GRAND THEORIES

MADELEINE LEININGER

 Developed the Transcultural Nursing Model.

 Advocated that nursing is a humanistic and scientific mode of
helping a client through specific cultural caring process to
improve or maintain a health condition.
- Leininger is the founder of the transcultural nursing movement in
education research and practice.

THEORY: Transcultural Nursing

 The Transcultural Nursing Theory or Culture Care Theory by

Madeleine Leininger involves knowing and understanding different
cultures with respect to nursing and health-illness caring
practices, beliefs and values with the goal to provide meaningful
and efficacious nursing care services to people according to their
cultural values and health-illness context.
 It focuses on the fact that different cultures have different
caring behaviors and different health and illness values, beliefs,
and patterns of behaviors.
 The cultural care worldview flows into knowledge about individuals,
families, groups, communities, and institutions in diverse health
care systems. This knowledge provides culturally specific meanings
and expressions in relation to care and health. The next focus is
on the generic or folk system, professional care system(s), and
nursing care. Information about these systems includes the
characteristics and the specific care features of each. This
information allows for the identification of similarities and
differences or cultural care universality and cultural care
diversity.
 Next are nursing care decisions and actions which involve cultural
care preservation/maintenance, cultural care
accommodation/negotiation and cultural care re-patterning or
restructuring. It is here that nursing care is delivered.

Major Concepts of Transcultural Nursing Theory:

The following are the major concepts and their definitions in Madeleine
Leininger’s Transcultural Nursing Theory.

1. Transcultural Nursing
Transcultural nursing is defined as a learned subfield or branch of
nursing which focuses upon the comparative study and analysis of
cultures with respect to nursing and health-illness caring practices,
beliefs, and values with the goal to provide meaningful and efficacious
nursing care services to people according to their cultural values and
health-illness context.
2. Ethnonursing
This is the study of nursing care beliefs, values, and practices as
cognitively perceived and known by a designated culture through their
direct experience, beliefs, and value system (Leininger, 1979).
3. Nursing
Nursing is defined as a learned humanistic and scientific profession and
discipline which is focused on human care phenomena and activities in
order to assist, support, facilitate, or enable individuals or groups to
maintain or regain their well-being (or health) in culturally meaningful
and beneficial ways, or to help people face handicaps or death.

4. Professional Nursing Care (Caring)

Professional nursing care (caring) is defined as formal and cognitively
learned professional care knowledge and practice skills obtained through
educational institutions that are used to provide assistive, supportive,
enabling, or facilitative acts to or for another individual or group in
order to improve a human health condition (or well-being), disability,
lifeway, or to work with dying clients.

5. Cultural Congruent (Nursing) Care

Cultural congruent (nursing) care is defined as those cognitively based
assistive, supportive, facilitative, or enabling acts or decisions that
are tailor-made to fit with individual, group, or institutional cultural
values, beliefs, and lifeways in order to provide or support meaningful,
beneficial, and satisfying health care, or well-being services.

6. Health
It is a state of well-being that is culturally defined, valued, and
practiced, and which reflects the ability of individuals (or groups) to
perform their daily role activities in culturally expressed, beneficial,
and patterned lifeways.

7. Human Beings
Such are believed to be caring and to be capable of being concerned
about the needs, well-being, and survival of others. Leininger also
indicates that nursing as a caring science should focus beyond
traditional nurse-patient interactions and dyads to include families,
groups, communities, total cultures, and institutions.

8. Society and Environment

These terms are not defined by Leininger; she speaks instead of
worldview, social structure, and environmental context.

9. Cultural and Social Structure Dimensions

Cultural and social structure dimensions are defined as involving the
dynamic patterns and features of interrelated structural and
organizational factors of a particular culture (subculture or society)
which includes religious, kinship (social), political (and legal),
economic, educational, technological and cultural values,
ethnohistorical factors, and how these factors may be interrelated and
function to influence human behavior in different environmental
contexts.

10. Environmental Context

Environmental context is the totality of an event, situation, or
particular experience that gives meaning to human expressions,
interpretations, and social interactions in particular physical,
ecological, sociopolitical and/or cultural settings.
11. Culture
Culture is the learned, shared and transmitted values, beliefs, norms,
and lifeways of a particular group that guides their thinking,
decisions, and actions in patterned ways.

