Dorothy Johnson’s Behavioral Systems Model

1. Dorothy Johnson’s Behavioral Systems Model Christine Douglas and dana Hogan

2. Backgound • Born August 21st 1919 • Associates Degree in 1938 from Armstrong Junior College in Savannah Georgia • 1942 BSN Vanderbilt University in Nashville Tennessee • 1948 Masters in public health Harvard University Boston Massachusetts

3. Influences • Florence Nightengale • Hans Selye • Teaching • Empirical approach to nursing

4. Nurse Goals • Nurses specifically …. “Contribute to patient welfare as that of fostering efficient and effective behavioral functioning in the person both to prevent illness and during and following illness” (Johnson, 1980)

5. Definitions • Person • A behavioral system comprised of subsystems constantly trying to maintain a steady state. • Environment • Not clearly defined. • Health • Balance and stability. • Nursing • External regulatory force that is only indicated when there is instability.

6. 7 or 8 Behavioral Subsystems • Affiliative • Dependency • Ingestive • Elimination • Sexual • Aggressive • Achievement • Restorative

7. Four Assumptions • Form of behavior can infer what drive or what goal • Predisposition to act • Different choices/scope of choices • Outcomes are produced Goal  Set  Choice  Behavior

8. Testing The Theory • 1980 Damus tested the validity of Johnson’s model which assisted in sustaining the utilization of model • Relationship exists between the patient’s unbalanced physiologic state and behavioral conduct • Alterations in behavioral patterns could be recognized/hypothesized • Nursing diagnosis and interventions were interrelated concepts

9. Tools Developed Based On Theory • 1978- Majesky, Brestor, and Nishio • Patient Indicators of Nursing Care • 1986- Auger and Dee • Patient Classification Instrument (PCI) • 1983- Lovejoy • Johnson Model First-Level Family Assessment Tool (JFFA-J) • 1983- Derdiarian • Derdiarian Behavioral Systems Model (DBSM) • 1991- Derdiarian • DBSM Self-Report Instrument for patients • DBSM-O Observation

10. Research • Bruce, G. L., Hinds, P., Hudak, J., Mucha, A., Taylor, M. C., & Thompson, C. R. (1980). Implementation of ANA’s quality assurance program for clients with end-stage renal disease, Advances in Nursing Science, 2(2), 79-95. • Coward, D. D., & Wilkie, D. (2000). Metastatic bone pain: Meanings associated with self-report and self-management decision making. CancerNursing: An International Journal for Cancer Care, 23(2), 101-108. • Dee, V., & Randell, B. (1989). NPH patient classification system theory-based nursing practice model for staffing nursing department. UCLA Neuropsychiatnc Institute and Hospital, Los Angeles. • Derdiarian, A. K. (1990). Effects of using systematic assessment instruments on patient and nurse satisfaction with nursing care. Oncology Nursing Forum, 17(1), 95-101. • Derdiarian, A.K., & Forsythe, A. B. (1983). An instrument for theory and research development using the behavioral systems model for nursing: The cancer patient. Nursing Research, 32(5), 260-266.

11. Research • Derdiarian, A. K., & Schobel, D. (1990). Comprehensive assessment of AIDS patients using the behavioural systems model for nursing practice instrument. Journal of Advanced Nursing, 15, 436-446. • Fruehwirth, S.E.S. (1989). An application of the Johnson’s behavioral model: A case study. Journal of Community Health Nursing, 6(2), 61-71. • Holaday, B. (1981). Maternal response to their chronically ill infants attachment behavior of crying. Nursing Research, 30(6), 343-347. • Lovejoy, N. (1983). The leukemic child’s perceptions of family behaviors. Oncology Nursing Forum, 10(4), 20-25. • Majesky, S. J., Brester, M. H., & Nishio, K. T. (1978). Development of a research tool: Patient indicators of nursing care. Nursing Research, 27(6), 365-371. • Moeller, K., Murvine, S., & Began, C. (2007). Utilizing a scenic curtain to decrease the patient’s anxiety and anger during initial chemotherapy treatment.

12. Theory Critique Cons Pros • Focused on hospitalized and ill stricken patient • Health promotion and patient education • Failure to incorporate the nursing process • Limited publication • Difficult to use in high level research • Undefined outcomes • Values/Ethics • Concepts are interrelated • Assumptions are descriptive • Simple • Very little “new language” • Significant impact of nursing

13. References • Dorothy Johnson Nursing Theory Website. (n.d). http://dorothyjohnson.wetpaint.com/ • Johnson, D. E. (1961, November). The significance of nursing care. The American Journal of Nursing Care, 61(11), 63-66. Retrieved from http://www.jstor.org/stable/3418646 • Johnson, D. (1980). The behavioral system model for nursing. In J.P. Riehl & C.Roy (eds.), Conceptual models for nursing practice (2nd ed.). NewYork: Appleton-Century-Crofts. Lobo, M.L. (1995). • Johnson’s Behaviour System Model. (n.d.). Retrieved October 07, 2011, from http://currentnursing.com/nursing_theory/behavioural_system_model.html • Parker, M. E. (Ed.). (1990). The behavioral system model for nursing. Nursing theories in practice (Illistrated ed., pp. 23-46). [Reader version]. Retrieved from http://books.google.com • Vanderbilt University. (n.d). Dorothy E. Johnson BSN, MPH (1919-1999). Retrieved October 12, 2011, from http://www.mc.vanderbilt.edu