Introduction •
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September 9, 2013 in Savannah, Georgia. B. S. N. from Vanderbilt Universit in Nashville, !e !ennessee, nnessee, in 19"2# and her $.%.&. from &arvard Universit in Boston in 19"'. (rom 19"9 till retirement in 19)' she *as an assistant professor of pediatri+ nrsing, an asso+iate professor of nrsing, and a professor of nrsing at the Universit of -alifornia in os /ngeles. ohnson stressed the importan+e of resear+hbased no*ledge abot the effe+t of nrsing +are on +lients.
Behavior system model •
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oroth first proposed her model of nrsing +are in 194' as fostering of 5the effi+ient and effe+tive behavioral fn+tioning in the patient to prevent illness6. She also stated that nrsing *as 5+on+erned *ith man as an integrated *hole and this is the spe+ifi+ no*ledge of order *e re7ire8. n 19'0 ohnson pblished her +on+eptali:ation of 5behavioral sstem of model for nrsing8*here she e;plains her definitions of the behavioral sstem model.
Definition of nursing She defined nrsing 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 behaviors constitutes a threat to the physical or social health, or in which illness is found” Four goals of nursing are nursing are to assist the patient< 1.
=hose =ho se behav behavior ior +ommen +ommensr srate ate *ith *ith so+ia so+iall demand demands. s.
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=ho is is able able to modif modif his his behavio behaviorr in *as *as that itit sppor spports ts biologi+al imperatives
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=ho is is able able to benefi benefitt to the fll fllest est e;te e;tent nt dring dring illn illness ess from the phsi+ians no*ledge and sill.
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=hose =ho se behav behavior ior does does not not give give eviden eviden+e +e of nne+e nne+essar ssar trama as a +onse7en+e of illness
Assumptions
!here are several laers of assmptions that ohnson maes in the development of +on+eptali:ation of the behavioral sstem model vi:. •
/ssmptions abot sstem
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/ssmptions abot str+tre
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/ssmptions abot fn+tions
Assumptions about system !here are " assmptions of sstem< 1.
(irst, there is 5orga 5organi:ati ni:ation, on, intera intera+tion, +tion, inter interdepen dependen+ den+ and integration of the parts and elements of behaviors that go to mae p the sstem 8
2.
/ sste sstem m 5tends 5tends to a+hie a+hieve ve a balan balan+e +e among among the the vario varios s for+es operating *ithin and pon it>, and that man strive +ontinall to maintain a behavioral sstem balan+e and stead state b more or less atomati+ ad?stments and adaptations to the natral for+es impinging pon him.8
3.
/ behav behavior ioral al sstem sstem,, *hi+h *hi+h both re7 re7ire ires s and resl reslts ts in some degree of reglarit and + onstan+ in behavior, is essential to man that is to sa, it is fn+tionall signifi+ant in that it serves a sefl prpose, both in so+ial life and for the individal.
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ast, as t, 5sstem 5sstem balan+ balan+e e refle+t refle+ts s ad?stme ad?stments nts and and adaptat adaptation ions s that are s++essfl in some *a and to some degree.8.
Assumptions about structure and function of each subsystem •
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5from the form the behavior taes and the +onse7en+es it a+hieves +an be inferred *hat 5drive8 has been stimlated or *hat 5goal8 is being soght8 @a+h individal has a 5predisposition to a+t *ith referen+e to the goal, in +ertain *as rather than the other *as8. !his predisposition is +alled as 5set8. @a+h sbsstem has a repertoire of +hoi+es or 5s+ope of a+tion8 !he forth assmption is that it prod+e 5observable ot+ome8 that is the individalAs behavior.
Each subsystem has three functional requirements 1.
Sstem Sst em mst mst be 5prote 5prote+te +ted6 d6 from from no;ios no;ios infle inflen+e n+es s *ith *hi+h sstem +annot +ope8.
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@a+h @a+ h sbsst sbsstem em mst mst be 5nrt 5nrtre red8 d8 thro throgh gh the inp inpt t of appropriate spplies from the environment.
!here are several laers of assmptions that ohnson maes in the development of +on+eptali:ation of the behavioral sstem model vi:. •
/ssmptions abot sstem
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/ssmptions abot str+tre
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/ssmptions abot fn+tions
Assumptions about system !here are " assmptions of sstem< 1.
(irst, there is 5orga 5organi:ati ni:ation, on, intera intera+tion, +tion, inter interdepen dependen+ den+ and integration of the parts and elements of behaviors that go to mae p the sstem 8
2.
/ sste sstem m 5tends 5tends to a+hie a+hieve ve a balan balan+e +e among among the the vario varios s for+es operating *ithin and pon it>, and that man strive +ontinall to maintain a behavioral sstem balan+e and stead state b more or less atomati+ ad?stments and adaptations to the natral for+es impinging pon him.8
3.
/ behav behavior ioral al sstem sstem,, *hi+h *hi+h both re7 re7ire ires s and resl reslts ts in some degree of reglarit and + onstan+ in behavior, is essential to man that is to sa, it is fn+tionall signifi+ant in that it serves a sefl prpose, both in so+ial life and for the individal.
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ast, as t, 5sstem 5sstem balan+ balan+e e refle+t refle+ts s ad?stme ad?stments nts and and adaptat adaptation ions s that are s++essfl in some *a and to some degree.8.
Assumptions about structure and function of each subsystem •
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5from the form the behavior taes and the +onse7en+es it a+hieves +an be inferred *hat 5drive8 has been stimlated or *hat 5goal8 is being soght8 @a+h individal has a 5predisposition to a+t *ith referen+e to the goal, in +ertain *as rather than the other *as8. !his predisposition is +alled as 5set8. @a+h sbsstem has a repertoire of +hoi+es or 5s+ope of a+tion8 !he forth assmption is that it prod+e 5observable ot+ome8 that is the individalAs behavior.
Each subsystem has three functional requirements 1.
Sstem Sst em mst mst be 5prote 5prote+te +ted6 d6 from from no;ios no;ios infle inflen+e n+es s *ith *hi+h sstem +annot +ope8.
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@a+h @a+ h sbsst sbsstem em mst mst be 5nrt 5nrtre red8 d8 thro throgh gh the inp inpt t of appropriate spplies from the environment.
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@a+h @a+ h sbsst sbsstem em mst mst be 5stim 5stimlat lated8 ed8 for for se to enha enhan+e n+e gro*th and prevent stagnation.
!hese behaviors are 5orderl, prposefl and predi+table and sffi+ientl stable and re+rrent to be amenable to des+ription and e;planation8
Johnson’s Behavioral Subsystem •
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Attachment or affiliative subsystem 5so+ial subsystem 5so+ial in+lsion intima+ and the formation and atta+hment of a strong so+ial bond.8 Dependency subsystem< subsystem< 5approval, attention or re+ognition and phsi+al assistan+e8 Ingestive subsystem 5the emphasis is on the meaning and str+tres of the so+ial events srronding the o++asion *hen the food is eaten8 Eliminative subsystem !hman !hman +ltres have defined different so+iall a++eptable behaviors for e;+retion of *aste ,bt the e;isten+e of s+h a pattern remains different from +ltre to -ltre.8 Se"ual subsystem# both subsystem# both biologi+al and so+ial fa+tor affe+t the behavior in the se;al sbsstem8 Aggressive subsystem # it relates to the behaviors +on+erned *ith prote+tion and self preservation ohnson vie*s aggressive sbsstem as one that generates defensive response from the individal *hen life or territor is being threatened8 Achievement subsystem # provoes behavior that attempt to +ontrol the environment intelle+tal, phsi+al, +reative, me+hani+al and so+ial sills a+hievement are some of the areas that ohnson re+ogni:es6.
$epresentation of Johnson%s &odel Goal Set -hoi+e of Behavior Behavior •
/ffiliation
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ependen+
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Se;alit
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/ggression
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@limination
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ngestion
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/+hievement
'he four ma(or concepts •
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5&man being8 as having t*o ma?or sstems, the biologi+al sstem and the behavioral sstem. t is role of the medi+ine to fo+s on biologi+al sstem *here as Nrsling>s fo+s is the behavioral sstem. 5So+iet8 relates to the environment on *hi+h the individal e;ists. /++ording to ohnson an individalAs behavior is inflen+ed b the events in the environment 5&ealth8 is a prposefl adaptive response, phsi+all mentall, emotionall, and so+iall to internal and e;ternal stimli in order to maintain stabilit and +omfort. 5Nrsing8 has a primar goal that is to foster e7ilibrim *ithin the individal. Nrsing is +on+erned *ith the organi:ed and integrated *hole, bt that the ma?or fo+s is on maintaining a balan+e in the Behavior sstem *hen illness o++rs in an individal.
