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Johnsons theory 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 behavior constitutes a threat to the physical or
social health, or in which illness is found.
It also states that each individual has patterned, purposeful, repetitive ways of acting
that comprises a behavioral system specific to that individual.

Johnson began her work on the model with the premise that nursing was a profession
that made a distinctive contribution to the welfare of society. Thus, nursing had an
explicit goal of action in patient welfare.
The goals of nursing are fourfold, according to the Behavior System Model: (1) To assist
the patient whose behavior is proportional to social demands. (2) To assist the patient
who is able to modify his behavior in ways that it supports biological imperatives. (3) To
assist the patient who is able to benefit to the fullest extent during illness from the
physicians knowledge and skill. And (4) To assist the patient whose behavior does not
give evidence of unnecessary trauma as a consequence of illness.

The assumptions made by Johnsons theory are in three categories: assumptions about
system, assumptions about structure, and assumptions about functions.
Johnson identified several assumptions that are critical to understanding the nature and
operation of the person as a behavioral system: (1) 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 occurring on him. (3) A behavioral system, which
requires and results in some degree of regularity and constancy in behavior, is essential
to man. It is functionally significant because it serves a useful purpose in social life as

well as for the individual. And (4) System balance reflects adjustments and
adaptations that are successful in some way and to some degree.
The four assumptions about structure and function are that: (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 person has a
predisposition to act with reference to the goal, in certain ways rather than the other
ways. This predisposition is called a set. (3) Each subsystem has a repertoire of
choices called a scope of action. And (4) The individual patients behavior produces an
outcome that can be observed.
And lastly, there are three functional requirements for the subsystems.: (1) The
system must be protected from toxic influences with which the system cannot cope. (2)
Each system has to be nurtured through the input of appropriate supplies from the
environment. And (3) The system must be stimulated for use to enhance growth and
prevent stagnation.

Major Concepts
Human Beings
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 nursings 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.

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.

Nursing is seen as an external regulatory force which acts to preserve the organization
and integration of the patients 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

Behavioral system
Man is a system that indicates the state of the system through behaviors.

That which functions as a whole by virtue of organized independent interaction of its

A mini system maintained in relationship to the entire system when it or the
environment is not disturbed.

The parts of the system that make up the whole.

Factors outside the system that influence the systems behavior, but which the system
lacks power to change.

The point that differentiates the interior of the system from the exterior.

Process of maintaining stability.

Balance or steady-state in maintaining balance of behavior within an acceptable range.

A stimulus from the internal or external world that results in stress or instability.

The systems adjustment to demands, change or growth, or to actual disruptions.

State in which the system output of energy depletes the energy needed to maintain

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.

Consequences or purposes of action.

7 Subsystems

Johnsons Behavioral System Model

Johnson identifies seven subsystems in the Behavioral System Model. They are:

Attachment or affiliative subsystem

Attachment or affiliative subsystem is the social inclusion intimacy and the formation
and attachment of a strong social bond. It is probably the most critical because it
forms the basis for all social organization. On a general level, it provides survival and
security. Its consequences are social inclusion, intimacy, and formation and
maintenance of a strong social bond

Dependency subsystem
Dependency subsystem is the approval, attention or recognition and physical
assistance. In the broadest sense, it promotes helping behavior that calls for a
nurturing response. Its consequences are approval, attention or recognition, and
physical assistance. Developmentally, dependency behavior evolves from almost total
dependence on others to a greater degree of dependence on self. A certain amount of
interdependence is essential for the survival of social groups.

Ingestive subsystem
Ingestive subsystem is the emphasis on the meaning and structures of the social
events surrounding the occasion when the food is eaten. It should not be seen as the
input and output mechanisms of the system. All subsystems are distinct subsystems
with their own input and output mechanisms. The ingestive subsystem has to do with
when, how, what, how much, and under what conditions we eat.

Eliminative subsystem
Eliminative subsystem states that 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. It addresses when, how, and under what
conditions we eliminate. As with the ingestive subsystem, the social and psychological
factors are viewed as influencing the biological aspects of this subsystem and may be,
at times, in conflict with the eliminative subsystem.

Sexual subsystem
Sexual subsystem is both a biological and social factor that affects behavior. It has the
dual functions of procreation and gratification. Including, but not limited to, courting
and mating, this response system begins with the development of gender role identity
and includes the broad range of sex-role behaviors.

Aggressive subsystem
Aggressive subsystem relates to the behaviors concerning protection and selfpreservation, generating a defense response when there is a threat to life or territory.
Its function is protection and preservation. Society demands that limits be placed on
modes of self-protection and that people and their property be respected and protected.

Achievement subsystem
Achievement subsystem provokes behavior that tries to control the environment. It
attempts to manipulate the environment. Its function is control or mastery of an aspect
of self or environment to some standard of excellence. Areas of achievement behavior
include intellectual, physical, creative, mechanical, and social skills.

Behavioral System Model and The Nursing Process

The nursing process of the Behavior System Model of Nursing begins with an
assessment and diagnosis of the patient. Once a diagnosis is made, the nurse and other
healthcare professionals develop a nursing care plan of interventions and setting them
in motion. The process ends with an evaluation, which is based on the balance of the
Johnsons Behavioral System Model is best applied in the evaluation phase, during
which time the nurse can determine whether or not there is balance in the subsystems
of the patient. If a nurse helps a patient maintain an equilibrium of the behavioral
system through an illness in the biological system, he or she has been successful in the


Johnsons theory guides nursing practice, education, and research; generates new ideas
about nursing; and differentiates nursing from other health professions.
It has been used in inpatient, outpatient, and community settings as well as in nursing
administration. It has always been useful to nursing education and has been used in
practice in educational institutions in different parts of the world.
Another advantage of the theory is that Johnson provided a frame of reference for
nurses concerned with specific client behaviors. It can also be generalized across the
lifespan and across cultures.
The theory also has potential for continued utility in nursing to achieve valued nursing

The theory is potentially complex because there are a number of possible
interrelationships among the behavioral system, its subsystems, and the environment.
Potential relationships have been explored, but more empirical work is needed.
Johnsons work has been used extensively with people who are ill or face the threat of
illness. However, its use with families, groups, and communities is limited.
Though the seven subsystems identified by Johnson are said to be open, linked, and
interrelated, there is a lack of clear definitions for the interrelationships among them
which makes it difficult to view the entire behavioral system as an entity.
The problem involving the interrelationships among the concepts also creates difficulty
in following the logic of Johnsons work.

Johnsons Behavioral System Model describes the person as a behavioral system with
seven subsystems: the achievement, attachment-affiliative, aggressive protective,
dependency, ingestive, eliminative, and sexual subsystems. Each subsystem is

interrelated with the others and the environment and specific structural elements and
functions that help maintain the integrity of the behavioral system.
Through these, the focus of her model is with what the behavior the person is
presenting making the concept more attuned with the psychological aspect of care in.
When the behavioral system has balance and stability, the individuals behaviors will be
purposeful, organized, and
predictable. Imbalance and instability in the behavioral system occur when tension and
stressors affect the relationship of the subsystems or the internal and external