Johnson behavior system model

OBJECTIVES

At the end of presentation, the students will be able to: a. determine the life and works of Dorothy Johnson. b. understanding the Behavioral System Model. c. Definitions and assumptions of Johnsons Behavioral System Model in relation to Nursing's Metaparadigm. d. Application of the theory in nursing. e. Acceptance of theory in the nursing community. f. know the points of critique and weakness.

INTRODUCING THE THEORIST

Dorothy Johnson was born on August 21, 1919, in Savannah,

Georgia. She received her(A.A) associate of arts degree from Armstrong Junior College in 1938 . Her (BSN) bachelor of science in nursing degree from Vanderbilt University in 1942. She practiced briefly as a staff nurse at the Chathamsavannah Health Council . she received her (MPH) master of public health from Harvard University in 1948.

Cont:She began her academic career at Vanderbilt

University School of Nursing A call from Lulu Hassenpplug, dean of the School of Nursing enticed her to go to the University of California at Los Angeles (UCLA) in 1949. She served there as an assistant, associate, and professor of pediatric nursing until her retirement in 1978

Cont: In 1955 and 1956 she was a pediatric nursing adviser

at the Christian medical collage school of nursing in Vellare, South India. She worked with California Nurses Association, National League for Nursing and American Nurses Association to examine the role of the clinical nurse specialist, the scope of nursing practice. Dorothy Johnsons body of published work includes more than 30 articles, 4 books, and numerous proceedings, reports, and abstracts.

Cont:Ms. Johnson received many awards, including the Founders Medal from Vanderbilt University (1942) Award from california nurses association and vanderbilt university school of nursing . Dorothy Johnson, passed away in February 1999

Theoretical recourses
Johnson has noted that her theory evolved from

philosophical ideas, theory and research, clinical background, and many years of thought, discussions, and writing . From Florence Nightingale came the belief that nursings concern is a focus on the person rather than the disease. From systems theory were all sources for her model. Johnsons background as a pediatric nurse is also evident in the development of her model.

Major concepts

BEHAVIOR: IS the out put of intra organismic structures

&process as they are coordinated and articulated by and responsive to changes in sensory stimulation.

System
From Rapport's definition of system, Johnson stated(A system is a whole that functions as a whole by virtue of the interdependence of its parts.) she accepted with chin's statement that it,s organization, interaction, interdependency and

integration of the parts & elements .

BEHAVOURAL SYSTEM
Behavioral system encompasses the patterned

,repetitive & purposeful ways of behaving. These ways of behaving form an organized & 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.

subsystems
Is a mini system with its own particular goal &function

that can be maintained as long as its relationship to the other subsystems or the environment is not disturbed. Which are open-linked & interrelated. Motivational drives direct the activities of these subsystems ,which are continually changing through maturation, experience & learning . And controlled by biological, psychological & sociological factors

1-attachment-affiliative subsystem
Is probably the most critical, because it forms the

basis for all social organization. It provided survival &security. Its consequences are social inclusion, intimacy, formation & maintenance of a strong social bond.

2-dependancy subsystem
-promotes helping behavior calls for

nurturing response . Developmentally dependency behavior evolves from almost total dependence on others to greater degree of dependence on self .

Ingestive sub-system
Should not seen as input &out put

mechanisms of the system, it has to do with(when, how, what, how much& under what conditions we eat). It serve the board function of appetitive satisfaction. which associated with psychological, social &biological consideration.

Eliminative sub-system
-it means when, how & under which condition we eliminate . As ingestion system social , psychological &biological aspect influencing this subsystem.

Sexual subsystem
Has a double functions: 1- procreation. 2- gratification.

This response system begins with the development of

gender role identity.

Achievement

Aggressive protective subsystem

Its function is protection & preservation.

And this opposed thinking of that aggressive behavior is not only learned ,but also has intend to harm others.

equilibrium
Is a key concept in nursings specific goal.

define as: A stabilized but more or less transitory, resting state in which the individual is in harmony with him self & his environment. It is not synonymous with state of health ,it may be found either in health or illness.

TENSION
DEFINE AS : State of being stretched or strained and can

be viewed as an end-product of a disturbance in equilibrium. It can be constructive in adaptive change or destructive in inefficient use of energy.

STRESSOR
Define as :Internal or external stimuli that produce tension & result in a degree of instability Stimuli may be positive or negative, endogenous or exogenous in origin. And may play upon one or more of our open linked system (physiological, personality and meaningful small group-(family) and larger social system.

ATTACHEMENT

DEPENDENCY

AGGRESSIV E

BEHAVIOR SYSTEM
INGESTIVE
ACHEVEMENT

ELEMINATIVE

SEXUAL

Major assumptions

Nursing
an external regulatory

An art and science, it

force which acts to preserve the organization and integration of the patients behavior at an optimal level when physical, psychological and social threatened.

supplies external assistance both before and during balance disturbance and therefore require knowledge of order ,disorder, and control.

stressor =
NURSE

client

= Tension
EQUILIPRIUM

Person
As a behavior system with patterned, repetitive , and

purposeful ways of behaving that link the person to environment. An individual's specific response patterns, form an organized and integrated whole. A person is a system of interdependent parts that require some regularity and adjustment to maintaining a balance.

health
An elusive, dynamic state

influenced by biological, psychological, and social factors. A desired value of health professionals and focused on a person rather than a disease. Reflected by the organization, interaction, interdependence, and integration of the subsystems of behavior system.