)ursing process Assessment Grbbs developed an assessment tool based on ohnsonAs seven sbsstems pls a sbsstem she labeled as restorative *hi+h fo+sed on a+tivities of dail living. /n assessment based on behavioral model does not easil permit the nrse to gather detailed information abot the biologi+al sstems< •
/ffiliation
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ependen+
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Se;alit
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/ggression
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@limination
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ngestion
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/+hievement estorative
Diagnosis iagnosis tends to be general to the sstem than spe+ifi+ to the problem. Grbb has proposed " +ategories of nrsing diagnosis derived from ohnson>s behavioral sstem model< •
nsffi+ien+
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is+repan+
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n+ompatibilit
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ominan+e
*lanning and implementation mplementation of the nrsing +are related to the diagnosis ma be diffi+lt be+ase of la+ of +lients inpt in to the plan. the plan *ill fo+s on nrses a+tions to modif +lients behavior, these plan than have a goal ,to bring abot homeostasis in a sbsstem, based on nrsing assessment of the individals drive, set behavior, repertoire, and observable behavior. !he plan ma in+lde prote+tion, nrtran+e or stimlation of the identified sbsstem. Evaluation @valation is based on the attainment of a goal of balan+e in the identified sbsstems. f the baseline data are available for an individal, the nrse ma have goal for the individal to retrn to the baseline behavior. f the alterations in the behavior t hat are planned do o++r, the nrse shold be able to observe the retrn to the previos behavior patterns. ohnson>s behavioral model *ith the nrsing pro+ess is a nrse +entered a+tivit, *ith the nrse determining the +lients needs and state behavior appropriate for that need.
Johnson’s and +haracteristics of a theory •
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nterrelate +on+epts to +reate a different *a of vie*ing a phenomenon -on+epts in ohnson>s theor are interrelated. !heories mst be logi+al in natre ohnson>s theor is logi+al in natre. !heories mst be simple et generali:able !he theor is simple. !heories +an be bases of hpothesis that +an be tested esear+h stdies are +ond+ted appling onhson>s theor. !heories +ontribte to and assist in in+reasing the bod of no*ledge *ithin the dis+ipline throgh the resear+h
implemented to validate them. •
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!heories +an be tili:ed b pra+titioners to gide and improve their pra+ti+e. !heories mst be +onsistent *ith other validated theories, la*s and prin+iples bt *ill leave nans*ered 7estions that need to be investigated.
,imitation •
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ohnson does not +learl interrelate her +on+epts of sbsstems +omprising the behavioral sstem model. !he definition of +on+ept is so abstra+t that the are diffi+lt to se. t is diffi+lt to test ohnson>s model b development of hpothesis. !he fo+s on the behavioral sstem maes it diffi+lt for nrses to *or *ith phsi+all impaired individal to se this theor. !he model is ver individal oriented so the nrses *oring *ith the grop have diffi+lt in its implementation. !he model is ver individal oriented so the famil of the +lient is onl +onsidered as an environment. ohnson does not define the e;pe+ted ot+omes *hen one of the sstem is affe+ted b the nrsing implementation an impli+it e;pe+tation is made that all hman in all +ltres *ill attain same ot+ome Chomeostasis. ohnsonAs behavioral sstem model is not fle;ible.
Summary ohnsonAs Behavioral sstem model is a model of nrsing +are that advo+ates the fostering of effi+ient and effe+tive behavioral fn+tioning in the patient to prevent illness. !he patient is defined as behavioral sstem +omposed of ) behavioral sbsstems. @a+h sbsstem +omposed of for str+tral +hara+teristi+s i.e. drives, set, +hoi+es and observable behavior. !hree fn+tional re7irement of ea+h sbsstem in+ldes •
D1E %rote+tion from no;ios inflen+es,
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D2E %rovision for the nrtring environment, and
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D3E stimlation for gro*th.
/n imbalan+e in ea+h sstem reslts in dise7ilibrim .it is nrsing role to assist the +lient to retrn to the state of e7ilibrim.
$eferences 1.
George B. lia , Nrsing !heories !he base for professional Nrsing %ra+ti+e , 3rd ed. Nor*al, /ppleton and ange.
2.
%olit (, &ngler B%. Nrsing esear+h< %rin+iples and $ethods. %hiladelphia< B ippin+ott -ompan# 199'.
3.
Brns N, Grove SF. !he pra+ti+e of Nrsing esear+h. "th @d. %hiladelphia< =B Sanders %bli+ations# 2001.
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!ree+e =, !ree+e @=. @lements of esear+h in Nrsing D3rded.E. St. ois< $osb# 19'2.
Do r o t h yE.J o hn s on i swel l k nownf orher“Behavi or alSyst em Model , ” wh i c hwa sfi r s t p r o po s edi n1 96 8.He rmo de lwa sg r e at l yi n fl ue nc e db yFl or enc eNi ght i ngal e’ sbo ok ,No t e s onNur s i ng.I tadv oc at est hef os t er i ngofeffic i entandeffec t i v ebehav i or al f unc t i oni ngi nt he pat i entt opr ev enti l l nes sands t r es s est hei mpor t anc eofr es ear c hbas edk nowl edgeabout t heeff ec tofnur s i ngc ar eonpat i ent s .
Des c r i pt i on ane xt er nal r egul at or yf or c ewhi c hac t st opr es er v e J oh ns on ’ st h eo r yd efi ne dNu r s i n ga s“ t heor gani z at i onandi nt egr at i onoft hepat i ent sbehav i or satanopt i mum l ev el undert hos e c ondi t i onsi nwhi c ht hebehav i orc ons t i t ut esat hr eatt ot heph y si c al ors oc i al heal t h,ori n whi c hi l l nes si sf ound. ” eac hi ndi v i dual haspat t er ned,pur pos ef ul ,r epet i t i v ewa ysofac t i ngt hat I tal s os t at est hat“ c ompr i s esabehav i or al s y st em s pec i fi ct ot hati ndi v i dual . ”
Goal s
J oh ns onb eg anh erwor kont h emo de lwi t ht h epr e mi s et h atnu r s i ngwa sapr o f e s s i o nt h at madeadi s t i nc t i v ec ont r i but i ont ot hewel f ar eofs oc i et y .Thus ,nur s i nghadanex pl i c i tgoal of ac t i oni npat i entwel f ar e. Thegoal sofnur s i ngar ef our f ol d,ac c or di ngt ot heBeha vi orSy s t em Model :( 1)T oas s i s tt he pat i entwhos ebehav i ori spr opor t i onal t os oc i al demands .( 2)T oas si s tt hepat i entwhoi s abl et omodi f yhi sbehav i ori nway st hati ts uppor t sbi ol ogi c al i mper at i v es .( 3)Toas si s tt he pat i entwhoi sabl et obenefi tt ot hef ul l es tex t entdur i ngi l l nes sf r om t hephy si c i an’ s k no wl edgea nds k i l l .And( 4)T oa ss i s tt hepat i e ntwhos ebeha v i ordoesno tgi v ee vi den ceof u nn ec e s sar yt r a umaasac on s eq uen c eo fi l l n es s .
Ass umpt i ons s s ump t i o nsab ou t Thea s su mp t i o nsma deb yJ o hn so n’ st h eor yar ei nt hr e ec a t eg or i e s:a s y s t em, as s umpt i onsabouts t r uc t ur e,andas s ump t i o nsaboutf u nc t i ons.
