Nursing Systems

Theories
 Dorothy Johnson
1919 - 1999

Behavioral System Model

• Central theme: the human as a
behavioral system
• Person: Persons have two major
systems, the biologic and behavioral.
• Environment: Society is the
environment in which an individual
exists thereby influencing the
individual’s behavior.
• Health: Health is a dynamic state
influenced by biologic, psychologic,
and social factors.
Biologic Behavioral
system system
7 Behavioral Subsystems:
• Attachment/affiliative  “social
inclusion, intimacy & the formation &
maintenance of a strong social bond”
 significant other  significant
others
• Dependency = “succoring” behaviors
 nurturing behaviors from other
individuals in the environment
(“approval, attention or recognition &
physical assistance”)
• Ingestive = meanings & structures of
social events when food is taken
• Eliminative = socially acceptable
manner (time & place) for excretion
of wastes
• Sexual – related to culture
• Aggressive = protection & self-
preservation  defensive responses
for self & society
• Achievement = efforts to control the
environment; areas of
accomplishment include intellectual,
physical, creative, mechanical &
social skills
• Nursing is an art and science whose
primary goal is to foster balance
within an individual by providing
external assistance before and
during balance disturbances.
 Betty Neuman
1924 -

Systems Model
• Central theme: a health systems
model for a total person approach
to client problems
• Person: Each human is a total
person as a client system and is a
composite of biologic, psychologic,
sociocultural, and developmental
variables.
• Environment: It is made up of
internal and external forces that
surround humans and with which
they constantly interact.
• Health: Optimal state of wellness at
a given time; continuum = dynamic
levels of wellness or stable lines of
defense. Health and wellness exist
if all parts and subparts are in
harmony with the whole person.
• Nursing: A unique profession in that
it is concerned with all the variables
affecting an individual’s response to
stressors.
Levels of prevention
• Primary
– Occurs before the system reacts to a
stressor
– Health promotion & maintenance of
wellness
– Preventing stress & strengthening the
flexible line of defense (outer
boundary of the person & the initial
response or protection of the system
to stressors)
• Secondary
– Occurs after the system reacts to a
stressor = existing symptoms
– Early case-finding & treatment of
symptoms
– Strengthening internal lines of
defense
• Normal line of defense – baseline used
for determining deviation from the normal
• Lines of resistance – protect the basic
structure & get activated when the
normal line of defense is invaded by
environmental stressors
• Tertiary
– Occurs after the system has been
treated through secondary prevention
strategies
– Purpose: to maintain stability
– Involves
• Reconstitution – increase in energy that
occurs in relation to the degree of reaction
to the stressor
• Rehabilitation – developing existing/
remaining potentials of the system