DOROTHY JOHNSON: BEHAVIORAL SYSTEM MODEL context of relationships with one another (subsystems)

and with other systems (environment).

BACKGROUND  Furthermore, Johnson proposed to view nursing in a
 Dorothy E Johnson was born August 21, 19191 in holistic manner ---- a behavioral system.
Savannah Georgia
 B.S.N. from Vanderbilt University in Nashville, FOUR GOALS OF NURSING
Tennessee, in 1942; and her M.P.H. from Harvard
University in Boston in 1948  To assist the patient
 From 1949 until her retirement in 1978 she was an  Whose behavior is commensurate with social
assistant professor of pediatric nursing, an associate demands
professor of nursing, and a professor of nursing at the  Who is able to modify his behavior in ways that
University of California in Los Angeles. supports biological imperatives
 Dorothy Johnson has had an influence on nursing  Who is able to benefit to the fullest extent during
through her publications since the 1950s. Throughout illness from the physician's knowledge and skill
her career, Johnson has stressed the importance of  Whose behavior does not give evidence of
research-based knowledge about the effect of nursing unnecessary trauma as a consequence of illness.
care on clients.
 In 1968 Dorothy Johnson first proposed her model of Johnson proposed that the client is a behavioral system,
nursing care as fostering of "the efficient and effective organized into seven subsystems of behavior which are as
behavioral functioning in the patient to prevent illness." follows:
 She also started that nursing was “concerned with man  Attachment or affiliative subsystem (forming
as an integrated whole and this is specific knowledge of relationships): "social inclusion, intimacy, and the
order we require” formation and attachment of a strong social bond." Its
 In 1980 Johnson published her conceptualization of ultimate function is survival.
"Behavioral System Model for Nursing" this is the first  Dependency subsystem (relying on others): "approval,
work of Johnson that explicates her definitions of the attention or recognition, and physical assistance
behavioral system model. (helping or nurturing).
 Other Works by Dorothy Johnson include;  Ingestive subsystem (eating and drinking): "the
 ✓ “Theory Development: What, Why, How?” emphasis is on the meaning and structures of the social
 ✓ “Barriers and Hazards in Counseling” events surrounding the occasion when the food is eaten.
 Johnson received many honors and achievement awards Its function is appetite satisfaction.
from distinguished Nursing organizations and  Eliminative subsystem (getting rid of waste): human
universities for her great contributions in nursing cultures have defined different socially acceptable
practice, education, and research. behaviors for excretion of waste but the existence of
 Johnson died in February, 1999. such a pattern remains different from culture to culture.
 Sexual subsystem (relating to gender and
THEORETICAL SOURCES reproduction): "both biological and social factor affect
the behavior in the sexual subsystem." E.g., role identity,
 Johnson’s Behavioral System Model (JBSM) was heavily courting, mating. The function is procreation and
influenced by Florence Nightingale’s book, Notes on gratification .
Nursing (Johnson, 1992). She began her work on the  Aggressive subsystem (protecting oneself): "related to
model with the premise that nursing was a profession the behavior concerned with protection and self-
that made a distinctive contribution to the welfare of preservation; one that generates defensive response
society. from the individual when life or territory is being
 Johnson accepted Nightingale’s belief that the first threatened.
concern of nursing is with the “relationship between the  Achievement subsystem (mastering skills and reaching
person who is ill and the environment, not with the goals): "provokes behavior that attempt to control
illness”. the environment; intellectual, physical, creative,
 Johnson used the work of behavioral scientists in mechanical and social skills; (efforts to gain mastery and
psychology, sociology, and ethnology to develop her control).
theory. The interdisciplinary literature that Johnson  Restorative. The restorative subsystem is concerned
cited focused on observable behaviors that were of with rest, sleep, comfort/freedom from pain.
adaptive significance.
 In 1968 Dorothy first proposed her model of nursing For the subsystem to develop and maintain stability, each
care as fostering of "the efficient and effective must have a constant supply of "functional requirements" or
behavioral functioning in the patient to prevent illness" sustenal imperatives
 She also stated that nursing was “concerned with man Each subsystem has three functional requirements, as follows:
as an integrated whole and this is the specific  System must be "protected" from noxious influences
knowledge of order we require" with which system cannot cope"; protection from
 The Johnson's Behavioral System Model provided a unwanted, disturbing stimuli
framework that is based on her synthesis of the  Each subsystem must-be "nurtured" through the input
component parts of this system and a description of the of appropriate supplies from the environment;
nurturance through giving input from the environment
 (e.g. food, caring, conditions that support growth and  is a tendency to act in a certain way in a given situation.
development); Set formation is influenced by societal norms and
 Each subsystem must be "stimulated" for use to variables as culture, family, values, perception, and
enhance growth and prevent stagnation; stimulation by perseveratory sets. Set plays a major role in determining
experiences, events, and behaviors that would enhance the choices a person makes and actions eventually
growth and prevent stagnation." taken.
 encouragement  Preparatory set
 describes one's focus in a particular situation.
MAJOR ASSUMPTIONS  Perseveratory set
 which implies persistence, refers to the habits
one maintains

Choice
 refers to the alternate behaviors the person considers in
any given situation
 Options are influenced by such variables as age, sex,
culture, and socioeconomic status.