J ohns oni dent i fi eds ev er al as s umpt i onst hatar ec r i t i c al t ounder s t andi ngt henat ur eand oper at i onoft heper s onasabeha vi or als 1)Ther ei s“ or gani z at i on,i nt er ac t i on, y s t e m:( i nt er dependen cyandi nt egr at i onoft hepar t sande l ement sofbeha vi or st hatgot omak eup t hes y s t em. ”( 2)As y s t em “ t endst oa ch i e v eab al anc eamongt hev a r i ousf or c esoper at i ng wi t hi nanduponi t ,andt hatmans t r i v ec ont i nual l yt omai nt ai nabeha vi or al s y st em bal anc e ands t eadys t at eb ymor eorl e ssaut omat i cadj us t ment sandadap t at i onst ot henat ur al f or c esoc cur r i ngonhi m. ”( 3)Abeha vi or al s y st em,whi c hr equi r esandr es ul t si ns ome degr eeofr egul ar i t yandc ons t anc yi nbehav i or ,i ses sent i al t oman.I ti sf unc t i onal l y s i gni fi cantbec aus ei ts er v esaus ef ul pur pos ei ns oc i al l i f easwel l asf ort hei ndi v i dual .And ( 4)“ Sy s t em ba l anc er efl ec t sadj us t ment sandadapt at i onst hatar es uc c es s f u li ns omewa y a ndt os omede gr e e. ” Th ef o ura s s ump t i o nsab ou ts t r uc t ur eandf unc t i on ar et hat :( 1)“ Fr om t hef or mt he beha vi ort ak e sandt hec on sequenc esi ta chi e v esc anbei nf er r edwhat‘ dr i v e ’ha sbeen s t i mul at edorwhat‘ goal ’ i sbei ngs ought . ”( 2)Eac hi ndi v i dual per s onhasa“ pr edi s pos i t i on t oac twi t hr ef er enc et ot hegoal ,i nc er t ai nway sr at hert hant heot herway s. ”Thi s pr edi s pos i t i oni scal l eda“ s et . ”( 3)Eac hs ubs ys t em hasar eper t oi r eofc hoi c escal l eda
“ s c opeofac t i on. ”And( 4)Thei ndi v i dual pat i ent ’ sbeha vi orpr oduc esanout c omet hatc an b eob s e r v e d . Andl as t l y ,t her ear et hr e ef unc t i ona lr equi r e me nt s f ort hes ubs y s t ems . :( 1)Thes y s t em mus tbepr o t ec t edf r om t o x i ci nfl ue nc eswi t hwhi c ht hesy s t em c anno tc ope.( 2)Eac h s y st em hast obenur t ur edt hr ought hei nputofappr opr i at es uppl i esf r om t heen vi r onment . An d( 3 )Th es y s t em mus tb es t i mu l a t e df o ru set oe nh an cegr o wt ha ndpr e v en ts t a gna t i o n.
Ma j o rCo nc e pt s HumanBei ngs J oh ns onv i e wsh uma nb ei n gsa sha v i n gt woma j o rs y s t e ms :t h eb i o l o gi c a ls y s t e ma ndt h e behav i or al s y st em.I ti st her ol eofmedi c i net of oc usont hebi ol ogi c al s ys t em,wher eas nur s i ng’ sf oc usi st hebehav i or al s ys t em. Th ec o nc e pto fh uma nb ei n gwa sd efi n eda sab eh av i o r a ls y s t e mt h ats t r i v e st oma k e c ont i nual adj us t ment st oac hi ev e,mai nt ai n,orr egai nbal anc et ot hes t eady s t at et hati s adapt at i on.
Envi r onment Env i r onmenti snotdi r ec t l ydefi ned,buti ti si mpl i edt oi nc l udeal l el ement soft he s ur r oundi ngsoft hehumans y st em andi nc l udesi nt er i ors t r es s or s .
Heal t h Heal t hi ss eenast heoppo si t eofi l l ne ss ,andJ ohn sondefi nesi tas“ s omedegr eeof r egul ar i t yandc ons t anc yi nbeha vi or ,t hebeha vi or al s y st em r efl ec t sadj us t ment sand a da pt a t i o nst h atar esu c c es s f u li ns omewa yan dt os omede gr e e… a da pt a t i o ni s f unc t i onal l yeffic i entandeffec t i v e. ”
Nur s i ng
Nur s i ngi sseenas“ ane xt er nal r egul at or yf or c ewhi c hac t st opr es er v et heor gani z at i onand i nt egr at i onoft hepat i ent ’ sbehav i oratanopt i mal l ev el undert hos ec ondi t i onsi nwhi c ht he behav i orc ons t i t ut esat hr eatt ophy si c al ors oc i al heal t h,ori nwhi c hi l l nes si sf ound. ”
Behav i or al s y st em Mani sas y s t em t hati ndi c at est hes t at eoft hes y s t em t hr oughbeha vi or s .
Sy s t em Thatwhi c hf unc t i onsasawhol ebyvi r t ueofor gani z edi ndependenti nt er ac t i onofi t spar t s .
Su bs y s t e m Ami ni s y s t em mai nt ai nedi nr el at i ons hi pt ot heent i r es y st em wheni tort heen vi r onmenti s notdi s t ur bed.
Subconcept s St r uc t ur e Thepa r t so ft h es y s t em t h atma k eu pt h ewh ol e .
Var i abl es Fac t or sout s i det hes y st em t hati nfl uenc et hes y st em’ sbeha vi or ,butwhi c ht hes y st em l ac k s p o we rt oc h an ge .
Bo und ar i e s Thepoi ntt hatdi ffer ent i at est hei nt er i oroft hes ys t em f r om t heex t er i or .
Homeost asi s Pr oc es sofmai nt ai ni ngs t abi l i t y .
St abi l i t y Bal anc eors t eady s t at ei nmai nt ai ni ngbal anc eofbeha vi orwi t hi nanac c ept abl er ange.
St r es s or As t i mul usf r om t hei nt er nal orex t er nal wor l dt hatr es ul t si ns t r es sori ns t abi l i t y .
T ens i on Thes y s t em’ sadj us t mentt odemand s,c han georgr o wt h,ort oac t ua ldi s r upt i ons .
I ns t abi l i t y St at ei nwhi c ht hes y st em out putofener gydepl et est heener gyneededt omai nt ai ns t abi l i t y .
Set Thepr edi s pos i t i ont oac t .I ti mpl i est hatdes pi t ehav i ngonl yaf ewal t er nat i v esf r om whi c ht o s el ec tabehav i or al r es pons e,t hei ndi v i dual wi l l r ankt hos eopt i onsandc hoos et heopt i on c on si d er edmos tdes i r abl e.
Func t i on Co ns e qu en c eso rp ur p os e sofa c t i o n.
7Subsy s t ems
Johnson’s Behavioral System Model
J oh ns oni d en t i fi ess e v ens ub s y s t emsi nt heBe ha v i or a lSy s t e m Mo de l .Th eya r e:
At t ac hmentoraffil i at i v es ubs ys t em At t ac hmentoraffil i at i v es ubs y st em i st he“ s oc i al i nc l us i oni nt i mac yandt hef or mat i onand at t ac hmentofas t r ongs oc i al bond. ”I ti spr obabl yt hemos tc r i t i c al bec aus ei tf or mst he bas i sf oral l s oc i al or gani z at i on.Onagener al l ev el ,i tpr ov i dess ur v i v al ands ec ur i t y .I t s c ons equenc esar esoc i al i nc l us i on,i nt i mac y ,andf or mat i onandmai nt enanc eofast r ong s oc i al bond
Dependencysubsy st em Dependenc ys ubs y st em i st he“ appr o val ,at t ent i onorr ec ogni t i onandph ys i c al as s i s t anc e. ” I nt hebr oades ts ens e,i tpr omot eshel pi ngbehav i ort hatc al l sf oranur t ur i ngr es pons e.I t s c ons equenc esar eappr ov al ,at t ent i onorr ec ogni t i on,andphy si c al as si s t anc e. De v el opment al l y , dependen cyb eha v i ore v ol v e sf r om a l mos tt o t al dependenc eonot her st o agr eat erd egr eeofdependenc eons el f .Ac er t ai namou ntofi nt er dependen cei ses s ent i al f ort hes ur v i v al ofs oc i al gr oups .
I nges t i v es ubs ys t em I nges t i v es ub sy s t em i st he“ emphas i sont hemeani ngan ds t r uc t ur esoft hes oc i al e v ent s s ur r oundi ngt heoc c as i onwhe nt hef oodi seat en. ”I ts houl dno tbes eenast hei nputan d out putme chan i s msoft hes y s t em.Al l s ubs y s t emsar edi s t i nc ts ubs y s t emswi t ht hei ro wn i n pu ta ndout p utmec h an i s ms .Th ei n ge st i v es ub sy s t e m“ h ast odowi t hwh en ,ho w,wh at , h owmu c h,a ndun de rwh atc o nd i t i o nsweea t . ”
El i mi nat i v es ubs ys t em El i mi nat i v es ubs y st em s t at est hat“ humanc ul t ur esha v edefi neddi ff er ents oc i al l yac c ept abl e behav i or sf ore xc r et i onofwas t e,butt heex i s t enc eofs uc hapat t er nr emai nsdi ffer entf r om c ul t ur et oc ul t ur e. ”I taddr es ses“ when,how,andunderwhatc ondi t i onsweel i mi nat e. ”As wi t ht hei nges t i v es ubs y st em,t hes oc i al andps y c hol ogi c al f ac t or sar ev i ewedasi nfl uenc i ng
t hebi ol ogi c al as pec t soft hi ssubs ys t em andma ybe,att i mes ,i nc onfl i c twi t ht heel i mi nat i v e subsys t em.
