Florence Nightingale (Environmental Theory)

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THEORIES OF NURSING

Florence Nightingale
(Environmental theory)
Florence nightingale, OM, RRC, dstj (12 may 1820 – 13 august 1910)
was an english social reformer and statistician, and the founder of
modern nursing.
Nightingale came to prominence while serving as a manager and trainer
of nurses during the crimean war, in which she organised care for
wounded soldiers.[3] she gave nursing a favourable reputation and
became an icon of victorian culture, especially in the persona of "the
lady with the lamp" making rounds of wounded soldiers at night

Florence Nightingale
(Environmental theory)
She stated in her nursing notes that nursing "is an act of
utilizing the environment of the patient to assist him in his
recovery" (nightingale 1860/1969),[3] that it involves the nurse's
initiative to configure environmental settings appropriate for
the gradual restoration of the patient's health, and that
external factors associated with the patient's surroundings
affect life or biologic and physiologic processes, and his
development

Florence Nightingale
(Environmental theory)
Pure fresh air- "to keep the air he breathes as pure as the external air without
chilling him/her."
Pure water- "well water of a very impure kind is used for domestic purposes. And
when epidemic disease shows itself, persons using such water are almost sure to
suffer."
Effective drainage- "all the while the sewer maybe nothing but a laboratory from
which epidemic disease and ill health is being installed into the house."
Cleanliness- "the greater part of nursing consists in preserving cleanliness."
Light(especially direct sunlight)- "the usefulness of light in treating disease is very
important."[5]
Any deficiency in one or more of these factors could lead to impaired functioning
of life processes or diminished health status.[6]

The factors posed great significance during nightingale's time, when


health institutions had poor sanitation, and health workers had little
education and training and were frequently incompetent and unreliable
in attending to the needs of the patients. Also emphasized in her
environmental theory is the provision of a quiet or noise-free and warm
environment, attending to patient's dietary needs by assessment,
documentation of time of food intake, and evaluating its effects on the
patient.[7]
Nightingale's theory was shown to be applicable during the crimean
war when she, along with other nurses she had trained, took care of
injured soldiers by attending to their immediate needs, when
communicable diseases and rapid spread of infections were rampant in
this early period in the development of disease-capable medicines. The
practice of environment configuration according to patient's health or
disease condition is still applied today, in such cases as patients
infected with clostridium tetani (suffering from tetanus), who need
minimal noise to calm them and a quiet environment to prevent
seizure-causing stimulus.
Ernestine Weidenbach
( Helping art of a clinical Nursing)
B.A. From wellesley college in 1922
R.N. From johns hopkins school of nursing in 1925
M.A. From teachers college, columbia university in 1934
Certificate in nurse-midwifery from the maternity center
association school for nurse-midwives in new york in
1946..
Career:
Wiedenbach joined the yale faculty in 1952 as an instructor in
maternity nursing.
Assistant professor of obstetric nursing in 1954 and an
associate professor in 1956.
She wrote family-centered maternity nursing in 1958.
She was influenced by ida orlando in her works on the
framework.
She died on march 8, 1998.
Concepts and definitions
He patient
"Any individual who is recieving help of some kind, be it care, instruction or advice
from a member of the health profession or from a worker in the field of health."
The patient is any person who has entered the healthcare system and is receiving
help of some kind, such as care, teaching, or advice.
The patient need not be ill since someone receiving health-related education
would qualify as a patient.
A need-for-help
A need-for-help is defined as "any measure desired by the patient that has the
potential to restore or extend the ability to cope with various life situations that
affect health and wellness.
It is crucial to nursing profession that a need-for-help be based on the individual
perception of his own situation.

Nurse
The nurse is functioning human being.
The nurse no only acts, but thinks and feels as well.
Knowledge
Knowledge encompasses all that has been percieved and grasped by
the human mind.
Knowledge may be :
• Factual
• Speculative or
• Practical
Judgment
Clinical judgment represents the nurse’s likeliness to make sound
decisions.
Sound decisions are based on differentiating fact from assumption and
relating them to cause and effect.
Sound judgment is the result of disciplined functioning of mind and
emotions, and improves with expanded knowledge and increased
clarity of professional purpose.

