KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT

THEORY & TRANSACTIONAL PROCESS

HISTORY AND BACKGROUND

 During her early high school years, she decided to pursue her career in
teaching, however, her uncle, the town surgeon, offered to pay her tuition
pay to nursing school
 She accepted the offer and seeing nursing school as a way to escape life in a
small town. Thus, began her remarkable career in nursing.
 After receiving her diploma in 1945, she worked in a variety of staff nurse
roles
DATE EVENT PLACE
1945 Diploma in Nursing St. John`s Hospital
School of Nursing in
St. Louis, Missouri
1947-1958 she worked as an St/ John`s Hospital
instructor in Medical- School of Nursing.
Surgical nursing and
was an Assistant
Director
1961-1966 develop a master` Loyala University in
degree program in Chicago
nursing based on a
nursing conceptual
framework
1964 Her 1st theory journal
“Nursing Science”,
which nurse Theorist
Martha Rogers edited
1968 to 1972 King served as the Ohio State University
Director of the School in Columbus
of Nursing
1972 Returned as a Loyola University
professor graduate program
1972 to 1975 King was a member of
the Defense Advisory
Committee on Women
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

in the service for the

U.S. Department of
Defense.
1978 to 1980 Coordinator of Loyola Medical Center
Research in Clinical Department of Nursing
Nursing
1975 to 1979 also elected as Ward 2 at Wood Dale,
“alderman” for a 4- Illinois
year term

 In 1980, King was appointed as a professor at the University of South

Florida College of Nursing, in Tampa. She continued to provide a
community service to help plan care through her conceptual system and
theory at various health care organizations.
 King earned recognition as a “nurse theorist” through the publication of
“Toward a Theory for Nursing: General Concepts of Human Behavior” in
1971 and “A Theory for Nursing: Systems, Concepts, Process” in 1981, as
well as numerous articles related to her conceptual system and a theory of
goal attainment.
 In 1981, the manuscript of her 2nd book, “A Theory for Nursing: Systems,
Concepts, Process” was published.
 In addition to her first 2 books, she authored multiple book chapters &
articles in professional journals.
 In 1986, her 3rd book, “Curriculum & Instruction in Nursing: Concepts &
Process” was published.
 In 1994, King was inducted into the American Academy of Nursing (AAN)
& served as AAN Theory of Expert Panel.
 In 1996, she received a Jessie M. Scott Award
 In 1997, King received a Gold Medallion from Gov. Chiles for advancing
the nursing profession in the state of Florida.
 In May 1998, she received an honorary doctorate from Loyola University,
where her “Nursing Collection” was housed.
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

 In 1999, King was inducted into the Teachers College, Columbia University
Hall of Fame.
 In 2004, she was inducted into the FNA Hall of Fame and the ANA Hall of
Fame and as a Living Legend in 2005.
 Despite of her many awards & honors, she considered teaching students to
be her important accomplishment. Over the years she enjoyed watching her
nursing students become expert practitioners, teachers & researchers.
 Imogene King died on December 24, 2007, 2 days after suffering from
stroke (84 years old)
OVERVIEW OF IMOGENE KING`S “CONCEPTUAL MODEL &
THEORY OF GOAL ATTAINMENT
 King`s concepts focus on the methods of a nurse-client communication and
working together toward mutually selected goals to help nurses in the nurse-
patient relationship.
 She used a “systems approach” in the development of her systems
framework & her subsequent Goal Attainment Theory.
 The “Goal Attainment Theory refers to the 3 interacting systems:
1. Individual or personal
2. Group or interpersonal
3. Society or social
 This theory pertains to the importance of interaction, perception,
communication, transaction, self, role, stress, growth & development, time
& personal space.
KING’S THEORY OF GOAL ATTAINMENT
 PERSONAL SYSTEM (INDIVIDUAL)
o The concepts of personal systems are: perception, self, growth &
development, body image, space & time.
o These concepts are fundamentals in understanding human being
because these refers to how the nurse views & integrates self from
personal goals & beliefs.
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

o Among the listed concepts, the most important is “perception”

