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Dorothy Johnson's Nursing Theory

The Behavioural System Model

Clinical Example...

Dorothy Johnson

Applying this Theory to Nursing Practice

  • Goal is to advocate for effective behavioural functioning to promote health and wellness
  • Johnson viewed humans as having two systems: biological and behavioural
  • medicine focuses on biological
  • nursing focuses on behavioural
  • patient is a behavioural system
  • 7 behavioural subsystems: attachment, dependency, ingestive, eliminative, sexual, aggressive, achievement
  • Born Aug 21st, 1919 in Savannah, Georgia
  • Graduated from nursing school in Nashville, Tennessee in 1942
  • Masters in Public Health from Harvard University Boston
  • Began creating her theory in the 1940s
  • Died in 1999
  • Applicable only in acute care
  • Ineffective in community nursing or long-term illness management

Class Discussion

Questions:

Critique Summary...

1. Do you agree or disagree with our hesitancy to use this theory? How could we make this theory more effective/applicable?

2. Describe a time when a client's behaviour has affected his or her health or healing process (as per Dorothy's model).

3. What other subsystems or human functional requirements would you add, if any, to this theory to better care for clients?

CRITIQUE

7 Behavioural Subsystems

Reference

  • Would not use theory in our current nursing practice
  • Does not promote holism
  • Is not family centered
  • Does not take into account of Social Determinants of Health
  • Lacks tangible goals

3 Requirements for Subsystems

Attachment: social inclusion and intimacy

Dependency: seeking attention, approval, physical assistance

Ingestive: adequate intake of food and fluids

Eliminative: excretion of waste

Sexual: pleasure and procreation

Aggressive: protection of self to ensure survival

Achievement: problem solving, control of oneself, knowledge of personal strengths and weaknesses

1) Protection from negative influences

2) Provides a nurturing environment

3) Stimulates growth

Brown, V. M. (2006). Dorothy E. Johnson: Behavioral system model. In A. M. Tomey, & M. R. Alligood (Eds.), Nursing theorists and their work (pp. 386-404). St. Louis, MO: Mosby Elsevier.

Chinn, P.L., & Kramer, M.K. (2011). Integrated Theory and Knowledge Development in Nursing (8th Ed.). St Louis, MO: Mosby Elsevier.

Current Nursing (2011). Johnson's Behavioural System Model. Retrieved from http://currentnursing.com

Nursing Theory. (2013). Dorothy Johnson – Nursing theorist. Retrieved from http://nursing-theory.org

Nurse's Role

To create homeostasis within the subsystems

How General is this Theory?

How Useful is this Theory?

  • In modern nursing, may lack relevance due to our current knowledge of the importance of external factors (ie. determinants of health)

What Guides our Assessment of Usefulness?

  • Nursing knowledge
  • influence of external factors
  • social determinants of health
  • Nursing values
  • holistic care
  • family-centered care
  • health promotion/prevention

How Clear is this Theory in Practice?

  • Very general
  • Pros and cons to how general it is
  • Pros
  • can be applied across all ages and cultures
  • Cons
  • only applies to individuals
  • does not involve families or communities

How Accessible is this Theory?

  • Abstract concepts
  • lack of concrete guidelines, may be difficult to achieve goals
  • Clinically relevant concepts when looking at just the client
  • when family or other factors are involved, the theory may lack applicability

How Simple is this Theory?

  • Structural
  • provides clear framework for human behaviour
  • easy to follow, clear guidelines

  • Semantic
  • concepts clear, consistent and easy to understand
  • can be generalized across all ages and cultures
  • may be too generalized and vague in desired outcomes
  • Simple to follow, but can be too generalized
  • Is not a holistic perspective of nursing
  • no interrelation
  • Does not show definitive connection between subsystems
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