Johnson’s Behavioral System Model
Introduction
Nowadays, health care providers use various methodologies for the improvement of the quality of patients’ treatment. One of such methodologies is Johnson’s Behavioral System Model. The current work provides a general description of this model with the emphasis on its concepts, propositions, and structure. Several examples of its application provide understanding of its considerable benefits to both patients and health care providers. The purpose of the presentation is the exploration of Johnson’s Behavioral System Model and its use in the clinical practice and research.
Objectives of the Presentation
The general objective of the current presentation is description of Johnson’s Behavioral System Model and its application in real-life situations with a view to showing its effectiveness in the establishment of regularities in patient’s behavior directed at the improvement of personal health. The exploration of the concepts of this model and its influence on the patient is aimed at bringing understanding of the necessity of application of this method of treatment in the practice of nurses.
Primary Concepts of Johnson’s Behavioral System Model
Johnson’s Behavioral System Model is the model of nursing care that “presents the view of the client as a living open system” (Alligood, 2014). This model is developed on the understanding of common human needs like comfort, care, and reduction of stress and tension. It advocates the stipulation and fostering of effective behavioral functioning of the patient for the prevention of various illnesses. The patient’s behavior is considered as the mix of seven subsystems: “affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement” (Alligood, 2014).
Propositions of Johnson’s Behavioral System Model
It is recommended for health care providers (especially nurses) to perform a systematic review of the patient’s behavior (Alligood, 2014). They should pay attention to the assessment of the patient’s subsystems for understanding behavior of the patient, proper determination of existing problems, and application of treatment methodologies, which can lead to the improvement of the patient’s condition.
Dorothy Johnson made the proposition to maintain, restore, or attain balance “in the behavioral system or in the system as a whole” (Alligood, 2014). The role of health care providers is the modification of the structure of these subsystems or their components for the improvement of the health condition of the patient. The modification is performed in the form of reparing of damaged structural units. Health care providers play the role of regulators or controllers in this process. Besides, they can help the patient to develop or increase the strength of these substructures. Additional attention should be paid to the fact that health care providers should have sufficient knowledge and skills for proper determination of existing damaged structural units of behavior, performance of the effective repairing process, and prediction of outcomes of the treatment.
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Structure of Johnson’s Behavioral System Model
As it has been stated above, behavior of the patient consists of seven various subsystems. Affiliation subsystem serves for the security of the individual through intimacy and social inclusion. Dependency subsystem is necessary for obtaining recognition, attention, and assistance from other individuals. Ingestive subsystem serves for the fulfillment of the need to cover biological requirements of the organism. Eliminative subsystem serves for the excretion of wastes. Such functions as procreation and reproduction are regulated by sexual subsystem. The individual’s preservation and social protection are granted by aggressive subsystem. The last behavioral subsystem is achievement. It is necessary for self-control.
It is notable that there are various characteristics of patient’s behavior, which have a considerable influence on the patient’s condition. These characteristics are the following: repetitiveness, regularity, predictability, and direction at reaching particular goals (Alligood, 2014). These characteristics should be strived to be brought into the balanced condition with the help of health care providers (Alligood, 2014).
Each of these subsystems has the goal that is based on the following factors: “universal drive, set, choice, and action” (Alligood, 2014). The universal drive represents the background of the goal of the subsystem. Different individuals have various goals, which depend on their values. The set represents “the tendency to act in a certain way in a given situation” (Alligood, 2014). This relatively stable formation is influenced greatly by social norms, culture, family, perceptions, etc. The set of alternative behaviors considered by the individual in any situation is known as the choice. The last factor is action. It reflects the observable behavior of the patient. All of these factors have the direct contribution to the activity of the individual.