Se x ual s ubs y s t em Se xual s ubs y st em i sbot habi ol ogi c al ands oc i al f ac t ort hataffec t sbehav i or .I thast hedual f unc t i onsofpr oc r eat i onandgr at i fi cat i on.I nc l udi ng,butnotl i mi t edt o,c our t i ngandmat i ng, t hi sr es pons es y st em begi nswi t ht hedev el opmentofgenderr ol ei dent i t yandi nc l udest he br oadr angeofs ex r ol ebeha vi or s .
Aggr es s i v esubs y s t em Aggr es si v es ubs ys t em r el at est ot hebehav i or sc onc er ni ngpr ot ec t i onandsel f pr es er v at i on, gener at i ngadef ens er es pons ewhent her ei sat hr eatt ol i f eort er r i t or y .I t sf unc t i oni s pr ot ec t i onandpr es er v at i on.Soc i et ydemandst hatl i mi t sbepl ac edonmodesofs el f pr ot ec t i onandt hatpeopl eandt hei rpr oper t yber es pec t edandpr ot ec t ed.
Ac h i e v eme nts u bs y s t e m Ac hi ev ements ubs y st em pr o vok esbeha vi ort hatt r i est oc ont r ol t heen vi r onment .I tat t empt s t omani pul at et heenv i r onment .I t sf unc t i oni sc ont r ol ormas t er yofanas pec tofs el for en vi r onmentt os omes t andar dofe x c el l enc e.Ar easofac hi e v ementbeha vi ori nc l ude i nt el l ec t ual ,phy si c al ,cr eat i v e,mec hani c al ,ands oc i al s k i l l s .
Be ha v i o r a lSy s t e m Mo de la ndTh eNu r s i n gPr o c es s Thenur s i n gp r oc e s soft h eBe ha v i o rSy s t e m Mo de lofNur s i n gbe gi n swi t hanas s e s sme nt anddi agnos i soft hepat i ent .Onc ead i agno si si smade,t henur s eando t herheal t hc ar e pr of es s i onal sdev el opanur s i ngc ar epl anofi nt er v ent i onsands et t i ngt hem i nmo t i on.The pr oc es sendswi t hanev al uat i on,whi c hi sb as edont hebal anc eoft hes ubs y s t ems . J ohn son ’ sBeha v i or al Sy s t em Mod el i sbes tappl i edi nt hee v al uat i onphas e,dur i ngwhi c h t i met henur s ec ande t er mi newhe t herorno tt her ei sbal anc ei nt hes ub sy s t emsoft he
pat i ent .I fanur s ehel psapat i entmai nt ai nanequi l i br i um oft hebeha vi or al s ys t em t hr ough ani l l nes si nt hebi ol ogi c al s ys t em,heors hehasbeens uc ces sf ul i nt her ol e.
St r engt hs J ohn son ’ st heor ygui de snur s i ngpr ac t i c e,edu cat i on,andr es ear c h;gener at esne wi dea s aboutnur s i ng;anddi ffer ent i at esnur s i ngf r om ot herheal t hpr of es si ons . I thasbeenus edi ni npat i ent ,out pat i ent ,andc ommuni t yset t i ngsaswel l asi nnur s i ng admi ni s t r at i on.I thasal wa ysbeenus ef ul t onur s i ngeduc at i onandhasbeenus edi n pr ac t i c ei neduc at i onal i ns t i t ut i onsi ndi ffer entpar t soft hewor l d. Ano t heradv ant ageoft het heor yi st hatJ ohns onpr o v i dedaf r ameofr ef er enc ef ornur s es c onc er nedwi t hspec i fi ccl i entbehav i or s .I tc anal s obegener al i z edac r os st hel i f es panand ac r os sc ul t ur es . Thet heor yal s ohaspot ent i al f orc ont i nuedut i l i t yi nnur s i ngt oac hi ev ev al uednur s i nggoal s .
Weak nes s es Thet heor yi spot ent i al l yc ompl e xbec aus et her ear eanumberofpos s i bl ei nt er r el at i ons hi ps amongt hebeha vi or al s y st em,i t ssubs y st ems ,andt heen vi r onment .Po t ent i al r el at i ons hi ps h av eb ee ne x pl or ed ,b utmo r ee mp i r i c a lwor ki snee de d. J ohns on’ swor khasbeenus ede xt ens i v el ywi t hpeopl ewhoar ei l l orf ac et het hr eatof i l l nes s.Howev er ,i t sus ewi t hf ami l i es ,gr oups ,andc ommuni t i esi sl i mi t ed. Tho ug ht hese v ens u bs y s t e msi de nt i fi edbyJ oh ns o na r es a i dt ob eo pe n,l i n k ed ,a nd i nt er r el at ed,t her ei sal ac kofc l eardefi ni t i onsf ort hei nt er r el at i ons hi psamongt hem whi c h mak esi tdi ffic ul tt ov i ewt heent i r ebehav i or al s ys t em asanent i t y . Thepr obl em i nv ol v i ngt hei nt er r el at i ons hi psamongt hec onc ept sal s oc r eat esdi ffic ul t yi n f ol l owi ngt hel ogi cofJ ohns on’ swor k .
Conc l us i on J oh ns on ’ sBe ha v i o r a lSy s t e m Mo del d es c r i b est h epe r s o na sab eh av i o r a ls y s t e m wi t h s ev ens ubs y st ems :t heac hi ev ement ,at t ac hment affil i at i v e,aggr es s i v epr ot ec t i v e, dependenc y ,i nges t i v e,el i mi nat i v e,ands ex ual s ubs y st ems .Eac hs ubs y st em i si nt er r el at ed wi t ht heot her sandt heen vi r onmentands pec i fi cs t r uc t ur al el ement sandf unc t i onst hathel p mai nt ai nt hei nt egr i t yoft hebehav i or al s ys t em. Thr ought hes e,t hef oc usofhermodel i swi t hwhatt hebeha vi ort heper s oni spr es ent i ng mak i ngt hec onc eptmor eat t unedwi t ht heps y c hol ogi c al as pec tofc ar ei n. Whent hebehav i or al s ys t em hasbal anc eands t abi l i t y , t hei ndi v i dual ’ sbeha vi or swi l l be pur pos ef ul ,or gani z ed,and pr edi c t abl e.I mbal anc eandi ns t abi l i t yi nt hebeha vi or al s y st em oc c urwhent ens i onand s t r es sor saffec tt her el at i ons hi poft hes ubs ys t emsort hei nt er nal andex t er nal e nv i r o nme nt s .
SeeAl so •
Do r o t h yE.J o h ns o n–Bi o gr a ph ya n dWo r k s
Ref er enc e s 1.J ohns on,D.E.( 1959a) .Aphi l o soph yofnur s i ng.Nur s i ngOut l ook ,7( 4) ,198–200. 2 .J o hn s on ,D. E.( 1 96 8) .On ec on c ep t u al mod el o fn ur s i n g.Un pu bl i s he dl ec t ur e , Vander bi l tUni v er s i t y ,Nas hv i l l e,TN.
Ex t er nal Li nk s •
Theor yDevel opment :What ,Why ,How?
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Bar r i er sandHaz ar dsi nCoun sel i ng
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On eCo nc e p t u al Mo de lo fNu r s i n g
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Th eNu r s eTh eo r i s t s–Do r o t h yJ o h ns o nPr o mo–YouT ubev i deoofa ni nt er v i e w wi t hDor o t h yJ ohns onher s el f .