Action
 is the observable behavior of the person.

(ADDITIONAL NOTES)
 There are 4 assumptions of the Behavioral System STRUCTURAL COM PON ENTS
model:  Goal: To internalize the external environment.
 There is “organization, interaction,  Perseveratory Set: digestive system, respiratory system,
interdependency, and integration of the parts and fluid and electrolyte balance; oral cavity conditions;
elements of behaviors that make up the system” Beliefs and values about times and places for eating and
 A system tends to achieve a balance among the drinking; types of foods and beverages preferred by the
various forces operating within and upon it, and social group, attitudes toward alcohol and smoking,
that man continually strive to maintain a beliefs about efficiency of oral, intravenous, and
behavioral system balance and steady state by subcutaneous medications. Perception of self as fat or
automatic adjustments and adaptations to the thin; abstainer or alcoholic, addict, smoker, asthmatic.
natural forces impinging upon him.  Preparatory Set: Awareness of being hungry of thirsty,
 A behavioral system, which both requires and in need of a drink, wish to be high, relief of pain, time
results is some degree of regularity and constancy for eating, availability of food, fluid or medication
in behavior is essential to man that is to say, it is resources; barriers to respiration, desire for information,
functionally significant in that it serves a useful awareness of ignorance.
purpose, both in social life and for the individual.  Choice: Behavioral options available for food and fluid,
 The final assumption states "system balance medication, air supply, tobacco, alcohol, marijuana,
reflects adjustments and adaptations that are narcotics; supplies available in the environment
successful in some ways and to some degree." selections are made on the basis of set and situation.
 According to Johnson each subsystem comprises four Choice includes deferred gratification and
structural characteristics: a goal based on (1) a universal overindulgence. Options available for taking in
drive; (2) set; (3) choice; and (4) action (behavior). Each information .
of these four factors contribute to the observable  Acts: Behavior may include visual, auditory, olfactory,
activity of a person. and gustatory acts of overindulgences (or less than
optimal) and preferences for particular substances.
Ingestive acts may be directed toward goals other than
ingestion. Sensory acts (seeing, hearing, smelling,
tasting, and sensations) are used in all other subsystems
According to Johnson each subsystem comprises four to serve other goals. When sensory acts are directed
structural characteristics: a goal based on (1) a universal toward getting information, the acts are ingestive goal-
drive; (2) set; (3) choice; and (4) action (behavior). Each of oriented. The process of hearing also requires ingestive
these four factors contributes to the observable activity of a acts. The ingestion may be for achievement goals.
person
The Johnson's Behavioral System Model differentiates four
Goal of a subsystem diagnostic classifications to delineate these disturbances:
 Is "the ultimate consequence of behaviors" (Grubbs,  Insufficiency - a state which exists when a particular
1974, p. 226). subsystem is not functioning or developed to its fullest
 Its basis is a universal drive, the existence of which is capacity due to inadequacy of functional requirements ...
supported by existing theory or research.  Discrepancy - a behavior that does not meet the
intended goal. The incongruity usually lies between the
Set action and the goal of the subsystem, although the set
 and choice may be strongly influencing the ineffective
action ...
 Incompatibility - the goals or behaviors of the two
subsystems in the same situation conflict with each
other to the detriment of the individual...
 Dominance - the behavior in one subsystem is used
more than any other subsystem regardless of the
situation or to the detriment of the other subsystems
Behavioral subsystem imbalances occur when structure,
function, or functional regimen is disturbed.

METAPARADIGM

PERSON
 A behavioral system comprised of subsystem constantly
trying to maintain a steady state.
 A "human being" having two major systems, the
biological system and the behavioral system. Nursing's
focus is the behavioral system; Medicine's focus is on
biological system.

ENVIRONMENT
 Relates to the environment on which the individual
exists. According to Johnson, an individual's behavior is
influenced by the events in the environment.

HEALTH
 Is a purposeful adaptive response, physically, mentally,
emotionally, and socially to internal and external stimuli
in order to maintain stability and comfort.

NURSING
 Has a primary goal that is to foster equilibrium within
the individual. An external regulatory force that is
indicated only when there is instability. She stated that
nursing is concerned with the organized and integrated
whole, but that the major focus is on maintaining a
balance in the Behavioral System when illness occurs in
an individual.