Johnson’s Behavioral System Model of Health
Johnson’s behavioral model system is an example of a nursing model that has been efficiently applied in the implementation of the nursing process in the holistic care of patients. This model was formulated by Dorothy Johnson with a view that nurses play a role in behavioral changes in patients that result in wellness. According to Johnson, the behavioral system can be divided into seven subsystems namely, affiliative, achievement, dependence, ingestive, eliminative, aggressive, and sexual subsystems(Karkhah et al., 2020). The balance and stability of these subsystems are equivalent to good health. Disruptions in any of the subsystems, however, cause an imbalance that results in impaired health. It is therefore the role of a nurse to objectively assess the patient’s behavior to identify any dysequilibrium. This will guide decision-making regarding the implementation of the nursing process in a patient-centered approach to support the patient in returning to balance.
Four distinct structural components make up each subsystem of Johnson’s behavioral system model. These include the drive/purpose, the set, the action, and the choice (Aşkar et al., 2022). The motivation and reasons behind one’s behavior may direct one’s choices and actions in arriving at the intended goal of any of the subsystems. If any of these choices are problematic, they result in diagnoses that can be described as insufficiency, incompatibility, discrepancy, or dominance (Aşkar et al., 2022). Nursing interventions and the plan of action are deduced based on these diagnoses.
Nursing professionals are tasked with determination of the presence of conditions that disrupt the subsystems in the behavioral system model. This is achieved from information obtained from the patient. A comprehensive history and physical assessment are done to identify any conditions that may cause an imbalance in the subsystems. Any observable negative patient behavior that may delay the return to good health can also be identified. The healthcare professional can then help the patient attain a behavioral change and implement a management plan that will effectively and efficiently restore the desired balance and stability.
Clinical Practice Situation
Johnson’s behavioral system model can provide a clear framework for nursing practices in the care of patients. This will require additional patient care services in addition to the conventional in-hospital care thus resulting in better quality care. A nursing plan can be designed based on the behavioral system model to manage diabetic patients and promote positive behavior change. The drive in this case scenario will be to adequately control and maintain blood glucose levels within the normal ranges. Another notable drive will be to minimize the risk of diabetes-associated complications.
To achieve the desired goals, a number of actions will need to be put in place. Anti-diabetic medications will be prescribed and will need adherence by the patient. The patient will also be put on a diabetic diet program. Regular exercises and physical activity will also be integral (Yang et al.,2019). Regular blood sugar level monitoring will be used to monitor the treatment progress. Before implementating this treatment plan, the nursing professional will educate the patient regarding the disease, the medications, and the importance of sticking to the treatment plan. Most of these actions will require behavior change by the patient. Any negative behavior will negatively impact the patient’s health outcomes. Through the interaction with the patient, the nurse can identify these negative behaviors and support the patient in changing them to restore health. Aspects that require more focus on the treatment plan will also be determined. Any patient-specific barriers that may impede compliance with the treatment plan will be determined, and appropriate actions are taken. For example, a disabled diabetic patient may not regularly exercise thus their treatment plan may be modified and focus more on medication and dietary modification.
Aşkar, S., & 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
Karkhah, S., Ghazanfari, M., Norouzi, M., Khaleghdoust, T., Dahka, S., Taheri, Z., & ghanbari, a. (2020). Designing a nursing care plan based on Johnson’s behavioral model in patients with wrist joint hematoma: A case study. https://doi.org/10.21203/rs.3.rs-34306/v1
Yang, D., Yang, Y., Li, Y., & Han, R. (2019). Physical exercise as therapy for type 2 diabetes mellitus: From mechanism to orientation. Annals of Nutrition and Metabolism, 74(4), 313-321. https://doi.org/10.1159/000500110
Module 3 Discussion
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 Johnson’s model of health. How can the nurse support this theory to return the patient to balance and stability?