NURSING THEORY: IMOGENE KINGs

Reported by: DAISY C. LORENZO

Educational Background
Diploma, St. John's Hospital School of Nursing St. Louis, MO - 1945 BS in Nursing Education, St. Louis University - 1948 MSN, St. Louis University - 1957 Doctor of Education, Teachers College, Columbia University, 1961

Honorary PhD, Southern Illinois University - 1980

Professional Background
began her academic career at St. Louis University spent several years at Loyola University in Chicago, then went to the University of South Florida, where she is now professor emeritus.
Honourably retired from assigned duties and retaining your title along with the additional title 'emeritus' as in 'professor emeritus'

KINGs NURSING THEORY

King began her work in nursing theory with a conceptual framework. King's considers her theory as a deviation from systems theory, with emphasis on interaction theory.

In 1981 she refined her concepts into a nursing theory that consisted of the following basis:
1. An open systems framework as the basis of goal attainment. 2. Nursing as a major system within the health care system. 3. Nursing process emphasis on interpersonal processes.

Man is an important focus of King's framework. King's concept of Man:

She proposes three basic premises; man is: 1. A reactive being 2. A time oriented being 3. A social being

Man as a reactive being is aware of other things; persons and events in the environment.
At various times this awareness makes the being respond to the environment based upon his perceptions, expectations and needs.

Kings Concept of Man

Man as a time-oriented being is influenced by time orientation. Each person presents with by his past experience that influences his actions. His awareness of the present helps shape the future. Man as a social being has a continuous exchange with persons in the environment. Language is a social link and facilitates interpersonal communication.

King identifies six (6) other characteristics of man:

1. The ability to perceive--perceptions will influence behavior and thus life and health.
2. The ability to think--thinking is based upon the inquiring mind of man. When man thinks he has the ability to discriminate and identify relationships. 3. The ability to feel--or have emotions.

4. The ability to choose between alternative course of action.

5. The ability to set goals 6. The ability to select means of accomplishing goals.

Kings' concept of environment:

King makes the assumption that humans are open systems which are in constant interactions with their environment through three interacting systems: 1)Personal system 2)Interpersonal system, & 3) Social system:

I. The personal interacting system consists of:

a. The Individual's Perception--the person's representation of reality and it is unique to each individual b. Self--The person's subjective environment, values, ideas, attitudes, and commitment. C. Growth and Development--involves all the changes that occur (cellular, molecular, and behavioral). These change are usually orderly and predictable, but may vary with individuals.

 D. Body Image--The way a person perceive their body and the reaction of others to their body. Body image is subjective and changes as the person changes physically or emotionally. E. Space--is the immediate physical territory occupied by the person and person's behavior. F. Time--is the order of events and their relationship to each other.

II. Interpersonal system occur when humans socialize. This includes:

a. Interaction--verbal and nonverbal behavior between the individual and the environment or between two or more individuals. B. Communication--The transmission of information directly, between persons or indirectly by other media (phone, letter, etc) c. Transaction--interaction between a person and another person or a person and the environment for the purpose of goal attainment.

 D. Role--the expected behavior of a person in a specific position and the rules that govern the position and affect the interactions between two or more person. E. Stress--the exchange of energy that is either positive or negative between a person and the environment, object, events and persons can serve as stressors. F. Coping--was considered important by King but defined.

Social systems occur when interpersonal systems come together to form larger systems; such as families, religious groups, school, work, and peer groups.
Social roles, behaviors, and practices that are developed to maintain values and include organizations, authority, power, status, and decision making. Authority--is the seat of power or the individual who make decisions that guide other's actions. Power may be official or functional, and it may not exist in the same person. Status--the role one occupies within the system of status-position. Decision Making--comes from developing and acting on perceived choices to obtain goals.

Kings' concept of Health:

Health--is a dynamic, ever changing process that is a state of being.

It is not a point to be achieved, it is an ongoing fluid existence, rather than a static state.
The dynamic state of health occurs in the life cycle from conception to death. Illness is an interference in the continuation of the life cycle. There is no consideration of age group or point of time in King's definition of health.

 All of society is involved in health, if a society is to be healthy, it must be at least partially composed of healthy individuals. The individual is constantly in adaption to meet the need of the internal and external environment. The individual's internal environment consist of the organs systems, cells, hormones, and inner thought processed. The external environment consist of things that impact the individual from the outside, sound air pollution, food, people.

Kings' concept of Nursing:

is a process of actions, reaction, interaction, and transaction whereby nurses assist individuals of any age and socioeconomic group to meet their basic needs in performing activities of daily living and to cope with health and illness at some particular point in the life cycle."

Goal Attainment Theory

A. General information
1. Represents an expansion of King's original ideas to incorporate the concept of the nurse and the patient mutually communicating information, establishing goals, and taking ACTION to attain goals 2. Describes a situation in which two people usually strangers, come together in a health care organization to help or be help to maintain a sate of health 3. Is based on the concepts Of the personal and interpersonal systems, including interaction, perception, communication, transaction role, stress, growth and development, time, and space

 Emphasis on client participation in goal setting and goal achievement is a major strength of this model. King's model is a useful framework for nurses whose social interactions with clients are a key focus of their practice.

B. Interaction
1. According to King, each individual brings to an interaction a different set of values, ideas, attitudes, and perceptions to exchange 2. Individuals come together for a purpose; each person makes a judgment, takes mental or physical action, and reacts to the other individuals and the situation

C. Perception
1. A person imports energy from the environment and transforms, processes, and stores it 2. The individual then exports this energy, as demonstrated by observable behaviors

D. Communication
1. A person provides information directly or indirectly to another person 2. The other person receives this information and processes it

E. Transaction
1. Two individuals mutually identify goals and the means to achieve them 2. They reach an agreement about how to attain these goals and then set about to realize them

F. Role
1. Each person occupies a position in a social system that has specific rules and obligations 2. Roles can be congruent (resulting in transactions) or in conflict (resulting in stress)

G. Stress
1. When an individual interacts with the environment, an energy response occurs to objects, events, and persons 2. The individual uses this energy response to maintain balance for growth, development, and performance

H. Growth and development

1. Individuals are in a constant state of molecular, cellular, and behavioral change 2. As these changes occur, transactions are made, moving the individual toward a level of maturity and selfactualization

I. Time
1. A person experiences a sequence of events that move toward the future 2. As the individual moves forward, changes occur

J. Space
1. Each person has a designated physical area or territory that extends from the individual equally in all directions 2. Specific behaviors exist for the person occupying that space

SUMMARY:
The goal of nursing is to help individuals maintain health so that they can function in their roles.

The open systems framework consists of three interacting systems: personal, interpersonal, and social.
The Goal Attainment Theory addresses interaction, perception, time, space, communication, transaction, role, stress, and growth and development. King describes "person, as a social, sentient, rational, perceiving, controlling, purposeful, action-oriented, time-oriented being.