Nursing

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Chapter 7

Dorothy Johnson’s Behavioral System Model and Its Applications

Developed by Bonnie Pope, and S. Gordon (2010)

Updated by D. Gullett (2014)

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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.

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Introducing the Theorist Dorothy Johnson

  • Born August 21, 1919, in Savannah, Georgia
  • Serves as faculty member
  • Vanderbilt University School of Nursing
  • UCLA 1949–1978
  • Died in 1999

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Education

  • Earned 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

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Johnson Behavioral System Model (JBSM) Overview

  • Evolved from philosophical ideas, theory, and research; her clinical background; and many years of thought, discussions, and writing
  • Influences:
  • Florence Nightingale
  • Systems theory
  • Developmental theory

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Five Core Principals

  • Wholeness and Order
  • Stabilization
  • Reorganization
  • Hierarchic Interaction
  • Dialectical 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.

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Stabilization

  • Dynamic 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.

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Reorganization

  • Occurs when the behavioral system encounters new experiences in the environment that cannot be balanced by existing system mechanisms
  • Nurse acts to provide conditions or resources essential to help the accommodation process:
  • May impose regulatory or control mechanisms to stimulate or reinforce certain behaviors
  • May attempt to repair structural components

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Hierarchic Interaction

  • Hierarchies, or a pattern of relying on particular subsystems, lead to a degree of stability.

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Dialectical Contradiction

  • Motivational force for behavioral change
  • Drives/responses developed and modified over time through maturation, experience, and learning
  • Environmental domains that the person is responding to include the biological, psychological, cultural, familial, social, and physical setting

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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

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Major Concepts of the Model

  • Person
  • Subsystems
  • Health
  • Nursing and nursing therapeutics

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Person

  • Viewed 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 system
  • Behavioral systems are orderly, repetitive, and organized

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Human Behavior Is

  • Orderly, purposeful, and predictable
  • Functionally efficient and effective most of the time
  • Sufficiently stable and recurrent to be amenable to description and exploration

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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 environment
  • Have 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 pattern
  • Goal
  • Set
  • Choice
  • Action

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Goal

  • This 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 Set

  • Is 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

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Behavioral Set Components

  • Perseveration
  • Consistent tendency to react to certain stimuli with the same pattern of behavior
  • Preparation
  • Functions to establish priorities for attending or not attending to various stimuli

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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.

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Action

  • Observable action of the individual
  • Concern is with the efficiency and effectiveness of the behavior in goal attainment.
  • Actions are observable responses to stimuli.

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The Johnson Model Proposes

  • For behavior to be maintained, it must be protected, nurtured, and stimulated.
  • Protection from noxious stimuli that threaten the survival of the behavioral system
  • Nurturance, which provides adequate input to sustain behavior
  • Stimulation to continue growth of the behavior and counteracts stagnation

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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.

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Health

  • Behavioral system balance or stability
  • Demonstrated 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

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Environment

  • Consists 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 imperatives
  • Manipulated by the nurse to achieve health

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External Environment

  • May include people, objects, and phenomena that can potentially permeate the boundary of the behavioral system
  • External stimulus forms an organized/meaningful pattern that elicits a response from the individual

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Internal Environment

  • Internalized 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

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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.

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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)

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Diagnostic Classifications

  • Insufficiency:
  • Exists when a subsystem is not functioning or developed to its fullest capacity due to inadequacy of functional requirements
  • Discrepancy:
  • Exists when a behavior does not meet the intended conceptual goal.

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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 individual
  • Dominance:
  • 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

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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

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The Nurse May Provide

  • Nurturance
  • Stimulation
  • Protection

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The Nurse-Client Relationship

  • The nurse and the client negotiate the treatment plan.

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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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