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Nursing: Dorothy Johnson’s Behavioral System Model


Various nursing theories are used today to find the most optimal approach to patients and to achieve a good quality of rendering medical care to those in need. One of such concepts is Dorothy Johnson’s behavioral system model, which was developed in the second half of the 20th century and implied a set of rules to which nurses should adhere. Today, this theory is quite actively used in many medical institutions and is one of the fundamental models of the junior medical personnel’s work. Therefore, the effectiveness of this concept is proved in practice, and the possibility of its application in medical institutions of different profiles makes it possible to achieve better results in the process of nursing care.

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Meaning of the Theory

According to Johnson’s model, the patient has a set of interconnected subsystems of behavior. It is necessary to consider how the person perceives his or her behavior and how much it can be changed. The first concept of the theory is as follows: particular attention should be drawn to how the patient adapts to specific illness and how stress, real or potential, can affect a person’s ability to adapt.

According to Holaday (2015), the patient is predisposed to a particular type of behavior that is created by different actions and surrounding objects. The second assumption is that a specific way of life is explained by existing habits. Some people can experience discomfort during the course of treatment, being influenced by certain addictions, for example, smoking or excessive food consumption. It means that it is these two concepts that underlie Johnson’s theory.

Both assumptions are inextricably linked to each other. People live in the society, which implies their close communication with one another and often determines a particular type of behavior. Surrounding objects and situations are frequently defining factors in the process of the human traits of character and lifestyle formation. At the same time, as Alligood (2014) claims, behavioral habits formed in childhood and developed in the process of life, also directly influence how precisely this or that person acts. Accordingly, both Johnson’s concepts intersect with each other and are the fundamental aspects of her model.

Origins of the Theory

By the mid-20th century, when Dorothy Johnson first introduced her behavioral model, there was a rather significant difference in opinions in American society, which was mainly acute in residents’ political views. At that time, people were well aware of what rights they had, but due to the insufficiently developed level of medicine, the quality of services sometimes left much to be desired (Masters, 2014).

What concerns nursing care, Johnson developed her theory mainly because the behavior of people who needed specific treatment was often caused by their established habits and personal beliefs. The theorist realized that the sources of patient problems were not only illnesses but also changes in lifestyle and behavior related to the surrounding social environment. It was this evidence that Johnson cited as support for her theory, based on personal experience and long-term communication with patients from different social groups.

The motives that prompted the author to develop the theory are quite obvious: she sought to bring to the public the fact that the existing order of life is one of the basic factors that determines patients’ problems. In her work, Johnson used a regulation and control approach to ensure the stability of patients. This model of nursing care is called behavioral, and its fundamental theses are quite reasonable and justified.

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Usefulness of the Theory

Johnson’s nursing theory is useful in practice because it allows junior medical personnel to provide not only physical but also psychological support to the patient, as well as inhibit inadequate behavior caused by this or that reason. This model makes it possible to change the motives of behavior created by existing experience and adjust the settings shaped by the environment. Through specific interventions, nurses use the behavioral model to protect patients and simultaneously stimulate their emotional state, trying to create a psychological contact with people (Bluhm, 2017).

Such a theory is relevant and practical today as the rapid movement of society towards progress often negatively affects the mental state of people. The advantage of the model is that any person can get qualified nursing care that aims not only at patients’ adaptation, for example, after a severe trauma but also at improving emotional well-being.

Also, Johnson’s theory allows partially predicting the results of treatment and imagining what emotional problem the patient is experiencing, and what measures should be taken to eliminate it. Targeted work on changing behavioral motives of people is sufficient when a medical worker has a full understanding of what type of disorders a specific patient is experiencing and what exactly concerns him or her. Such a nursing model can be used, for example, in departments where people undergo rehabilitation after a severe trauma or surgery. As a rule, such patients experience depressive moods and are prone to a depressed emotional state.

