Dorothy Johnson's Behavioral System Model - Research Paper Example

Dorothy Johnson’s Behavioral System Model Introduction Nursing theories aim to illustrate, explain, and predict the health-intervention approaches in nursing (Meleis, 2007). They transpired through a consensus among nursing professionals that the nursing endeavor needs validity to be recognized as a profession. The conceptual models of nursing illustrate the interrelationships of theoretical concepts and applications in identifying, analyzing, interpreting, and evaluating client-based interventions and outcomes. Most nursing models describe the interdependence of patients, nurse, health, and environment. Generally, nursing theories illuminate the influences of other health endeavors along with psychosociological theorists like Abraham Maslow, Helen Erickson, and other experts in social and behavioral disciplines (Meleis, 2007). In 1959, Dorothy Johnson’s Behavioral System Model was established. This model emphasized human needs, comfort, care, as well as the reduction of stress and tension, in practice setting (Meleis, 2007). As nursing gears towards professionalism, the theories that underpin nursing practices are further scrutinized. In particular, Dorothy E. Johnson, a nursing theorist, accentuated the role of environment in clinical interventions. Johnson’s behavioral model, according to Marriner-Tomey and Alligood (2006), sprouted from Nightingale’s principle, asserting that nursing helps individuals to recover from or prevent disease (p. 387). Johnson argued that nurses must learn to efficiently manipulate the environment to ascertain patient stability and regain the normal health condition. Johnson Behavioral System Model Overview Dorothy E. Johnson was a pioneer in conceiving the nursing endeavor as a body of knowledge possessing the qualities of both arts and sciences. She contended that effective nursing entails the synthesis, integration, and application of scientific knowledge, drawn from basic to applied science disciplines, in the field of nursing (Alligood and Marriner-Tomey, 2006). Johnson further suggested that nursing practices must facilitate the achievement and maintenance of balance or equilibrium in the patient’s health status. When patients are stressed by external or internal stimulus, their health conditions are disturbed which results to a disequilibrium state. In order to regain the equilibrium, Johnson proposed that the stressful stimulus must be eliminated, or at least reduced, and the environment must provide aegis for the spontaneous adaptation. Similar to Nightingale’s principle, Johnson’s model is grounded on the notion that nursing aims for patient’s recovery from and prevention of injury or disease (Alligood and Marriner-Tomey, 2006). Dorothy Johnson’s Behavioral Systems Model in nursing endeavor treats an individual as an open behavioral system, consisting of interdependent and interactive components. This behavioral system has seven subsystems that include sexual, achievement, aggressive-protective, eliminative, affiliative, dependency, and ingestive (Chitty, 2005). Each subsystem is examined and explained with reference to functional and structural requirements. Some functions are dependent on the person’s sex, values, age, beliefs, and motives, while the structural requirements involve the drive or goal, the action, the behavioral responses, and the behavioral alternatives. Each subsystem needs stimulation, nurturance, and protection as functional requirements or sustenal imperatives directly provided by the environment (Chitty, 2005). These sustenal imperatives are requisites to the achievement of a healthy behavioral status. Nursing, as both science and art, must not emphasized disease entity, but must value individuals as patients. The efficient utilization of Johnson’s behavioral model leads the nursing process in at least four significant stages: assessment, diagnosis, interventions, and evaluation. The assessment stage has two levels, in which the first level shows any changes in the patient’s behavioral pattern with respect to the subsystem while the second level is an in-depth examination of the subsystems where the behavioral actions applied failed in achieving the subsystem goals (Alligood and Marriner-Tomey, 2006). On the other hand, the actions that failed to meet the system goals are specified and analyzed in the diagnosis stage. These actions necessitate specific interventions in order to regain stability. The inability to meet the system goal is primarily caused by functional or structural stress. Whereas the functional stress is brought by the inadequate or overload of any sustenal imperatives due to environmental restrictions or changes, the structural stress is induced by some inconsistencies in actions, goals, set, or choice. Functional stress requires nurturance, protection, and motivational interventions, while structural stress needs actions, goals, set, or choice that could instigate behavioral functioning and prevent