12. Culture Care

Culture care is defined as the subjectively and objectively learned and
transmitted values, beliefs, and patterned lifeways that assist,
support, facilitate, or enable another individual or group to maintain
their well-being, health, improve their human condition and lifeway, or
to deal with illness, handicaps or death.

13. Culture Care Diversity

Culture care diversity indicates the variabilities and/or differences in
meanings, patterns, values, lifeways, or symbols of care within or
between collectives that are related to assistive, supportive, or
enabling human care expressions.

14. Culture Care Universality

Culture care universality indicates the common, similar, or dominant
uniform care meanings, pattern, values, lifeways or symbols that are
manifest among many cultures and reflect assistive, supportive,
facilitative, or enabling ways to help people. (Leininger, 1991)

Sunrise Model of Madeleine Leininger’s Theory:

  The cultural care worldview flows into knowledge about individuals,
families, groups, communities, and institutions in diverse health
care systems. This knowledge provides culturally specific meanings
and expressions in relation to care and health. The next focus is
on the generic or folk system, professional care systems, and
nursing care. Information about these systems includes the
characteristics and the specific care features of each. This
information allows for the identification of similarities and
differences or cultural care universality and cultural care
diversity.
 Next are nursing care decisions and actions which involve cultural
care preservation or maintenance, cultural care accommodation or
negotiation and cultural care repatterning or restructuring. It is
here that nursing care is delivered.

Three modes of nursing care decisions and actions:

1. Cultural care preservation or Maintenance

Cultural care preservation is also known as maintenance and includes
those assistive, supporting, facilitative, or enabling professional
actions and decisions that help people of a particular culture to retain
and/or preserve relevant care values so that they can maintain their
well-being, recover from illness, or face handicaps and/or death.

2. Cultural care accommodation or Negotiation

Cultural care accommodation also known as negotiation, includes those
assistive, supportive, facilitative, or enabling creative professional
actions and decisions that help people of a designated culture to adapt
to or negotiate with others for a beneficial or satisfying health
outcome with professional care providers.

3. Culture care repatterning or Restructuring

Culture care repatterning or restructuring includes those assistive,
supporting, facilitative, or enabling professional actions and decisions
that help a clients reorder, change, or greatly modify their lifeways
for new, different, and beneficial health care pattern while respecting
the clients cultural values and beliefs and still providing a beneficial
or healthier lifeway than before the changes were coestablished with the
clients. (Leininger, 1991)

DOROTHEA OREM

 Dorothea Elizabeth Orem (July 15, 1914 – June 22, 2007) was one of
America’s foremost nursing theorists who developed the Self-
Care Deficit Nursing Theory, also known as the Orem Model of
Nursing.
 Her theory defined Nursing as “The act of assisting others in the
provision and management of self-care to maintain or improve human
functioning at home level of effectiveness.” It focuses on each
individual’s ability to perform self-care, defined as “the practice
of activities that individuals initiate and perform on their own
behalf in maintaining life, health, and well-being.”
Theory: Self Care and Self Deficit Theory

 Dorothea Orem’s Self-Care Deficit Theory focuses on

each “individual’s ability to perform self-care, defined as ‘the
practice of activities that individuals initiate and perform on
their own behalf in maintaining life, health, and well-being.'” The
Self-Care or Self-Care Deficit Theory of Nursing is composed of
three interrelated theories: (1) the theory of self-care, (2) the
self-care deficit theory, and (3) the theory of nursing
systems, which is further classified into wholly compensatory,
partial compensatory and supportive-educative. It is discussed
further below.

