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338 UNIT III Nursing Conceptual Models

requirements/sustenal imperatives, or a change in the The behavioral system attempts to maintain equilib-
environment. A person’s attempt to reestablish balance rium in response to environmental factors by adjusting
may require an extraordinary expenditure of energy and adapting to the forces that impinge on it. Exces-
that leaves a shortage of energy to assist biological sively strong environmental forces disturb the behav-
processes and recovery. ioral system balance and threaten the person’s stability.
An unusual amount of energy is required to the system
Health to reestablish equilibrium in the fact of continuing
Johnson perceived health as an elusive, dynamic state forces (Loveland-Cherry & Wilkerson, 1983).
influenced by biological, psychological, and social The environment is also the source of the sustenal
factors. Health is reflected by the organization, inter- imperatives of protection, nurturance, and stimula-
action, interdependence, and integration of the sub- tion that are necessary prerequisites to maintaining
systems of the behavioral system (Johnson, 1980). An health (behavioral system balance) (Grubbs, 1980).
individual attempts to achieve a balance in this sys- When behavioral system imbalance (disequilibrium)
tem, which will lead to functional behavior. A lack of occurs, the nurse may need to become the temporary
balance in the structural or functional requirements regulator of the environment and provide the person’s
of the subsystems leads to poor health. Thus, when supply of functional requirements so the person can
evaluating “health,” one focuses on the behavioral adapt to stressors. The type and the amount of func-
system and system balance and stability, effective and tional requirements needed vary by age, gender, cul-
efficient functioning, and behavioral system imbal- ture, coping ability, and type and severity of illness.
ance and instability. The outcomes of behavior system
balance are: (1) a minimum expenditure of energy is
required (implying more energy is available to main- Theoretical Assertions
tain health, or, in the case of illness, energy is available The Johnson Behavioral System Theory addresses the
for the biological processes needed for recovery); metaparadigm concepts of person, environment, and
(2) continued biologic and social survival are en- nursing. The person is a behavioral system with seven
sured; and (3) some degree of personal satisfaction interrelated subsystems (Figure 18–1). Each subsystem
accrues (Grubbs, 1980; Johnson 1980). is formed of a set of behavioral responses, or responsive
tendencies, or action systems that share a common
Environment drive or goal. Organized around drives, (some type
In Johnson’s theory, the environment consists of all of intraorganismic motivational structure), these re-
the factors that are not part of the individual’s behav- sponses are differentiated, developed, and modified
ioral system, but that influence the system. The nurse over time through maturation, experience, and learn-
may manipulate some aspects of the environment so ing. They are determined developmentally and are
the goal of health or behavioral system balance can be continuously governed by a multitude of physical, bio-
achieved for the patient (Brown, 2006). logical, and psychological factors operating in a com-
The behavioral system “determines and limits the plex and interlocking fashion.
interaction between the person and their environment Each subsystem is described and analyzed in terms
and establishes the relationship of the person to the of structural and functional requirements. The four
objects, events and situations in the environment” structural elements that have been identified include
(Johnson 1978). Such behavior is orderly and predict- the following: (1) drive or goal—the ultimate conse-
able. It is maintained because it has been functionally quence of behaviors in it; (2) set—a tendency or pre-
efficient and effective most of the time in managing disposition to act in a certain way. Set is subdivided
the person’s relationship to the environment. It changes into two types—preparatory or what a person usually
when this is no longer the case, or when the person attends to, and perseverative, the habits one maintains
desires a more optimum level of functioning. The be- in a situation; (3) choice represents the behavior a
havioral system has many tasks and missions to per- patient sees himself or herself as being able to use in
form in maintaining its own integrity and in managing any given situation; and (4) action or the behavior of
the system’s relationship to its environment. an individual (Grubbs, 1980; Johnson, 1980). Set will