26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Biography
Ateneo de Davao University • Dorothy E. Johnson (August 21, 1919 –
February 1999) was one of the greatest
nursing theorists who developed the
Dorothy Johnson “Behavioral System Model.”
• Her theory of nursing defines nursing as
Behavioral System Model “an external regulatory force which acts to
preserve the organization and integration of
the patients behaviors at an optimum level
Lectured by: under those conditions in which the
JENNY-ANN B. SORIANO, RN MAN behavior constitutes a threat to the physical
Clinical Instructor, Ateneo de Davao
University or social health, or in which illness is found.”
Davao City, Philippines

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

1 2

Biography Biography
• Dorothy Johnson’s professional nursing • After graduation, Dorothy Johnson’s professional
career began in 1942 when she graduated from experiences involved mostly teaching, although she was a
Vanderbilt University School of Nursing in in staff nurse at the Chatham-Savannah Health Council from
Nashville, Tennessee. 1943 to 1944.

• She was the top student in her class and • She was an instructor and an assistant professor in
pediatric nursing at Vanderbilt University School of
received the prestigious Vanderbilt Founder’s Nursing.
Medal.
• From 1949 until her retirement in 1978 and her
• In 1948, she received her Masters in public subsequent move to Key Largo, Florida, Johnson was an
health from Harvard University in Boston, assistant professor of pediatric nursing, an associate
Massachusetts. professor of nursing, and a professor of nursing at the
University of California, Los Angeles.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

3 4

Biography Works

• In 1955 and 1956, Johnson was a pediatric • Dorothy Johnson was a prolific writer on the subject of
nursing advisor assigned to the Christian nursing theory.
Medical College School of Nursing in
Vellore, South India. • Her many publications on this subject profoundly
influenced theoretical thinking in nursing during the
• From 1965 to 1967, she served as second half of the twentieth century.
chairperson on the committee of the
California Nurses Association that • Johnson’s publications include four books, more than
developed a position statement on 30 articles in periodicals, and many papers, reports,
specifications for the clinical specialist. proceedings, and monographs.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

5 6

1
 26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Works The Behavioral System Model of Nursing

• Dorothy Johnson is known for her “Behavioral System Model of Nursing,”

• Dorothy E. Johnson is well-known for her “Behavioral System Model,” which
which was first proposed in 1968.
was first proposed in 1968.
• Her nursing model states that “each individual has patterned, purposeful,
• Her model was greatly influenced by Florence Nightingale’s book, Notes on
repetitive ways of acting that comprises a behavioral system specific to
Nursing.
that individual.”
• It advocates the fostering of efficient and effective behavioral functioning in
• It advocates the fostering of efficient and effective behavioral functioning
the patient to prevent illness and stresses the importance of research-based
in the patient to prevent illness.
knowledge about the effect of nursing care on patients.
• The patient is defined as a behavioral system composed of seven
behavioral subsystems: affiliative, dependency, ingestive, eliminative,
sexual, aggressive, and achievement.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

7 8

The Behavioral System Model of Nursing Description

• Each subsystem also has three functional requirements
which include (1) protection from noxious influences, (2) Dorothy Johnson’s theory defined Nursing as “an
external regulatory force which acts to preserve the
provision for a nurturing environment, and (3) organization and integration of the patient’s
stimulation for growth. behaviors at an optimum level under those
• An imbalance in each system results in disequilibrium. conditions in which the behavior constitutes a threat
The nurse’s role is to help the patient maintain his or to the physical or social health, or in which illness is
her equilibrium. found.”

It also states that “each individual has patterned,

purposeful, repetitive ways of acting that comprises
a behavioral system specific to that individual.”

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

9 10

Goals Goals

• Dorothy Johnson began her work on the model with The goals of nursing are fourfold, according to the
the premise that nursing was a profession that made a Behavior System Model:
distinctive contribution to the welfare of society. (1) To assist the patient whose behavior is proportional to
social demands.
• Thus, nursing had an explicit goal of action in patient
(2) To assist the patient who is able to modify his behavior
welfare. 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 physician’s knowledge and
skill.
(4) To assist the patient whose behavior does not give
evidence of unnecessary trauma as a consequence of
illness.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

11 12

2

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY
Assumptions
The assumptions made by Dorothy Johnson’s
theory are in three categories:
1. Assumptions about system,
2. Assumptions about structure, and
3. Assumptions about functions.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
13
Assumption on Person as a behavioral system
Johnson identified several assumptions that are critical to
understanding the nature and operation of the person as a
behavioral system:
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.”
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
15
Major Concepts
The following are the major concepts and definitions of the Johnson’s
nursing model including the definition for its nursing metaparadigm:
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 nursing’s
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.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
17
26/08/2020
Assumption on Person as a behavioral system
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.”
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
14
Assumption about structure and function
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.”
4. The individual patient’s behavior produces an outcome that can
be observed.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
16
Major Concepts
Environment
• 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
• 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.”
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
18
3
 26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Major Concepts Major Concepts

Nursing System
• Nursing is seen as “an external regulatory force which acts to • That which functions as a whole by virtue of organized
preserve the organization and integration of the patient’s behavior independent interaction of its parts.
at an optimal level under those conditions in which the behavior
constitutes a threat to physical or social health, or in which illness Subsystem
is found.” • A mini system maintained in relationship to the entire
Behavioral system system when it or the environment is not disturbed.
• Man is a system that indicates the state of the system through
behaviors.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

