Johnson behavior system model البشير خير الله وارث الدين محمد جيهان عبد العظيم الطيب محمود

OBJECTIVES At the end of presentation, the students will be able to: a. determine the life and works of Dorothy Johnson. b. understanding the Behavioral System Model. c. Definitions and assumptions of Johnson’s Behavioral System Model in relation to Nursing's Metaparadigm. d. Application of the theory in nursing. e. Acceptance of theory in the nursing community. f. know the points of critique and weakness.

 Dorothy Johnson was born on August 21, 1 919, in Savannah, Georgia.  She received her(A.A) associate of arts degree from Armstrong Junior College in  Her ( BSN ) bachelor of science in nursing degree from Vanderbilt University in  She practiced briefly as a staff nurse at the Chatham- savannah Health Council.  she received her (MPH) master of public health from Harvard University in INTRODUCING THE THEORIST

 She began her academic career at Vanderbilt University School of Nursing  A call from Lulu Hassenpplug, dean of the School of Nursing enticed her to go to the University of California at Los Angeles (UCLA) in  She served there as an assistant, associate, and professor of pediatric nursing until her retirement in 1978 Cont:-

 In 1955 and 1956 she was a pediatric nursing adviser at the Christian medical collage school of nursing in Vellare, South India.  She worked with California Nurses Association, National League for Nursing and American Nurses’ Association to examine the role of the clinical nurse specialist, the scope of nursing practice.  Dorothy Johnson’s body of published work includes more than 30 articles, 4 books, and numerous proceedings, reports, and abstracts. Cont:-

Ms. Johnson received many awards, including the Founders Medal from Vanderbilt University (1942) Award from california nurses association and vanderbilt university school of nursing. Dorothy Johnson, passed away in February 1999 Cont:-

Theoretical recourses Johnson has noted that her theory evolved from philosophical ideas, theory and research, clinical background, and many years of thought, discussions, and writing. From Florence Nightingale came the belief that nursing’s concern is a focus on the person rather than the disease. From systems theory were all sources for her model. Johnson’s background as a pediatric nurse is also evident in the development of her model.

Major concepts

IS the out put of intra organismic structures &process as they are coordinated and articulated by and responsive to changes in sensory stimulation. BEHAVIOR:-

- From Rapport's definition of system, Johnson stated(A system is a whole that functions as a whole by virtue of the interdependence of it’s parts.) she accepted with chin's statement that it,s organization, interaction, interdependency and integration of the parts & elements. System

Behavioral system encompasses the patterned,repetitive & purposeful ways of behaving. These ways of behaving form an organized & integrated functional unit that determines and limits the interaction between the person and his or her environment, and establishes the relationship of the person to the objects, events and situations within his or her environment. BEHAVOURAL SYSTEM

Is a mini system with it’s own particular goal &function that can be maintained as long as it’s relationship to the other subsystems or the environment is not disturbed. Which are open-linked & interrelated. Motivational drives direct the activities of these subsystems,which are continually changing through maturation, experience & learning. And controlled by biological, psychological & sociological factors subsystems

Is probably the most critical, because it forms the basis for all social organization. It provided survival &security. It’s consequences are social inclusion, intimacy, formation & maintenance of a strong social bond. 1-attachment-affiliative subsystem

-promotes helping behavior calls for nurturing response. Developmentally dependency behavior evolves from almost total dependence on others to greater degree of dependence on self. 2-dependancy subsystem

Should not seen as input &out put mechanisms of the system, it has to do with(when, how, what, how much& under what conditions we eat). It serve the board function of appetitive satisfaction. which associated with psychological, social &biological consideration. Ingestive sub-system

-it means when, how & under which condition we eliminate. As ingestion system social, psychological &biological aspect influencing this subsystem. Eliminative sub-system

Has a double functions:- 1- procreation. 2- gratification. This response system begins with the development of gender role identity. Sexual subsystem

Achievement

It’s function is protection & preservation. And this opposed thinking of that aggressive behavior is not only learned,but also has intend to harm others. Aggressive –protective subsystem

Is a key concept in nursing’s specific goal. define as:- A stabilized but more or less transitory, resting state in which the individual is in harmony with him self & his environment. It is not synonymous with state of health,it may be found either in health or illness. equilibrium

DEFINE AS :- State of being stretched or strained and can be viewed as an end-product of a disturbance in equilibrium. It can be constructive in adaptive change or destructive in inefficient use of energy. TENSION

Define as :- Internal or external stimuli that produce tension & result in a degree of instability Stimuli may be positive or negative, endogenous or exogenous in origin. And may play upon one or more of our open linked system (physiological, personality and meaningful small group-(family) and larger social system. STRESSOR

BEHAVIOR SYSTEM ATTACHEMENT AGGRESSIV E ACHEVEMENT SEXUAL ELEMINATIVE INGESTIVE DEPENDENCY

Major assumptions

“an external regulatory force which acts to preserve the organization and integration of the patient’s behavior at an optimal level when physical, psychological and social threatened. Nursing An art and science, it supplies external assistance both before and during balance disturbance and therefore require knowledge of order,disorder, and control.

