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THEORY-Johnson’s Behavioural System Model
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SUBJECT-Advanced Nursing Practice
SUBMITTED TO-Ma’am Mrs. Sunita Sharma
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SUBMITTED BY-Renu Bala
M.Sc.(N)-1st Year
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 JOHNSON’S BEHAVIOUR SYSTEM MODEL

INTRODUCTION

 Dorothy E. Johnson was born August 21, 1919, 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 until her 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.
 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’s publications 16 includes 4 books, more than 30 articles in
periodicals and many reports, proceedings and monographs.

JOHNSON’S BEHAVIOR SYSTEM MODEL

 In 1968 Dorothy first proposed her model of nursing care as fostering of   
“the efficient and effective behavioural functioning in the patient to
prevent illness".
 She also stated that nursing was “concerned with man as an integrated
whole and this is the specific knowledge of order we require”.
 In 1980 Johnson published her conceptualization of “behavioural system
of model for nursing” this is the first work of Dorothy that explicates her
definitions of the behavioural’’ .

EVOLUTION OF THEORY

 The individual patient is a behavioural system composed of subsystems.

As behaviour system, the patient’s subsystems strive to maintain balance
by making adjustments to factors impinging on them.
 Humans seek experiences that may disturb balance and require behaviour
modifications to re-establish balance.
 Behavioural systems are essential and reflect adaptations that are
successful.
 The behavioural system is composed of behaviours that form an
integrated unit.
 Behavioural system maintain their own integrity , link individuals with
environment and are self-perpetuating if environmental conditions remain
orderly and predictable.
 The multiple tasks of behavioural system require continual systems
changes also must be protected, nurtured and stimulated.
  Johnson’s behavioural system theory springs from Nightingale’s belief that
Nursing’s goal is to help individuals prevent or recover from disease or
injury.
 Johnson developed her model, an increasing number of observational
studies on child and adult behaviour patterns were published during 1950s
and 1960s.During these same years, general system theory was also
discussed frequently. All these experiences influenced her (1992) as the
development of ‘Behavioural systems Model.’

DEFINITION OF NURSING

She defined nursing as “an external regulatory force which acts to preserve the
organization and integration of the patients behaviours at an optimum level
under those conditions in which the behaviours constitutes a threat to the
physical or social health, or in which illness is found”
Based on this definition there are four goals of nursing are to assist the patient:
 Whose behaviour commensurate with social demands.
 Who is able to modify his behaviour 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 behaviour  does not give evidence of unnecessary trauma as a
consequence of illness 

DEVELOPMENT OF MODEL-

Assumptions of behavioral system model

 When developing her conceptualization of the behavioural system model,

Johnson made some assumptions about the system as whole as about
subsystems and also made assumptions deals with the knowledge base
necessary to practice nursing .
 She believes that nurses need to be well-grounded in the physical and
social sciences that is found to influence behaviour.
 It is understood that it would be of an equal importance available, about
endocrine influence on behaviour as well as about psychological influences
on behaviour.
 There are several layers of assumptions that Johnson makes in the
development of conceptualization of the behavioral system model
(Johnson was influenced by Buckley ,Chin and  Rapport) there are  4
assumptions of system:
1.   First assumption states that there is “organization, interaction,
interdependency and integration of the parts and elements of  behaviors that go
to make up The  system ” 
2.    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.”
3.  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.
4.  The final assumption states “system balance reflects adjustments and
adaptations that are successful in some way and to some degree.”
 The integration of these assumptions provides the behavioral system
with the pattern of action to form “an organized and integrated functional unit
that determines and limits the interaction between the person and his
environment and establishes the relation of the person to the objects, events
and situations in his environment.

