Reporters: Amelie Rose R.

Robles &
Marion Kaz P. Alayon
At the end of this class the students would be able to:
 Relate life history of Dorothy Johnson
 Identify and explain briefly the theoretical sources of
Johnson’s Theory
 Enumerate Johnson’s Metaparadigm in Nursing
 Explain the acceptance of this theory by the Nursing
Community
 Analysis and application of the theory to present day
situation (nursing practice, nursing education and nursing
research)
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Born August 21, 1919, in Savannah Georgia

 Died Feb. 1999 at 80 years old

 B. S. N. from Vanderbilt University in

Nashville, Tennessee, in 1942; and her M.P.H.
from Harvard University in Boston,
Massachusetts in 1948.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Influenced nursing through her publications since
the 1950’s

 Most of her education career was in Pediatric

Nursing at the University of California, L.A.

 She withdrew from the Academe as a Professor

Emeritus in January 1, 1978

 An early advocate of Nursing as a Science and an art

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 1961: she proposed that nursing care
facilitated the client’s maintenance of a state
of equilibrium. She recognized 2 areas of
focus for nursing care:

1.) nursing care should lessen stimuli (stressors)

2.) nursing care should offer support of the

client’s normal defenses and adaptive process
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Influences in the development of her Model:

 Nightingale: focused more on the primary needs of

the patient rather than the disease process.

 In the 1950s – 1960s there was an escalating

number of observational studies on child and adult
behavior patterns available.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 General Systems Theory

 1968: she first proposed her model of nursing care

as the nurturing of the competent and helpful
behavioral functioning in the patient to avoid
illness.

 1980: printed her conceptualization of the

Behavioral System Model for Nursing.
 
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Behavior  the output of intraorgasmic structures and
processes as they are coordinated and articulated by and
responsive to changes in sensory stimulation.
 
 System  a whole that functions as a whole by virtue of the
interdependence of its parts (Rapaport); there is
organization, interaction and interdependence of parts
(Chinn)
 
 Subsystems  a minisystem with its own particular goal and
function that can be maintained as long as its relationship to
other subsystems and the environment is not disturbed.
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Equilibrium  a stabilized but more or less transitory,
resting state in which the individual is in harmony with
himself and his environment; it is not synonymous with state
of health since it may be found either in health or illness.

 Tension  a state of being stretched or strained and can be

viewed as an end-product of a disturbance in equilibrium;
can be constructive or destructive.

 Stressor  internal or external stimuli that produce tension

and result in a degree of instability

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 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, events, and situations in the environment.
These behaviors are “orderly, purposeful and predictable and
sufficiently stable and recurrent to be amenable to
description and explanation”.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 The theory addresses
two major components:
 the patient
 nursing

 Each system can be described and analyzed

in terms of structure and functional
requirements.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 4 structural elements:
 drive or goal
 set, predisposition to act
 choice, alternatives for action
 behavior
3 functional requirements:
 protection
 nurturance
 stimulation
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
  the system and subsystems tend to be self-
maintaining and self-perpetuating as long as
internal or external conditions are orderly and
predictable.

 the responses to the subsystems are developed

through motivation, experience, and learning and
are influenced by biological, psychological and
social factors.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Attachment / Affiliative Subsystem
 Earliest response system to expand in a person
 Allows social inclusion, closeness and a pattern and
continuance of a strong public bond.

 Dependency Subsystem
 Dependency behaviors are actions that trigger nurturing
behaviors from other individuals in the environment.
 The product is consent, interest or appreciation, and
physical support

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Ingestive Subsystem
 the emphasis is on the meaning and structures of the
social events surrounding the occasion when food is eaten

 Eliminative Subsystem
 Cultures have defined different socially acceptable
behaviors for excretion of waste, but the existence of such
a pattern remains different from culture to culture.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Sexual Subsystem
 Imitates behaviors related to procreation or reproduction.
 Both biological and social factors are involved.

