Behavioral system model
l Dorothy E. Johnson (August 21, 1919 – February 1999) was one of the greatest nursing
theorists who developed the “Behavioral System Model.” Her theory of nursing defines
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 behavior constitutes a threat to the physical or social health, or in which illness is
found.”
Biography of the theorist
Early Life
Dorothy Johnson was born on August 21, 1919, in Savannah, Georgia. She was the youngest
of seven children. Her father was the superintendent of a shrimp and oyster factory, and her
mother was very involved and enjoyed reading. In 1938, she finished her associate’s degree
at Armstrong Junior College in Savannah, Georgia. Due to the Great Depression, she took a
year off from school to be a governess, or teacher, for two children in Miami, Florida. This
was when she began to realize her love for children, nursing, and education.
Education
Vanderbilt University School of Nursing Class of 1942 with Dorothy Johnson on the back row
second from left.
Dorothy Johnson’s professional nursing career began in 1942 when she graduated from
Vanderbilt University School of Nursing in Nashville, Tennessee. She was the top student in
her class and received the prestigious Vanderbilt Founder’s Medal.
In 1948, she received her master’s in public health from Harvard University in Boston,
Massachusetts.
Career and Appointments
Dorothy E. Johnson
After graduation, Dorothy Johnson’s professional experiences involved mostly teaching,
although she was a staff nurse at the Chatham-Savannah Health Council from 1943 to 1944.
She was an instructor and an assistant professor in pediatric nursing at Vanderbilt University
School of Nursing. From 1949 until her retirement in 1978 and her subsequent move to Key
Largo, Florida, Johnson was an assistant professor of pediatric nursing, an associate
professor of nursing, and a nursing professor at the University of California, Los Angeles.
In 1955 and 1956, Johnson was a pediatric nursing advisor assigned to the Christian Medical
College School of Nursing in Vellore, South India. From 1965 to 1967, she served as
chairperson on the California Nurses Association committee that developed a position
statement on specifications for the clinical specialist.
Behavioral System Model
Dorothy Johnson is known for her “Behavioral System Model of Nursing,” which was first
proposed in 1968. Her nursing model states that “each individual has patterned, purposeful,
repetitive ways of acting that comprises a behavioral system specific to that individual.”
It advocates the fostering of efficient and effective behavioral functioning in the patient to
prevent illness. The patient is defined as a behavioral system composed of seven behavioral
subsystems: affiliative, dependency, ingestive, eliminative, sexual, aggressive, and
achievement.
Each subsystem also has three functional requirements, which include (1) protection from
noxious influences, (2) provision for a nurturing environment, and (3) stimulation for
growth. An imbalance in each system results in disequilibrium. The nurse’s role is to help the
patient maintain his or her equilibrium.
The Behavioral System Model of Nursing is further discussed below.
Works
Johnson, author of “One Conceptual Model of Nursing.”
Dorothy Johnson was a prolific writer on the subject of nursing theory. Her many
publications on this subject profoundly influenced theoretical thinking in nursing during the
second half of the twentieth century. Johnson’s publications include four books, more than
30 articles in periodicals, and many papers, reports, proceedings, and monographs.She held
a strong conviction that continuous improvement of care was the ultimate goal of nursing.
Her 1968 paper, entitled, One Conceptual Model of Nursing, is a classic contribution to
Nursing literature.Two of Johnson’s many works include Theory Development: What, Why,
How? and Barriers and Hazards in Counseling.
Awards and Honors
Screengrab from Johnson’s interview
about her Behavioral Systems Model
Of the many honors she received, Dorothy Johnson was proudest of the 1975 Faculty Award
from graduate students, the 1977 Lulu Hassenplug Distinguished Achievement Award from
the California Nurses Association, and the 1981 Vanderbilt University School of Nursing
Award for Excellence in Nursing.
Death
Dorothy Johnson died in February 1999 at the age of 80. Before she died, she was pleased
that her theory had been found useful in furthering the development of a theoretical basis
for nursing and was being used as a nursing practice model on an institution-wide basis. Still,
she reported that her greatest source of satisfaction came from following her students’
productive careers.