Nursing skills
Nursing skills are carried out to achieve a specific patient-centered
purpose rather than completion of the skill itself being the end goal.
Skills are made up of a variety of actions, and characterized by harmony
of movement, precision, and effective use of self.
Person
Each person (whether nurse or patient), is endowed with a unique
potential to develop self-sustaining resources.
People generally tend towards independence and fulfillment of
responsibilities.
Self-awareness and self-acceptance are essential to personal integrity
and self-worth.
Whatever an individual does at any given moment represents the best
available judgment for that person at the time.
Key elements
Wiedenbach proposes 4 main elements to clinical
nursing.
A philosophy
A purpose
A practice and
The art.

The philosophy
The nurses' philosophy is their attitude and belief about
life and how that effected reality for them.
Wiedenbach believed that there were 3 essential
components associated with a nursing philosophy:
• Reverence for life
• Respect for the dignity, worth, autonomy and
individuality of each human being and
• Resolution to act on personally and professionally held
beliefs.
The purpose
Nurses purpose is that which the nurse wants to
accomplish through what she does.
It is all of the activities directed towards the overall good
of the patient.
The practice
Practice are those observable nursing actions that are
affected by beliefs and feelings about meeting the
patient’s need for help.
The art
The art of nursing includes
• Understanding patients needs and concerns
• Developing goals and actions intended to enhance patients ability and
• Directing the activities related to the medical plan to improve the patients condition.
The nurses also focuses on prevention of complications related
to reoccurrence or development of new concerns.

Jean Watson
( Philosophy and Science of Caring)
Jean Watson is an American nurse theorist and
nursing professor who is best known for her
Theory of human caring. She is the author of
numerous texts, including Nursing: The
Philosophy and Science of Caring. Watson's
research on caring has been incorporated into
education and patient care at hundreds of
nursing schools and healthcare facilities across
the world
She refers to the human being as "a valued
person in and of him or herself to be cared for,
respected, nurtured, understood and assisted;
in general a philosophical view of a person as a
fully functional integrated self. Human is
viewed as greater than and different from the
sum of his or her parts."

Health is defined as a high level of overall


physical, mental, and social functioning; a
general adaptive-maintenance level of daily
functioning; and the absence of illness, or the
presence of efforts leading to the absence of
illness.
Watson's definition of environment/society addresses
the idea that nurses have existed in every society, and
that a caring attitude is transmitted from generation to
generation by the culture of the nursing profession as a
unique way of coping with its environment.

The nursing model states that nursing is concerned with


promoting health, preventing illn ess, caring for the sick,
and restoring health. It focuses on health promotion, as
well as the treatment of diseases. Watson believed that
holistic health care is central to the practice of caring in
nursing. She defines nursing as "a human science of
persons and human health-illness experiences that are
mediated by professional, personal, scientific, esthetic
and ethical human transactions."
The nursing process outlined in the model contains the same
steps as the scientific research process: assessment, plan,
intervention, and evaluation. The assessment includes
observation, identification, and review of the problem, as well
as the formation of a hypothesis. Creating a care plan helps the
nurse determine how variables would be examined or
measured, and what data would be collected. Intervention is
the implementation of the care plan and data collection.
Finally, the evaluation analyzes the data, interprets the results,
and may lead to an additional hypothesis.
Watson's model makes seven assumptions:

Caring can be effectively demonstrated and practiced only


interpersonally.
Caring consists of carative factors that result in the satisfaction of
certain human needs.
Effective caring promotes health and individual or family growth.
Caring responses accept the patient as he or she is now, as well as what
he or she may become.
A caring environment is one that offers the development of potential
while allowing the patient to choose the best action for him or herself
at a given point in time.
A science of caring is complementary to the science of curing.
The practice of caring is central to nursing.
The first three carative factors are the "philosophical foundation" for
the science of caring, while the remaining seven derive from that
foundation. The ten primary carative factors are:
The formation of a humanistic-altruistic system of values, which begins
at an early age with the values shared by parents. The system of values
is mediated by the nurse's life experiences, learning gained, and
exposure to the humanities. It is perceived as necessary to the nurse's
maturation which in turn promotes altruistic behavior toward others.
The installation of faith-hope, which is essential to the carative and
curative processes. When modern science has nothing else to offer a
patient, a nurse can continue to use faith-hope to provide a sense of
well-being through a belief system meaningful to the individual.

3. The cultivation of sensitivity to one's self and to others, which


explores the need of nurses to feel an emotion as it presents itself. The
development of a nurse's own feeling is needed to interact genuinely
and sensitively with patients. By striving to become more sensitive, the
nurse is more authentic. This encourages self-growth and self-
actualization in both the nurse and the patients who interact with the
nurse. The nurses promote health and higher-level functioning only
when they form person-to-person relationships.

