References:
• Tomey, A. & Alligood, M. (2002). Nursing theorists and
their work. (5th ed.). Mosby Inc.
• George, J. Nursing theories: The base for professional
nursing practice. (5th ed.). Pearson Prentice Hall
• McEwen, W. & Wills, E. Theoretical basis for nursing.
(2nd ed.). Lippincott Williams & Wilkins.
• Octaviano, E. & Balita, C. Theoretical foundation of
Nursing: The Philippine perspective. Ultimate Learning
Series
• http://www.mc.vanderbilt.edu/biolib/hc/biopages/djohn
son.html
• https://www.currentnursing.com/nursing_theory/behavi
oural_system_model.html
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