Johnson's Behaviour System Model

Introduction

Dorothy E. Johnson was born August 21, 1919, in Savannah, Georgia. She completed her B.
S. N. from Vanderbilt University in Nashville, Tennessee, in 1942; and her M.P.H. from
Harvard University in Boston in 1948. From 1949 until her retirement in 1978 she was an
assistant professor of pediatric nursing, an associate professor of nursing, and a professor
of nursing at the University of California in Los Angeles. Dorothy Johnson has had an
influence on nursing through her publications since the 1950s. Johnson stressed the
importance of research-based knowledge about the effect of nursing care on clients.

Johnson’s behavior system model

In 1968 Dorothy first proposed her model of nursing care as fostering of “the efficient and
effective behavioral functioning in the patient to prevent illness". She also stated that
nursing was “concerned with man as an integrated whole and this is the specific knowledge
of order we require”. In 1980 Johnson published her conceptualization of “behavioral
system of model for nursing” this is the first work of Dorothy that explicates her definitions
of the behavioral system model.

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The Behavioral System Model Johnson believed that by grouping behaviors they could be
predicted and ordered. She categorized all human behaviors into eight subsystems. Each
subsystem has a specific task, however, the individual is viewed as a whole by virtue of the
interdependence of each subsystem (Reynolds and Cormack, 1991). When there is an equal
distribution among all eight subsystems then balance and equilibrium can be achieved.
Patient Behavioral
Systems - adapted
from Dee V and
Randell B (1989):

1. Ingestive –
Behaviors
associated
with the
intake of
needed
resources
from the
external

environments, including food, fluid, information, objects, for the purpose of

establishing an effective relationship with the environment. the emphasis is on the
meaning and structures of the social events surrounding the occasion when the food
is eaten”

2. Eliminative – Behaviors associated with the release of physical waste products.

human cultures have defined different socially acceptable behaviors for excretion of
waste ,but the existence of such a pattern remains different from culture to Culture.

3. Affiliative – Behaviors associated with the development and maintenance of

interpersonal relationships with parents, peers, authority figures. Established a
sense of relatedness and belonging with others including attachment behaviors,
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 interpersonal relationships and communication skills. social inclusion intimacy and
the formation and attachment of a strong social bond.”

4. Dependency – Behaviors associated with obtaining assistance from others in the

environment for completing tasks and/or emotional supports. Includes seeking of
attention, approval, recognition, basic self-care skills and emotional security.
approval, attention or recognition and physical assistance.

5. Sexual- Behaviors associated with a specific gender identity for the purpose of
ensuring pleasure/procreation, and knowledge and behavior being congruent with
biological sex. both biological and social factor affect the behavior in the sexual
subsystem.

6. Aggressive-protective – Behaviors associated with real or potential threat in the

environment for the purpose of ensuring survival. Protection of self through direct
or indirect acts. Identification of potential danger. It relates to the behaviors
concerned with protection and self preservation Johnson views aggressive
subsystem as one that generates defensive response from the individual when life or
territory is being threatened.

7. Achievement – Behaviors associated with mastery of oneself and one’s environment

for the purpose of producing a desired effect. Includes problem- solving activities.
Knowledge of personal strengths and weaknesses. provokes behavior that attempt
to control the environment intellectual, physical, creative, mechanical and social
skills achievement are some of the areas that Johnson recognizes. Restorative –
Behaviors associated with maintaining or restoring energy equilibrium, e.g. relief
from fatigue, recovery from illness, sleep behavior, leisure/recreational interests and
sick role behavior.

The structure of each subsystem includes four elements:

(1) Drive or goal—the motivation for behavior.
(2) Set—the individual's predisposition to act in certain ways to fulfill the function
of the subsystem.
(3) Choice—the individual's total behavioral repertoire for fulfilling subsystem
functions, which encompasses the scope of action alternatives from which the
person can choose.
(4) Action—the individual's actual behavior in a situation. Action is the only
structural element that can be observed directly; all other elements must be
inferred from the individual's actual behavior and from the consequences of that
behavior.

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Definition of nursing according to Dorothey E. Johnson She defined nursing as “an
external regulatory force which acts to preserve the organization and integration of the
patients behaviors at an optimum level under those conditions in which the behaviors
constitutes a threat to the physical or social health, or in which illness is found”

Based on this definition there are four goals of nursing are to assist the patient:

 Whose behavior commensurate with social demands.

 Who is able to modify his behavior in ways that it supports biological imperatives.