4. The development of a helping-trust relationship, which includes


congruence, empathy, and warmth. The strongest tool a nurse has is his
or her mode of communication, which establishes a rapport with the
patient, as well as caring by the nurse. Communication includes verbal
and nonverbal communication, as well as listening that connotes
empathetic understanding.

5. The promotion and acceptance of the expression of both positive and


negative feelings, which need to be considered and allowed for in a
caring relationship because of how feelings alter thoughts and
behavior. The awareness of the feelings helps the nurse and patient
understand the behavior it causes.

6. The systematic use of the scientific method for problem-solving and


decision-making, which allows for control and prediction, and permits
self-correction. The science of caring should not always be neutral and
objective.

7. The promotion of interpersonal teaching-learning, since the nurse


should focus on the learning process as much as the teaching process.
Understanding the person's perception of the situation assists the
nurse to prepare a cognitive plan.

8. The provision for a supportive, protective and/or corrective mental,


physical, socio-cultural, and spiritual environment, which Watson
divides into interdependent internal and external variables,
manipulated by the nurse in order to provide support and protection
for the patient's mental and physical health. The nurse must provide
comfort, privacy, and safety as part of the carative factor.

9. Assistance with satisfying human needs based on a hierarchy of


needs similar to Maslow's. Each need is equally important for quality
nursing care and the promotion of the patient's health. In addition, all
needs deserve to be valued and attended to by the nurse and patient.

10. The allowance for existential-phenomenological forces, which helps


the nurse to reconcile and mediate the incongruity of viewing the
patient holistically while at the same time attending to the hierarchical
ordering of needs. This helps the nurse assist the patient to find
strength and courage to confront life or death. Phenomology is a way
of understanding the patient from his or her frame of reference.
Existential psychology is the study of human existence.
• Watson's hierarchy of needs begins with lower-order biophysical needs, which include the
need for food and fluid, elimination, and ventilation. Next are the lower-order
psychophysical needs, which include the need for activity, inactivity, and sexuality. Finally, are
the higher order needs, which are psychosocial. These include the need for achievement,
affiliation, and self-actualization.

Dorothea Orem
( Self-Care Deficit theory)
The Self-Care Deficit Theory developed as a result of Dorothea E. Orem
working toward her goal of improving the quality of nursing in general
hospitals in her state. The model interrelates concepts in such a way as
to create a different way of looking at a particular phenomenon. The
theory is relatively simple, but generalizable to apply to a wide variety
of patients. It can be used by nurses to guide and improve practice, but
it must be consistent with other validated theories, laws and principles.

The major assumptions of Orem's Self-Care Deficit Theory are:


People should be self-reliant, and responsible for their care, as well as
others in their family who need care.
People are distinct individuals.
Nursing is a form of action. It is an interaction between two or more
people.
Successfully meeting universal and development self-care requisites is
an important component of primary care prevention and ill health.
A person's knowledge of potential health problems is needed for
promoting self-care behaviors.
Self-care and dependent care are behaviors learned within a socio-
cultural context.
Orem's theory is comprised of three related parts: theory of self-care; theory of
self-care deficit; and theory of nursing system.
The theory of self-care includes self-care, which is the practice of activities that an
individual initiates and performs on his or her own behalf to maintain life, health,
and well-being; self-care agency, which is a human ability that is "the ability for
engaging in self-care," conditioned by age, developmental state, life experience,
socio-cultural orientation, health, and available resources; therapeutic self-care
demand, which is the total self-care actions to be performed over a specific
duration to meet self-care requisites by using valid methods and related sets of
operations and actions; and self-care requisites, which include the categories of
universal, developmental, and health deviation self-care requisites.

Universal self-care requisites are associated with life processes,


as well as the maintenance of the integrity of human structure
and functioning. Orem identifies these requisites, also called
activities of daily living, or ADLs, as:
the maintenance of sufficient intake of air, food, and water
provision of care associated with the elimination process
a balance between activities and rest, as well as between solitude and
social interaction
the prevention of hazards to human life and well-being
the promotion of human functioning
Developmental self-care requisites are associated with developmental processes. They are
generally derived from a condition or associated with an event.

Health deviation self-care is required in conditions of illness, injury, or


disease. These include:
Seeking and securing appropriate medical assistance
Being aware of and attending to the effects and results of pathologic
conditions
Effectively carrying out medically prescribed measures
Modifying self-concepts to accept onseself as being in a particular state
of health and in specific forms of health care
Learning to live with the effects of pathologic conditions.
The second part of the theory, self-care deficit, specifies when nursing
is needed. According to Orem, nursing is required when an adult is
incapable or limited in the provision of continuous, effective self-care.
The theory identifies five methods of helping: acting for and doing for
others; guiding others; supporting another; providing an environment
promoting personal development in relation to meet future demands;
and teaching another.