19 20

Sub-Concepts Conservational Models

Homeostasis
Structure • Process of maintaining stability.
• The parts of the system that make up the Stability
whole.
• Balance or steady-state in maintaining
balance of behavior within an acceptable
Variables
range.
• Factors outside the system that influence the
Stressor
system’s behavior, but which the system lacks
• A stimulus from the internal or external
power to change. world that results in stress or instability.
Boundaries Tension
• The point that differentiates the interior of the • The system’s adjustment to demands,
system from the exterior. change or growth, or to actual
disruptions.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
Instability
• State in which the system output of
energy depletes the energy needed to
maintain stability.
Set
• 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.
Function
• Consequences or purposes of action.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

21 22

7 Subsystems of the Behavior System Model 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 the formation
and maintenance of a strong social bond

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

23 24

4
 26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Dependency Subsystem Ingestive 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.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
• 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.”
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

25 26

Eliminative Subsystem Sexual Subsystem

• Eliminative subsystem states that “human cultures have defined • Sexual subsystem is both a biological
different socially acceptable behaviors for excretion of waste, but and social factor that affects behavior.
the existence of such a pattern remains different from culture to • It has the dual functions of procreation
culture.” and gratification.
• It addresses “when, how, and under what conditions we eliminate.” • Including, but not limited to, courting
• As with the ingestive subsystem, the social and psychological and mating, this response system
begins with the development of
factors are viewed as influencing the biological aspects of this gender role identity and includes the
subsystem and may be, at times, in conflict with the eliminative broad range of sex-role behaviors.
subsystem.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

27 28

Aggressive Subsystem Aggressive Subsystem

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

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

29 30

5
 26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

Aggressive Subsystem Achievement Subsystem

• Aggressive subsystem relates to the • Achievement subsystem provokes behavior that tries to control the
behaviors concerning protection and self- environment.
preservation, generating a defense • It attempts to manipulate the environment.
response when there is a threat to life or
territory. • Its function is control or mastery of an aspect of self or
• Its function is protection and
environment to some standard of excellence.
preservation. • Areas of achievement behavior include intellectual, physical,
• Society demands that limits be placed on creative, mechanical, and social skills.
modes of self-protection and that people
and their property be respected and
protected.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

31 32

Strengths Weaknesses
• Dorothy Johnson’s theory guides nursing practice, • The theory is potentially complex • Though the seven subsystems
education, and research; generates new ideas about
nursing; and differentiates nursing from other health because there are a number of identified by Johnson are said to be
professions. possible interrelationships among the open, linked, and interrelated, there is
• It has been used in inpatient, outpatient, and community behavioral system, its subsystems, and a lack of clear definitions for the
settings as well as in nursing administration. It has always the environment. Potential interrelationships among them which
been useful to nursing education and has been used in relationships have been explored, but makes it difficult to view the entire
practice in educational institutions in different parts of the
world. more empirical work is needed. behavioral system as an entity.
• Another advantage of the theory is that Johnson provided a • Johnson’s work has been used • The problem involving the
frame of reference for nurses concerned with specific client extensively with people who are ill or interrelationships among the concepts
behaviors. It can also be generalized across the lifespan and
across cultures. face the threat of illness. However, its also creates difficulty in following the
• The theory also has potential for continued utility in use with families, groups, and logic of Johnson’s work.
nursing to achieve valued nursing goals. communities is limited.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

33 34

Conclusion Conclusion
• Johnson’s Behavioral System Model describes the person as a • When the behavioral system has
behavioral system with seven subsystems: the achievement, balance and stability, the individual’s
attachment-affiliative, aggressive protective, dependency, ingestive, behaviors will be purposeful,
eliminative, and sexual subsystems. organized, and predictable.
• Each subsystem is interrelated with the others and the environment • Imbalance and instability in the
and specific structural elements and functions that help maintain the behavioral system occur when tension
integrity of the behavioral system. and stressors affect the relationship of
• Through these, the focus of her model is with what the behavior the the subsystems or the internal and
person is presenting making the concept more attuned with the external environments.
psychological aspect of care in.
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

35 36

6
 26/08/2020

DO NOT DISTRIBUTE. | J.SORIANO | TFN - ATENEO DE DAVAO UNIVERSITY

References
1. Alligood, M., & Tomey, A. (2010). Nursing theorists and their work, seventh edition. Maryland
Heights: Mosby-Elsevier.
2. Dorothy E. Johnson Biographical File. (n.d.). Retrieved August 7, 2014, from
https://www.mc.vanderbilt.edu/diglib/sc_diglib/archColl/1014.html
3. Johnson, D. E. (1959a). A philosophy of nursing. Nursing Outlook, 7(4), 198–200.
4. Johnson, D.E. (1968). One conceptual model of nursing. Unpublished lecture, Vanderbilt
University, Nashville, TN.
5. Johnson, D. E. (1980). The behavioral system model for nursing. In McEwen, M. and Wills, E.
(Ed.). Theoretical basis for nursing. USA: Lippincott Williams & Wilkins.

Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN

37