Tension = stressor =» client NURSE EQUILIPRIUM

As a behavior system with patterned, repetitive, and purposeful ways of behaving that link the person to environment. An individual's specific response patterns, form an organized and integrated whole. A person is a system of interdependent parts that require some regularity and adjustment to maintaining a balance. Person

An elusive, dynamic state influenced by biological, psychological, and social factors. A desired value of health professionals and focused on a person rather than a disease. Reflected by the organization, interaction, interdependence, and integration of the subsystems of behavior system. health

Consists of all factors that not part of the individual's behavioral system, but influence the system. The individual links to and interact with the environment. The behavior system attempt to maintain equilibrium in response to environmental factors by adjusting and adapting to the forces that impinging on it. Environment

Theoretical assertion JBS addressed that patient is a behavior system with seven interrelated subsystem. Each subsystem can be described and analyzed in term of structural and functional component. And the system is tend to be self- maintaining and self- perpetuating when the internal and external conditions remain orderly and predictable. The behavior attempt to achieve balance when the change is occurs. the state of instability result in need of nursing intervention.

Functional requirements “Protected from noxious influences with which the system cannot cope” “Nurtured through the input of appropriate supplies from the environment” “Stimulated for use to enhance growth and prevent stagnation”

Structural requirement Drives or goals. Set, predisposition to act. Choice, alternatives to action. behavior

subsystems depen attac h achiev e aggre ssiv ingest eleme sexual Dynamic enviro Stress tolerance flexibility Ex stressor Int stressor Active dynamic bs Person, group tension Structural R Dynamic equilibrium Nurse action Nurture Protect stimuli

Nursing application A 67-years old man is admitted to hospital for diagnostic test after CVA, he has been marriage and father of tow adult children who live in same city, he came with right side weakness, expressive aphasia and slurred speech and other problems. Nursing application with JBS. o NURSING ASSESSMENT:  Behavior assessment 1. attachment : (family, friends). 2. Dependency: (on others physically, financially).

3. Ingestive :(decrease appetite, difficulty swallowing). 4. Eliminative:(walk to bathroom). 5. Sexual:(sexual dysfunction). 6. Aggressive-protective:(worry of travel family & wife). 7. Achievement :(relearn walk, talk and ADLs,).  Environmental assessment:- external environment (hospitalization, diagnostic test, disabilities). Internal environment (biological,psychological, cognitive).  Structural component:- Drive or gaol(motivate to complete diagnostic test and return to home). Set (evident to make decision).

Choice( home, rehabilitation program). action (socialization, request for assistance).  Functional component:- Protection( falling down). Nurturing ( use of left hand). Stimulation (socialization).  Nursing diagnoses:- Incompatibility. Discrepancy. Insufficiency. Dominance.

 Planning :-  for intervention.  Nursing intervention:-  External regulatory forces that should protect, stimulate and nurture the behavior system.  Explanation and teaching the pt,family and friends.  Evaluation :-  Result of implementation  Balance and equilibrium

Acceptance by the nursing community Acceptence by th nursing community practiceresearcheducation

-:PRACTICE Johnson does not use the term nursing process. Assessment,Disorders, treatment, and evaluation are concepts referred to in a variety of Johnson`s works. For the practitioner conceptual models provide a diagnostic and treatment orientation, and thus are of considerable practical importance. The Nursing process becomes applicable in the behavioral system model when behavioral malfunction occurs.

Recent studies of nursing practice using Johnson's model have focused on decision making and evaluation of outcomes. Grice (1997) found that the nurse, patient, and situational characteristics influenced assessment and decision making for the administration of antianxiety and antipsychotic medication for psychiatric inpatient at certain hours.

Education Loveland and Wilkerson analyzed Johnson theory and concluded that it has utility in nursing education. A curriculum based on a person as a behavioral system would have definite goals & straight forward course planning. The model has been used in practice and educational institutions.

Research Johnson stated that nursing research would need to identify and explain the behavioral system disorders which arise in connection with illness and develop the rationale for the means of management. Nurse researchers have demonstrated the usefulness of Johnson's theory in clinical practice.most of these studies have been conducted with individuals with long-term illnesses, such as urinary incontinence, chronic pain, cancer, aids And psychiatric illnesses.

Critique :- simplicity Johnson's theory is relatively simple in relation to the number of concepts. a person is described as behavioral system composed of seven subsystems. Nursing is an external regulatory force. However, the theory is potentially complex because there are a number of possible interrelationships between and among the behavioral system, its subsystems,and the forces on them. At this point, only a few of the potential relationships have been explored.

generality Johnson's theory is relatively unlimited when applied to sick individuals, but it has not been used as much with well individuals or groups. Johnson perceived a person as behavioral system comprised of seven subsystems.

Derivable consequences Johnson's model guides nursing practice, education, and research; generates new ideas about nursing and differentiates nursing from other health professions. By focusing on behavior rather than biology. Johnson's behavioral system model provides a conceptual framework for nursing education, practice, and research.

limitations Very individual. Family is only considered as an environment. Focused in nursing care of hospitalized and ill, not focused on health promotion or prevention

ANY QUISTIONS?