The document discusses Johnson's Behavioral System Model (JBSM) which views patients as having seven interactive subsystems that can cause stability or instability. The role of nursing is to create stability through interventions that shape patient behavior. The JBSM can be tested using empirical indicators to measure the concepts. Testable hypotheses are proposed about how each subsystem correlates with health outcomes. A plan is outlined to collect data by applying interventions targeting each subsystem and assessing their impact on symptom severity. The JBSM provides a framework for nursing assessments and targeting specific interventions to improve health outcomes.

1. Empirical Indicators
Johnson’s Behavioral System Model
Name:

2. Analysis of Theory
• JBSM considers nursing as an external controlling factor and views
patients as an open behavioral system comprising interactive components.
• The seven subsystems, including aggressive-protective, achievement,
affiliative, ingestive, eliminative, dependency, and sexual, within the
JBSM, interact causing stability or instability.
• The role of nursing, as an external factor, is to create stability in the
system by implementing procedures that shape patient’s behavior
• The model provides important guidelines for nursing practice
• The practice efficacy of the JBSM has been investigated, and it has been
found to result in positive outcome.
(Poster & Beliz, 1992)

3. JBSM Empirical Indicators
• Definition: Empirical indicators refer to the tangible and explicit
real world substitutes for middle-range theory concepts.
• They can also be viewed as the actual instruments, or procedures
utilized in measuring theory concept.
• Data is the evidence attained from the empirical indicators
• The empirical indicators offer the ways through which JBSM can
be tested.
(Fawcett, 2005).

4. Analyzing JBSM using Testable Hypotheses
• The JBSM comprises seven subsystems that interact to create
instability, undesirable health outcome, and stability, desirable
health outcome.
(Ghanbari & Pouy, 2018)
• The protocols adopted by the nurse ought to target the stability of
the whole system.
• Consequently, each of the subsystems can be hypothesized to
result in certain health outcome, leading to stability of the
system.

5. Cont… Hypotheses
• The following hypotheses can be used to evaluate the
effectiveness of JBSM:
Achievement subsystem can predict the severity of
symptoms and patient care requirements
Attachment subsystem can predict the severity of symptoms
and patient care requirements
Aggressive subsystem determines the severity of symptoms
and patient care requirements

6. Cont… Hypotheses
Sexual subsystem cannot predict severity of symptoms
and patient care requirements
Dependency subsystem can determine the severity of
symptoms
Ingestive subsystem can predict the severity of
symptoms
Eliminative subsystem cannot predict the severity of
symptoms and patient care requirements

7. Plan for Collecting and Testing Data
• Each subsystem in the JBSM has a goal, set, choice, and action.
• The goal is the incentive of a subsystems behavior
• The set refers to the collection of natural , regular and norm behaviors that an
individual does to meet his needs.
(Ghanbari & Pouy, 2018)
• Choice is the option selected from the set by an individual to meet his or her
goal.
• Action is the reaction that is shown by the system against the incentive.
• Of all these elements, action can be used as an intervention for health
conditions.
• The action of each subsystem can be applied to patients whose symptoms
severity is then monitored.

8. Cont… Plan for Data Collection
• The patients can be assessed and scored for each subsystem by
both admitting and shit nurses.
• Each subsystem can be operationalized in terms of
critical/effective and inefficient behaviors
• The scores can be based on initial observations and the history
provided by the patient.
• The reason for using two nurses is to address interrater reliability
issues

9. Conclusion
• JBSM offers nurses and cili clinicians valuable information on
which to aim specific interventions, monitor behavioral change,
and assess impact of interventions.
• The model has been adopted and established to e efficient in
different health care setting, including the assessment of
behavioral change with an objective to improve health outcomes.
• The individual subsystems can be operationalized in terms of
effective or ineffective to determine their impact on behaviors
that lead to instability.

10. References
• Fawcett, J. (2005). Middle range nursing theories are necessary
for the advancement of the discipline. Aquichan, 5(1), 32-43.
• Ghanbari, A., & Pouy, S. (2018). Designing nursing care program
based on Johnson behavioral model in children with acute
lymphoblastic leukemia: a case study. International Journal of
Caring Sciences, 11(1), 631.
• Poster, E. C., & Beliz, L. (1992). The use of the Johnson Behavioral
System Model to measure changes during adolescent
hospitalization. International journal of Adolescence and
Youth, 4(1), 73-84.