because it influences behavior.
o King summarized the connections among these concepts as “An
individual perception of self, of body image, of time, of space that
influences the way a person responds to object & events in one`s
life.
o As an individual person grow & develop the lifespan experiences
with changes in structure & function of their bodies overtime, this
influences the perception of their self.
o Personal systems are individuals, who are regarded as rational,
sentient, social beings.
o Concepts related to the personal systems are:
o Perception: a process of organizing, interpreting & transforming
information from sense data & memory that gives meaning to one`s
experiences, represents one`s image of reality & influences one`s
behavior.
o Self: a composite of thoughts & feelings that constitute a person`s
awareness of individual existence, of who they are & what they are.
o Growth & Development: cellular, molecular & behavioral changes
in human beings that are a function of genetic endowment,
meaningful & satisfying experiences & an environment conducive to
helping individuals move toward maturity.
o Body Image: a person`s perception of their body
o Time: the duration between the occurrence of one event & the
occurrence of another event.
o Space: the physical area called territory that exist in all directions.
o Learning: gaining knowledge
 INTERPERSONAL SYSTEM (NURSE-PATIENT DIALOGUE)
o Concepts associated for the interpersonal system are: interaction,
communication, transaction, role & stress.
o King refers to the “2 individuals as dyads, 3 as triads & 4 or more
individuals as small group or large group.
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

o This shows how the nurse interrelates with co-worker or patient,

particularly in a nurse-patient relationship.
o Communication between the nurse & the patient can be verbal or
non-verbal.
o Collaboration between dyads (nurse-patient) is very important for
the attainment of the goal
o Interactions: the acts of 2 or more persons in mutual presence; a
sequence of verbal & non-verbal behaviors that are goal directed.
o Communication: the vehicle by which human relations are
developed & maintained; encompasses intrapersonal, interpersonal,
verbal & non-verbal communication.
o Transaction: a process of interaction in which human beings
communicate with the environment to achieve goals that are valued;
goal-directed human behaviors
o Role: a set of behaviors expected of a person occupying a position in
a social system.
o Stress: a dynamic state whereby a human being interacts with the
environment to maintain balance for growth, development &
performance, involving an exchange of energy & information
between the person & the environment for regulation and control of
stressors.
o Coping: a way of dealing with stress
 SOCIAL SYSTEM (THE FAMILY, THE SCHOOL & THE CHURCH)
o This shows how the nurse interacts with co-workers, superiors,
subordinates and the client`s environment in general
o These are groups of people within the community or society that
shares a common goals, values & interest
o It provides a framework for social interaction & relationships &
establishes rules of behavior & courses of action
o Are organized boundary systems of social roles, behaviors, &
practices developed to maintain values & the mechanism to regulate
the practices & roles.
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THEORY & TRANSACTIONAL PROCESS

o Organization: composed of human beings with prescribed roles &

positions who use resources to accomplish personal &
organizational goals
o Authority: a transactional process characterized by active,
reciprocal relations in which member`s values, backgrounds &
perceptions play a role in defining, validating & accepting the
authority of individuals within an organization.
o Power: the process whereby one or more persons influence other
persons in a situation.
o Status: the position of an individual in a group or a group in relation
to other groups in an organization.
o Decision Making: a dynamic & systematic process by which goal-
directed choice of perceived alternatives is made & acted upon by
individuals or groups to answer a question & attain a goal.
o Control: being in-charge
 Among the 3 systems, the conceptual framework of interpersonal system
had the greatest influence on the development of her theory.
 King stated that “although personal systems & social systems influence
quality of care, the major elements in a theory of goal attainment are
discovered in the interpersonal systems in which 2 people, who are usually
strangers to each other, come together in a health care organization to help
& to be helped to maintain a state of health that permits functioning in roles.
“
 Originated from the elements or concepts in her Interacting Systems
Framework but it focuses on the Interpersonal Systems & the interactions,
communications & transactions between 2 individuals (the nurse & the
patient)
 The essence of her theory is that the nurse & the patient come together,
communicate & make transactions – they set goals & work to achieve the
goals set.
 Each of them had purpose, they perceive, judge, act & react upon each
other. At the end of their communication, a goal will be set & with these
transactions will be made.
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

