My specialty area as a DP nurse is comprehensive assessment of the patients using Johnson’s Behavioral System theory that allows me to gain insight into their health-related predispositions and possible issues. Dorothy Johnson proposed with her behavioral system model in 1968 to move away from the concept of human needs and ideas about a person in medical practice. She determined the role of each of a patient’s 7 subsystems in their effort to achieve certain goals based on past experience. The logic of the theory lies in the concept that the result of this effort depends on how the patient perceives their behavior and how they understand their ability to change it.
Johnson’s theory distinguishes between two main types of human behavior: adjustment caused by actions and objects directly around a person, and the attitude created by past habits. Thus, the theory means that an illness or lifestyle changes can unbalance the subsystems of human behavior, therefore, nursing care should be aimed at restoring that balance. The scope of the theory focuses on individual approach to each patient, as imbalance in one subsystem affects the interrelated subsystems differently in different organisms. Thus, to establish a proper algorithm of nursing intervention, the nurse has to assess the specific condition of each subsystem of the patient’s behavior. According to Zaccagnini and Pechacek (2021), “the nurse might act as a regulatory force, enacting controls to restore stability” (p. 18). In any case, the nurse’s detailed plan should establish short-term, intermediate, and long-term goals for rebalancing the subsystems.
The theory, however, proposes a generalized approach to assessing a patient, which supports its usefulness to the practicing nurses. Having established an imbalance in concrete subsystems, the nurse has to team up with the patient to establish the care goals. It is a simple algorithm that can be adjusted and tailored for each individual case, with understandable results that can assist nurse in designing further interventions. The theory can be tested in various settings, as it depends entirely on the nurse’s assessment skills and knowledge of the theoretic background.
This theory can be successfully used to improve the quality of patient assessment in real practice. DP nurses could apply the two-stage assessment to determine functional or organic imbalances affecting the patient, and plan more targeted interventions. It is an effective tool for nursing practitioners that facilitates active engagement of the patient in the process of treatment and promotion of health education.
Reference
Zaccagnini, M. E., & Pechacek, J. M. (2021). The doctor of nursing practice essentials: a new model for advanced practice nursing. Jones & Bartlett Learning.