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Theory of Dorothy Johnson

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Joanna Dantes

on 5 January 2014

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Transcript of Theory of Dorothy Johnson

Theory of Dorothy Johnson
The Behavioral System Model

Johnson’s Behavioral System Model is a model of nursing care that advocates the fostering of efficient and effective behavioral functioning in the patient to prevent illness. The patient is identified as a behavioral system composed of seven behavioral subsystems: affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement. The three functional requirements for each subsystem include protection from noxious influences, provision for a nurturing environment, and stimulation for growth. An imbalance in any of the behavioral subsystems results in disequilibrium. It is nursing’s role to assist the client to return to a state of equilibrium.
Dorothy Johnson
Major Concepts
Johnson views human beings as having two major systems: the biological system and the behavioral system. It is the role of medicine to focus on the biological system, whereas nursing’s focus is the behavioral system.
The concept of human being was defined as a behavioral system that strives to make continual adjustments to achieve, maintain, or regain balance to the steady-state that is adaptation.
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Environment is not directly defined, but it is implied to include all elements of the surroundings of the human system and includes interior stressors.
Health is seen as the opposite of illness, and Johnson defines it as “some degree of regularity and constancy in behavior, the behavioral system reflects adjustments and adaptations that are successful in some way and to some degree… adaptation is functionally efficient and effective.”
Behavioral system-
It is a system that indicates the state of the system through behaviors.
Nursing is seen as “an external regulatory force which acts to preserve the organization and integration of the patient’s behavior at an optimal level under those conditions in which the behavior constitutes a threat to physical or social health, or in which illness is found.”
System-
functions as a whole by virtue of organized independent interaction of its parts.
Subsystem- A minisystem maintained in relationship to the entire system when it or the environment is not disturbed.
Seven Subsystems
Attachment or affiliative subsystem – serves the need for security through social inclusion or intimacy
Dependency subsystem – behaviors designed to get attention, recognition, and physical assistance

Ingestive subsystem – fulfills the need to supply the biologic requirements for food and fluids

Eliminative subsystem – functions to excrete wastes
Sexual subsystem – serves the biologic requirements of procreation and reproduction

Aggressive subsystem – functions in self and social protection and preservation

Achievement subsystem – functions to master and control the self or the environment
Set- The predisposition to act. It implies that despite having only a few alternatives from which to select a behavioral response, the individual will rank those options and choose the option considered most desirable.
Function- Consequences or purposes of action.
Functional requirements-

Input that the system must receive to survive and develop

Three functional requirements of humans
To be protected from noxious influences with which the person cannot cope
To be nurtured through the input of supplies from the environment
To be stimulated to enhance growth and prevent stagnation
September 9, 2013 in Savannah, Georgia.

B. S. N. from Vanderbilt University in Nashville, Tennessee, in 1942; and her M.P.H. from Harvard University in Boston in 1948.

From 1949 'til retirement in 1978 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.

Johnson stressed the importance of research-based knowledge about the effect of nursing care on clients.
There are several layers of assumptions that Johnson makes in the development of conceptualization of the behavioral system model viz.
Assumptions
Assumptions about system

Assumptions about structure

Assumptions about functions
Assumptions about system
There are 4 assumptions of system:
First, there is “organization, interaction, interdependency and integration of the parts and elements of behaviors that go to make up the system ”
A system “tends to achieve a balance among the various forces operating within and upon it', and that man strive continually to maintain a behavioral system balance and steady state by more or less automatic adjustments and adaptations to the natural forces impinging upon him.”
A behavioral system, which both requires and results in some degree of regularity and constancy in behavior, is essential to man that is to say, it is functionally significant in that it serves a useful purpose, both in social life and for the individual.
Last, “system balance reflects adjustments and adaptations that are successful in some way and to some degree.”.
Theoretical Foundation of Nursing
Nursing process
Grubbs developed an assessment tool based on Johnson’s seven subsystems plus a subsystem she labeled as restorative which focused on activities of daily living. An assessment based on behavioral model does not easily permit the nurse to gather detailed information about the biological systems:


Dependency
Sexuality
Affiliation
Aggresion
Elimination
Ingestion
Achievement
Restorative
Assessment
Diagnosis
Diagnosis tends to be general to the system than specific to the problem. Grubb has proposed 4 categories of nursing diagnosis derived from Johnson's behavioral system model:
Insufficiency Discrepancy Incompatibility Dominance
Definition of nursing
She defined nursing 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 to assist the patient:
Whose behavior commensurate with social demands.

Who is able to modify his behavior in ways that it supports biological imperatives

Who is able to benefit to the fullest extent during illness from the physicians knowledge and skill.

Whose behavior does not give evidence of unnecessary trauma as a consequence of illness
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