Dorothy Johnson

1. Dorothy Johnson Behavioral Systems Model Deborah Meshel

2. Dorothy JohnsonBackground • 1919 Born in Savannah Georgia • 1938 AA Armstrong Jr. College • 1942 BSN Vanderbilt University School of Nursing • 1948 MPH Harvard University

3. Dorothy JohnsonBackground cont Professional Experience Mostly involved teaching • 1943 – 1944 staff nurse at Chatham- Savannah Health Council • 1949 – 1978 Instructor and assistant professor in pediatric nursing at Vanderbilt University School of Nursing • Professor of nursing at University of California in LA • 1980 published the B.S. model • Early proponent of nursing as a science and an art • BS model based on Nightingale’s belief

4. Purpose of Systems Theory Nurse creates balance between client and environment to achieve an optimal level of functioning.

5. Subsystems • Individual made up of 7 sub systems • interrelated parts functioning together to form a whole • Interact with each other • Interrelated and interconnected • Environment constantly acting on subsystems

6. Johnson’s 7 Subsystems

7. Subsystems • Attachment- goal attainment- form relationships and social bonds • Aggressive- protect oneself to respond to threats • Dependency – attention, recognition, physical assistance • Ingestion- intake of nutrients to obtain knowledge • Elimination- eliminate waste and to express feelings • Sexual- to procreate, to have sexual relationships, to develop gender based identity • Achievement- mastery or control of some aspect of the environment

8. Client Stressor=> = Tension (Internal or external) Nurse = equilibrium

11. System is out of balance when… 1. insufficiency = does not get enough of something 2. discrepancy = not optimally working 3. incompatibility = subsystems conflict 4. dominance = one subsystem is always used

12. Nurses… • Reduce stressful stimuli • Support natural adaptive process • Makes changes to environment • Focus is the patient not illness

13. Functional Requirements Needed by each subsystem to fulfill its function Protection Nurturance Simulation

14. Structural RequirementsCharacteristics of each subsystem • Goal • Set • Choice • Action

15. Person • Environment • Health • Nursing

16. Person Subsystems Interdependent parts Adjustment to maintain balance Maintain a steady state of equilibrium

17. Environment • Any factor influencing the behavioral subsystem • Not part of the client’s behavioral system • Internal and external

18. Health Balance and stability of the subsystems Lack of balance = poor health Balance = health

19. Nursing When there is instability or stressors External regulatory force Helps maintain equilibrium Art and Science

20. Internal Criticism Clarity Simplicity Specificity or Generality Accessibility Scope

21. Contagious Very Contagious! Behavioral Systems Model is used in: practice, education, research

22. Nursing Implications

23. Case Study 10 year old boy Not doing well in school Comes to school dirty, does not brush teeth, has dirty cloths/ often brings no lunch Parents divorced/ lives with mother Mother clinically depressed Father physically abused him Mother states she can not handle her son’s behavior/ hard to enforce the rules Student is not doing well in school. He is in the office everyday with behavioral problems, and not getting along with peers.

24. Diagnostic and Treatment Process • Does a problem exist? • Diagnostic classification of the problem • Management of nursing problems • Evaluation of behavioral systems balance and stability.

25. limitations • Very individual Family of the client is only considered as an environment Focused on nursing care of the hospitalized and ill. Does not focus on health promotion, primary prevention, disease prevention

26. Do I like this theory? YES!

27. Discussion Question: • Describe a client in your work whose subsystems were not in balance? How can you as a nurse create equilibrium?

28. References Alligood, M.R., Tomey, M.T., (2010). Nursing Theorist and Their Work, (7th, ed). Maryland Heights: Mosby Elsevier. Botha, E. (1989). Theory development in perspective: The role of conceptual frameworks and models in theory development, Journal of Advanced Nursing, 14, 49-55. Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2nd ed.). F.A. Reynolds, W. and Cormack, D. (1991). An evaluation of the Johnson Behavioral Systems Model of Nursing, Journal of Advanced Nursing, 16, 1122-1130. Tourville, C., & Ingalls, K. (2003). The living tree of nursing theories, Nursing Forum, 38(3), 21-36.