Transcript of behavioral system model by Dorothy Johnson Born August 21, 1919, in Savannah, eorgia! "oungest in a family of seven! #btain her B! S! $! degree from %anderbilt &niversity in $ashville, Tennessee, in 19'2( and her )!*!+! from +arvard &niversity in Boston in 19'! She began publishing her ideas about nursing soon after her graduation! She -or.ed brie/y as a public health nurse and in 19'' returned to %anderbilt as an instructor in *ediatric $ursing! 0n 19'9 she oined the faculty of &niversity alifornia, 3A -here she and 3ulu 4! 5olf +assenplug developed the 67rst four year generic basic nursing program in the &nited States!6 She held a strong conviction that continuing improvement of care -as the ultimate goal of nursing! Johnson stressed the importance of research8based .no-ledge about the eect of nursing care on clients! After her retirement from &3A Dorothy Johnson moved to the :lorida coast to pursue her hobby of the study of sea shells! She remained active in retirement as a spea.er and advocate for nursing education! Behavior system model De7nition of nursing Dorothy 7rst proposed her model of nursing care in 19; as fostering of
uire?! uence of illness :our goals of nursing are to assist the patientC $ursings )etaparadigm *erson +ealth Environment $ursing F<+uman being? as having t-o maor systems, the biological system and the behavioral system! 0t is role of the medicine to focus on biological system -here as $urslingGs focus is the behavioral system! F <+ealth? is a purposeful adaptive response, physically mentally, emotionally, and socially to internal and e@ternal stimuli in order to maintain stability and comfort! F
e@ists! According to Johnson an individuals behavior is in/uenced by the events in the environment F<$ursing? has a primary goal that is to foster e>uilibrium -ithin the individual! $ursing is concerned -ith the organied and integrated -hole, but that the maor focus is on maintaining a balance in the Behavior system -hen illness occurs in an individual! Assumptions Assumptions about system Assumptions about structure and function of each subsystem Each subsystem has three functional re>uirements There are ' assumptions of systemC 1!:irst, there is uires and results in some degree of regularity and constancy in behavior, is essential to man that is to say, it is functionally signi7cant in that it serves a useful purpose, both in social life and for the individual! '!3ast, uences it achieves can be inferred -hat
attachment of a strong social bond?
Johnson Behavioral System (JBS) Model Author Unknown retrieved from the internet September 1 !""! httpCHH---!myfreeessays!comHscienceIandItechnologyH'1!sht
ml #n this paper # am $oin$ to summari%e the Johnson Behavioral System (JBS) Model (Johnson 1&'" 1&&") eplain the perspetives for nursin$ pratie and eplore its
appliability in nursin$ pratie* +irst # am $oin$ to talk a little about ,orothy -* Johnson the nurse that wrote the Model* ,orothy -* Johnson was born Au$ust !1 1&1& in Savannah .eor$ia (/obo 1&&0)* She reeived her A* A* from Armstron$ Junior olle$e in Savannah .eor$ia in 1&2'3 her B* S* 4* from 5anderbilt University in 4ashville 6ennessee in 1&7!3 and her M*8*9* from 9arvard University in Boston in 1&7' (onner 9arbour Ma$ers and :att 1&&7)* Johnson was an instrutor and an assistant professor in pediatri nursin$ at 5anderbilt University Shool of 4ursin$ from 1&77 to 1&7&* +rom 1&7& until her retirement in 1&;' and subse she was eli$ible to $o on a sabbatial and went to the hristian Medial olle$e Shool of 4ursin$ in 5ellore South #ndia were she was interested in startin$ a baalaureate pro$ram whih was reeived well (/obo 1&&0)* ,orothy Johnson has had an influene on nursin$ throu$h her publiations sine the 1&0"s* 6hrou$hout her areer Johnson has stressed the importane of researh?based knowled$e about the effet of nursin$ are on lients* Johnson was an early proponent of nursin$ as a siene as well as an art* She also believed nursin$ had a body of knowled$e refletin$ both the siene and the art* +rom the be$innin$ Johnson (1&0&) proposed that the knowled$e of the siene of nursin$ neessary for effetive nursin$ are inluded a synthesis of key onepts drawn from basi and applied sienes* #n 1&>1 Johnson proposed that nursin$ are failitated the lient@s maintenane of a state of e
Johnson states that by ate$ori%in$ behaviors they an be predited and ordered* Johnson ate$ori%ed all human behavior into seven subsystems (SSs)C Attahment Ahievement A$$ressive ,ependene Seual #n$estive and -liminative* -ah subsystem is omposed of a set of behavioral responses or tendenies that share a ommon $oal* 6hese responses are developed throu$h eperiene and learnin$ and are determined by numerous physial biolo$ial psyholo$ial and soial fators* +our assumptions are made about the struture and funtion of eah SS* 6hese four assumptions are the strutural elements ommon to eah of the seven SSs* 6he first assumption is from the form the behavior takes and the onse
holds that a$$ressive behavior is not only learned but has a primary intent to harm others* 9owever soiety has plaed limits when dealin$ with self?protetion and that people and their property be respeted and proteted* 6he ,ependeny subsystem promotes helpin$ behavior that alls for a nurturin$ response* #ts onse
6he seond re
9ealth is pereived as an elusive dynami state influened by biolo$ial psyholo$ial and soial fators* #t fouses on the person rather than the illness (onner et al* 1&&7)* 9ealth is refleted by the or$ani%ation interation interdependene and inte$ration of the SSs of the behavioral system (Johnson 1&'")* Man attempts to ahieve a balane in this system whih will lead to funtional behavior* A lak of balane in the re?!"1* ,erdiarian A* =* (1&&2)* 6he Johnson Behavioral System Model* #n M* -* 8arker (-d*) 8atterns of 4ursin$ 6heories in 8ratie* 4ew HorkC 4ational /ea$ue for 4ursin$ 8ress* Johnson ,*-* (1&'")* 6he behavioral system model for nursin$* #n J*8* Eiehl I * Eoy (-ds*) oneptual models for nursin$ pratie (!nd ed*)* 4ew HorkC Appleton? entury?rofts* /obo M* /* (1&&0)* ,orothy -* Johnson* #n J* B* .eor$e (-d*) 4ursin$ 6heoriesC 6he Base for 8rofessional 4ursin$ 8ratie (7th ed*)* 4ew HorkC Mamillian o* Eandom 9ouse olle$e ,itionary 1&''*