Environment
Consists of all factors that not

part of the individual's behavioral system, but influence the system. The individual links to and interact with the environment. The behavior system attempt to maintain equilibrium in response to environmental factors by adjusting and adapting to the forces that impinging on it.

Theoretical assertion
JBS addressed that patient is a behavior system with

seven interrelated subsystem. Each subsystem can be described and analyzed in term of structural and functional component. And the system is tend to be self- maintaining and self- perpetuating when the internal and external conditions remain orderly and predictable. The behavior attempt to achieve balance when the change is occurs. the state of instability result in need of nursing intervention.

Functional requirements
Protected from noxious influences with which the

system cannot cope Nurtured through the input of appropriate supplies from the environment Stimulated for use to enhance growth and prevent stagnation

Structural requirement
Drives or goals.
Set, predisposition to act. Choice, alternatives to action.

behavior

Dynamic enviro

attac h Ex stressor depen achiev e

Nurse action Nurture Protect stimuli

Stress tolerance flexibility

subsystems
aggre ssiv

sexual

tension

ingest

eleme Structural R Dynamic equilibrium

Int stressor Active dynamic bs Person, group

Nursing application
A 67-years old man is admitted to hospital for

diagnostic test after CVA , he has been marriage and father of tow adult children who live in same city, he came with right side weakness, expressive aphasia and slurred speech and other problems. Nursing application with JBS. o NURSING ASSESSMENT: Behavior assessment 1. attachment : (family, friends). 2. Dependency: (on others physically, financially).

3. 4. 5. 6. 7.

Ingestive :(decrease appetite, difficulty swallowing). Eliminative:(walk to bathroom). Sexual:(sexual dysfunction). Aggressive-protective:(worry of travel family & wife). Achievement :(relearn walk , talk and ADLs,).
Environmental assessment:external environment (hospitalization, diagnostic test, disabilities). Internal environment (biological ,psychological , cognitive).

Structural component: Drive or gaol(motivate to complete diagnostic test and

return to home). Set (evident to make decision).

 Choice( home, rehabilitation program). action (socialization , request for assistance). Functional component: Protection( falling down). Nurturing ( use of left hand). Stimulation (socialization). Nursing diagnoses: Incompatibility.

Discrepancy.

Insufficiency . Dominance.

Planning : for intervention. Nursing intervention: External regulatory forces that should protect ,

stimulate and nurture the behavior system. Explanation and teaching the pt ,family and friends. Evaluation :-

Result of implementation Balance and equilibrium

Acceptance by the nursing community

practice

Acceptence by th nursing community

education research

PRACTICE:Johnson does not use the term nursing process. Assessment ,Disorders , treatment , and evaluation are concepts referred to in a variety of Johnson`s works. For the practitioner conceptual models provide a diagnostic and treatment orientation , and thus are of considerable practical importance. The Nursing process becomes applicable in the behavioral system model when behavioral malfunction occurs.

Recent studies of nursing practice using Johnson's model have focused on decision making and evaluation of outcomes. Grice (1997) found that the nurse , patient, and situational characteristics influenced assessment and administration of antianxiety decision making for the and antipsychotic medication for psychiatric inpatient at certain hours.

Education
Loveland and Wilkerson analyzed Johnson theory and concluded that it has utility in nursing education . A curriculum based on a person as a behavioral system would have definite goals & straight forward course planning. The model has been used in practice and educational institutions.

Research
Johnson stated that nursing research would need to identify and explain the behavioral system disorders which arise in connection with illness and develop the rationale for the means of management. usefulness of Nurse researchers have demonstrated the Johnson's theory in clinical practice .most of these individuals with conducted with studies have been long-term illnesses, such as urinary incontinence, chronic pain, cancer, aids And psychiatric illnesses.

Critique :Johnson's theory is relatively simple in relation to the number of concepts. a person is described as behavioral system composed of seven subsystems. Nursing is an external regulatory force. However, the theory is potentially complex because there are a number of possible interrelationships between and among the behavioral system, its subsystems ,and the forces on them. At this point, only a few of the potential relationships have been explored.

simplicity

generality

Johnson's theory is relatively unlimited when applied to sick individuals, but it has not been used as much with well individuals or groups. Johnson perceived a person as behavioral system comprised of seven subsystems.

Derivable consequences

Johnson's model guides nursing practice, education, and research; generates new ideas about nursing and differentiates nursing from other health professions. By focusing on behavior rather than biology. Johnson's behavioral system model provides a conceptual framework for nursing education, practice, and research.

limitations
Very individual.
Family is only considered as an environment. Focused in nursing care of hospitalized and ill, not

focused on health promotion or prevention

ANY QUISTIONS?