The theory of nursing systems describes how the patient's self-care


needs will be met by the nurse, the patient, or by both. Orem identifies
three classifications of nursing system to meet the self-care requisites
of the patient: wholly compensatory system, partly compensatory
system, and supportive-educative system.
Orem recognized that specialized technologies are usually developed by members
of the health care industry. The theory identifies two categories of technologies.

The first is social or interpersonal. In this category, communication is adjusted to


age and health status. The nurse helps maintain interpersonal, intra-group, or
inter-group relations for the coordination of efforts. The nurse should also
maintain a therapeutic relationship in light of pscyhosocial modes of functioning
in health and disease. In this category, human assistance adapted to human
needs, actions, abilities, and limitations is given by the nurse.

The second is regulatory technologies, which maintain and promote life


processes. This category regulates psycho- and physiological modes of functioning
in health and disease. Nurses should promote human growth and development,
as well as regulating position and movement in space

Orem's approach to the nursing process provides a method to determine the self-
care deficits and then to define the roles of patient or nurse to meet the self-care
demands. The steps in the approach are thought of uas the technical component
of the nursing process. Orem emphasizes that the technological component
"must be coordinated with interpersonal and social pressures within nursing
situations.
The nursing process in this model has three parts. First is the assessment, which
collects data to determine the problem or concern that needs to be addressed.
The next step is the diagnosis and creation of a nursing care plan. The third and
final step of the nursing process is implementation and evaluation. The nurse sets
the health care plan into motion to meet the goals set by the patient and his or
her health care team, and, when finished, evaluate the nursing care by
interpreting the results of the implementation of the plan.

Myra Estrin Levine


( The conservation model)
A major influence in the nursing profession) set out to find a new and effective
method for teaching nursing degree students major concepts and patient care.
Levine's goal was to provide individualized and responsive patient care, that was
less focused on medical procedures, and more on the individual patient's context.
This led to the creation of a new nursing theory and approach to patient care

The main focus of levine’s conservation model is to promote the physical and
emotional well being of a patient, by addressing the four areas of conservation
she set out. By aiming to address the conservation of energy, structure, and
personal and social integrity, levine's model helps guide nurses in provision of
care that will help support the client's health.[3] though conservation of physical
and emotional well being is the most vital part of attaining a successful outcome
for patients, two additional concepts, adaptation and wholeness, are also
extremely important in a patient's health;
Adaptation- adaptation consists of how a patient adapts to the realities
of their new health situation- the better a patient can adapt to changes
in health, the better they are able to respond to treatment and care.

Wholeness - the concept of wholeness maintains that a nurse must


strive to address the client's external and internal environments. This
allows the client to be viewed as a whole person, and not just an illness.
Conservation -the product of adaptation; “Conservation describes the
way complex systems are able to continue to function even when
severely challenged”. Conservation allows individuals to effectively
respond to the changes their body faces, while maintaining their
uniqueness as a person

The central concept of Levine’s theory is conservation. When a person is


in a state of conservation, it means that individual has been able to
effectively adapt to the health challenges, with the least amount of
effort.
Myra Levine described the Four Conservation Principles. These
principles focus on conserving an individual's wholeness:
Conservation of energy: Making sure the client does not expend too
much energy, through rest and exercise.
Example: Making sure one's client gets enough sleep and balanced
nutrition.
Conservation of structural integrity: Doing activities or tasks that will
aid in the client's physical healing
Example: Helping the client stay active and promoting good personal
care.

Conservation of personal integrity: Helping clients maintain uniqueness


and individuality
Example: Giving clients choice in how to receive care.

Conservation of social integrity: Assisting the patient in maintaining


social and community ties will increase their support system during
their time in hospital, and will also help the client's sense of self-worth.
Example: Making a pastor available to maintain religious ties during
hospitalization

Nursing Process Using Levine’s Model


Assessment- The collection of facts, by way of interviews and
observation with the patient (considering conservation principles)

Judgement (Trophicognosis)- The application of nursing diagnoses


which will provide the collected facts with meaning in the context of
the patient’s circumstance.