Johnson’s Behavioral System Model
Dorothy E. Johnson is well-known for her “Behavioral System Model,” which was first
proposed in 1968. Her model was greatly influenced by Florence Nightingale’s book, Notes
on Nursing. It advocates fostering efficient and effective behavioral functioning in the
patient to prevent illness and stresses the importance of research-based knowledge about
the effect of nursing care on patients.
Johnson’s Behavioral System Model is a nursing care model that advocates the fostering of
efficient and effective behavioral functioning in the patient to prevent illness. The patient is
identified as a behavioral system composed of seven behavioral subsystems: affiliative,
dependency, ingestive, eliminative, sexual, aggressive, and achievement. Each subsystem’s
three functional requirements include protection from noxious influences, provision for a
nurturing environment, and stimulation for growth. An imbalance in any of the behavioral
subsystems results in disequilibrium. It is nursing’s role to assist the client in returning to a
state of equilibrium.
Behavioral System Model
Dorothy Johnson’s theory defined Nursing as “an external regulatory force which acts to
preserve the organization and integration of the patient’s behaviors at an optimum level
under those conditions in which the behavior constitutes a threat to the physical or social
health, or in which illness is found.”
It also states that “each individual has patterned, purposeful, repetitive ways of acting that
comprises a behavioral system specific to that individual.”
Goals
Dorothy Johnson began her work on the model with the premise that nursing was a
profession that made a distinctive contribution to society’s welfare. Thus, nursing had an
explicit goal of action in patient welfare.
According to the Behavior System Model, the goals of nursing are fourfold: (1) To assist the
patient whose behavior is proportional to social demands. (2) To assist the patient who can
modify his behavior in ways that supports biological imperatives. (3) To assist the patient
who can benefit to the fullest extent during illness from the physician’s knowledge and skill.
And (4) To assist the patient whose behavior does not give evidence of unnecessary trauma
as a consequence of illness.
Assumptions of the Behavioral System Model
The assumptions made by Dorothy Johnson’s theory are in three categories: assumptions
about system, assumptions about structure, and assumptions about functions.
Johnson identified several assumptions that are critical to understanding the nature and
operation of the person as a behavioral system: (1) There is “organization, interaction,
interdependency and integration of the parts and elements of behaviors that go to make up
the system.” (2) A system “tends to achieve a balance among the various forces operating
within and upon it, and that man strives continually to maintain a behavioral system balance
and steady-state by more or less automatic adjustments and adaptations to the natural
forces occurring on him.” (3) A behavioral system, which requires and results in regularity
and constancy in behavior, is essential to man. It is functionally significant because it serves
a useful purpose in social life and the individual. And (4) “System balance reflects
adjustments and adaptations that are successful in some way and to some degree.”
The four assumptions about structure and function are that: (1) “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.” (2) Each person has a “predisposition to act
concerning the goal, in certain ways rather than the other ways.” This predisposition is
called a “set.” (3) Each subsystem has a repertoire of choices called a “scope of action.” And
(4) The individual patient’s behavior produces an outcome that can be observed.
And lastly, there are three functional requirements for the subsystems.: (1) The system
must be protected from toxic influences with which the system cannot cope. (2) Each
system has to be nurtured through the input of appropriate supplies from the environment.
And (3) The system must be stimulated for use to enhance growth and prevent stagnation.
Major Concepts
The following are the major concepts and definitions of Johnson’s nursing model, including
the definition for its nursing metaparadigm:
Human Beings
Johnson views human beings as having two major systems: the biological system and the
behavioral system. It is the role of medicine to focus on the biological system, whereas
nursing focuses on the behavioral system.
The concept of a human being was defined as a behavioral system that strives to make
continual adjustments to achieve, maintain, or regain balance to the steady-state
adaptation.
Environment
The environment is not directly defined, but it is implied to include all elements of the
human system’s surroundings and includes interior stressors.
Health
Health is seen as the opposite of illness, and Johnson defines it as “some degree of
regularity and constancy in behavior. The behavioral system reflects adjustments and
adaptations that are successful somehow, and to some degree… adaptation is functionally
efficient and effective.”
Nursing
Nursing is seen as “an external regulatory force that acts to preserve the organization and
integrate the patient’s behavior at an optimal level under those conditions in which the
behavior constitutes a threat to physical or social health or in which illness is found.”
