Page 359 - alligood 8th edition_Neat

340 UNIT III Nursing Conceptual Models

to achieve balance by adapting to internal and envi- system functioning when this is desired and possible
ronmental stimuli. The behavioral system is made (Johnson, 1978).
up of “all the patterned, repetitive, and purposeful
ways of behaving that characterize each man’s life”
(Johnson, 1980, p. 209). This functional unit of Logical Form
behavior “determines and limits the interaction of Johnson approached the task of delineating nursing’s
the person and his environment and establishes the mission from historical, analytical, and empirical
relationship of the person with the objects, events, perspectives. Deductive and inductive thinking is
and situations in his environment” (Johnson, 1980, evident throughout the process of developing the
p. 209). “The behavioral system manages its relation- Johnson behavioral system theory. A system, inas-
ship with its environment” (Johnson, 1980, p. 209). much as it is a whole, will lose its synergetic properties
The behavioral system appears to be active and not if it is decomposed. Understanding must therefore
passive. The nurse is external to and interactive with progress from the whole to its parts—a synthesis.
the behavioral system. Johnson first identified the behavioral system and
Successful use of the Johnson’s Behavioral System then explained the properties and behavior of the
Theory in clinical practice requires the incorporation system. Finally, she explained the properties and be-
of the nursing process. The clinician must develop an havior of the subsystems as a part or function of the
assessment instrument that incorporates the compo- system. The analysis gave us description and knowl-
nents of the theory so they are able to assess the edge, while the systems thinking (synthesis) gave us
patient as a behavioral system to determine if there explanation and understanding.
is an actual or perceived threat of illness, and to de-
termine the person’s ability to adapt to illness or Acceptance by the Nursing Community
threat of illness without developing behavioral sys-
tem imbalance. This means developing appropriate Practice
questions and observations for each of the behavioral The utility of the Johnson Behavioral System Theory
subsystems. is evident from the variety of clinical settings and age
A state of instability in the behavioral system re- groups where the theory has been used. It has been
sults in a need for nursing intervention. Identification used in inpatient, outpatient, and community settings
of the source of the problem in the system leads to as well as in nursing administration. It has been used
appropriate nursing action that results in the mainte- with a variety of client populations, and several prac-
nance or restoration of behavioral system balance tice tools have been developed (Fawcett, 2005).
(Brown, 2006). Nursing interventions can be in Johnson does not use the term nursing process.
such general forms as: (1) repairing structural units; Assessment, disorders, treatment,and evaluation are
(2) temporarily imposing external regulatory or con- concepts referred to in a variety of Johnson’s works.
trol measures; (3) supplying environmental condi- “For the practitioner, conceptual models provide a
tions or resources; or (4) providing stimulation to the diagnostic and treatment orientation, and thus are of
extent that any problem can be anticipated, and pre- considerable practical import” (Johnson, 1968, p. 2).
ventive nursing action is in order (Johnson, 1978). “If The nursing process becomes applicable in the Behav-
the source of the problem has a structural stressor, the ioral System Model when behavioral malfunction
nurse will focus on either the goal, set, choice, or occurs “that is in part disorganized, erratic, and
action of the subsystem. If the problem is one of dysfunctional. Illness or other sudden internal or
function, the nurse will focus on the source and suf- external environmental change is most frequently
ficiency of the functional requirements since func- responsible for such malfunctions” (Johnson, 1980,
tional problems originate from an environmental ex- p. 212). “Assistance is appropriate at those times the
cess or deficiency” (Grubbs, 1980, p. 242). The goal individual is experiencing stress of a health-illness
of nursing is to maintain or restore the person’s be- nature which disturbs equilibrium, producing tension”
havioral system balance and stability or to help the (Johnson, 1961a, p. 6). However, it is important to note
person achieve a more optimum level of behavioral that systems analysis is an important component of