Johnson Theory of Nursing

Definition

Johnson's theory of nursing believes that humans are behavioral systems made up of seven subsystems.

Description

Johnson's theory of nursing, also known as the behavioral systems model, was created by Dorothy Johnson. She was born on August 21, 1919 in Georgia. She attended Armstrong Junior College, from which she received her A.A. in 1938, and Vanderbilt University from which she received her B.S.N. in 1942. She also attended Harvard University from which she received her M.P.H. in 1948. She taught pediatric nursing at Vanderbilt University and later at the University of California, Los Angeles.

Johnson believed that humans are behavioral systems made up of seven subsystems. These subsystems are:

• achievement—to deal with goals, goal setting, goal attainment
• affiliative—to form relationships and relate to others
• aggressive/protective—to protect oneself, to respond to threats
• dependency—to obtain feedback about the self, to recognize need for dependence upon others
• eliminative—to eliminate waste, to express feelings
• ingestive—to intake nutrients, to obtain knowledge
• sexual—to develop gender based identity, to have sexual relationships, to procreate

The seven subsystems interact with each other and are all interrelated and interconnected. They are also acted on by external factors. Johnson believed that the environment was constantly acting on the subsystems, and that the environment was made up of everything outside the person, including other people, cultural factors, and environmental factors such as temperature. When the seven subsystems are not all in balance the behavior exhibited by the person will not be optimal. Johnson believed the goal of nursing was to help the patient to restore the subsystems to balance to achieve the best possible functioning behavior.

Johnson believed that there are four possible things that can be wrong with a subsystem and cause it to become out of balance. The first is insufficiency, when the subsystem has not developed fully or does not get enough of something. The second is discrepancy, which is when the subsystem is not working in a way that leads to the optimal goal state. The third is incompatibility, which is when subsystems conflict, and the fourth is dominance, which is when one subsystem is always used even though it might not be the best to lead to the goal state or most functional behavior.

When the nurse diagnoses a problem with a subsystem Johnson believed that the nurse should act to help restore it to balance. This can be done by helping the patient regulate his or her behavior by restricting it, by altering the external or internal environment to lead to balance, or by providing the patient with nurturance, stimulation, and protection to help the patient have the opportunity to restore balance himself or herself.

Viewpoints

Johnson's theory may be seen as a very general one. It has seven subsystems that interact and interrelate which can make it very complex. Determination of which subsystem or subsystems cause problematic behavior can be difficult as they are all constantly interacting, and there are many external forces also acting on the subsystems.

Professional implications

Johnson believed that the nurse's goal was to help the patient achieve balance of the subsystems, or to restore balance when it may have been lost. When the subsystems are in balance the behavior that results will be functional. To assist patients productively it is necessary to observe the behavior that is occurring and try to determine which subsystem or subsystems are causing the problem. The appropriate actions can then be taken by the nurse in relation to those subsystems. She believed that the focus of nursing care should be on the patient, instead of on the illness. The nurse should assist the patient in restoring balance by making changes to the environment as necessary, and assisting the patient in developing new behaviors. This can be done by reinforcing the desired behavior, or regulating the behaviors. Research has been done on the Johnson model with a number of different patient populations, especially children. Methods of observing behavior and determining which subsystems are involved have been created.

Resources

BOOKS

Parker, Marilyn E. Nursing Theories and Nursing Practice. Philadelphia, PA: E.A. Davis Company, 2001.

ORGANIZATIONS

American Nurses Association. 8515 Georgia Ave., Ste. 400, Silver Spring, MD 20910. (800) 274-4ANA. http://www.nursingworld.org.

OTHER

"Model and Theories of Nursing." Cardinal Stritch University Library 2005. 〈http://library.stritch.edu/nursingtheroies/nursingtheories.htm〉 (November 03, 2005).

"VUMC Biographies." Vanderbilt Medical Center 2005. http://www.mc.vanderbilt.edu/biolib/hc/biopages/djohnson.html (November 02, 2005).