THE BEHAVIORAL SYSTEM MODEL NURSING
DOROTHY E. JOHNSON Is an external force acting to preserve the organization
Background
Aug. 21, 1919 – Born in Savannah, Georgia
1942 – BSN from Vanderbilt University
1948 – MSN in Public Health from Harvard
1949 – Faculty at UCLA
1977 – Retired in Florida
- Johnson first proposed her model in 1968 to foster the
“efficient & effective behavioral functioning in the
patient to prevent illness”
- She based her model on Florence Nightingale’s belief
that nursing is designed to help people prevent or
recover from illness or injury
- She borrowed ideas from systems theory to explain that
nursing is concerned with the individual as an integrated
whole
Johnson, 1990
The person experiencing a disease is more important
than the disease itself
Behavioral Systems Model
- The person is a behavioral system comprised of a set of
organized, interactive, interdependent, and integrated
subsystems
- Constancy is maintained through actions & behaviors
that are regulated & controlled by biological,
psychological, and sociological factors.
Metaparadigm
PERSON
- views person as having two major systems: biological
and behavioral system.
- As a behavioral system with patterned, repetitive &
purposeful ways of behaving that link the person to the
environment
- An individual composed of seven open & interactive
subsystems; a disturbance in one usually affects the
others
- Continually strives to maintain a steady state by
adapting & adjusting to environmental forces that cause
an imbalance; when an imbalance or health problem
occurs, the person’s physical, social or psychological
integrity is threatened.
HEALTH
- A state that is affected by social, biological
psychological, and physiological factors.
- The individual strives to maintain stability in these
factors.
ENVIRONMENT
- Consists of all the factors that are not part of the
individual’s behavioral system, but influence the system,
some of which can be manipulated by the nurse to
achieve the health goal for the patient.
- An individual’s behavior is influenced by all the events in
the environment. It varies from culture to culture.
of the patient’s behavior by means of imposing
regulatory mechanisms or by providing resources while
the patient is under stress
“A steady state is maintained through adjusting and
adapting to internal and external forces.”
Johnson’s 7 Subsystems
1. Attachment or Affiliative Subsystem
- Forms the basis for all social organization
- Promotes survival & provides a sense of
security
- Results in social inclusion, intimacy & the
formation of strong bonds
2. Dependency Subsystem
- promotes helping or nurturing behavior from
others
- Results in approval, attention, recognition &
physical assistance
3. Ingestive Subsystem
- Involves food intake
- Relates to the biological need for food & the
psychological meanings & structures of social
events surrounding food consumption
- Results in appetite satisfaction
4. Eliminative Subsystem
- involves behavior surrounding the excretion
of waste from the body
- Includes the psychological meanings & structures
of socially acceptable behaviors for waste
elimination
5. Sexual Subsystem
- involves behavior associated with procreation &
sexual gratification
- includes psychologically & socially acceptable
behaviors such as courtship & mating results in the
development of sex role identity & sex role behavior
6. Aggressive Subsystem
- involves behavior related to self- protection &
preservation of the self & society
- includes the belief that aggression is learned &
harmful & that people & property must be
respected & protected
- includes acknowledgment of realor imaginary
dangers to develop defenses to these threats
7. Achievement Subsystem
- involves behavior related to manipulation of the
environment to gain mastery & control over some
aspect of oneself or environment, this control is
measured against a standard of excellence
- includes intellectual, physical, creative,
mechanical & social skills
3 Functional Requirements of Humans
1. To be protected from noxious influences with which
the person cannot cope
2. To be nurtured through the input of supplies from
the environment
3. To be stimulated to enhance growth and prevent
stagnation
THEORY OF INTERPERSONAL RELATIONS
HILDEGARD PEPLAU
Interpersonal Relations Model
General Information:
- Peplau based her model on psychodynamic nursing,
which she defines as using the understanding of one’s
behavior to help others identify their difficulties
- In this model, the phases of nurse-patient relationship
reflect occurrences in personal interactions and during
these phases, the nurse assumes various roles such as
teacher, resource , counselor, leader, technical expert
and surrogate
Phase of Nurse-Patient Relationship
1. Orientation Phase
- The individual has a felt need and seeks professional
assistance
- The nurse helps the patient recognize & understand his
or her problem and determine his or her need for help
- Collaborative clarifying and defining of the problem.
- Patient & nurse work together to understand their
reactions to each other, mindful of potential
influencing factors such culture, religion, personal
experiences and preconceived ideas
2. Identification Phase
- The patient identifies with those who can help him or
her (relatedness)
- The nurse permits exploration of feelings to aid the
patient in undergoing illness as an experience that
reorient feelings & strengthens positive forces in the
personality & provides needed satisfaction
- The patient may begin to feel a sense of belonging and
may gain confidence in dealing with the targeted
problem
3. Exploitation Phase
- The patient derives the full value of the relationship as
he moves on from a dependent role to an independent
role
- The nurse can project new goals to be achieved through
personal effort & power shifts from the nurse to the
patient delays gratification to achieve newly formed
goals
4. Resolution Phase
- After the patient’s needs have been met, the
therapeutic relations ends
- The patient earns independence over his care as he
gradually puts aside old goals & formulates new goals
- This is a process in which the patient free himself or
herself from identification with the nurse
Metaparadigm
PERSON
- A man who is an organism that lives in an unstable
balance of a given system
HEALTH
- A word that symbolizes movement of the personality &
other ongoing human processes that directs the person
towards creative and, constructive, productive &
community living
- Peplau also gave importance on the belief that for
one’s health to be achieved & maintained, his needs
must be met
- These needs are physiological demands and
interpersonal conditions .
NURSING
- Describes as a significant, therapeutic interpersonal
process
- Is a human relationship between an individual who is
sick or has a felt need & a nurse who is educated to
recognize & respond to the need for help
- Achieve its goal by promoting the patient’s
development of skills to deal with problems & achieve
health; this is a mutual & collaborative process that
attempts to resolve this problem
- Views nursing process as having sequential steps that
focus on therapeutic interactions
ENVIRONMENT
- Defined as forces outside the organism & in the context
of the socially approved way of living, from which vital
human social processes are derived such as norms,
customs and beliefs
- However, these given conditions that lead to health
always include the interpersonal process
To help clients fulfill their needs, nurses assume many
roles: NURSING ROLES
1. Role of the Stranger
- The nurse must treat the patient with utmost courtesy,
which includes acceptance of the patient as a person &
due respect over his individuality
- Coincides with identification phase
2. Role of the resource person
- The nurse provides specific answers to questions which
include health information, advices & a simple
explanation of the healthcare team’s course of care
3. Teaching Role
- Combination of all roles
- Gives instructions and provides training; involves
analysis and synthesis of the learner's experience.
- The nurse gives much importance for self-care & in
helping him understand the therapeutic plan
3. Leadership Role
- The nurse as a leader must act in behalf of the patient’s
best interest & at the same time enable him to make
decisions over his care.
- This is achieved through cooperation and active
participation
5. Surrogate Role
- The patient’s dependency for his care gives the nurse a
surrogate role
- This creates an atmosphere wherein feelings previously
felt such as feelings towards her mother;
some other relationships are reactivated & nurtured
- The nurse then helps the patient & see the differences
between the nurse’s role & that of the recalled person

6. Counseling Role
- The role that has the greatest importance & emphasis in
nursing
- This role strengthens the nurse-patient relationship as
the nurse becomes a listening friend, an understanding
family member & someone who gives sound and
emphatic advises.
- Helps client understand and integrate the meaning of
current life circumstances; provides guidance and
encouragement to make changes.