 Who is able to benefit to the fullest extent during illness from the physicians
knowledge and skill.

 Whose behavior does not give evidence of unnecessary trauma as a consequence of

illness.

Assumptions of behavioral system model

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There are several layers of assumptions that Johnson makes in the development of
conceptualization of the behavioral system model

There are 4 assumptions of system:

 First assumption states that there is “organization, interaction, interdependency and

integration of the parts and elements of behaviors o to make up the system ” .

 A system “tends to achieve a balance among the various forces operating within and
upon it', and that man strive continually to maintain a behavioral system balance
and steady state by more or less automatic adjustments and adaptations to the
natural forces impinging upon him.”

 A behavioral system, which both requires and results in some degree of regularity
and constancy in behavior, is essential to man that is to say, it is functionally
significant in that it serves a useful purpose, both in social life and for the individual.

 The final assumption states “system balance reflects adjustments and adaptations
that are successful in some way and to some degree.”

The integration of these assumptions provides the behavioral system with the pattern of
action to form “an organized and integrated functional unit that determines and limits the
interaction between the person and his environment and establishes the relation of the
person to the objects, events and situations in his environment.

Assumptions about structure and function of each subsystem are:

 “From the form the behavior takes and the consequences it achieves can be inferred
what “drive” has been stimulated or what “goal” is being sought”

 Each individual has a “predisposition to act with reference to the goal, in certain
ways rather than the other ways”. This predisposition is called asthat g “set”.

 Each subsystem has a repertoire of choices or “scope of action”

 The fourth assumption is that it produce “observable outcome” that is the

individual’s behavior.

Each subsystem has three functional requirements

 System must be “protected" from noxious influences with which system cannot
cope”.

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  Each subsystem must be “nurtured” through the input of appropriate supplies from
the environment.

 Each subsystem must be “stimulated” for use to enhance growth and prevent
stagnation.

 Johnson believes each individual has patterned, purposeful, repetitive ways of

acting that comprise a behavioral system specific to that individual.

These actions and behaviors form an organized and integrated functional unit that
determines and limits the interaction between the person and his environment and
establishes the relationship of the person to the objects event situations in the
environment.

These behaviors are “orderly, purposeful and predictable and sufficiently stable and
recurrent to be amenable to description and explanation”

The four major concepts

“Individual”:

Johnson views “human being” as having two major systems,

(1) biological system and

(2) behavioral system.

It is role of the medicine to focus on biological system where as Nursling's focus is

the behavioral system.

“Society”:

Relates to the environment on which the individual exists. According to Johnson an

individual’s behavior is influenced by the events in the environment.

“Health”:

is a purposeful adaptive response, physically mentally, emotionally, and socially to internal

and external stimuli in order to maintain stability and comfort.

“Nursing” has a primary goal that is to foster equilibrium within the individual. She stated
that nursing is concerned with the organized and integrated whole, but that the major focus
is on maintaining a balance in the Behavior system when illness occurs in an individual.

Nursing process

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Assessment

Grubbs developed an assessment tool based on Johnson’s seven subsystems plus a

subsystem she labeled as restorative which focused on activities of daily living.

An assessment based on behavioral model does not easily permit the nurse to gather
detailed information about the biological systems:

Affiliation, Dependency, sexuality, Aggression, Elimination, Ingestion, Achievement,

Restorative

Diagnosis

Diagnosis tends to be general to the system than specific to the problem. Grubb has
proposed 4 categories of nursing diagnosis derived from Johnson's behavioral system
model.

Insufficiency

Discrepancy

Incompatibility

Dominance

EvaluationEvaluation is based on the attainment of a goal of balance in the identified

subsystems. If the baseline data are available for an individual, the nurse may have goal for
the individual to return to the baseline behavior. If the alterations in the behavior that are
planned do occur, the nurse should be able to observe the return to the previous behavior
patterns. Johnson's behavioral model with the nursing process is a nurse centered activity,
with the nurse determining the clients needs and state behavior appropriate for that need.

Johnson’s Characteristics of a theory

Interrelate concepts to create a different way of viewing a phenomenon.
Theories must be logical in nature.
Theories must be simple yet generalizable.
Theories can be bases of hypothesis that can be tested.
Theories contribute to and assist in increasing the body of knowledge within the discipline
through the research implemented to validate them.
Theories can be utilized by practitioners to guide and improve their practice.
Theories must be consistent with other validated theories, laws and principles but will
leave unanswered questions that need to be investigated.
Limitation

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  Johnson does not clearly interrelate her concepts of subsystems comprising the
behavioral system model.