1 .1 .Do r o t h yJ o hn s o nsTh eBe ha v i o ur a lSy s t e m Mo de l Co mp i l e dBy: -Pr o f( Mr s )Cy n t h i a Ba r r e t tCh ak r a de oMs c( Ps y)Ns g .RNRM ( I n di a )RN( Wi s c o n s i n ) 2. 2.Do r o t h yJ o h ns o n•Th eBe ha v i o r a lSy s t e m Mo de l 3. 3.Ba c k g r o un dofDo r o t h yJ o h ns o n •Bo r no n2 1s tAu g19 19i nGe or g i aUSA. •1 94 2 -BScNs g f r om Nas hv i l l eT enne ss ee. •Mas t er si nPub l i cheal t hf r o m Har v ar dUni v er s i t yBos t on i n 19 48 . Wo r k e da tv a r i o uspl a c esi nt h eUSa ndi n1 95 5a tCMCVa l l o r eSON. •Cr e at i o no f he rt h eo r ybe ga ni n1 94 0’ swhe ns heb eg ant ot e ac h. •. Re t i r edi n1 978 ,a ndd i e di n1 999 . 4. 4.Th eTh eo r y •Th eBSM o fNs gwa sfi r s tpr o po se di n1 96 8. •I tad v oc a t e st h ef o s t e r i ngof effic i entandeffec t i v ebeha vi or al f unc t i oni ngoft hepat i entt opr ev enti l l nes s. •Thepti s d efi n edasabe ha v i o r a ls y s t e mc o mp os e do fs e v e nb eh a vi o r a ls u bs y s t e ms . •Ea c h s ubs ys t em i sc ompr i s edoff ours t r uc t ur al c har ac t er i s t i c s. •Ani mbal anc ei neac hr es ul t si n di s equi l i br i um. •Thenur s esr ol ei st ohel pt hepat i entmai nt ai nhi sorherequi l i br i um. 5. 5.Go al sofNs ga cc or d i ngt oBSM1.T oas s i s tt hepat i en twh os ebe ha v i ori spr opo r t i onal t o s oc i al demands . 2.T oas si s tt hepat i entwhoi sabl et omodi f yhi sbeha vi ori nwa yst hati t s uppor t sbi ol ogi c al i mper at i v es . 3.T oas si s tt hepat i entwhoi sabl et obenefi tt ot hef ul l es t e xt entdur i ngi l l nes sf r om t heph ys i c i ansknowl edgeands k i l l . 4.T oas s i s tt hepat i entwhos e be ha v i o rd oe sn otg i v eev i d en ceo fu nne c es s ar yt r a umaasac on se qu en ceo fi l l n es s . 6. 6.J o hn s onBe ha v i o r a lSy s t e m Mo de l( BSM)Ov e r v i e wEv o l v e df r o mp hi l o s op hi c a li d ea s , t heo r y ,andr es ear c h;herc l i ni c al bac k gr ound;andman yy ear soft hought ,d i s c us s i ons ,and wr i t i n gI nfl uenc es :Fl or enc eNi gh t i ng al eSy s t emst h eo r yDe v el opmen t al t heor y 7. 7.Dor ot hyJohns onGoal :r es t or eormai nt ai nbehav i or al i nt egr i t y ,s t abi l i t y ,andeffic i entand effec t i v ebeha vi or al f unc t i oni ngCl i ent :abi ops y chos oc i al bei ngwi t hani ns t abi l i t yi noneoft he s ubs y st emsduet os t r es s Nur s i ng:“ anex t er nal r egul at or yf or c ewhi c hac t st opr es er v et he or g ani z at i ona ndi nt egr at i onoft hepat i e nt ’ sbeha vi or sa ta nopt i mu ml e v el …. ” 7Su bs y s t e ms: Ea chhass t r uc t ur al andf un ct i onal c omponent s . 8. 8.TheBehavi orSys t em Model 9. 9.Affil i a t i v eorAt t a ch me ntSu bs y s t e ms •Be ha v i o ra s so ci a t e dwi t ht h ed ev e l o pmen ta nd mai nt enanc eofi nt er per s onal r el at i ons hi pswi t hpar ent s ,peer s ,aut hor i t yfigur es . •Es t abl i s ha s ens eofr el at ednes sandbel ongi ngwi t hot her si nc l udi ngat t ac hmentbeha vi or ,i nt er per s onal r el at i ons hi psandc ommuni c at i ons k i l l s . •Goal at t ai nment 10.10.De pe nd en c ySub s y s t em•Be ha v i ou ra s so ci a t e dwi t ho bt a i n i n ga s si s t an c ef r o mo t h er si n t heen vi r onmentf orc ompl et i ngt as k sand/ oremo t i onal s uppor t . •I nc l udess eek i ngof at t ent i on,appr ov al ,r ec ogni t i on,bas i cs el fc ar es ki l l sandemot i onal s ec ur i t y . 11.11.I nge st i v eSu bs y s t em•Beha vi o r sas s oc i at edwi t ht hei nt a keofneededr es our c esf r om t he e xt er nal en vi r onment s ,i nc l udi ngf ood,fl ui d,i nf or mat i on,k no wl edgeandobj ec t sf ort he pr opos eofes t abl i s hi nganeffec t i v er el at i ons hi pwi t ht heen vi r onment . 12.12.El i mi na t i v eSu bs y s t em•Beha vi o uras s oc i at e dwi t ht h er el eas eofph y si c al was t epr o duc t s f r om t hebody . •Ex pr es sf eel i ngs 13.13.Se xua lSub sy s t ems •Beha v i ora ss oc i at edwi t has pec i fi cgend erba sedi d en t i t yf ort he pu r p os eofen sur i n gpl eas ur e / pr oc r eat i on ,andk no wl edgean dbeha v i orb ei ngc ong r u entwi t h bi ol ogi c al s ex .
14.14.Aggr es si v ePr ot ec t i v eSubs y st em•Beha vi ouras soc i at edwi t hr eal orpo t ent i al t hr eati n t heenv i r onmentf ort hepur pos eofens ur i ngs ur v i v al . •Pr ot ec t i onofs el ft hr oughdi r ec tor i ndi r ec tac t s . •I dent i fi c at i onofpot ent i al danger . 15.15.Ac hi e v eme ntSu bs y s t e m•Be ha v i o ura s so ci a t edwi t hma st e r yo fo ne se l fa ndone ’ s en vi r onmentf ort hepur pos eofpr oduc i ngades i r edeffec t . •I nc l udespr obl em s ol v i ngac t i v i t y • Kn owl e dg eo fp er s o na ls t r e ng t h sa ndwe ak n es s e s . 16.16.Res t or at i v e•Beha vi ouras s oc i at edwi t hmai nt ai ni ngandr es t or i ngener gyequi l i br i um,e. g. r el i eff r om f at i gue,r ec ov er yf r om i l l nes s,s l eepbehav i our ,l ei s ur e/ r ec r e at i onal i nt er es t sand s i c kr ol ebehav i our . 17.17.J o h ns o n ’ sBe ha v i o r a lSy s t e msMo de l 18.18.Pu r p os eo ft h eSy s t e msTh eo r y Nu r s ec r e at e saba l a nc ebe t we enc l i e nta nden v i r o nme nt t oac hi ev eanopt i mal l ev el off unc t i oni ng 19.19.Subs y st ems •I ndi v i dual madeupof7subs y st ems •I nt er r el at edpar t sf unc t i ont oget hert o f or m awhol e•I nt er ac twi t heac hot her •I nt er r el at edandi nt er c onnec t ed•En vi r onment c ons t an t l ya ct i ngons ub sy s t ems 20.20.Fi v eCor ePr i nc i pal s Who l enes sandOr der St a bi l i z at i onReor g ani z at i onHi er ar c hi c I nt er ac t i onDi al ec t i c al Cont r adi c t i on 21.21.Wh ol e ne s sa ndOr d er •De v e l o pme nt a la na l o gyofwh ol e ne s sa ndo r d eri sc on t i n ui t yan d i dent i t y . •Cont i nui t yandc hangec anex i s tac r o s st hel i f es pan. •Cont i nui t yi si nt he r el at i ons hi poft hepar t sr at hert hani nt hei ri ndi v i dual i t y . 22.22.St abi l i z at i o n•Dy nami cs y s t e msr es pondt oc ont e x t ual c hangesSe tpoi ntma i nt ai nedby al t er i ngi nt er nal c ondi t i onst oc ompens at ef orc hangesi ne xt er nal c ondi t i ons . •Nur s esac tas ex t er nal r egul at or s .–Moni t orpat i entr es pons e,l ook i ngf ors uc ces sf ul adapt at i ont ooc cur . • Nur s esi nt er v enet ohel ppat i entr es t or ebehav i or al s ys t em bal anc e. •I nt er v ent i oni snot ne ededi fbeha vi or a ls y s t em ba l an cer e t ur ns . 23.23.Re or g an i z at i o n•Oc c ur swh ent h eb eh av i o r a ls y s t e me nc ou nt e r sne we x pe r i e nc e si nt h e en v i r o nme ntt h atc a nno tbeba l a nc edbye x i s t i n gs y s t e m me ch an i s ms •Nu r s ea ct st op r o v i d e c on di t i o nsorr e so ur c e se s se nt i a lt oh el pt hea c co mmo da t i o np r o ce s s:–Ma yi mp os e r egul at or yorc ont r ol mec hani s mst os t i mul at eorr ei nf or c ec er t ai nbeha vi or s–Ma yat t emptt o r epai rs t r uc t ur al c omponent s 24.24.Hi er ar c hi cI nt er ac t i on•Hi er ar c hi es ,orapat t er nofr el y i ngonpar t i c ul ars ubs ys t ems ,l ead t oadegr eeofs t abi l i t y . 25.25.Di al ec t i c al Cont r adi c t i on•Mot i v at i onal f or c ef orbeha vi or al c hange•Dr i v es / r es pons es de v el o pedandmodi fi edov ert i met hr oughmat ur at i o n,e xper i enc e,an dl ea r ni ng• Env i r onment al domai nst hatt heper s oni sr es pondi ngt oi nc l udet hebi ol ogi c al ,ps y chol ogi c al , c ul t ur al ,f ami l i al ,s oc i al ,andphy s i c al s et t i ng 26.26.Di al ec t i c al Cont r adi c t i on( c ont i nued) •F ac edwi t hi l l nes sort het hr eatofi l l nes s,t he pe r s onnee dst or es ol v e( mai nt ai nbeha vi or al s y s t em bal anc eof )ac as c ad eofc ont r a di c t i on s bet weengoal sr el at edt o:–Phy si c al s t at us ,s oc i al r ol es ,andc ogni t i v es t at us . •Nur s es ’ i n t er v ent i o ns :–Foc usonr e st or i ngbeha vi or al s y s t e m bal a nc e–Leadi ngt oan ewl e v el of devel opment
