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SUPERVISED BY
DR SALWA OBIESAT
OUTLINES
Background
Contribution to nursing
Theory development and influences
Major concepts
Metapardigm
Concepts
assumptions
Applications and future directions
Nursing process
Theory critique
References
BIOGRAPHY (1919-1999)
Born in Savannah, Georgia in August 21, 1919
Youngest in the family of seven
She finished her associates degree in arts 1938 from Armstrong Junior
college in Savannah, Georgia.
Finished a degree in Bachelor of Science in Nursing in 1942 from
Vanderbilt University, Nashville, Tennessee
She was studying nursing and how it was being taught and realized that
there was no evidence that supported what should be taught to nurses
After more than 15 years, she began to think of man and the behavioral
systems model and how it best supported nursing practice. This theory is
a highly abstract concept.
(GRAND THEORY)
CONTRIBUTION TO NURSING
Definition of Nursing According to Johnson:
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
MAJOR CONCEPT
The human being strives to make continual adjustments to achieve,
maintain, or regain balance to the steady-state that is adaptation.
It has two major systems: the biological and behavioral systems.
Society relates to the environment in which the patient exists; the the
environment and events that occur in it influence a patient's behavior
directly
PERSON
A system of independent parts with patterned, repetitive, purposeful
ways of behaving behavioral system composed of
7 subsystems
ENVIROMENT
All forces that affect the person and influence the behavioral system
HEALTH
Health is reflected by the organization, interaction, interdependence,
and integration of subsystem of the
behavioral system
NURSING
Promotion of behavioral system balance and stability; an external
regulatory force that acts to preserve the
organization and integration of the client's behavior at
optimal level under those condition, which the behavior constitutes a
threat to physical or social health, or which
illness is found
CONCEPTS
Behavioral system
Man is a system that indicates the state of the system through behaviors.
Boundaries
The point that differentiates the interior of the system from the exterior.
Environment
All elements of the surroundings of the human system and includes
interior stressors (not directly defined but implied).
Function
Consequences or purpose of actions.
Functional requirements
Health
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.
Homeostasis
Process of maintaining stability.
Human
A behavioral system that strives to make continual adjustments to
achieve, maintain, or regain balance to the steady-state that is
adaptation.
Instability
State in which the system output of energy depletes the energy needed
to maintain stability.
Stability
Balance or steady-state in maintaining balance of behavior within an
acceptable range.
Stressor
A stimulus from the internal or external world that results in stress or
instability.
Structure
The parts of the system that make up the whole.
System
That which 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.
Tension
The system's adjustments to demands, change or growth, or to actual
disruptions.
Variables
Factors outside the system that influence the system's behavior, but
which the system lacks power to change.
ASSUMPTIONS
Assumptions about system
Assumptions about structure
Assumptions about functions
DOROTHY E. JOHNSON
SUBSYSTEMS
1. Attachment or
affiliative
2. Dependency
3. Ingestive
4. Eliminative
5. Sexual
6. Aggressive
7. Achievement
She proposed the idea that the focus of nursing should be on a persons
behavior rather than on the health state or disease condition (Cromwell,
2008).
Nursing Education
Johnsons vision was to create a curriculum focused on nursing and not
derived solely from other disciplines.
She believed that nursing is a discrete science and her beliefs have held
true (McEwen & Willis in Cromwell, 2008).
ou Can Be a Nurse!
Nursing Research
According to McEwen &Willis (2007), Johnsons theory was tested in
more than twenty research studies.
These include studies conducted in various patient populations such as
the visually impaired, elementary school children, and cancer patients
(Johnson & Webber in Cromwell, 2008), and in the development of tools
to measure the concepts presented in the model.
The explanation of the concepts in the behavioural model was criticized
for being highly-abstract and the theoretical assumptions were
descriptive.
This gives researchers the chance to review and examine the aspects of
her theory that may lack in clarity.
DOROTHY E. JOHNSON
Behavioral Systems Model
- EVIDENCE OF EMPIRICAL TESTING/TESTABILITY
More than 20 research studies have been identified using Johnsons
model. (Ex: Turner-Henson, 1992, used it as a framework to examine
how mothers of chronically ill children perceived the environment, i.e.,
whether it was supportive, safe, and accessible).
Poster, Dee & Randell (1997) used Johnsons theory as a conceptual
framework in a study of client outcome evaluation; they found that the
nursing theory made it possible to prescribe nursing care and to
distinguish it from medical care.
Derdiarian & Schobel (1990) used the model to develop an assessment
tool for individuals with acquired immunodeficiency syndrome.
Derdiarian (1990) examined the relationship between
aggressive/protective subsystem & the other six model subsystems.
NURSING PROCESS
I. Assessment
Grubbs developed an assessment tool based on Johnsons 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
II. Diagnosis
Diagnosis tends to be general to the system than specific to the
problem.
Insufficiency
Discrepancy
Incompatibility
Dominance
IV. 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.
STRENGTH
Dorothy Johnson's Behavioral System model contributed much on the
nursing profession.
She identified the major purpose and role of the theory in the nursing
profession and that is to keep the level of behavioral system in
equilibrium up to the highest level.
Its scope and uses was not limited only to the patient care in
practice of nursing but it was also used by the administrators and
also in researches.
Her theory change how the world see nursing profession separate in
medicine because Johnson believes that nursing care has a definite
effect on the health of a person which is not the same on how medicine
perform its duties and responsibilities in alleviating the health of the
person.
LIMITATIONS
The recipient of her nursing care was only limited to the person who are
admitted in the hospital (obviously the sick individuals).
She also fails to include and give importance to the Nursing Process in
her theory and instead focuses on the behavior of the client in response
to illness or disability.
MY VIEW
I think that Johnson theory gives
the researchers the base for new
ideas, innovations which driven
from her abstract concepts and
assumptions and in any theory
there is always strengths and
limitations points so with our bright
minds and our limitless potential
we can use limitations to
improvement and development and
strengths to support and guided us
in the search
References
http://www.authorstream.com/Presentation/meredithmead-1440387dorothy-johnson-model-presentation-revision/
http://ar.scribd.com/doc/44968945/Dorothy-Johnson
http://dorothyjohnson.wetpaint.com.
http://group-j.blogspot.com/p/strengths-and-limitations.html
http;//currentnursing.com/...theory