Dorothy Johnson

Behavioral Systems Model

Deborah Meshel

Dorothy JohnsonBackground

• 1919 Born in Savannah Georgia

• 1938 AA Armstrong Jr. College

• 1942 BSN Vanderbilt University School of Nursing

• 1948 MPH Harvard University

Dorothy JohnsonBackground cont

Professional ExperienceMostly involved teaching• 1943 – 1944 staff nurse at Chatham- Savannah Health

Council• 1949 – 1978 Instructor and assistant professor in pediatric

nursing at Vanderbilt University School of Nursing• Professor of nursing at University of California in LA• 1980 published the B.S. model• Early proponent of nursing as a science and an art• BS model based on Nightingale’s belief

Purpose of Systems Theory

Nurse creates balance between client and environment to achieve an optimal level of functioning.

Subsystems

• Individual made up of 7 sub systems• interrelated parts functioning together to form

a whole• Interact with each other• Interrelated and interconnected• Environment constantly acting on subsystems

Johnson’s 7 Subsystems

Subsystems• Attachment- goal attainment- form relationships and

social bonds

• Aggressive- protect oneself to respond to threats

• Dependency – attention, recognition, physical assistance

• Ingestion- intake of nutrients to obtain knowledge

• Elimination- eliminate waste and to express feelings

• Sexual- to procreate, to have sexual relationships, to develop gender based identity

• Achievement- mastery or control of some aspect of the environment

Stressor=>

= Tension(Internal or external)

Nurse = equilibrium

Client

System is out of balance when…

1. insufficiency = does not get enough of something

2. discrepancy = not optimally working3. incompatibility = subsystems conflict4. dominance = one subsystem is always used

Nurses…

1. Reduce stressful stimuli2. Support natural adaptive process3. Makes changes to environment4. Focus is the patient not illness

Functional Requirements

Needed by each subsystem to fulfill its function

Protection

Nurturance Simulation

Structural RequirementsCharacteristics of each subsystem

1. Goal2. Set3. Choice4. Action

•Person

• Environment

•Health

•Nursing

Person

SubsystemsInterdependent parts

Adjustment to maintain balanceMaintain a steady state of equilibrium

Environment

• Any factor influencing the behavioral subsystem

• Not part of the client’s behavioral system• Internal and external

Health

Balance and stability of the subsystems

Lack of balance = poor healthBalance = health

Nursing

When there is instability or stressorsExternal regulatory force

Helps maintain equilibriumArt and Science

Internal Criticism

Clarity

Simplicity

Specificity or Generality

Accessibility

Scope

Contagious

Very Contagious!Behavioral Systems Model is used in: practice, education, research

Nursing Implications

Case Study

10 year old boyNot doing well in schoolComes to school dirty, does not brush teeth, has dirty cloths/

often brings no lunchParents divorced/ lives with motherMother clinically depressedFather physically abused himMother states she can not handle her son’s behavior/ hard to

enforce the rulesStudent is not doing well in school. He is in the office everyday

with behavioral problems, and not getting along with peers.

Diagnostic and Treatment Process

• Does a problem exist?• Diagnostic classification of the problem• Management of nursing problems• Evaluation of behavioral systems balance and

stability.

limitations

• Very individualFamily of the client is only considered as an

environmentFocused on nursing care of the hospitalized and

ill. Does not focus on health promotion, primary prevention, disease prevention

Do I like this theory?

YES!

Discussion Question:

• Describe a client in your work whose subsystems were not in balance? How can you as a nurse create equilibrium?

References

Alligood, M.R., Tomey, M.T., (2010). Nursing Theorist and Their Work, (7th, ed). Maryland Heights: Mosby Elsevier.

Botha, E. (1989). Theory development in perspective: The role of conceptual frameworks and models in theory development, Journal of Advanced Nursing, 14, 49-55.

Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2nd ed.). F.A.

Reynolds, W. and Cormack, D. (1991). An evaluation of the Johnson Behavioral Systems Model of Nursing, Journal of Advanced Nursing, 16, 1122-1130.

Tourville, C., & Ingalls, K. (2003). The living tree of nursing theories, Nursing Forum, 38(3), 21-36.