Johnson, Orlando, and the 1950s to 1960s Essay
Dorothy E Johnson and Ida Jean Orlando are some of the nursing theorists who developed their work in the 1950s and 1960s. Their theories are the behavioral system model of nursing and the deliberative nursing process theory, respectively. The theorist of focus in this discussion is Dorothy Johnson. This discussion presents a clinical practice situation that demonstrates Johnson’s model of health and how the nurse can use the theory to support returning the patient to balance and stability.
The behavioral system model of nursing is built on the belief that patients’ illnesses are all caused by ineffective behavioral functioning. The model also emphasizes fostering efficient and effective behavioral functioning to prevent patients’ illnesses. Johnson defined the patient as a behavioral system containing seven subsystems with four structural characteristics. The seven subsystems include affiliative, ingestive, dependency, sexual, eliminative, aggressive and achievement (Walker, 2020). The model also states that every individual has specific purposeful, patterned, and repetitive ways of acting, which form the behavioral system, and makes them unique. The model additionally maintains that the system should be balanced, and an imbalance in any system causes disequilibrium. According to this model, the nurse’s role is to assist the patient in maintaining equilibrium.
Johnson’s model of health has been applied in clinical practice across various sectors. One of the clinical practice situations that demonstrates the application of the Johnsons model of health is when caring for chronically ill patients. Chronically ill patients require care services for a long time. When caring for chronically ill patients, for instance, diabetes patients, Johnson’s behavioral system model can be used to assess and evaluate the effectiveness of nursing interventions. Additionally, the model can be applied to assess whether the patient has changed their behavior occasionally. Change in behavior for the diabetic patient would be demonstrated in things such as engaging in physical exercises, attending check-ups and follow-ups, administering insulin injections for home patients, keeping records of their blood sugar regulation, and seeking medical help when needed. Evgin and Bayat (2020) note that nursing interventions are said to have been effective if the patient has stabilized their behavior to improve health or facilitate healing. Chronically ill patients require constant emotional and psychosocial support, which is one of the provisions of the behavioral model in enhancing behavior change.
Nurses can use the behavioral system theory to support patients in returning to balance and stability by offering emotional support and encouragement to the patient. According to Askar and Ovayolu (2022), in the behavioral system model, nursing practice is the external force that preserves and maintains behavior that would influence physical and social health or cause illness. Holistic nursing practice includes meeting patient needs in all dimensions, including social and emotional needs. Nurses can use Johnson’s behavioral system theory to help patients regain functional balance through openness, creating a nurse-patient relationship of trust, and helping patients deal with their fears concerning the illness.
Furthermore, the nurse can use the theory to support the patient’s stability by creating an environment whereby the patient feels safe, supported and provided with the necessary care to enhance behavior change. In Johnson’s health model, environment entails the human’s behavioral system’s surroundings and the internal stressors that influence behavior. The nurse can improve the patient’s environment and stressors by ensuring the unit is clean and free of noise and unnecessary interruptions. The nurse can help the patient deal with their fears and address their concerns, thus enhancing system balance and stability.
As discussed above, the behavioral system model has been instrumental in nursing practice, especially when caring for chronically ill patients. It enhances holistic nursing practice since the nurse addresses not only the patient’s physical and psychological needs by striving to achieve a behavioral balance. Behavioral balance and stability help achieve and maintain health.
Aşkar, S. E., & Ovayolu, Ö. (2022). Nursing care based on Dorothy Johnson’s Behavioral System Model in Coronary Artery Disease: A case report. Medical Science and Discovery, 9(2), 138-142. https://doi.org/10.36472/msd.v9i2.671
Evgin, D., & Bayat, M. (2020). The Effect of Behavioral System Model Based Nursing Intervention on Adolescent Bullying. Florence Nightingale Journal of Nursing, 28(1), 71–82. https://doi.org/10.5152/FNJN.2020.18061
Walker, L. O. (2020). Gifts of wise women: A reflection on enduring ideas in nursing that transcend time. Nursing Outlook, 68(3), 355-364. https://doi.org/10.1016/j.outlook.2020.01.004
Johnson viewed health as efficient and effective functioning of the system, and as behavioral system balance and stability. Behavioral system balance and stability are demonstrated by observed behavior that is purposeful, orderly, and predictable. Consider a clinical-practice situation that demonstrates Johnsonâ€™s model of health. How can the nurse support this theory to return the patient to balance and stability?