Nursing Theories: Dorothy Johnson's Behavioral System Model

Nursing Theories Guide

Dorothy Johnson

  • Key Concept: When the behavioral system is balanced and stable, individuals' behaviors become purposeful, organized, and predictable.

Concept of Nursing

  • Definition: "Nursing is an external regulatory force that acts to preserve the organization and integration of the patient's behaviors at an optimum level under conditions that threaten physical or social health or in the presence of illness."

Behavioral System Model

  • Foundation: Proposed that nursing care facilitates the client’s maintenance of a state of equilibrium.

  • Client Interaction: Clients experience stress from stimuli, whether internal or external, which can lead to disturbances, or “tensions,” resulting in a state of disequilibrium.

Human Beings and Systems

  • Major Systems Identified:

    • Biological System: Focus of medicine.

    • Behavioral System: Focus of nursing.

Key Concepts

  • Equilibrium: A state of harmony between the individual and his/her environment.

  • Tension: A state representing strain, viewed as a resultant disturbance in equilibrium.

  • Stressor: External or internal stimuli producing tension, contributing to instability.

  • Nursing Role: Assist clients in achieving a return to a state of equilibrium.

Areas of Focus in Nursing

  • To Achieve Equilibrium:

    1. Reduce stressful stimuli.

    2. Support natural and adaptive processes.

Overview of the Behavioral System Model

  • Behavioral System of the Patient Includes:

    • Attachment/Affiliation

    • Dependence

    • Behavioral Disorders

    • Aggression

    • Ingestive/Eliminative Behaviors

    • Achievement

    • Sexual Functioning

  • Dynamic Aspects: Health changes through dynamic interactions with both internal and external stressors, requiring nursing actions to nurture, protect, and stimulate the patient.

Subsystems of the Behavioral System Model

  • Overall Count: Seven (7) subsystems.

  • Subsystems Identified:

    1. Attachment/Affiliation

    2. Dependency

    3. Sexuality

    4. Aggression

    5. Elimination

    6. Ingestion

    7. Achievement

Functional Requirements of Each Subsystem

  1. Protection: Each subsystem must be shielded from harmful influences beyond its coping capacity.

  2. Nurturing: Input of appropriate resources from the environment is essential for each subsystem's health.

  3. Stimulation: Each subsystem requires encouragement to promote growth and prevent stagnation.

Responses to Alterations in Equilibrium

  • Model Utility: The model provides a framework for diagnosing issues within a subsystem when equilibrium is disrupted.

  • Nursing Intervention: Nursing is essential for restoring the client to homeostasis at this juncture.

Detailed Exploration of Subsystems

  1. Attachment/Affiliation Subsystem:

    • Purpose: Forms the foundation of social organization, providing survival and security.

    • Consequences: Includes social inclusion, intimacy, and strong social bonds.

    • Example: Allowing family members to visit patients.

  2. Achievement Subsystem:

    • Definition: Involves control or mastery of self/environment regarding set standards of excellence.

    • Skills Recognized: Intellectual, physical, creative, mechanical, and social skills.

    • Example: Providing positive feedback or praise after task completion.

  3. Ingestion Subsystem:

    • Focus: Concerns the significance and conditioning of social events surrounding food consumption.

    • Variables: Includes when, how, what, how much, and under what conditions food is consumed.

    • Example: Taking patient preferences into account for food choices.

  4. Elimination Subsystem:

    • Cultural Variation: Human cultures define social behaviors related to waste excretion, which varies across cultures.

    • Considerations: Looks at when, how, and under what conditions elimination occurs.

    • Example: Promoting regular bowel patterns (e.g., encouraging morning bowel movements).

  5. Aggressive Subsystem:

    • Definition: Pertains to behavior associated with protection and self-preservation.

    • Response Mechanism: Triggers defensive behaviors when the individual or territory is threatened.

    • Example: Explaining medication mechanisms to patients who refuse their medication, asserting self-protection.

  6. Dependency Subsystem:

    • Goal: Aims to encourage nurturing behaviors leading to approval, attention, and assistance.

    • Behavior Development: Dependency arises from a reliance on others for resources necessary for survival.

    • Example: Offering approval, attention, or physical assistance to patients.

  7. Sexual Subsystem:

    • Functions: Involves procreation and gratification, encompassing gender role identification and behaviors.

    • Cross Factors: Both biological and social factors influence this subsystem.

    • Example: Supporting a mother in fulfilling her maternal role within the sexual subsystem.