In this paper, I am going to summarize the Johnson Behavioral System (JBS) Model (Johnson, 1980, 1990), explain the perspectives for nursing practice, and explore its applicability in nursing practice. First, I am going to talk a little about Dorothy E. Johnson the nurse that wrote the Model. Dorothy E. Johnson was born August 21, 1919, in Savannah, Georgia (Lobo, 1995). She received her A. A. from Armstrong Junior College in Savannah, Georgia, in 1938; her B. S. N. from Vanderbilt University in Nashville, Tennessee, in 1942; and her M. P. H. from Harvard University in Boston in 1948 (Conner, Harbour, Magers, and Watt 1994).
Johnson was an instructor and an assistant professor in pediatric nursing at Vanderbilt University School of Nursing from 1944 to 1949. From 1949 until her retirement in 1978 and subsequent move to Key Largo, Florida, she was an assistant professor of pediatric nursing, an associate professor of nursing, and a professor of nursing at the University of California in Los Angeles (Conner et. al. 1994). In 1955 and 1956 she was eligible to go on a sabbatical and went to the Christian Medical College School of Nursing in Vellore, South India, were she was interested in starting a baccalaureate program which was received well Lobo, 1995).
Dorothy Johnson has had an influence on nursing through her publications since the 1950s. Throughout her career, Johnson has stressed the importance of research-based knowledge about the effect of nursing care on clients. Johnson was an early proponent of nursing as a science as well as an art. She also believed nursing had a body of knowledge reflecting both the science and the art. From the beginning, Johnson (1959) proposed that the knowledge of the science of nursing necessary for effective nursing care included a synthesis of key concepts drawn from basic and applied sciences.
In 1961, Johnson proposed that nursing care facilitated the client’s maintenance of a state of equilibrium. Johnson proposed that clients were “stressed” by a stimulus of either an internal or external nature. These stressful stimuli created such disturbances, or “tensions,” in the patient that a state of disequilibrium occurred. Johnson identified two areas that nursing care should be based in order to return the client to a state of equilibrium. First, by reducing stressful stimuli, and second, by supporting natural and adaptive processes.
Johnson’s behavioral system theory springs from Nightingales belief that nursing’s goal is to help individuals prevent or recover from disease or injury. The “science and art” of nursing should focus on the patient as an individual and not on the specific disease entity. Johnson used the work of behavioral scientists in psychology, sociology, and ethnology to develop her theory. The model is patterned after a systems model; a system is defined as consisting of interrelated parts functioning together to form a whole (Conner et. al. 1994). Johnson states that a nurses should use the behavioral system as their knowledge ase; comparable to the biological system that physicians use as their base of knowledge (Lobo, 1995).
Theory The reason Johnson chose the behavioral system model is the idea that “all the patterned, repetitive, purposeful ways of behaving that characterize each person’s life make up an organized and integrated whole, or a system” (other). Johnson states that by categorizing behaviors, they can be predicted and ordered. Johnson categorized all human behavior into seven subsystems (SSs): Attachment, Achievement, Aggressive, Dependence, Sexual, Ingestive, and Eliminative.
Each subsystem is composed of a set of behavioral responses or tendencies that share a common goal. These responses are developed through experience and learning and are determined by numerous physical, biological, psychological, and social factors. Four assumptions are made about the structure and function of each SS. These four assumptions are the “structural elements” common to each of the seven SSs. The first assumption is “from the form the behavior takes and the consequences it achieves can be inferred what drive has been stimulated or what goal is being sought” (Johnson, 1980).
The ultimate goal for each subsystem is expected to be the same for all individuals. The second assumption is that each individual has a “predisposition to act, with reference to the goal, in certain ways rather than in other ways” (Johnson, 1980). This predisposition to act is labeled “set” by Johnson. The third assumption is that each subsystem has available a repertoire of choices or “scope of action” alternatives from which choices can be made. As life experiences occur, individuals add to the number of alternative actions available to them. At some point, however, the acquisition of new lternatives of behavior decreases as the! individual becomes comfortable with the available repertoire. The fourth assumption about the behavioral subsystem is that they produce observable outcomes-that is, the individuals behavior (Johnson, 1980).
The observable behaviors allow an outsider to note the actions the individual is taking to reach a goal related to a specified SS. In addition, each of the SSs has three functional requirements. First, each subsystem must be “protected from noxious influences with which the system cannot cope” (Johnson, 1980). Second, each ubsystem must be “nurtured through the input of appropriate supplies from the environment. ” Finally each subsystem must be “stimulated for use to enhance growth and prevent stagnation. ” As long as the SSs are meeting these functional requirements, the system and the SSs are viewed as self-maintaining and self- perpetuating. The internal and external environments of the system need to remain orderly and predictable for the system to maintain homeostasis. The interrelationships of the structural elements of the subsystem to maintain a balance that is adaptive to that individual’s needs.
Johnson’s Behavioral Subsystems The Attachment subsystem is probably the most critical, because it forms the basis for all social organization. It provides survival and security. Its consequences are social inclusion, intimacy, and formation and maintenance of a strong social bond. The Achievement subsystem attempts to manipulate the environment. Its function is control or mastery of an aspect of self or environment to some standard of excellence. Areas of achievement behavior include intellectual, physical, creative, mechanical, and social skills. The Aggressive subsystem function is protection and preservation.
It holds that aggressive behavior is not only learned, but has a primary intent to harm others. However, society has placed limits when dealing with self-protection and that people and their property be respected and protected. The Dependency subsystem promotes helping behavior that calls for a nurturing response. Its consequences are approval, attention or recognition, and physical assistance. Ultimately, dependency behavior develops from the complete reliance on others for certain resources essential for survival. An imbalance in a behavioral subsystem produces tension, which results in disequilibrium.