Evidence-based Application of Johnson’s Behavioral System Model
Nurses, which apply Johnson’s Behavioral System Model, usually direct their efforts to the decrease of human sufferings by the change of existing behaviors or facilitation of the development of the new ones. An example of successful implementation of psychological intervention is used for supporting women to stop smoking during pregnancy. This particular case is considered to be the evidence-based example of the application of the described model because it shows the analysis of health care providers of the described subsystems (for the determination of reasons of smoking) and taking an active role in the smoking abstinence. The research described in the article on psychosocial interventions used for supporting women to stop smoking during pregnancy involved over 29,000 pregnant women who stopped smoking in late pregnancy (Chamberlain et al., 2013). The emphasis was made on the application of various interventive strategies like counselling. Health care providers assessed their understanding of patient’s perceptions and needs (like social inclusion, attention, preservation, etc.). As it has been mentioned in the article, “issues around smoking in pregnancy are complicated by the intersection of gender, where a woman’s role is seen primarily as a ‘reproducer’” (Chamberlain et al., 2013). Hence, women feel that they lack control in their lives. Besides, much attention should be paid to the fact that various stresses are considered as the major cause of smoking of pregnant women during these studies. That is why, the intervention was directed on the minimization of the feelings of the lack of control and stresses. Some psychological interventions used in this study were self-help exercises, individual behavior councelling, motivational interventions, nursing and physician advices, interventions to reduce non-cigarette tobacco use, etc. (Chamberlain et al., 2013). According to the outcomes of this research, counselling has a considerable positive effect on women who smoked during pregnancy (about 55% stopped smoking) (Chamberlain et al., 2013). According to additional studies provided in the article “Facilitators and Barriers to Effective Smoking Cessation: Counselling Services for Inpatients from Nurse-Counsellors’ Perspectives — A Qualitative Study”, during the realization of the smoking cessation program additional attention should be paid to specific needs of each patient and environment: “an effective smoking cessation program should be patient-centered and provide a supportive environment” (Li et al., 2014). It should also be noted that this methodology is successful for the facilitation of smoking cessation for patients with various illnesses like lung cancer (Nishihara et al., 2013).
Student-Developed Clinical Application in Autonomous Nursing Practice
The current work will show how Johnson’s Behavioral System Model can be applied by students in the nursing practice autonomously. It means that these individuals should have enough professional knowledge and skills to make correct decisions freely. They should clearly understand that the nursing profession is rapidly changing because of the development and realization of new methods of treatment. Furthermore, they should apply various treatment methodologies to different patients because each patient has unique needs. The work “The meaning of autonomy in nursing practice” describes the process of exploring education and work qualification of nursing students who intend to become professionals in these fields. This work is based on the application of “the qualitative hermeneutic approach, inspired by Ghadames’s philosophy, guided the research process and the analysis and interpretation of the transcribed interview-texts” (Skar, 2010). The outcomes of this work show that students should “have a holistic view, to know the patient, you know that you know and to dare” (Skar, 2010). John Rowe (2010) provided the following understanding of the concept “to know what you know”: “knowledge about the patient’s medical condition and the confidence about the assessment and interventions”. This knowledge provides an ability to make correct decisions, freely make clinical judgements, and establish friendly professional relationships with patients that facilitate improvement of their health condition.
Reflection on the Impact of Johnson’s Behavioral System Model
Application of Johnson’s Behavioral System Model has a considerable positive impact on quality and effectiveness of treatment. It helps to understand patients’ needs and problems correctly, determine health issues and their causes, and apply appropriate methodologies of treatment for gaining the best possible result. The stated example of smoking abstinence of pregnant women shows the success of the use of this method in the development and support of preventive behavior. Besides, Johnson’s Behavioral System Model is extremely beneficial for students who want to be professionals in nursing. It helps them to understand patients’ needs and perform effective treatment.
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Conclusion
The current work describes concepts, propositions, and structure of Johnson’s Behavioral System Model. According to this nursing model, patient’s behavior consists of seven subsystems (affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement). Each of these systems has several factors (universal drive, set, choice, and action) and depends on the outer environment and the inherent condition of an individual. That is why, nurses should take into consideration all these systems and factors for the correct analysis of patient’s condition and application of the most appropriate way of treatment. The application of Johnson’s Behavioral System Model is shown on the example of the smoking cessation of pregnant women. It should be noted that this method of nursing care is beneficial both for patients and nurses (especially students).