ASSUMPTIONS ABOUT STRUCTURE AND FUNCTION OF EACH SUBSYSTEM

1. “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”
2. Each individual has a “predisposition to act with reference to the goal, in
certain ways rather than the other ways”. This predisposition is called as “set”.
3. Each subsystem has a repertoire of choices or “scope of action”
 The fourth assumption is that it produce “observable outcome” that is the individual’s
behavior.
 Each subsystem has three functional requirements
 System must be “protected" from noxious influences with which system cannot cope”.
 Each subsystem must be “nurtured” through the input of appropriate supplies from the
environment.
 Each subsystem must be “stimulated” for use to enhance growth and prevent stagnation
 Johnson believes each individual has patterned, purposeful, repetitive ways of acting that
comprise a behavioral system specific to that individual.
 These actions and behaviors form an organized and integrated functional unit that
determines and limits the interaction between the person and his environment and
establishes the relationship of the person to the objects event situations in the
environment.
 These behaviors are “orderly, purposeful and predictable and sufficiently stable and
recurrent to be amenable to description and explanation”  

JOHNSON’S BEHAVIORAL SUBSYSTEM 

SUBSYSTEMS ARE IDENTIFIED AS-

 Attachment or affiliative subsystem: “social inclusion intimacy and the formation and
attachment of a strong social bond.”
 Dependency subsystem: “approval, attention or recognition and physical assistance”
  Ingestive subsystem: “the emphasis is on the meaning and structures of the social
events  surrounding the occasion when the food is eaten”
 Eliminative subsystem: “human cultures have defined different socially acceptable
behaviors for excretion of waste ,but the existence of such a pattern remains different
from culture to Culture.”
 Sexual subsystem:" both biological and social factor  affect the behavior in the sexual
subsystem”
 Aggressive subsystem:" it relates to the behaviors concerned with protection  and self
preservation Johnson views aggressive subsystem as one that generates defensive
response from the individual when life or territory is being threatened”
 Achievement subsystem:” provokes behavior that attempt to control the environment
intellectual, physical, creative, mechanical and social skills achievement are some of the
areas that Johnson recognizes".

REPRESENTATION OF JOHNSON'S MODEL

Goal    -----     Set       ---       Choice of Behavior ---       Behavior

 Affiliation
 Dependency
 Sexuality
 Aggression
 Elimination
 Ingestion
 Achievement
Effective

Attachment and Affiliation Functioning

Forces
&
Dependency Elimination adaptations

Functional And
behavioural
model Sexuality Ingestion

Stress Ineffective
Aggression Achievements

Feedback

FIGURE-Johnson behavioural system model

FOUR MAJOR CONCEPTS USED BY JOHNSON

 Johnson views “Human being” as having two major systems, the biological system and
the behavioral system. It is role of the medicine to focus on biological system where as
Nursling's focus is the behavioral system.
 “Society” relates to the environment on which the individual exists. According to
Johnson an individual’s behavior is influenced by the events in the environment
 “Health” is a purposeful adaptive response, physically mentally, emotionally, and socially
to internal and external stimuli in order to maintain stability and comfort.
 “Nursing” has a primary goal that is to foster equilibrium within the individual
.she stated that nursing is concerned with the organized and integrated whole, but
that the major focus is on maintaining a balance in the Behavior system when
illness occurs in an individual.

The Subsystems of Behavior

Achievement Subsystem

Goal:- Mastery or control of self or the environment

Function :-
 To set appropriate goals
 To direct behaviors toward achieving a desired goal
 To perceive recognition from others
 To differentiate between immediate goals and long-term goals
 To interpret feedback (input received) to evaluate the achievement of goals

Affiliative Subsystem

Goal :- To relate or belong to someone or something other than oneself; to achieve intimacy
and inclusion
Function:-
 To form cooperative and interdependent role relationships within human social systems
 To develop and use interpersonal skills to achieve intimacy and inclusion
 To share
 To be related to another in a definite way
 To use narcissistic feelings in an appropriate way

Aggressive/Protective Subsystem

Goal:- To protect self or others from real or imagined threatening objects, persons, or ideas,
To achieve self-protection and self-assertion
Function :-
 To recognize biological, environmental, or health systems that are potential threats to self
or others
 To mobilize resources to respond to challenges identified as threats
  To use resources or feedback mechanisms to alter biological, environmental, or health
input or human
 responses in order to diminish threats to self or others
 To protect one’s achievement goals
 To protect one’s beliefs
 To protect one’s identify or self-concept