Behavioral system
Man is a system that indicates the state of the system through behaviors.
System
That which functions as a whole under organized independent interaction of its parts.
Subsystem
A mini system is maintained concerning the entire system when it or the environment is not
disturbed.
Subconcepts
Structure
The parts of the system that make up the whole.
Variables
Factors outside the system influence the system’s behavior, but the system lacks the power
to change.
Boundaries
The point that differentiates the interior of the system from the exterior.
Homeostasis
Process of maintaining stability.
Stability
Balance or steady-state in maintaining a balance of behavior within an acceptable range.
Stressor
A stimulus from the internal or external world that results in stress or instability.
Tension
The system’s adjustment to demands, change or growth, or to actual disruptions.
Instability
State in which the system output of energy depletes the energy needed to maintain
stability.
Set
The predisposition to act. It implies that despite having only a few alternatives to select a
behavioral response, the individual will rank those options and choose the option
considered most desirable.
Function
Consequences or purposes of action.
7 Subsystems of the Behavior System Model
Johnson identifies seven subsystems in the Behavioral System Model. They are:
Johnson’s Behavioral System Model
Attachment or affiliative subsystem
Attachment or affiliative subsystem is the “social inclusion intimacy and the formation and
attachment of a strong social bond.” It is probably the most critical because it forms the
basis for all social organizations. On a general level, it provides survival and security. Its
consequences are social inclusion, intimacy, and the formation and maintenance of a strong
social bond.
Dependency subsystem
The dependency subsystem is the “approval, attention or recognition and physical
assistance.” In the broadest sense, it promotes helping behavior that calls for a nurturing
response. Its consequences are approval, attention or recognition, and physical assistance.
Developmentally, dependency behavior evolves from almost total dependence on others to
a greater degree of dependence on self. A certain amount of interdependence is essential
for the survival of social groups.
Ingestive subsystem
An ingestive subsystem is the “emphasis on the meaning and structures of the social events
surrounding the occasion when the food is eaten.” It should not be seen as the input and
output mechanisms of the system. All subsystems are distinct subsystems with their own
input and output mechanisms. The ingestive subsystem “has to do with when, how, what,
how much, and under what conditions we eat.”
Eliminative subsystem
Eliminative subsystem states that “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.” It addresses “when, how, and under what conditions we
eliminate.” As with the ingestive subsystem, the social and psychological factors influence
the biological aspects of this subsystem and may conflict with the eliminative subsystem.
Sexual subsystem
A sexual subsystem is both a biological and social factor that affects behavior. It has the dual
functions of procreation and gratification. Including, but not limited to, courting and mating,
this response system begins with the development of gender role identity and includes a
broad range of sex-role behaviors.
Aggressive subsystem
The aggressive subsystem relates to protection and self-preservation, generating a defense
response when there is a threat to life or territory. Its function is protection and
preservation. Society demands that limits be placed on self-protection modes and that
people and their property be respected and protected.
Achievement subsystem
The achievement subsystem provokes behavior that tries to control the environment. It
attempts to manipulate the environment. Its function is to control or mastery an aspect of
self or environment to some standard of excellence. Areas of achievement behavior include
intellectual, physical, creative, mechanical, and social skills.
Behavioral System Model and The Nursing
Process
The nursing process of the Behavior System Model of Nursing begins with assessing and
diagnosing the patient. Once a diagnosis is made, the nurse and other healthcare
professionals develop a nursing care plan of interventions and setting them in motion. The
process ends with an evaluation, which is based on the balance of the subsystems.
Johnson’s Behavioral System Model is best applied in the evaluation phase, during which
time the nurse can determine whether or not there is balance in the subsystems of the
patient. If a nurse helps a patient maintain an equilibrium of the behavioral system through
an illness in the biological system, they have been successful in the role.
Strengths
Dorothy Johnson’s theory guides nursing practice, education, and research, generate new
ideas about nursing; and differentiates nursing from other health professions. It has been
used in inpatient, outpatient, and community settings as well as in nursing administration. It
has always been useful to nursing education and has been used in educational institutions in
different parts of the world.
Another advantage of the theory is that Johnson provided a frame of reference for nurses
concerned with specific client behaviors. It can also be generalized across the lifespan and
cultures. The theory also has the potential for continued utility in nursing to achieve valued
nursing goals.
