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Critique of Theory

Theories are used to explain phenomena and guide practice among various disciplines. Models such as Johnson's behavioral model attempt to explain an observation or concept related to nursing. Johnson's behavioral model has served as a guide for nursing practice and research; however, there are several strengths, limitations, and opportunities for improvement in Johnson's theory. Johnson's theory is focused on the nursing care of the hospitalized and ill stricken patient. The theory does not focus on or address the paradigm of health promotion, primary prevention, and disease prevention. Health promotion and patient education is one of the focuses of nursing care. Nurses are responsible for the majority of the patient education that takes place in the hospital setting. Patient education is what helps prevent patients from experiencing disease and illness, which Johnson refers to as "stressors." Johnson's theory only focuses on the nurse's role of restoring equilibrium for the patient while they are in a state of distress. In reality, the nurse's role is more comprehensive than the behavioral model encompasses (Meleis, 1995). Johnson's theory has also been criticized for its failure to incorporate the nursing process. The nursing process is the basis of many undergraduate nursing curriculums. In contrast, Johnson's theory focuses on human behavior in response to stress or illness. The behavioral model underscores the importance of the nursing process. Johnson's behavioral model could have been used in addition to the nursing process. Additionally, the concepts of nursing in Johnson's theory have been criticized because of their high level of abstraction; however, several researchers have developed operational definitions for Johnson's original definitions (Meleis, 1995). Limited publication of Johnson's theory and research has hindered the pervasiveness of the behavioral model. Although, Johnson never published a book on her theory, she did write several chapters and articles explaining her ideas (McEwen & Willis, 2007). Most of Johnson's ideas regarding her theory were implemented only at the institution where she taught at the University of California. Ideas from her theory have been incorporated in the nursing education programs at the University of Colorado, University of Honolulu, and Vanderbilt University. There is little documentation or published works regarding Johnson's original ideas involving the development of a nursing education curriculum. Johnson's theory emphasizes her concern for ethical standards in nursing theories. Johnson stated that the use of the behavioral model should be in congruence with the values of the nursing profession as well as the values of the individual nurse. Johnson also stressed that patient interventions and treatment should be negotiated between the nurse and patient (Fawcett, 1994). Johnson's theory has provided several contributions to the nursing field. The assumptions of the behavioral model are descriptive, this allows future researchers the ability to retest and clarify

assumptions that lack clarity. The behavioral model identifies a clear purpose for nursing which is to restore or maintain behavioral system balance at the highest level for the individual. By establishing a goal, researchers are able to develop standards and measure the effectiveness of nursing interventions. Additionally, the behavioral model provides guidelines for the basis of patient distress by identifying the subsystems that are most likely to motivate human behavior (Fawcett, 1984). Johnson's behavioral model has been tested and utilized in nursing practice, administration, and research. The testability of Johnson's theory has been well documented in more than twenty research studies (McEwen & Willis, 2007). Johnson's clear explanation of concepts can serve as a guideline for researchers interested in nursing and its relation to the behavioral system. Johnson was influential in changing the way nursing was viewed. According to Johnson, nursing care has a significant impact on the health of individuals and the contribution that nursing offers is separate from the field of medicine. Johnson asserted that nursing and the medical field view patients in different ways. Johnson's proposition regarding the goal of nursing is remarkable, it help prompt the recognition of nursing as a discipline of its own (Fawcett, 1984). In conclusion, Johnson's theory has been utilized by various nurses and researchers. Despite the fact, her theory is not well known Dorothy Johnson should be recognized for her inspirational and thought provoking contributions to the field of nursing.

Critique of Her Theory


This presents an analysis and evaluation of Henderson 's nursing theory using Fawcett`s framework of analysis and evaluation of conceptual models of nursin g (2000). Henderson came up with a definition of nursing because of the observed differences in how nursing is defined, both by society and the nurses themselves. She felt it was necessary for nurses to have at least a guiding principle of what to them is nursing and act accordingly to that principle. Moreover, during that time, nurses functions were not identified programs for skills training and even education varied from school to school, to countries and even in hospitals . There were also legal barriers to how nurses should carry out their duties, which made the professions position in healthcare ambiguous an d misunderstood. The conceptual model of nursing developed by Henderson followed the humanistic approach, in which it emphasized the caring of the sick, the incapable and even the dying. It stressed more on what the nurses should do and who should they take care of and thus belongs to the reciprocal interaction world view category. The functions of nurses were to give intimate care to people who cannot function effectively on their own .It also emphasized that nurses be thought the skills and knowledge that would enable them to help their patients. The model also stressed that as soon as the patients are able nurses should be able to assist them in their recovery and if not to care for them in regaining their dignity and basic functioning.The person as defined in Hendersons model is all encompassing it applies to the sick, the well and the dying. It may be old, young, newborn, and children, normal, abnormal, male, and female, of different races and cultures and religion. For Henderson, the person is alive, breathing, needs to be loved and cared for, to be talked to and listened to.The environment of the person is described as limiting and keeps him /her from living.

Usefulness

Nursing education has been deeply affected by Hendersons clear vision of the functions of nurses. The principles of Hendersons theory were published in the major nursing textbooks used from the 1930s through the 1960s, and the principles embodied by the 14 activities are still important in evaluating nursing care in thee21st centaury. Others concepts that Henderson (1966) proposed have been used in nursing education from the 1930s until the present O'Malley, 1996)

Testability

Henderson supported nursing research, but believed that it should be clinical research (OMalley, 1996). Much of the research before her time had been on educational processes and on the profession of nursing itself, rather than on; the practice and outcomes of nursing , and she worked to change that. Each of the 14 activities can be the basis for research. Although the statements are not. Written in testable terms, they may be reformulated into researchable questions. Further, the theory can guide re search in any aspect of the ind ividuals care needs.

Limitations

Lack of conceptual linkage between physiological and other human characteristics. No concept of the holistic nature of human being. If the assumption is made that the 14 components prioritized, the relationship among the components is unclear. Lacks inter-relate of factors and the influence of nursing care. Assisting the individual in the dying process she contends that the nurse helps, but there is little explanation of what the nurse does.Peaceful death is curious and significant nursing role