The The Ingestive and Eliminative SSs “have to do with when, how, what, how much and under what conditions we eat, and when, how, and under what conditions we eliminate”. The Sexual subsystem has the dual functions of procreation and gratification. It begins with the development of gender role identity and includes the broad range of sex role behaviors (Johnson, 1980). When there is an alteration in the “equilibrium” that exists, Johnson’s Model tends to diagnose to a subsystem rather than a specific problem. Johnson’s Model states that it is at this point when the nurse is eeded in order to return the client to homeostasis (Conner et al. , 1994).
Application in Nursing Practice The application of any nursing model to practice requires three conditions: the model’s congruence with practice requirements, its comprehensive development in relation to practice requirements, and its specificity in relation to practice requirements. These conditions governing a nursing model’s applicability should be understood to enable practitioners to appropriately and effectively use models in practice (Derdiarian, 1993). What is nursing practice and what are requirements of the practice?
Nursing practice derives its definition from that of professional practice, the action or process of performing something, the habitual or customary performance of something (Random House College Dictionary, 1988). Professional practice has three main requirements: perspective, structure and scientific substance. The first requirement is the perspective, or a mental view, of facts or ideas and their interrelationships pertinent of the professions’ practice. In nursing, the perspective of the practice refers to nursing’s view of the patient and its role in relation to the patient (Derdiarian, 1993).
More specifically, the profession’s perspective clarifies the nature, goal, focus, and scope of its realm of its science and practice (Derdiarian, 1993). By so doing, the profession’s perspective distinguishes nursing’s realm of science and practice from those of related fields. At the same time, the perspective identifies appropriate alignments between nursing’s research and practice and those of other professions. In other words, the professional perspective provides the professional with a knowledge base and a mind-set about the patient, about her/his ole in relation to the patient, and her/his actions necessary to fulfill that role (Derdiarian, 1993). The second requirement of professional practice is a structure for practice to organize and standardize practice and, thus, render practice habitual and customary. Professional practice is structured to evaluate a client’s well-being, identify problems, and provide solutions. The latter require organized and scientifically rational processes of assessment, diagnosis, intervention, and evaluation of outcomes. In nursing, this structure pertains to the Nursing Process (Derdiarian, 1993).
Finally, the third requirement of professional practice is the coherent scientific body of knowledge that underlies it or the profession’s actions and processes. The scientific body of knowledge includes facts, theories, hypotheses, and precepts, and assumptions underlying both the perspective and structure of practice. In nursing, this body of knowledge includes the facts, theories, hypotheses, and precepts about nursing, nursing practice actions, and nursing practice methods. Stated more specifically, nursing practice requires a body of scientific knowledge that rationalizes its view of the client, its role, nature, goal focus, nd scope. Furthermore, nursing practice requires a body of scientific knowledge that rationalizes the nursing methods of assessment, diagnosis, intervention, and evaluation of outcomes (Derdiarian, 1993).
The JBS model meets the professional perspective requirements because of its interaction between the SSs. The SSs are interactive and interdependent, restoration in one subsystem could effect restoration of behavior in another or others. Thus requiring diagnostic and interventive action directed at all the SSs (Derdiarian, 1993). The model as it stood before did not meet the practice structure requirements well Derdiarian, 1983), but interaction and studies into the model prompted Johnson to add five types of interventions-nurturance, stimulation, protection, regulation, and control (Derdiarian, 1993). It still leaves a gap in where to actually look for the problems that exist.
The JBS model does not meet the scientific substance for practice well because it needs to be tested on its concepts, propositions, and assumptions. Despite the obvious overall failure of the JBS model to pass the professional requirements, the model is always being tested by someone, and some! day maybe conclude its worth and add to its value.
Summary as related to Nursing, Person, Health, and Environment Nursing is a force acting to preserve to organization of the patient’s behavior while the patient is under stress by means of imposing regulatory mechanisms or by providing resources(Conner et al. , 1994). An art and a science, it supplies external assistance both before and during system balance disturbance and therefore requires knowledge of order, disorder, and control (Johnson, 1980). Nursing activities are complementary of medicine, not dependent on. Person is viewed as a behavioral system with patterned, repetitive, and purposeful ways of ehaving that link him to the environment (Johnson, 1980). Man’s specific response patterns form an organized and integrated whole (Conner et al. , 1994). Person is a system of interdependent parts that requires some regularity and adjustment to maintain a balance (Johnson, 1980). Health is perceived as an “elusive, dynamic state influenced by biological, psychological, and social factors.
It focuses on the person rather than the illness (Conner et al. , 1994). Health is reflected by the organization, interaction, interdependence, and integration of the SSs of the behavioral system Johnson, 1980). Man attempts to achieve a balance in this system, which will lead to functional behavior. A lack of balance in the requirements of the SSs lead to poor health (Conner et al. , 1994). Environment consists of all the factors that are not part of the individual’s behavioral system but that influence the system and the nurse to achieve the health goal for the client. Conclusion Johnson’s theory could help guide the future of nursing theories, models, research, and education. By focusing on behavioral rather than biology, the theory clearly differentiates nursing from medicine.
But do we need to separate the behavioral from the biological. It can be an asset, and it can work, that has been proven by Johnson and some of her followers. In order to focus on the holistic idea of nursing, it is important to think of the behavioral and biological together as health. We cannot look at one without looking at the other. There is not sufficient research to substantiate the real applicability of this model. This theory does provide a conceptual framework to work from, but this model will never be the standard for nursing.