Dependency Subsystem

Goal:- To obtain focused attention, approval, nurturance, and physical assistance;

To maintain the environmental resources needed for assistance; to gain trust and reliance
Function :-
 To obtain approval, reassurance about self
 To make others aware of self
 To induce others to care for physical needs
 To evolve from a state of total dependence on others to a state of increased dependence
on the self
 To recognize and accept situations requiring reversal of self-dependence (dependence
upon others)
 To focus on another or oneself in relation to social, psychological, and cultural needs and
desires

Eliminative Subsystem

Goal:- To expel biological wastes;

To externalize the internal biological environment
Function:-
 To recognize and interpret input from the biological system that signals readiness for
waste excretion
 To maintain physiological homeostasis through excretion
 To adjust to alterations in biological capabilities related to waste excretion while
maintaining a sense of
 control over waste excretion
 To relieve feelings of tension in the self
 To express one’s feelings, emotions, and ideas verbally or nonverbally

Ingestive Subsystem

Goal:- To take in needed resources from the environment to maintain the integrity of the
organism or to achieve a state of pleasure; to internalize the external environment
Function:-
 To sustain life through nutritive intake
 To alter ineffective patterns of nutritive intake
 To relieve pain or other psycho physiological subsystems
 To obtain knowledge or information useful to the self
 To obtain physical and/or emotional pleasure from intake of nutritive or non-nutritive
substances

Restorative Subsystem

Goal:- To relieve fatigue and/or achieve a state of equilibrium by re-establishing or

replenishing the energy distribution among the other subsystems; to redistribute energy
Function :-
 To maintain and/or return to physiological homeostasis
 To produce relaxation of the self system

Sexual Subsystem

Goal:- To procreate, to gratify or attract; to fulfil expectations associated with one’s sex;
-to care for others and to be cared about by them
Function:-
 To develop a self-concept or self-identity based on gender
 To project an image of oneself as a sexual being
 To recognize and interpret biological system input related to sexual gratification and/or
procreation
 To establish meaningful relationships in which sexual gratification and/or procreation may
be obtained.

APPLICATION OF THEORY IN NURSING EDUCATION:-

-Curriculum is based on behavioural system of human-being
-Use of nursing process to understand the behavioural needs & dysfunctions
-Gain knowledge regarding behavioural sciences
-Guide for planning & giving care based on scientific knowledge

APPLICATION OF THEORY IN CLINICAL PRACTICE:-

-reduce stressful stimuli
-support natural adaptive system
-makes changes to environment
-focus is the patient not the illness.

APPLICATION OF THEORY IN RESEARCH:-

- -Identify & explain the behavioural system disorders which arise in connection with illness.
-Helps to understand behavior from infancy to adolescence & during aging
-Helps to gather diagnostic data or problem solving activities as they influence the behavioural
system.
-Helps to manage the patient completely by keeping all the subsystems in mind.

NURSING PROCESS

This behavioural system model easily fits the nursing process model.

Assessment
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:
  Affiliation
 Dependency
 Sexuality
 Aggression
 Elimination
 Ingestion
 Achievement
 Restorative

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

Planning and implementation

Implementation of the nursing care related to the diagnosis may be difficult because of lack of
clients input in to the plan. the plan will focus on nurses actions to modify clients behavior,
these plan than have a goal ,to bring about homeostasis in a subsystem, based on nursing
assessment of the individuals drive, set behavior, repertoire, and observable behavior. The plan
may include protection, nurturance or stimulation of the identified subsystem.  

Evaluation
Evaluation is based on the attainment of a goal of balance in the identified subsystems. If the
baseline data are available for an individual, the nurse may have goal for the individual to return
to the baseline behavior. If the alterations in the behavior that are planned do occur, the nurse
should be able to observe the return to the previous behavior patterns. Johnson's behavioral
model with the nursing process is a nurse centered activity, with the nurse determining the
clients needs and state behavior appropriate for that need.