Hypotheses- The application of interventions that aim to maintain the


patient’s wholeness and promote their adaptation in the current
situation

Interventions- The use of interventions will test the nurse’s hypotheses

Evaluation- Assessment of the client’s responses to imposed


interventions.
Assessment- The nurse will observe and speak with the patient,
in conjunction with medical reports, results and diagnostic
studies to gather information- referred to as the collection of
provocative facts.
Patients will be assessed for challenges to their external and
internal environments that may impede their ability to achieve
complete wellness and health. Areas focused on which may
present such challenges are:
Energy Conservation- the balance between energy expenditure and the
client’s energy supply
Structural Integrity- the defense system for the body
Personal Integrity- the client’s sense of self-worth, independence and
validation
Social Integrity- how well one can be part of a social system (family,
community, etc.)
Limitation:
Due to the fact that Myra’s Conventional Model primary focus is on the
individual and their wholeness measured by one’s personal and
emotional well being during a specific period of time, it has been
contested that this model is not the best suited when it comes to
addressing one’s illness in the long term. Thus, the conventions that
Myra imposes on nursing students are more driven towards a patient’s
satisfaction in their current state without looking to future conditions.
In addition, satisfying only current conditions does not allow room for
nurses to attempt to prevent illness if following this specific model as
they are concentrated more on the individual than the illness

Martha Rogers
(Science of Unitary Human
Beings)
Martha Elizabeth Rogers (May 12, 1914 – March 13, 1994) was an American
nurse, researcher, theorist, and author. While professor of nursing at New York
University, Rogers developed the "Science of Unitary Human Beings", a body of
ideas that she described in her book An Introduction to the Theoretical Basis of
Nursing.

She was born in Dallas, Texas, the oldest of four children of Bruce Taylor Rogers
and Lucy Mulholland Keener Rogers. She began college at the University of
Tennessee, studying pre-med (1931-1933) and withdrew due to pressure that
medicine was an unsuitable career for a woman. She received a diploma from the
Knoxville General Hospital School of Nursing in 1936. The following year she
received an undergraduate degree in public health nursing at George Peabody
College in Nashville, Tennessee.<ref[1] She received an M.A. in public health
nursing from Teachers College, Columbia University in 1945, an M.P.H. in 1952
and a Sc.D. in 1954, both from Johns Hopkins School of Public Health.

Rogers' theory is known as the Science of Unitary Human


Beings. Its primary tenets include the following:
Nursing is both a science and art; the uniqueness of nursing, like that of
any other science, lies in the phenomenon central to its focus.
Nurses long established concern with the people and the world they
live is in a natural forerunner of an organized abstract system
encompassing people and the environments.
The irreducible nature of individuals is different from the sum of the
parts.
The integralness of people and the environment that coordinate with a
multidimensional universe of open systems points to a new paradigm:
the identity of nursing as a science.
The purpose of nurses is to promote health and wellbeing for all
persons wherever they are.

A form of energy medicine, the Science of Unitary Human


Beings is based on the idea that "human beings and
environment are energy fields" that are characterized by "four-
dimensionality", a "nonlinear domain without spatial or
temporal attributes"; postulates that physicist Alan Sokal
describes as "pseudoscientific verbiage" and "perfectly
meaningless". Jef Raskin wrote that Rogers' writings were filled
with contradictions, "fuzzy physics," and vagaries. "Unlike
science, nursing theory has no built-in mechanisms for rejecting
falsehoods, tautologies, and irrelevancies.
When applying the Science of Unitary Human Beings to the individual level, the
first thing to note is Rogers’s maxim to treat each person as irreducible. Though
certainly, each human is made up of systems and tissue which must be
understood to save a life or reduce one’s suffering, Rogers insists that individuals
are more than the sum of their parts. Each human being has value intrinsic to his
or herself that cannot be understood through mere knowledge of the workings of
that human’s body (Alligood, 2014).

The mind plays a role in Rogers’s nursing model, and it seems to be part of what
she sees as being the driving force to do good work in the field. Every nurse, much
like every doctor, must reconcile within themselves why they do their work and
why it is important to continue. Rogers’s offers that humans are more complex
than the parts nurses interact with when endeavouring to cure or mend them.
Therefore, nurses’ efforts are amplified when they endeavor to help save a life
since that life is more valuable than the body that the nurse helped save. In this
way, a nurse can find strong motivation to do this work to the best degree
possible (Alligood, 2014).

