行为系统模式课件.ppt

1、 一、约翰逊简介及其理论发展背景 二、行为系统模式基本内容 三、行为系统模式与护理的四个主要概念 四、行为系统模式与护理程序 五、行为系统模式的评价 六、行为系统模式的应用 Johnson is known for her Behavior System Model of Nursing, which was first proposed in 1968. The model advocates the fostering of efficient and effective behavioral functioning in the patient to prevent illness. T

2、he patient is defined as a behavioral system composed of seven behavioral subsystems. Each subsystem is comprised of four structural characteristics. An imbalance in each system results in disequilibrium. The nurses role is to help the patient maintain his or her equilibrium. The Behavior System Mod

3、el of Nursing was developed by Dorothy E. Johnson. It stresses the importance of research-based knowledge about the effect of nursing care on patients. When she first proposed the theory in 1968, she explained that it was to foster the efficient and effective behavioral functioning in the patient to

4、 prevent illness. 约翰逊以一般系统论为主要理论来源，约翰逊将人视为由7个子系统个子系统构成的行为系统，将个体的健康归功于整个行为系统的平衡、稳定和高效运行。而护理护理则是在系统失衡或需要达到更高层次的平衡时提供帮助的主要力量。由于个体的行为反映出整个系统的运行状况，因此护士可以通过对行为的观察发现个体存在的问题，并通过适当的干预使个体的行为发生改变来解决问题。约翰逊的理论使护理护理从对患者的健康和疾病的关注转到对患者全部行为的关注，从而将医疗和护理的医疗和护理的职责区别开来职责区别开来，为护理成为一门独立的学科独立的学科做出了贡献。一、约翰逊简介及其理论发展背景 1919年出

5、生于美国乔治亚州 1938年毕业于阿姆斯特朗专科学校 1942年获得护理学士学位，成为一名公共卫生护士 1944年担任Vanderbilt大学儿科护理学讲师、助理教授 1948年获得哈佛大学公共卫生学硕士学位 1949年担任加利福尼亚大学儿科护理教授 1978年作为荣誉教授退休 1959年发表A philosophy of nursing，提出护理必须综合基础应用学科的相关要素 1961年发表The significance of nursing care，提出护理能使病人维持在一个平衡的状态 1980年提出了完整的Behavioral System Modle理论 1990年发表护理行为系统

6、模式护理行为系统模式 1992年发表行为系统模式起源行为系统模式起源二行为系统模式（一）Assumption The assumptions made by Johnsons theory are in three categories: assumptions about system, assumptions about structure, and assumptions about functions.（二）行为系统模式（二）行为系统模式 约翰逊认为每个人都是一个有一定型态的一定型态的、有目的的有目的的和重复活动重复活动所构成的行为系统。这个行为系统是一个有组织的有组织的、完整的完整的

7、功能单位，其功能功能是调解人与环境之间的互动，并在人与其环境中的客观事物和情景之间建立联系和处理人与环境之间的关系。1.行为系统的结构结构和功能功能 约翰逊将人的行为系统描述为由7个子系统个子系统组成。每个子系统都有其各自的特定目标和功能，而各子系统之间又是开放的开放的，彼此之间相互关联相互关联的。一个子系统的变化会影响影响其他子系统，只有各子系统整体协调协调运转运转，才能维持整个行为系统的完整和系统的良好运行。Seven subsystems1.Affiliative subsystem, which is social inclusion intimacy and the formatio

8、n and attachment of a strong social bond.2.Dependency subsystem, which is the approval, attention or recognition and physical assistance.3.Ingestive subsystem, in which the emphasis is on the meaning and structures of the social events surrounding the occasion when the food is eaten.4.Eliminative su

9、bsystem, which states that human cultures have defined different socially acceptable behaviors for excretion of waste, but the existence of such a pattern remains different from culture to culture.5.Sexual subsystem, which is both a biological and social factor that affects behavior.6.Aggressive sub

10、system, which relates to the behaviors concerning protection and self-preservation, generating a defense response when there is a threat to life or territory.7.Achievement subsystem, which provokes behavior that tries to control the environment.2.Subsystem has three functional requirements1.Each sub

11、system must be protected from noxious influences that the system cannot cope with. 2.Each subsystem must be nurtured with appropriate supplies from the environment. 3. Each subsystem must be stimulated for use in order to enhance growth and protect from stagnation. 3.行为系统的结构要素结构要素1.驱动力或目标驱动力或目标：指行为系

12、统采取某一行为的动机。2.定向定向：个体通常有采取某些固定的行为方式来完成子系统功能的行为倾向性。3.选择选择：个体每个子系统都有一个满足其功能的行为技能范围，涵盖了个体可能从中进行选择的全部行为选项。4.行为行为：在某一条件下的实际行为。Four major concepts 1.The human being has two major systems: the biological and behavioral systems. The role of medicine is to focus on the biological system, while nursings focus

13、is on the behavioral system. 2.Society relates to the environment in which the patient exists; a patients behavior is directly influenced by the environment and events that occur in the environmen 3.Health is a purposeful adaptive response to internal and external stimuli in order to maintain stabil

14、ity and control. The responses include physical, mental, emotional, and social realms. 4.The primary goal of nursing is to foster equilibrium in the individual patient. One focus of nursing concerns the organized and integrated whole, but the major focus is on maintaining balance in the behavioral s

15、ystem during an illness in the biological system.四.行为系统模式与护理程序 The nursing process of the Behavior System Model of Nursing begins with an assessment and diagnosis of the patient. Once a diagnosis is made, the nurse and other healthcare professionals develop a nursing care plan of interventions and s

16、etting them in motion. The process ends with an evaluation, which is based on the balance of the subsystems.1.评估评估-分析系统功能分析系统功能：（1）收集资料以描述各子系统及系统整体的结构和功能（2）分析资料以确定系统功能的有效性和效率水平2.诊断诊断：确定系统及子系统功能和结构上及其起源和性质3.计划计划：确定护理目标和任务、制定护理措施护理目标和任务、制定护理措施4.评价评价：在评价目标是否实现目标是否实现时，护士需要将执行护理措施后的患者的行为与行为系统及子系统平衡的标准相比较，与系统有效和高效运转的状态相比较，从而确定系统是否回复平衡和高效的状态。理论的应用 1.在临床和社区护理中的应用 2.在护理教育中的应用 3.在护理研究中的应用理论的分析与评价 1.理论既简洁又抽象 2.理论具有逻辑性 3.理论推动了护理学科的发展 4.理论有待发展理论的应用实例