27.27.Sy s t em i sou tofba l an cewh en . . 1 .I n su ffic i e nc y =d oe sno tg ete no ughofs o me t h i ng 2. Di s c r ep anc y =no top t i mal l ywo r k i ng 3.I n compat i bi l i t y =s ub sy s t emsc on fli c t 4 .Domi nan ce= o nes y c t e mi sa l wa y su s ed 28.28.Ma j o rc on c ep t so ft hemo de l Pe r s on Su bs y s t e ms He al t h Nu r s i n ga ndnu r s i ngt h er ap eu t i c s 29.29.Per s on•Vi e wedasanopensy s t em wi t hor ga ni z ed ,i nt er r el at ed,a ndi nt er dependent s ub sy s t e ms . •Th ewh ol eo ft h eh uma no r g an i s m( s y s t e m)i sgr e at e rt h ant hes u mo fi t spa r t s ( s ub sy s t ems ) . •Who l esandpa r t sc r ea t eas y s t em wi t hd ua lc ons t r ai nt s :Nei t herh as c ont i nui t yandi dent i t ywi t houtt heot her . •Nur s i ngc l i entv i ewedasabehav i or al s ys t em• Beha vi or al s ys t emsar eor der l y ,r epet i t i v e,andor gani z ed 30.30.Subs y st ems •Ar epar t soft hebeha vi or al s y st em•Car r youts pec i al i z edt as ks / f unc t i ons ne ededt omai n t ai nt hei n t eg r i t yoft hewh ol es y s t em•Manages y s t em r el a t i ons hi pt ot he en v i r o nme nt •Ha v eas eto fb eha v i o r a lr e s po ns est h atar ede v el o pe da ndmo di fi edt h r o ug h mot i v at i on,ex per i enc e,andl ear ni ng 31.31.Ea chSu bs y s t e m•Co mpos edofatl ea stf ours t r uc t u r al c ompon ent st h ati nt er ac ti na s pe ci fi cpa t t e r n–Go al –Se t–Ch oi c e–Ac t i o n 32.32.Goal •Thi si sdefi nedast hed es i r edr e sul torc on sequen ceoft hebeha vi or . •Theba si sf or t hegoal i saun i v er s al dr i v ewh os ee xi s t enc ec anbes uppo r t edb ys c i en t i fi cr es ear c h. 33.33.Beha vi or al Set •I sapr edi s pos i t i ont oac ti nac er t ai nwayi nagi v ens i t uat i on•Repr es ent s ar el at i v el yst abl eandhabi t ual beha v i or al pat t er nofr es pons est opar t i c ul ardr i v esors t i mul i • Repr e sent sl ea r ne dbeha vi ora ndi si n fluenc edb yk no wl edge,at t i t ud es ,a ndb el i ef s 34.34.Beha vi or al Se tComp on ent s •Per s ev er a t i on–Con si s t en tt e nd enc yt or eac tt oc er t ai n s t i mul i wi t ht hes amepat t er nofbehav i or •Pr epar at i on–Func t i onst oes t abl i s hpr i or i t i esf or at t endi ngornotat t endi ngt ov ar i ousst i mul i 35.35.Choi c e•Ref er st ot hei ndi v i dual ’ sr eper t oi r eofal t er nat i v ebeha v i or si nas i t uat i ont hatwi l l bes tmeett hegoal andat t ai nt hedes i r edout c ome. •Thegr eat ert hebeha vi or al r eper t oi r eof al t er nat i v ebehav i or si nas i t uat i on,t hemor eadapt abl et hei ndi v i dual . 36.36.Ac t i on •Obs er v abl eac t i onoft hei ndi v i dua l–Conc er ni swi t ht heeffic i en cyand eff ec t i v ene ssoft hebeha v i o ri ngoal at t ai nment .–Ac t i o nsar eo bs er v abl er es po ns est o s t i mul i . 37.37.TheJo hn so nMod el Pr o po se s •F orb eha v i o rt ob ema i n t a i n ed ,i tmu s tb ep r o t e ct e d, nur t ur ed,ands t i mul at ed.•Pr ot ec t i onf r om no xi ouss t i mul i t hatt hr eat ent hes ur v i v al oft he be ha v i or al s y s t em •Nur t ur a nc e,whi c hp r o vi desadeq ua t ei n putt os us t ai nbeha vi or• St i mul at i ont oc ont i nuegr owt hoft hebeha vi orandc ount er ac t ss t agnat i on 38.38.TheJo hns onMod el ( c on t i nued•Defi c i en cyi nan yoral l oft hes ef un ct i ona lr e qu i r ement s –Thr eat enst hebeha vi or al s y st em asawhol eort heeff ec t i v ef unc t i oni ngoft hepar t i c ul ar s ubs ys t em wi t hwhi c hi ti sdi r ec t l yi nv ol v ed. 39.39.Env i r onment •Cons i s t sofal l el ement st hatar enotapar toft hei ndi v i dual ’ sbehav i or al s y s t e mb uti n flu en cet h es y s t e ma ndca ns e r v easas ou r c eo fs u st e na li mp er at i v e s • Man i pul at edb yt henu r s et oa chi e v eheal t h 40.40.Ex t e r n al en vi r o nme nt •Ma yi nc l ud epeopl e,obj ec t s ,andpheno menat h atc anpo t ent i a l l y pe r me at et heboundar yo ft hebeha vi o r al s y s t e m•Ex t er n al s t i mul usf o r msa n or gani z ed/ meani ngf ul pat t er nt hatel i c i t sar es pons ef r om t hei ndi v i dual
41.41.I nt er nal En vi r onment •I nt er nal i z edi nt er v eni ngv ar i abl es :–Ph ys i ol ogy , t emper ament ,ego, ageandr el at eddev el opment al c apac i t i es ,at t i t udes ,ands el f -c onc ept •Gener al r egul at or s– Var i abl e st ha ti n fluen ces et ,c ho i c e,a nda ct i on•Ke yar easf ornur s i nga ss es s me nt 42.42.Heal t h•Beh av i o r al s y s t em bal anc eo rs t abi l i t y •Demon st r at edb yobs er v edbe ha v i ort hat i spur pos ef ul ,or der l y , andpr edi c t abl e. •Beha vi ormai nt ai nedwheni ti seffic i entandeff ec t i v e i nma nagi n gt heper s on ’ sr el at i on shi pt ot h een vi r onment 43.43.Nur s i nga ndNur s i ngTh er apeut i c s •Nur s i ngi s“ as er v i c et hati scompl ement a r yt ot ha to f medi c i neandot herheal t hpr of es s i ons ,butwhi c hmak esi t sowndi s t i nc t i v ec ont r i but i ont ot he heal t handwel l bei ngofpeopl e. ” •Nur s i ngvi ewspat i ent sasbeha vi or al s y st ems ,and med i c i nev i e wspa t i en t sasbi o l og i c al s y s t ems . 