Major Concepts of the Self-Care Deficit Theory:

In this section are the definitions of the major concepts of Dorothea

Orem’s Self-Care Deficit Theory:

Nursing
 Nursing is an art through which the practitioner of nursing gives
specialized assistance to persons with disabilities which makes
more than ordinary assistance necessary to meet needs for self-
care. The nurse also intelligently participates in the medical care
the individual receives from the physician.
Humans
 Humans are defined as “men, women, and children cared for either
singly or as social units,” and are the “material object” of nurses
and others who provide direct care.
Environment
 The environment has physical, chemical and biological features. It
includes the family, culture, and community.
Health
 Health is “being structurally and functionally whole or sound.”
Also, health is a state that encompasses both the health of
individuals and of groups, and human health is the ability to
reflect on one’s self, to symbolize experience, and to communicate
with others.
Self-Care
 Self-care is the performance or practice of activities that
individuals initiate and perform on their own behalf to maintain
life, health, and well-being.

Self-Care Agency
 Self-care agency is the human’s ability or power to engage in self-
care and is affected by basic conditioning factors.
Basic Conditioning Factors
 Basic conditioning factors are age, gender, developmental state,
health state, socio-cultural orientation, health care system
factors, family system factors, patterns of living, environmental
factors, and resource adequacy and availability.
Therapeutic Self-Care Demand
 Therapeutic Self-care Demand is the totality of “self-care actions
to be performed for some duration in order to meet known self-care
requisites by using valid methods and related sets of actions and
operations.”
Self-Care Deficit
 Self-care Deficit delineates when nursing is needed. Nursing is
required when an adult (or in the case of a dependent, the parent
or guardian) is incapable of or limited in the provision of
continuous effective self-care.
Nursing Agency
 Nursing Agency is a complex property or attribute of people
educated and trained as nurses that enables them to act, to know,
and to help others meet their therapeutic self-care demands by
exercising or developing their own self-care agency.
Nursing System
 Nursing System is the product of a series of relations between the
persons: legitimate nurse and legitimate client. This system is
activated when the client’s therapeutic self-care demand exceeds
available self-care agency, leading to the need for nursing.
Theories
 The Self-Care or Self-Care Deficit Theory of Nursing is composed of
three interrelated theories: (1) the theory of self-care, (2) the
self-care deficit theory, and (3) the theory of nursing
systems, which is further classified into wholly
compensatory, partial compensatory and supportive-educative.

A. Theory of Self-Care
 This theory focuses on the performance or practice of activities
that individuals initiate and perform on their own behalf to
maintain life, health and well-being.
Self-Care Requisites
 Self-care Requisites or requirements can be defined as actions
directed toward the provision of self-care. It is presented in
three categories:
Universal Self-Care Requisites
 Universal self-care requisites are associated with life processes
and the maintenance of the integrity of human structure and
functioning.
- The maintenance of a sufficient intake of air
- The maintenance of a sufficient intake of water
- The maintenance of a sufficient intake of food
- The provision of care associated with elimination process and
excrements
- The maintenance of a balance between activity and rest
- The maintenance of a balance between solitude and social
interaction
- The prevention of hazards to human life, human functioning, and
human well-being
- The promotion of human functioning and development within social
groups in accord with human potential, known human limitations, and
the human desire to be normal
 Normalcy is used in the sense of that which is essentially human
and that which is in accord with the genetic and constitutional
characteristics and the talents of individuals.
Developmental self-care requisites
 Developmental self-care requisites are “either specialized
expressions of universal self-care requisites that have been
particularized for developmental processes or they are new
requisites derived from a condition or associated with an event.”
Health deviation self-care requisites
 Health deviation self-care requisites are required in conditions of
illness, injury, or disease or may result from medical measures
required to diagnose and correct the condition.
- Seeking and securing appropriate medical assistance
- Being aware of and attending to the effects and results of
pathologic conditions and states
- Effectively carrying out medically prescribed diagnostic,
therapeutic, and rehabilitative measures
- Being aware of and attending to or regulating the discomforting or
deleterious effects of prescribed medical measures
- Modifying the self-concept (and self-image) in accepting oneself as
being in a particular state of health and in need of specific forms
of health care
- Learning to live with the effects of pathologic conditions and states
and the effects of medical diagnostic and treatment measures in a
lifestyle that promotes continued personal development

B. Theory of Self-Care Deficit

 This theory delineates when nursing is needed. Nursing is required
when an adult (or in the case of a dependent, the parent or
guardian) is incapable of or limited in the provision of continuous
effective self-care. Orem identified 5 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
- Teaching another

C. Theory of Nursing System

 This theory is the product of a series of relations between the
persons: legitimate nurse and legitimate client. This system is
activated when the client’s therapeutic self-care demand exceeds
available self-care agency, leading to the need for nursing.

