Nursing science is characterized by middle-range theories and conceptual models located at the core of nursing. Theorical frameworks give nurses an organized way of managing their practice which further enables the nurses to guide their care and obtain the best results among the clients. In this paper, a synthesis of the Model of Self-Care Agency, a middle-range nursing theory, and the Behavioral System Model, a conceptual model of nursing, will be made. We will introduce their main ideas, the way they function, and their clinical utility highlighting them.
Johnson Behavioral System Model
Dorothy E. Johnson was the author of the Johnson Behavioral System Model, the application of which is meant for a comprehensive approach to the way people react to stress and how their behaviors affect their health. The concept of the behavioral system perceived as the behaviorally coherent, integrated, and functional individual element serves as the principle of this theory (Wayne, 2023). The Johnson Behavioral System Model portrays the way people react to challenges to regain balance. (Gonzalo, 2020). Dynamic adaptation mechanism maintains equilibrium and ensures living. Equilibrium is disturbed by the stress which subsequently activates the system and results in adaptive or adaptive reactions. The behavioral system is comprised of several sub-systems which can be activated by stress such as attachment, dependency, achievement, and aggression. Stressors – be they internal or external – destroy the harmonious balance of the individual and elicit adaptive responses that reestablish this balance.
Adaptation, which is the capacity of the individual to modify and react properly to stress, according to the Johnson model’s notion, is very important. Adaptation allows the individual to stay on his/ her feet through the maintenance of equilibrium while eliminating obstacles and perturbations. Due to this, it promotes health and life; hence, it is a fundamental concept in nursing. The nursing intervention in this model focuses on helping the client achieve his/ her maximum functional level while coping with stress. The nurses are the ones that play a central role when it comes to assessing, planning, and carrying out behavioral treatments which improve a patient’s behavioral system thereby enabling the adaptive response (Gonzalo, 2020). Nurses administer the evaluation of responses, determination of a pattern of conduct, and supportive interventions that are adaptive and promote health (Wayne, 2023). The Johnson model concentrates on the human behavioral system, which is intrinsic and a dynamic subsystem. Whatever stressors are – external or internal – they disturb the balance of the individual and trigger the behavioral system to act (Gonzalo 2020). The ability to adjust to and cope with stressors is adaptation and such actions will result in the promotion of well-being and balance. Nursing interventions are paramount in alleviating psychobiological stress adaptation and promoting well-being.
Self-care and readmissions due to heart failure are linked to the Johnson Behavioral System model on how people respond to stress and their behavioral patterns that support healthy behaviors. By understanding the interaction of an individual’s behavioral system with stressors (changed lifestyle, medication intake, and psychosocial factors ), nurses can give individualized intervention to promote self-management skills and minimize the chances of readmission due to heart failure. Some examples of nursing interventions to mention are assessment of the patient’s capability of self-care, identifying the factors inhibiting the observance of dietary and drug protocols, and looking for ways to improve self-care. ( Ghorbanzadeh, Badavi, Tohid, & Khorshidi, 2023).
Model of Self-Care Agency
The Johnson Behavioural System Model is enhanced by Dorothea Orem’s Self-Care Agency Model which manipulates elements that affect self-care practices and health outcomes. self-care, an idea or a theoretical framework that encompasses any actions individuals engage in for the maintenance and improvement of their health and quality of life, is central to this method. The activities can include among others practices such as nutrition, exercise, sleeping, and cleanliness. Simultaneously, self-care agency implies that an individual can care for herself/himself the most (Sousa 1,2020). Health literacy includes everything that allows an individual to be the captain of his/her health including knowledge, action, skills as well as resources.
Self-care agency model shows that nursing interventions target to assist people in fulfilling their needs for self-care and developing self-care agency. The nurse is of utmost importance in determining the person’s self-care abilities, highlighting barriers to self-care, and supplying information, support, and guidance. Nurses significantly contribute to better health outcomes and a better quality of life when people manage their health.
The central point of Orm’s idea is self-care, i.e. a strict adherence to medical prescriptions and hygiene rules, proper nourishment, rest, and physical exercise. The capacity to engage oneself in self-care and maintenance activities is called self-care agency and is highly influenced by factors such as knowledge, motivation, skills, available resources as well and structures that provide support and care to individuals (Sousa1, 2020). Environmental factors, social support, and individual traits are all involved in this. Self-care is promoted through the nursing system which involves evaluation of capacities and barriers identification as well as providing counseling, coaching, and guidance. Nurses are facilitators hence enabling individuals to actively participate in their healthcare management.
Nurses will look at external support that already exists and for potential complications such as lack of social support or lack of access to inadequate healthcare services when assessing the self-care capabilities of a person. They altogether construct healthcare programs aimed at promoting self-care, preventing heart failure-related readmission, setting up attainable goals, providing education about disease management, and helping patients overcome obstacles.
Medication compliance, measuring self-parameters, encouraging community resources liaison, as well as counseling with education initiation, are the essence of the interventions. Nurses monitor if these treatments are effective by observing the clinical outcomes, identifying the critical areas that require extra assistance or interventions, and whether a positive change in self-care practices was observed. Nurses can establish the prognosis relevant to self-management and re-admission related to heart failure using the Model of Self-Care Agency. Thus, those who have good self-care agencies probably engage in behaviors that promote health and prevent re-hospitalization. Through perceived control and autonomy, positive patient-provider relations can be developed
Patient satisfaction has also increased. Self-management complements negative care cascade procedures that lessen healthcare use, and reduce hospital readmissions and expenses as well. Finally, heart failure patients may have a better quality of life due to that thought.
Conclusion
The integration of the Model of Self-Care Agency, together with the Johnson Behavioral System Model, thus leads to a systematic and purposefully structured approach to nursing practice. The nursing personnel are capable of assessing, designing, implementing, and evaluating those interventions that influence and contribute to increasing the highest level of quality of life at individual and community levels by knowing the concepts, methods, and implications of these frameworks and the comprehensive approach that combines the response of patients to the stressors and self-care skills promotes individuals to live lives that are healthy and fulfilling.
References
Ghorbanzadeh, M., Khosravirad, Z., Rostamzadeh, M., Azizi, S., Khodashenas, M., Shahraki, B. K., & Ghasemi, F. (2023). The Efficacy of Self-care Behaviors, Educational Interventions, and Follow-up Strategies on Hospital Readmission and Mortality Rates in Patients with Heart Failure: Self-care Behaviors in Heart Failure Patients: Self-care Behaviors in Heart Failure Patients. Galen Medical Journal, 12, e3116–e3116. https://doi.org/10.31661/gmj.v12i.3116
Gonzalo, A. (2020, September 11). Dorothy Johnson: Behavioral system model. Nurseslabs. https://nurseslabs.com/dorothy-e-johnsons-behavioral-system-model/
Sousa1, V. (2020). Conceptual analysis of self-care agency. https://docs.bvsalud.org/biblioref/2020/12/1129232/4811-texto-do-artigo-23747-1-10-20150610.pdf
Wayne, G. (2023). Nursing theories and theorists: An ultimate guide for nurses. Nurseslabs. https://nurseslabs.com/nursing-theories/
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