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Brief overview of the theory
Dorothy Johnson was among the first “grand theorists” with the views of a conceptual model (Callista Roy, 2013). Her model was the first to consider both the understanding as well as action in healthcare. Actually, the Johnson Behavioral System Model (JBSM) was developed from the philosophical ideas, theories, and researches, as well as thoughts of many years. The model is comprised of a behavioral system (person) that is present within an environment consisting of physical, interpersonal, and sociocultural components. These environmental components are necessary for better functioning of the behavioral system (Smith & Parker, 2015).
There are five basic principles of system thinking in the Johnson’s model. Those principles include wholeness as well as order for continuity and identity, stabilization for the process of development, hierarchic interaction for the process of discontinuity, reorganization for the growth and development and/or change, and dialectical contradiction for motivation. According to the Johnson’s ideas, human body is actually an open system having several interrelated, organized, and interdependent subsystems: ingestive, affiliative, eliminative, dependency, achievement, sexual, and aggressive subsystems, and interaction of these subsystems make a human organism. No part of the body can work without the work of other part. JBSM helps in finding common organizational parameters in almost every scientific explanation by using a shared language of nursing as well as nursing care (Smith & Parker, 2015).
Meaning of theory and its utilization in actual practice
This theory of JBSM deals with the complexity as well as richness of the nursing profession. It is advocating the development of effective and efficient behavioral functioning in patients to prevent their illness. Actually, an individual is often unable to work on subsystem tasks, and the nurse could help the person in the development or restoration of the tasks and this restoration finally lead to the optimal functioning behavior. The process of JBSM in nursing practice starts with an assessment of the patient. Nurses and other healthcare experts, initially, diagnose the problems of the patient, and then they develop a nursing care plan of interventions and start working on that plan. This model can best be applied in the evaluation phase in which a nurse can check the presence of balance within the subsystems in a patient. If the nurse successfully develops equilibrium in the behavioral system and helps in dealing with the biological illness, he or she is considered successful in his or her role.
Nursing situation
This theory can be illustrated further with the help of an example case. Suppose, a man, having the age of 68 years, has been admitted to a hospital with the problem of abdominal pain and blood in the stool. He is also facing hypertension and type II diabetes, and taking antihypertensives, anti-inflammatory, anticoagulant, and antidiabetic medications. He also faced acute cerebral vascular accident, a few weeks ago, that resulted in partial paralysis and numbness of the left leg and arm, and slurred speech. After some rehabilitation, he was able to walk with little assistance. With encouragement of the family, he was able to eat small portions of meal and drink fluids. The patient is a college graduate. He is married for more than 40 years and has three adult children living in the same city. He is a leader in the social community, and his friends and family members keep on visiting him in the hospital. He meets cheerfully with all of them. However, he is worried about the travelling of his wife and her eating schedule.
Behavioral assessment of the patient shows that he has achieved many progressive goals of life, thereby showing better achievement subsystem. His contact with wife and children, and his affiliation with friends and social community show a better affiliative-attachment subsystem. His aggressive-protective subsystem needs work as he is worried about his wife. His dependency subsystem also needs work as he is dependent on others, especially after paralysis and disturbance in the left arm and leg. He is also good at ingestive subsystem as he is eating his meals. His eliminative subsystem is also good as he can urinate without any difficulty. However, his sexual subsystem is disturbed. Some of the environmental factors such as additional stress to the weakened behavioral system and stroke are disturbing the balance and stability of the behavioral system. Therefore, working on these environmental factors could help in improving the situation of the patient.
Concluding Remarks
JBSM works on the patients in a rational way, but it has some weakness or limitations as, for example, this theory is unable to deal with physically impaired patients. Moreover, it would be difficult to deal with a group of patients on the basis of this theory, and it is not flexible in nature and cannot be adapted for utilization in different complicated situations. In the theory, Johnson has also not clearly described the interrelationship of subsystems. On the other hand, the theory can be used across the lifespan and in different cultures, which is among the strengths of the theory. It is also useful for nurses as it has provided a frame of reference for nurses dealing with specific client behaviors. It is also important for nursing profession as it helps in differentiating nursing from other professions.
References
Callista Roy, P. D. R. N. F. (2013). Generating Middle Range Theory: From Evidence to Practice: Springer Publishing Company.
Smith, M. C., & Parker, M. E. (2015). Nursing Theories and Nursing Practice: F. A. Davis Company.