The task of the nurse, in this case, will be to assess the degree of the patient’s concern and take necessary measures to ensure that the recovery period passes as quickly as possible. Also, this practice will help protect people from ill-considered and dangerous acts and make them adapt to temporary living conditions in a medical institution.

Testability of the Theory

It is necessary to assess the patient’s condition concerning each subsystem of behavior to determine the type of intervention and learn how much Johnson’s theory is testable. The success of work depends on how competently and timely the nurse defines the imbalance in the subsystems of patients’ behavior and their causes. The effectiveness of this model can be checked in practice in any medical institution where there are patients who experience behavioral disorders and stresses caused by different factors.

Johnson’s theory has become quite popular in the medical environment and has generated various types of research, including multiple analyses of its effectiveness, as well as possible modifications in the algorithm of nursing care. It generated various qualitative studies on the usefulness of its implementation and comparison with other nursing theories. One of these studies was conducted by Arora (2015) who considered this model in connection with other theories and evaluated its effectiveness and the possibility of application in modern conditions. The results of the research confirmed that Johnson’s concepts are relevant and can be used as one of the methods of complex treatment of patients’ behavioral disorders.

Author’s propositions relate to how the described model can be used to care for patients for short, intermediate, and long-term purposes (Arora, 2015). Also, the author claims that nursing intervention can limit inadequate behavior, protect the patient from adverse environmental factors, and suppress negative and inadequate responses to specific situations (Arora, 2015). Thus, the theory is testable and justified from the point of view of its efficiency.

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Overall Evaluation of the Theory

A described theory is specific enough to apply it in practice in specialized medical institutions without the necessity to change any of its provisions. In a general sense, Johnson’s model reflects the order in which nurses work with patients who experience behavioral problems. However, the concepts that are included in the theory are entirely accurate and suitable for working with people at different stages.

The strength of the model is the possibility of its application for a variety of cases, including both severe behavioral disorders and less severe deviations. Moreover, Johnson’s theory allows nurses to assess the psycho-emotional state of each patient thoroughly and draw the right conclusions based on the information obtained (McEwen, 2014). Perhaps, its only weakness is that it is suitable for treating behavioral problems and cannot be used in other cases, for example, to provide physical assistance.

The use of this theory in advanced personal practice helps to assess the patient’s condition from a professional point of view and draw the appropriate conclusions regarding the optimal course of treatment. Furthermore, this model is universal and suitable for patients with different behavioral problems. Nurses following the described concepts can achieve efficient results of treatment and gain the patients’ and leaders’ trust.


Thus, the effectiveness of Johnson’s system model is proved in practice. The theory is useful and relevant and can be applied in various medical institutions for patients with some behavioral disorders. The concepts are testable and have been a basis for scientific research. The practical benefits of the model are manifested in various advantages and can be of considerable help in the nursing care process. The implementation of the theory helps to achieve particular professional success and gain recognition among patients.


Alligood, M. R. (2014). Nursing theorists and their work (8th ed.). Sent Louis, MO: Elsevier.

Arora, S. (2015). Integration of nursing theories in practice. International Journal of Nursing Science Practice and Research, 1(1), 8-12.

Bluhm, R. (2017). Nursing theory, social theory, and philosophy of science. In M. Lipscomb (Ed.), Social theory and nursing (pp. 35-59). New York, NY: Routledge.

Holaday, B. (2015). Dorothy Johnson’s behavioral system model and its applications. In M. C. Smith & M. E. Parker (Eds.), Nursing theories and nursing practice (4th ed.) (pp. 89-104). Philadelphia, PA: F.A. Davis Company.

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Masters, K. (2014). Nursing theories: A framework for professional practice (2nd ed.). Burlington, MA: Jones & Bartlett Publishers.

McEwen, M. (2014). Theoretical frameworks for research. In G. Lobiondo-Wood & J. Haber (Eds.), Nursing research-e-book: Methods and critical appraisal for evidence-based practice (9th ed.) (pp. 66-87). Sent Louis, MO: Elsevier.

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