 King believed that the goal of nursing is to “help individuals maintain their
health so they can function in their roles (King, 1981), transactions occur to
set goals related to the health of the patient.
 She proposed that through mutual goal setting & goal attainment,
transactions result in enhanced growth and development for the client.
 King used 10 major concepts from the personal and interpersonal systems to
support the Theory of Goal Attainment.
 These concepts include: human interactions, perception, communication,
role, stress, time, space, growth & development and transactions.
MAJOR CONCEPTS OF IMOGENE KING`S THEORY OF GOAL
ATTAINMENT
HUMAN BEING
 Individuals are social beings who are rational & sentient.
 Humans communicate their thoughts, actions, customs & beliefs through
language
 Persons exhibit common characteristics such as the ability to perceive, to
think, to feel, to choose between alternative courses of action, to set goals,
to select the means to achieve goals & to make decisions.
HEALTH
 Is a dynamic life experience of a human being, which implies continuous
adjustment to stressors in the internal & external environment through
optimum use of one`s resources to achieve maximum potential for daily
living.
ENVIRONMENT
 Is the background for human interactions
 It is both external to and internal to the individual
NURSING
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

 Is a action, reaction and interaction whereby nurse & client share

information about their perceptions in the nursing situation.
 The nurse & client share specific goals, problems, concerns & explore
means to achieve a goal.
ASSUMTIONS OF THE THEORY
 The focus of nursing is the care of the human being (patient).
 The goal of nursing is health care of both individuals and groups.
 Human beings are open systems interacting with their environments
constantly.
 The nurse and patient communicate information, set goals mutually, and
then act to achieve those goals. This is also the basic assumption of the
nursing process.
 Patients perceive the world as a complete person making transactions with
individuals and things in the environment.
 Transaction represents a life situation in which the perceiver and the thing
being perceived are encountered. It also represents a life situation in which a
person enters the situation as an active participant. Each is changed in the
process of these experiences.
STRENGTHS
 A major strong point of King’s conceptual system and Theory of Goal
Attainment is the ease with which it can be understood by nurses.
 The theory of goal attainment also does describe a logical sequence of
events.
 For most parts, concepts are concretely defined and illustrated.
 King’s definitions are clear and are conceptually derived from research
literature. Her Theory of Goal Attainment presents ten major concepts, and
the concepts are easily understood and derived from research literature,
which clearly establishes King’s work as important for knowledge building
in the discipline of nursing.
LIMITATIONS OF THE THEORY
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

 Theory of Goal Attainment has been criticized for having limited

application in areas of nursing in which patients are unable to interact
competently with the nurse. King maintained the broad use of the theory in
most nursing situations.
 Another limitation relates to the lack of development of application of the
theory in providing nursing care to groups, families, or communities.
 King’s theory also contains some inconsistencies: (1) She indicates that
nurses are concerned about the health care of groups but concentrates her
discussion on nursing as occurring in a dyadic relationship. (2) King says
that the nurse and client are strangers, yet she speaks of their working
together for goal attainment and of the importance of health maintenance.
APPLICATION TO NURSING PRACTICE, EDUCATION & RESEARCH
 Professionals have used King’s theory in different specialized area with
the use of dynamic, interactive communication between the nurse and
the client as proof.
 The Goal Oriented Nursing Records (GNOR) that King developed have
been useful in documenting the outcomes of care that was performed by
nurses.
 It helps nurses to easily facilitate the present problem from careful
assessment of the client gathered through the interactive communication
process between the nurse and the client. Her record management
facilitates proper and correct range for the use of education system.
 The significance of King’s theory has been applied to different
professional practice setting such as in nursing administration, theory –
based practice in the emergency department, in tertiary hospitals and in
the community.
 King’s interacting system has been used to design the nursing
curriculum in different schools and universities and framework for
nursing education.
 It provides a systematic means of viewing the nursing profession,
organizing nursing knowledge and clarifying the nursing discipline
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
THEORY & TRANSACTIONAL PROCESS

 King’s theory has been one of the theoretical bases of some researches
that helped in formulating a system view of the application of the
nursing practice.
 Some research have formulated a middle range theory out of King’s
theory out of King’s theory such as patient’s satisfaction from nursing
care, clients with chronic illness and family health.
 The theory can also help set a framework for nursing studies which can
further prove the use and advantages of the nursing practice.