44.44.Spec i fi cGoal ofNur s i ngAc t i onI s “ t or es t or e,mai nt ai n,orat t ai nbeha vi or al s y st em bal anc eands t abi l i t yatt hehi ghes tpos si bl el ev el f ort hei ndi v i dual ”( J ohns on,1980,p214) 45.45.Nur s i ngTher apeut i c s •At t emptt or epai rdamageds t r uc t ur al uni t sbyal t er i ngt he i n di v i d ual ’ ss etandc ho i c e•I mpos er egul at or ya ndc on t r ol mea sur es •Suppl yorhel pt he c l i entfi ndhi sorherowns uppl i esofes sent i al f unc t i onal r equi r ement s 46.46.Thenur s ema ypr o v i de •Nu r t ur an ce–t hr ou ght hei nputo fappr o pr i at es uppl i esf r om t he en vi r onme nt •St i mul at i o n–f orus et oenhanc egr o wt handpr e v ents t agnat i on•Pr o t ec t i onf r o mn o x i o usi n fl ue nc e swi t hwh i c ht h es y s t e mc a nn otc o pe ” 47.47.As s ump t i o nsma debyt h et h eo r y Th es ea r edi v i d edi n t ot h r eeca t e go r i e s1 .As s ump t i on s ab outs y s t e m. 2 .As s ump t i onabo uts t r uc t ur e. 3.As s umpt i o naboutf unc t i on s. 48.48.As s umpt i onsaboutt hes y st emsi nt hemodel 1.Ther ei sor gani z at i on,i nt er ac t i on, i n t er d ep end en cyandi nt eg r at i onoft hepar t sandel ement sofb eha vi or st hatgot omak eup t h es ub s y s t e m. 2 .As y s t e mt e nd st oa ch i e v eaba l a nc ea mo ngt h ev a r i o usf o r c esop er a t i n g wi t hi nanduponi tandc ont i nuous l yst r i v est omai nt ai nanequi l i br i um. 3.Abeha vi or al s y st em whi c hr equi r esandr es ul t si ns omedegr eeofr egul ar i t yandc ons i s t enc yi nbeha vi or ,i s es sent i al t omanasi ti sf unc t i onal l ysi gni fi cantasani ndi v i dual andi ns oc i al l i f e. 4.Sy st ems ba l an cer efl ec t sadj u st ment sandadap t at i onst hatar es uc c es s f ul . 49.49.As s ump t i o nsab ou tt h es t r u ct ur e 1.Fr o mt h ef o r mt h eb eh av i o rt a k esan dt h e c ons equen cei tac hi e v esc anbei nf er r edwh at‘ Dr i v e ’hasbeens t i mul at e dandwha t‘ Goal ’ i s bei ngs ought . 2.Eac hi ndi v i dual per s onhasapr edi s pos i t i ont oac twi t hr ef er enc et ot hegoal , i nc er t ai nwa ysr at hert hant heot her .Thi sPr edi s pos i t i oni scal l eda‘ SET’ 3.Eac hs ubs y st em hasar eper t oi r eofc hoi c ec al l eda‘ Sc opeofAc t i on’ 4.Thei ndi v i dual pat i ent ’ sbeha vi or p r o du c e sanou t c o met h atc a nbeob s e r v e d . 50.50.As s ump t i o nsa bo utt h eFu nc t i on s 1.Th es y s t e m mu s tbepr o t e ct edf r o mt o x i ci n flu en ce s wi t hwi t c ht hesy s t em c an no tc ope . 2.Eac hs y s t em hast obenur t ur edt hr oug ht hei nputof ap pr o pr i at es uppl i esf r o mt heen vi r onmen t . 3.Thes y s t em mus tb es t i mu l at edf orus et o en ha nc egr o wt han dp r e v en ts t a gn at i o n. 51.51.Br i ef Thusbeha vi or sar e-or der l y-Pur pos ef ul -Pr edi c t i v e-s uffic i ent l yst abl e&r ec ur r en t T obea menabl et ode sc r i pt i onande xpl anat i on . 52.52.Li mi t at i ons •Ver yi ndi v i dual i s t i c •F ami l yoft hec l i enti sonl ycons i der edasenv i r onment • Fo cus edo nt h enur s i ngc ar eoft h ehos pi t al i z edan di l l •Doesno tf o cusonheal t hpr omo t i on , pr i mar ypr ev ent i on,ordi s eas epr ev ent i on
53.53.Cr i t i q ue•Pas tob ser v a t i on al s t u di e sandg ene r al s y s t emst heor yi nfl uenc edDor o t h y J o hn s oni nt h ed ev e l o pme nto fh erBSM. •Th er ea r e–7b eh a vi o r a ls u bs y s t e ms •-3 f un ct i o na lr e qu i r e men t •Th ema j o rp he nome no no fc on ce r ni nJo hn so n’ swo r ki sbe ha v i o r 54.54.Cont d. . . . . •Canbegener al i z edac r os st hel i f es panandac r o sscul t ur es •I ti sdi ffic ul tt ot es t J oh ns on smo de lb yt h ede v el o pme nto fh y po t h es i s •De ci s i o nma ki n gf o rn ur s i n gp r a ct i c e us i ngt hi smodel woul di nv ol v ec r i t i c al t hi nk i ng•Doesnotc l ear l ydefi net hee xpec t edout c ome whenon eoft hes ubs y s t emsi sbei n gaff ec t edbynur s i ngi nt e r v e nt i on 55.55.Cont d. . . . . . . . . •Ref er st oc ommuni c at i onr at hert handi r ec t i ng•Ther ei sal i mi t edbodyof l i t er at ur eont heus eofBSM i nc l i ni c al pr ac t i c eort opr ov i def r amewor kf ornur s i ngr es ear c h 56.56.Al i t t l ebac k gr oundWhatt y peoft heor ydi dDor o t h yJ oh ns onPo st ul at e ? 57.57.GENERALTHEORI ES1 .Fl o r e nc eNi g ht i n g al e 2 .Vi r g i n i a nHe nd er s o n3 .Ma r t h aRo ge r s 4 . SrCe l l i s t e aRo y 5.Do r o t h eaOr e m6 .Be t t yNu me n7 .Do r o t h yJ o hn s on 58.58.Sy s t e msTh eo r y 1 .Ro y ’ sad ap t a t i o nt h eo r y 2 .Nu me n’ sHe al t hc a r es y s t e msmo de l 3 . J ohns on ’ sheal t hc ar ebeha vi or a lmode l 4.Ki n g’ sgoal at t a i nme ntt h eor y 59.59.I nt er per s onal /Car i ngTheor i es 1.Pepl au’ sPs y chody nami cNur s i ngt heor i es 2.Lei ni nger ’ s T r anc ul t ur al c ar et heor i es . 3.Wat s on’ sPhi l os oph yands c i enc eofc ar i ngt heor y 60.60.Cl i e nti sCl i em bi op sy c hos oc i al nti y s t esanoral sPer s onc anbebr ok e nadaeha vi i t h do wni n t op ar t sf o rs t ud y / c ar e2ad app t i v ea be ac hwat i v es y snti sms ,san da das u bs t e m Cl i es t ebs yonens umpt•Sy s t em’ sTheor ypt i vy s tem e msr alo•Hol i s t i cv i e w of c l i entodeandea vi our al cct i on.hc t•Cl i enti nt er ac t swi t ht heenv i r onments47bs t r uf un4 al •Cl i enti st hec ent er f oc usoft heor et i c al viduni ndi f r amewor kandofnur s i ngc ar enti s a•Nur s i ngf ac i l i t at escl i ent ’ spr ogr es st owar dCl i es omebal anc eorhomeos t as i s ( adapt at i on,or der ,s t abi l i t y ,et c . )•Weakdefi ni t i onofnur s epat i entr el at i ons•Per s on be comesnu r s i n gc l i en twhent hr eat en edb yi nt er nal ore xt er nal f or c esAc k no wl edgec l i e ntas •Ps yc hol ogi c al ,bi ol ogi c al ,ands oc i ol ogi c al as pec t sofi ndi v i dual ,f ami l y ,c l i entr ec ogni z ed gr oup,orc ommuni t yPhy si ol ogi c al ,ps y chol ogi c al ,s oc i ol ogi c al ,dev el opment al ,ands pi r i t ual v ar i abl esCl i entr epr es ent edascent r al s t r uc t ur e,l i nesofdef ens e,andr es i s t anc e. 61.61.Ca s es t u dy Ra m ada i l ywa gel a bo r e ri nas t o nequ er yh adal a c er a t e dwo un do nh i s f o r eh ea d.Hewa sr ef e r r e dt ot h ePHC.Thewou ndex t e nd edt ot hes k ul l .Asar e su l th ewa s ou to fwo r kan ds pe ndp l e nt yoft i mewi t hh i sf r i e nd sa nds e emedd ep r e ss ed .Hi swi f es pe nt h ou r se ac hd a yma k i n gav a r i e t yo fs n ac k s. t oc h ee rh i mu pa ndf o un di twa sago odwa yt o r e l e as eh era nx i e t ya bou th erh us ba ndco nd i t i o n. Af t ert h r e ewe ek st h ewo un ds h owe dn o i mpr o v eme nt ,al t h oughi twasno ti nf ec t e d.Dur i ngt h ev i s i tt ot hePHCt hewi f ec onfi dedt o t henur s es t a t i ngt hathe rh us bandwa sd r i nk i ngal o tofwat era nds ee medt obeur i nat i ng f r equent l y , e v enatn i ghthehadadi s t ur beds l e epdueot hi spr o bl e m.Shewa swonder i ngi f t her ewasan ypi l l t ohel phi ms l eept hr ought heni ght . 62.62.Att hePHCUmat henur seusedt heBHM t osol vet hepr obl em. •SheassessedRam and hi sf ami l yus i ngt he7s ubs y s t emsofb eh av i ours hef ou nddefi c i ti n3s ub sy s t ems• Ac hi e v ements ubs y s t em duet ol ac kofs oc i al i n v ol v ementa nddepr e ss i on•El i mi nat i v e s ubs y st em duet opol y ur i a,noc t ur i a•I nges t i v es ubs y st em duet odr i nk i ngl o t sofwat er ,and eat i ngl ot sof