 The definition of concept is so abstract that they are difficult to use.

 It is difficult to test Johnson's model by development of hypothesis.

 The focus on the behavioral system makes it difficult for nurses to work with
physically impaired individual to use this theory.

 The model is very individual oriented so the nurses working with the group have
difficulty in its implementation.

 The model is very individual oriented so the family of the client is only considered as
an environment.

 Johnson does not define the expected outcomes when one of the system is affected
by the nursing implementation an implicit expectation is made that all human in all
cultures will attain same outcome –homeostasis.

 Johnson’s behavioral system model is not flexible.

Implications for Nursing Practice

Nursing practice is directed toward restoration, maintenance, or attainment of behavioral
system balance and dynamic stability at the highest possible level for the individual.
Johnson's practice methodology, which is called the Nursing Diagnostic and Treatment
Process, encompasses four steps:

Determination of the existence of a problem The nurse obtains past and present family
and individual behavioral system histories by means of interviews, structured and
unstructured observations, and objective methodologies. The nurse obtains data about the
nature of behavioral system functioning in terms of the efficiency and effectiveness with
which the client's goals are obtained. The nurse obtains data to determine the degree to
which the behavior is purposeful, orderly, and predictable. The nurse interviews the client
and family to determine the condition of the subsystem structural components and uses the
obtained data to: make inferences about drive strength, direction, and value; make
inferences about the solidity and specificity of the set; make inferences about the range of
behavior patterns available to the client; make inferences about the usual behavior in a
given situation. The nurse assesses and compares the client's behavior with the following
indices for behavioral system balance and stability: the behavior is succeeding to achieve
the consequences sought; effective motor, expressive, or social skills are evident; the
behavior is purposeful; the behavior is orderly; the behavior is predictable; the amount of
energy expended to achieve desired goals is acceptable; the behavior reflects appropriate
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choices; the client is sufficiently satisfied with the behavior; the nurse makes inferences
about the organization, interaction, and integration of the subsystems.

1. Diagnostic classification of problems Internal Subsystem Problems are present

when: functional requirements are not met; inconsistency or disharmony among the
structural components of subsystems is evident; the behavior is inappropriate in the
ambient culture. Intersystem Problems are present when: the entire behavioral
system is dominated by one or two subsystems; a conflict exists between two or
more subsystems.

2. Management of nursing problems The general goals of action are to: restore,
maintain, or attain the client's behavioral system balance and stability; help the
client to achieve a more optimum level of balance and functioning when this is
possible and desired. The nurse determines what nursing is to accomplish on behalf
of the behavioral system by determining who makes the judgment regarding the
acceptable level of behavioral system balance and stability. The nurse identifies the
value system of the nursing profession as well as his or her own explicit value
system.
The nurse negotiates with the client to select a type of treatment: The nurse
temporarily Imposes External Regulatory or Control Mechanisms by: setting limits for
behavior by either permissive or inhibitory means; inhibiting ineffective behavioral
responses; assisting the client to acquire new responses; reinforcing appropriate
behaviors. The nurse Repairs Damaged Structural Components in the desirable
direction by: reducing drive strength by changing attitudes; redirecting goals by
changing attitudes; altering set by instruction or counseling; adding choices by
teaching new skills. The nurse Fulfills Functional Requirements of the subsystems by:
protecting the client from overwhelming noxious influences; supplying adequate
nurturance through an appropriate input of essential supplies; providing
stimulation to enhance growth and to inhibit stagnation. The nurse negotiates the
treatment modality with the client by: establishing a contract with the client;
helping the client to understand the meaning of the nursing diagnosis and the
proposed treatment. If the diagnosis and/or proposed treatment is rejected, the
nurse continues to negotiate with the client until agreement is reached.

3. Evaluation of behavioral system balance and stability The nurse compares the
client's behavior after treatment to indices of behavioral system balance and
stability.

Implications for Nursing Education

Education for nursing practice requires a thorough grounding in the natural and social
sciences, with emphasis on the genetic, neurological, and endocrine bases of behavior;
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psychological and social mechanisms for the regulation and control of behavior; social
learning theories; and motivational structures and processes. The professional aspects of
the curriculum focus on study of the behavioral system as a whole and as a composite of
subsystems; pathophysiology; the clinical sciences of nursing and medicine; and the health
care system.

By ;

Sneha patel

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