As the population increases and we began to see a new genre of individuals the world of nursing must adapt to meet these changes. The evolution of nursing is an ever-evolving cycle as the medical world changes through technology, medical advancements, and new innovative ideas to care for patients. Researchers continually use conceptual models to aid in their studies as conceptual models are an organized way to process data as it relates to a certain discipline such as nursing. The most common use of conceptual models is to provide an organizing structure for the research design and methods.
A second purpose is to guide the development and testing of interventions and hypotheses based on the tenets of the theory. A third function is to explain the study results and place the findings within the context of science in a specific field of investigation (Polit). The interpretation of findings flows from the conceptualization represented by the framework. Dorothy Johnson created an exemplary model as it relates to human behavior and nursing care.
Dorothy E. Johnson realized as a mere nursing student that nurses offered something special that differs from the traditional contributions from physicians or other health professional. Works of several nurse scholars are recognized as broad conceptual models of nursing including Dorothy Johnson’s Behavioral system model. Johnson’s model focuses on the individual as a behavioral system (Kearney-Nunnery). The idea for the framework of this model comes from the idea that all patterned, repetitive, purposeful ways of behaving that characterize each person’s life make up an organized and integrated whole system.
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A reading my Florence Nightingale titled Notes on Nursing: What it is and what it is not is what profoundly influenced Johnson for the concept of her model. She accepted the fact of nursing focuses on the person rather than the disease. Throughout several other studies and research that were implicated in the late 1940s, Johnson kept her focus on the behavioral function of the client. As the physician views the patient as a biological system, nurses view the patient as a behavioral system.
To maintain the veracity of the system, subsystems were developed to carry out the task or mission and maintain its relationship to the environment (Johnson). Each subsystem is composed of different functions and carry out its own specialized task for the system as a whole. There are seven subsystems listed as follows: affiliative or attachment, dependency, ingestive, eliminative, sexual, aggressive and achievement.
As mention in the previous paragraph, the behavioral model is composed of 7 subsystems each serving a specialized function to maintain the system. The first subsystem mentioned is attachment or affiliative which serves the function of security. This is probably the most critical because it is the basis for all social organization (Kearney-Nunnery). The individual needs security for survival as it relates to social inclusion, intimacy, formation, and maintenance of social bonds. Dependency is also under the same conceptual hat. Dependency is the second subsystem developed where the behaviors have a more definitive and limited function. This behavior supports the call for nurturing as well as approval, attention, recognition and physical assistance(Johnson).
The next two subsystems are associated together with ingestive and eliminative. These response systems are a part of the behavioral system because they have to do with when, how, what, how much and under what conditions the individual eats or eliminates waste (Johnson). Ingestive serves the function of appetite satisfaction. It is controlled by psychological and biological needs for food and fluids. The eliminative subsystem, of course, deals with how we eliminate waste. The Sexual subsystem has the dual functioning of procreation and gratification. Gender role identity is developed.
Protection and preservation of self and society describe the function of the subsystem aggressive. The last subsystem mentioned is the achievement. The function of achievement is mastery or control of some aspect of self or environment. It is measured against a standard of excellence. All these subsystems collectively compose the behavioral conceptual model.
The structure of each subsystem consists of the following four elements: Drive or goal, set, choice and action. The element drive or goal is what motivates us for each behavior. Set is an individual’s tendency to behave in a certain way to fulfill the functions of the subsystem. The choice is the person scope of action alternatives from which the person can choose, and the action is an individual’s actual behavior in a certain condition. The action is the only element that can be directly observed. The other elements are concluded from a person behavior and the consequences. In addition to the elements needed for the fulfillment of the subsystem, they also require these three functional requirements: Protection from harmful impacts with which the system cannot cope, nurturance from applicable supplies from the environment and Stimulation to improve growth and counteract stagnation (Kearney-Nunnery) (Johnson).
Implications for nursing practice is geared toward restoration, maintenance, and dynamic stability at the maximum point possible for the individual. To achieve this, Johnson behavioral system model is broken down in four steps;
- Determination of the existence of a problem,
- Diagnostic classification of a problem,
- Management of nursing problems, and
- Evaluation of behavioral system balance and stability. In order to evaluate and determine the effectiveness, the nurse needs to compare the patient’s behavior after treatment with indicators of behavioral system balance and stability (Kearney-Nunnery).
In summary, Dorothy Johnson’s Conceptual model is based on scientific study of a patient’s behavior. It is imperative that the nurse is familiar with how the subsystems develop over time and factors that may negatively impact development. The nurse also needs to be aware of how living systems operate and gain an understanding, so the data obtained can be dissected and nursing interventions can be effective (Johnson). The nurse will need to establish a rapport with the patient to gain trust and a contract with the patient to help them comprehend the meaning of their diagnoses and the proposed treatments (Radwin).
References
- Johnson, D. E. (1980). The behavioral system model of nursing.
- J. Riehl and C. Roy (Eds.). Conceptual Models for Nursing Practice
- (2nd ed.), (pp. 207-216). New York: Appleton-Century-Crofts.
- Kearney-Nunnery, R. (2016). Advancing your career: Concepts of professional nursing (6th ed.). Philadelphia: F.A. Davis Company. Dorothy Johnson’s Behavioral system model
- Polit DF, Beck CT. Nursing Research: Principles and Methods. 7th edn. Lippincott Williams & Wilkins; Philadelphia, PA: 2004.
- Radwin L, Fawcett J. A conceptual model-based programme of nursing research: retrospective and prospective applications. Journal of Advanced Nursing. 2002;40(3):255–360.
