untitled

healthy lifestyle regimen to prevent problems in
later years are all examples where accommodation
not only promotes behavioral system balance, but
also involves a developmental process that results in
the establishment of a higher order or more com-
plex behavioral system.

Hierarchic Interaction

Each behavioral system exists in a context of hier-
archical relationships and environmental relation-
ships. From the perspective of general systems
theory, a behavioral system that has the properties
of wholeness and order, stabilization, and reorga-
nization will also demonstrate a hierarchic struc-
ture (Buckley, 1968). Hierarchies, or a pattern of
relying on particular subsystems, lead to a degree of
stability. A disruption or failure will not destroy the
whole system but leads instead to a decomposition
to the next level of stability.
The judgment that a discontinuity has occurred
is typically based on a lack of correlation between
assessments at two points of time. For example,
one’s lifestyle prior to surgery is not a good fit post-
operatively. These discontinuities can provide op-
portunities for reorganization and development.

Dialectical Contradiction

The last core principle is the motivational force for
behavioral change. Johnson (1980) described these
as drives and noted that these responses are devel-
oped and modified over time through maturation,
experience, and learning. A person’s activities in the
environment lead to knowledge and development.
However, by acting on the world, each person is
constantly changing it and his or her goals, and
therefore changing what he or she needs to know.
The number of environmental domains that the
person is responding to include the biological, psy-
chological, cultural, familial, social, and physical
setting. The person needs to resolve (maintain be-
havioral system balance of ) a cascade of contradic-
tions between goals related to physical status, social
roles, and cognitive status when faced with illness
or the threat of illness. Nurses’ interventions during
these periods can make a significant difference in
the lives of the persons involved. Behavioral system
balance is restored and a new level of development
is attained.
Johnson’s model is unique, in part, because it
takes from both general systems and developmental
theories. One may analyze the patient’s response in

terms of behavioral system balance, and, from a de-

velopmental perspective ask, “Where did this come

from and where is it going?” The developmental

component necessitates that we identify and under-

stand the processes of stabilization and sources of

disturbances that lead to reorganization. These

need to be evaluated by age, gender, and culture.

The combination of systems theory and develop-

ment identifies “nursing’s unique social mission

and our special realm of original responsibility in

patient care” (Johnson, 1990, p. 32).

MAJOR CONCEPTS OF THE MODEL

Next, we review the model as a behavioral system

within an environment.

Person

Johnson conceptualized a nursing client as a behav-

ioral system. The behavioral system is orderly,

repetitive, and organized with interrelated and in-

terdependent biological and behavioral subsys-

tems. The client is seen as a collection of behavioral

subsystems that interrelate to form the behavioral

The client is seen as a collection of behav-

ioral subsystems that interrelate to form

the behavioral system.

system. The system may be defined as “those com-

plex, overt actions or responses to a variety of stim-

uli present in the surrounding environment that

are purposeful and functional” (Auger, 1976, p. 22).

These ways of behaving form an organized and in-

tegrated functional unit that determines and limits

the interaction between the person and environ-

ment and establishes the relationship of the person

to the objects, events, and situations in the environ-

ment. Johnson (1980, p. 209) considered such “be-

havior to be orderly, purposeful and predictable;

that is, it is functionally efficient and effective most

of the time, and is sufficiently stable and recurrent

to be amenable to description and exploration.”

Subsystems

The parts of the behavioral system are called sub-

systems.They carry out specialized tasks or func-

tions needed to maintain the integrity of the whole

behavioral system and manage its relationship to

the environment. Each of these subsystems has a set

82 SECTION II Evolution of Nursing Theory: Essential Influences