actions that hinder effective functioning (Alligood and Marriner-Tomey, 2006). Then, every intervention is evaluated in line with the behavioral output that instigated the effective adaptation and proper functioning of the whole behavioral system. Table 1. The Nursing Process and the Johnson’s Behavioral System Model (Alligood and Marriner-Tomey, 2006 p. 163) Relationships Among the Johnson’s Model Subsystems In the development of her theory, Johnson posited on the works of behavioral experts in the fields of sociology, ethnology, and psychology. Johnson argued that nurses must treat the behavioral system as similar to the physician’s value for the biological system and made it as their knowledge base in nursing practices. Her model was patterned after the systems model, wherein some interrelated components are working hand-in-hand to attain an efficient functioning. Johnson chose the behavioral system as model for her theory due to the belief that all behavioral patterns either purposeful or repetitive, describing the life of an individual, is comprised of an integrated, organized, and systematic whole. Johnson believed that through the categorization of behaviors, complex behaviors can be systematized, making behavioral prediction possible. Thus, she categorized behaviors into subsystems: sexual, achievement, aggressive-protective, eliminative, affiliative, dependency, and ingestive (Alligood and Marriner-Tomey, 2006). Each subsystem, under a common goal, has a set of behavioral tendencies or responses. These behavioral responses are developed under the influences of various social, physical, psychological, and biological factors and are acquired through learning experiences. The seven subsystems in Johnson’s model have at least four postulates regarding the function and structure of each. That is, all postulates describe the “structural elements” common to the seven subsystems. The first postulate emphasize that on the basis of the behavioral form, one can infer the goal, motives, and consequences of one’s actions (Alligood and Marriner-Tomey, 2006). It is expected that the ultimate goal for each subsystem is identical for all individuals. The second postulate describes the individual’s predisposition to act in a defined manner, with respect to the goal. Johnson called this predisposition as “set.” Another postulate asserts that each subsystem possessed a “scope of action” or alternatives from which a desired action can be chosen. As an individual continue to persevere life experiences, new alternatives will be added to his repertoire of choices. Nevertheless, as he becomes complacent to his present set of alternatives, the acquisition of novel behavioral responses decline. The last postulate pertains to the empirical behaviors generated by the subsystems. The observable behaviors generated by one’s subsystems provide cues to other individuals in deciphering the motive and goals of his actions in relation to a specified subsystem (Alligood and Marriner-Tomey, 2006). Each of the seven subsystems has three key functional requirements. One of such is the protection of every subsystem from peculiar influences with which that subsystem can hardly muddle through. Another functional requirement is the subsystem’s nurturance by means of the appropriate input directly from the environment. Lastly, in order to assure the continuity of growth and avoid stagnancy, each subsystem needs proper stimulation. Provided that the subsystems continuously meet the functional requirements, the subsystems or the system as a whole, maintain and perpetuate itself (Alligood and Marriner-Tomey, 2006). Nonetheless, it is necessary to maintain orderly external and internal so that a predictive system, as well as system homeostasis, can be sustained. The interdependence of the subsystems’ structural elements must achieve a homeostasis appropriate to the individual’s needs. Theoretical Model and Nursing Practice The application of any nursing theories to nursing practices necessitates the model’s suitability to the practice requisites, extensive development of the model with regard to practice requirements, and the model’s aptness to the practice requisites (Peterson and Bredow, 2009). These conditional model prerequisites are crucial in determining the efficacy of a theory to practice setting, which in turn are essential to the recognition of nursing as a legitimate profession. The professional practices of nursing involve three major requirements: scientific attributes, perspective, and structure. The scientific attributes encompass the underpinning scientific theories, precepts, facts, and postulates of the structure and perspective of the nursing practices. Nursing practices need scientific knowledge which provides rationale to its nature, scope, goal, and role. In addition, all methods and techniques employed in nursing assessment, diagnosis, intervention, and evaluation are grounded on the body of scientific knowledge. Another requirement for professional practice