 Aggressive subsystem
 Relates to behaviors concerned with defense and self-
preservation.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Achievement Subsystem
 Contains behaviors that attempt to control the
environment.
 Intellectual, physical, imaginative, mechanical and
communal skills are some areas Johnson distinguishes

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Simplicity
 The theory is straightforward in relation to the
number of concepts. However, it is potentially
complex since there is a number of a possible
interrelationship between and among the
behavioral systems, its subsystems, and the forces
drawing them.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Generality
 It is relatively limitless when applied to sick
individuals, but it has not been used as much with
the well individual or groups. A person is the sum
of interactive behavioral systems. In later
publications, Johnson emphasized the role of
nurses in the preventive healthcare of individuals
and for the society. She stated that Nursing needs
to focus on developing preventive nursing to fulfill
its social obligations.
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Empirical Precision
 So far, a moderate degree of empirical precision
has been demonstrated in research using Johnson’s
model. However, throughout Johnson’s writings,
terms such as balance, stability, and equilibrium,
adjustments and adaptations, disturbances,
disequilibrium and behavioral disorders are used
interchangeably, which confuse their meanings.
The clarity of definitions in the subsystems
improves the model’s empirical precision.
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Derivable Consequences
 Johnson’s model guides nursing practice, education and
research; generates new ideas about nursing; and
differentiates nursing from other professions. By focusing on
Behavior rather than biology it clearly differentiates nursing
from medicine although the concepts overlap with the
psychosocial professions. The theory has directed questions
for nursing research. It has been analyzed and judge to be
appropriate as a basis for development of nursing curriculum.
Practitioners and patients have judged the resulting nursing
actions to be satisfactory. The theory has good potential for
continued use in nursing to achieve valued nursing goals.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Jose, 8 weeks old, was brought into the clinic for a routine check-
up. He presents with no weight gain since his check-up at age 4
weeks. His mother states that she feeds him but does not seem to
eat much. He sleeps 4-5 hours between feedings. His mother holds
him in her arms without making trunk – to – trunk contact. When
assessed by the nurse, it was noted that his mother never looks
and speaks at Jose. She states that he was a planned baby but she
never realized how much work an infant could be. She says her
mother has told her she was not a good mother because Jose is not
gaining weight as he should. She states that she has not called the
nurse when she knew that Jose was not gaining weight because
the nurse would think that she was a bad mother just as her own
mother thought she was.
12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon
 Because of the nature of this problem, a decision is made to use a tool
that specifically focuses on parent-infant interaction during a feeding
situation. Thus the Nursing Child Assessment Feeding scale is used
during a feeding that takes place at a normal feeding time for Jose. Jose
cries at the beginning of the feeding and turns toward his mother’s
hand when she touches his cheek. His mother does not speak to Jose or
in any verbal way acknowledge his hunger. When Jose slightly chokes
on some formula, she does not remove the bottle from his mouth. His
mother does not describe any of the environments to Jose nor does she
stroke his body or make eye contact with him. Jose does not reach out
to touch his mother nor make any vocalizations. The assessment scale
indicates that both mother and baby are not giving signals to each
other at a level at which they can respond appropriately.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 All subsystems should be involved.
 Affiliative subsystem
▪ -focuses on the specific behaviors manifested by Jose to
indicate attachment to his mother.
 Dependency subsystem
▪ - focuses on the specific behaviors manifested by Jose to
signal his mother to his needs.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

  Insufficient development of the affiliative
subsystem

 Insufficient development of the dependency

subsystem

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

  Focuses on developing the mother’s awareness of
the meaning of Jose’s infrequent cues.

 Further assistance needs to be given in helping

the mother in communicating with her infant.

 The nurse should place herself in Jose’s role and

talk for him to his mother.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 Two Criteria:
 Jose’s weight gains or losses are carefully
assessed.
 The mother- infant contact can be reassessed
again using the Nursing Child Assessment
Feeding Scale, which allows for comparison of
the observation with a series of succeeding
observations.

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon

 References:

 Theoretical Foundations of Nursing: The Philippine

Perspective by Octaviano, E.F. & Balita, C.E

 Fundamentals of Nursing (5th Edition) by Kozier, B., Erb,

G., Blais, K. & Wilkinson, J.

 Nursing Theorists and their Work (5th Edition) by Tomey,

Ann Marriner, Alligood, Martha Raile

12/08/21 Reporters: Amelie Rose R. Robles & Marion Kaz P. Alayon