That an individual is naturally embedded within their environment, is strongly


influential on Rogers’s belief that nursing must be treated as a science. Nurses
inherently are involved with observations and interventions that affect the world
around them. Though each human is a complete individual unto themselves and
is greater than the sum of their parts, these humans fit into a larger network of
people known as a social structure or simple society. Therefore, nursing must be
responsible for the effect it has on the world as a whole.

This observation on Rogers’s part has two implications. One is that an individual’s
health is inherently linked to those around that individual and cannot be entirely
understood in a vacuum. This is a common theme, explored by other nursing
theorists as well. More unique is the way Rogers uses this concept to connect
nursing to the sciences, arguing that an individual’s impact on and influence by
their environment makes nursing a naturally scientific field. Koffi & Fawcett (2016)
point out that Rogers’s theories helped spark a new era of scientific thought
within the nursing community.

As has been hinted at so far, Marth Roger’s theory, the Science of


Unitary Human Beings, has had a strong impact on health and nursing.
But more clearly, it is important to note that by emphasizing both an
individual's inherent worth as well as how that individual relates to the
environment, Rogers’s helped improve patient centered nursing
practice. Under Rogers’s model, the concept of health expands beyond
the body to the mind and, even more impressively, the relationships a
patient has. This allows nurses to assess patients based on their
psychosocial functioning in the world (Alligood, 2014).

Dorothy Johnson
(Behavioral system model)
Johnson’s Behavioral System Model is a model of nursing care that advocates the
fostering of efficient and effective behavioral functioning in the patient to prevent
illness. The patient is identified as a behavioral system composed of seven
behavioral subsystems: affiliative, dependency, ingestive, eliminative, sexual,
aggressive, and achievement. The three functional requirements for each
subsystem include protection from noxious influences, provision for a nurturing
environment, and stimulation for growth. An imbalance in any of the behavioral
subsystems results in disequilibrium. It is nursing’s role to assist the client to
return to a state of equilibrium.

Johnson (1980) views human beings as having two major systems: the biological
system and the behavioral system. It is the role of medicine to focus on the
biological system, whereas nursing’s focus is the behavioral system.

The concept of human being was defined as a behavioral system that strives to
make continual adjustments to achieve, maintain, or regain balance to the steady-
state that is adaptation.

Environment is not directly defined, but it is implied to include all elements of the
surroundings of the human system and includes interior stressors.

Health is seen as the opposite of illness, and Johnson defines it as “some degree
of regularity and constancy in behavior, the behavioral system reflects
adjustments and adaptations that are successful in some way and to some
degree… adaptation is functionally efficient and effective.”
Nursing is seen as “an external regulatory force which acts to preserve the
organization and integration of the patient’s behavior at an optimal level under
those conditions in which the behavior constitutes a threat to physical or social
health, or in which illness is found.”
Behavioral system
Man is a system that indicates the state of the system through behaviors.

System
That which functions as a whole by virtue of organized independent interaction of
its parts.

Subsystem
A minisystem maintained in relationship to the entire system when it or the
environment is not disturbed.

Subconcepts

Structure
The parts of the system that make up the whole.

Variables
Factors outside the system that influence the system’s behavior, but which the
system lacks power to change.

Boundaries
The point that differentiates the interior of the system from the exterior.

Homeostasis
Process of maintaining stability.
Stability
Balance or steady-state in maintaining balance of behavior within an acceptable
range.

Stressor
A stimulus from the internal or external world that results in stress or instability.

Tension
The system’s adjustment to demands, change or growth, or to actual disruptions.
Instability
State in which the system output of energy depletes the energy needed to
maintain stability.

Seven Subsystems (Johnson, 1980)

1. Attachment or affiliative subsystem – serves the need for security through


social inclusion or intimacy

2. Dependency subsystem – behaviors designed to get attention, recognition, and


physical assistance

3. Ingestive subsystem – fulfills the need to supply the biologic requirements for
food and fluids

4. Eliminative subsystem – functions to excrete wastes

5. Sexual subsystem – serves the biologic requirements of procreation and


reproduction

6. Aggressive subsystem – functions in self and social protection and preservation

7. Achievement subsystem – functions to master and control the self or the


environment

Set
The predisposition to act. It implies that despite having only a few alternatives
from which to select a behavioral response, the individual will rank those options
and choose the option considered most desirable.
Function
Consequences or purposes of action.

Functional requirements
Input that the system must receive to survive and develop

Three functional requirements of humans (Johnson, 1980)


1. To be protected from noxious influences with which the person cannot cope
2. To be nurtured through the input of supplies from the environment
3. To be stimulated to enhance growth and prevent stagnation

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