is the perspective of nursing practices. This particularly pertains to the view on the interrelationships among patients, nurses, environment, and health condition (Peterson and Bredow, 2009). Nursing perspective must plausibly describe the nature, scope, goal, and role of nursing practices in line with a body of scientific knowledge. In such way, the professional practice of nursing differentiates the nursing endeavor from the other fields of disciplines. Likewise, the perspective links nursing practice and research to that of the other professions. The perspective, then, establishes a rationale for the nature, scope, goal, and role of nursing profession, including the fulfillment of such role, grounded on a scientific body of knowledge. Lastly, the practice of nursing profession requires a structure for the standardization of its methodological practices. This calls for a well-structured identification of health problems, intervention plans, and evaluation of patient’s health conditions (Peterson and Bredow, 2009). The fruition of such structure is an organized, systematic, and logical nursing process that involves assessment, diagnosis, intervention, and evaluation of methodological practices. Analysis and Conclusion The application of nursing models in healthcare institutions is not merely an armchair activity for nurses and other health providers, but a way of deriving feedback on and improving nursing care (Baldwin, 1983). Nursing models identify goals, describe recipient of services, assess nurse roles, determine the sources of difficulty, and specify the focus and outcome of any interventions. They guide the coherent nursing curricular programs with regard to the actual nursing process. Nursing models also describe the essential contents of teaching and nursing training courses (Peterson and Bredow, 2009). The Johnson’s behavioral system model treats any disease as a noxious stimulus that disturbs the homeostasis among the individual’s subsystems, inducing behavioral changes (Derdiarian, 1990). These changes, if forceful enough and left unattended, leads to the loss of behavioral functionality. Since the subsystems are interdependent and interactive, the disturbance in just a single subsystem causes disruptions in the function of the other subsystems. Accordingly, once the homeostasis in one or more subsystems has been restored, the rest of the subsystems will regain balance. After the diagnosis of any troubles in the subsystems, Johnson believed that the primary role of nurses is to regain the system’s homeostasis. This could be done by facilitating the patient’s regulation of his own behavior, manipulating the internal or external environment, and nurturing, stimulating, or protecting the patient from noxious environmental influences. Even though the Johnson’s model is a middle-range theory, the interactions and interrelations of its seven subsystems impart complexity on the model’s application. The continuous interactions of the subsystems, along with the external forces acting on the system, bring forth difficulties in identifying the subsystem that causes behavioral imbalance. The appropriate intervention then should properly be taken in relation to the subsystems. This signifies that the focus of nursing care is not on the disease, but on the patient. However, the Johnson’s behavioral system model falls short in terms of scientific substance, which requires an extensive empirical application of theoretical concepts, assumptions, and principles. In fact, earlier after it was established, the model has failed to meet the structure requirement, which incited Johnson to integrate a number of interventions into her system model. In spite of its theoretical limitations, some professionals are still testing Johnson’s model for its practical worth and validity. In sum, the implementation of an established nursing model to practice setting may always encounter difficulties due to its theoretical imperfections. These difficulties can possibly be attributed to the model’s degree of implementation, the perceptions of nurses regarding the model, and the nature and quality of nursing care. References Alligood, M. R. and Marriner-Tomey, A. (2006). Nursing theory: Utilization and application. St. Louis, Mo: Elsevier Mosby. Baldwin, S. (1983). Nursing models in special hospital settings. Journal of Advanced Nursing, 8, 473-476. Chitty, K. K. (2005). Professional nursing: Concepts & challenges. St. Louis: Elsevier Saunders. Derdiarian, A.K. (1990). The relationships among the subsystems of Johnson’s behavioral model. IMAGE: Journal of Nursing Scholarship, 22(4), 219-225. Marriner-Tomey, A. and Alligood, M. R. (2006). Nursing theorists and their work. St. Louis: Mosby/Elsevier. Meleis, A. I. (2007). Theoretical nursing: Development and progress. Philadelphia, Pa: Lippincott Williams & Wilkins. Peterson, S. J. and Bredow, T. S. (2009). Middle range theories: Application to nursing research. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Read More