Situation
John Smith, 6 weeks brought into the clinic for a routine check-up.  He presents with no weight
gain since his check up at the age of 2 weeks .His mother stated she feeds him but he does not
seem to eat much. He sleeps 4to 5 hour between the feedings. His mother holds him in her
arms without trunk to trunk contact. As the assessment is made the nurse notes that Mrs.
Smith never looks at Johnny and never speaks to him. She stated he was a planned baby but
that she never realized how much work a baby could be. She says, her mother told her she was
not a good mother because John is not gaining weight like he should.  She states she had not
called the nurse when she knew John was not gaining weight because she thought nurse would
think she was a bad mother just like her own mother thought she was a bad mother.

Assessment
  Affiliative subsystem between mother and John.
 Dependency subsystem between mother and John
 Affiliative subsystem between Mrs.Smith and her mother.
 Insufficiency ingesion subsystem.

Diagnosis
 Insufficient development of the affiliative subsystem.
 Insufficient development of the dependency subsystem

Planning and implementation

 Increasing mother’s awareness of the baby’s clues.
 Assisting her to talk with the baby.
 Teach her to bring a bond between her and the baby by touch, pat and cuddles etc.

Evaluation
 Johnny's weight gain or weight loss will be carefully assessed.
 The –infant interaction could be reassessed, using the nursing child assessment feeding
scale.
 The interaction of Mrs. Smith with her mother.  

JOHNSON’S AND CHARACTERISTICS OF A THEORY

 Interrelate concepts to create a different way of viewing a phenomenon.

 Theories must be logical in nature.
 Theories must be simple yet generalizable
 Theories can be bases of hypothesis that can be tested.
 Theories contribute to and assist in increasing the body of knowledge within the discipline
through the research implemented to validate them
 Theories can be utilized by practitioners to guide and improve their practice.
 Theories must be consistent with other validated theories, laws and principles but will
leave unanswered questions that need to be investigated.   

EVALUATION & LIMITATIONS OF THIS THEORY

 Johnson does not clearly interrelate her concepts of subsystems comprising the
behavioral system model.
 The definition of concept is so abstract that they are difficult to use.
 It is difficult to test Johnson's model by development of hypothesis.
 The focus on the behavioral system makes it difficult for nurses to work with physically
impaired individual to use this theory.
 The model is very individual oriented so the nurses working with the group have difficulty
in its implementation.
 The model is very individual oriented so the family of the client is only considered as an
environment.
  Johnson does not define the expected outcomes when one of the system is affected by
the nursing implementation an implicit expectation is made that all human in all cultures
will attain same outcome –homeostasis.
 Johnson’s behavioral system model is not flexible.

SUMMARY

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
defined as behavioral system composed of 7 behavioral subsystems. Each subsystem composed
of four structural characteristics i.e. drives, set, choices and observable behaviour.
Three functional requirement of each subsystem includes
(1) Protection from noxious influences,
(2) Provision for the nurturing environment,
(3) stimulation for growth.
Any imbalance in each system results in disequilibrium .it is nursing role to assist
the client to return to the state of equilibrium.

REFERENCES--

 Parker, Marilyn;(2007), “Nursing Theories and Nursing Practice”, J.A.Davis,

2nd edition, page no-79-93
 George B. Julia, “Nursing Theories- The base for professional Nursing Practice ”, 3rd ed.
Norwalk, Appleton and Lange.page no-67-89
 Polit DF, Hungler BP. “Nursing Research: Principles and Methods.” Philadelphia: JB Lippincott
Company; 1998. Page no-98-106
 Burns N, Grove SK. “The practice of Nursing Research”. 4th Ed. Philadelphia: WB Saunders
Publications; 2001.  Page no-50-62
 Treece JW, Treece EW. “Elements of Research in Nursing” 3 rd edition, St. Louis: Mosby;
1982.page no-107-118
 BT Basavanthappa;(2009)’’Nursing Theories”, Jaypee Publications, New Delhi,
Page no.190-204
 http://www.currentnursing.com
 http://www.myfreeessays.com/science_and_technology/041.shtml