Weaknesses
The theory is potentially complex because there are several possible interrelationships
among the behavioral system, its subsystems, and the environment. Potential relationships
have been explored, but more empirical work is needed. Johnson’s work has been used
extensively with people who are ill or face the threat of illness. However, its use with
families, groups, and communities is limited. Though the seven subsystems identified by
Johnson are said to be open, linked, and interrelated, there is a lack of clear definitions for
the interrelationships among them, making it difficult to view the entire behavioral system
as an entity. The problem involving the interrelationships among the concepts also creates
difficulty following the logic of Johnson’s work.
NURSING PROCESS:
ASSESMENT:
Grubbs developed an assessment tool based on Johnson seven subsystems. She added a
subsystem known as restorative. As assessment based on model does not easily allow the
nurse to gather detailed information about biological systems
DIAGNOSIS:
Diagnosis tends to be general to the system than specific to the problem, Johnson model
didn’t write about the nursing diagnosis.
PLANNAING:
The plan will focus on the nurse actions to change clients behaviour, these plans then have
goals, to bring about homeostasis in a subsystem.
EVALUATION:
Its based on the achievement pf a goal of balance in the identified subsystem..
CHARECTERISTICS OF A THEORY:
1. Interrelated concepts to create a different way of viewing a phenomenon
2. Theory must be logical in nature
3. Theory must be simple yet generalized.
4. Theory can be bases of hypothesis that can be tested.
5. Theories contribute to and assist in increasing the body of knowledge with in the
discipline through the research implemented to validate them.
6. Theories can be utilized by practitioners to guide and improve their practice.
7. Theories must be consistent with other validated theories, laws and principle but
will leave unanswered question that need to be investigated.
APPLICATIONS
NURSING EDUCATION
This theory can be used in research and education.
his model has utility in nursing education by analysing it.
Person as a behavioural system has goals and straight forward curse planning and can be
used in curriculum.
The individual observed as a whole considering external influence s, and studied within the
subsystem.
The Nursing process linked with theoretical model are commonly used to address all areas.
NURSING ADMINISTRATION
Cooperation of staff is needed , to implement Dorothy Johnsons theory.
Social workers will be needed for environmental issues and for economical issues. That
affects medication fulfilment.
This theory has been used for the management of impaired nurse.
NURSING REASERCH
Nursing research needed to identify and explain behavioural system disorder which arise in
connection with illness and develop the rational for the management.
Many nursing researchers have demonstrated this m0odel is useful in practice.
NURSING PRACTICE
In behavioural system theory both deductive and inductive system thinking is evident.
The system as a whole works well
Understand of the theory must be progress from the bigger picture.
Conceptual model provides a diagnostics and treatment orientation to the practice.
Group of individual could be considered group interactive behavioural system.
Conclusion
Johnson’s Behavioral System Model describes the person as a behavioral system with seven
subsystems: the achievement, attachment-affiliative, aggressive protective, dependency,
ingestive, eliminative, and sexual subsystems. Each subsystem is interrelated with the
others and the environment and specific structural elements and functions that help
maintain the behavioral system’s integrity.
Through these, her model focuses on what the behavior person is presenting, making the
concept more attuned with the psychological aspect of care.
When the behavioral system has balance and stability, the individual’s behaviors will be
purposeful, organized, and predictable. Imbalance and instability in the behavioral system
occur when tension and stressors affect the subsystems’ relationship or the internal and
external environments.
Bibliography
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Delhi:Jaypee Brothers:2017
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https://www.mc.vanderbilt.edu/diglib/sc_diglib/archColl/1014.html
3. Johnson, D. E. (1959a). A philosophy of nursing. Nursing Outlook, 7(4), 198–200.
4. Johnson, D.E. (1968). One conceptual model of nursing. Unpublished lecture,
Vanderbilt University, Nashville, TN.
5. Johnson, D. E. (1980). The behavioral system model for nursing. In McEwen, M. and
Wills, E. (Ed.). Theoretical basis for nursing. USA: Lippincott Williams & Wilkins.
6. Navdeep Kumar Brar ,HC Rawar.Text book of advanced nursing practice.New
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