Wholly Compensatory Nursing System

 This is represented by a situation in which the individual is
unable “to engage in those self-care actions requiring self-
directed and controlled ambulation and manipulative movement or the
medical prescription to refrain from such activity… Persons with
these limitations are socially dependent on others for their
continued existence and well-being.”

Example: care of a newborn, care of client recovering from surgery in a

post-anesthesia care unit

Partial Compensatory Nursing System

 This is represented by a situation in which “both nurse and perform
care measures or other actions involving manipulative tasks or
ambulation… [Either] the patient or the nurse may have a major role
in the performance of care measures.”

Example: Nurse can assist postoperative client to ambulate, Nurse can

bring a meal tray for client who can feed himself

Supportive-Educative System
 This is also known as supportive-developmental system, the person
“is able to perform or can and should learn to perform required
measures of externally or internally oriented therapeutic self-care
but cannot do so without assistance.”

Example: Nurse guides a mother how to breastfeed her baby, Counseling a

psychiatric client on more adaptive coping strategies.
MARTHA ROGERS

 Martha Elizabeth Rogers (May 12, 1914 – March 13, 1994) was an

American nurse, researcher, theorist, and author widely known for
developing the Science of Unitary Human Beings and for her landmark
book, An Introduction to the Theoretical Basis of Nursing.
 She believes that a patient can never be separated from his or her
environment when addressing health and treatment. Her knowledge
about the coexistence of the human and his or her environment
contributed a lot in the process of change toward better health.

THEORY: Unitary Human Beings

 The belief of the coexistence of the human and the environment has
greatly influenced the process of change toward better health. In
short, a patient can’t be separated from his or her environment
when addressing health and treatment. This view lead and opened
Martha E. Rogers’ theory, known as the “Science of Unitary Human
Beings,” which allowed nursing to be considered one of the
scientific disciplines.
 Rogers’ theory defined Nursing as “an art and science that is
humanistic and humanitarian. It is directed toward the unitary
human and is concerned with the nature and direction of human
development. The goal of nurses is to participate in the process of
change.”
 According to Rogers, the Science of Unitary Human Beings contains
two dimensions: the science of nursing, which is the knowledge
specific to the field of nursing that comes from scientific
research; and the art of nursing, which involves using the science
of nursing creatively to help better the life of the patient.

Major Concepts:

1. Human-unitary human beings

A person is defined as an indivisible, pan-dimensional energy field
identified by a pattern, and manifesting characteristics specific to the
whole, and that can’t be predicted from knowledge of the parts. A person
is also a unified whole, having its own distinct characteristics that
can’t be viewed by looking at, describing, or summarizing the parts.

2. Health
Rogers defines health as an expression of the life process. It is the
characteristics and behavior coming from the mutual, simultaneous
interaction of the human and environmental fields, and health and
illness are part of the same continuum. The multiple events occurring
during the life process show the extent to which a person is achieving
his or her maximum health potential. The events vary in their
expressions from greatest health to those conditions that are
incompatible with the maintaining life process.

3. Nursing
It is the study of unitary, irreducible, indivisible human and
environmental fields: people and their world. Rogers claims that nursing
exists to serve people, and the safe practice of nursing depends on the
nature and amount of scientific nursing knowledge the nurse brings to
his or her practice

4. Scope of Nursing
Nursing aims to assist people in achieving their maximum health
potential. Maintenance and promotion of health, prevention of
disease, nursing diagnosis, intervention, and rehabilitation encompass
the scope of nursing’s goals.
Nursing is concerned with people-all people-well and sick, rich and
poor, young and old. The arenas of nursing’s services extend into all
areas where there are people: at home, at school, at work, at play; in
hospital, nursing home, and clinic; on this planet and now moving into
outer space.

5. Environmental Field
“An irreducible, indivisible, pandimensional energy field identified by
pattern and integral with the human field.”

6. Energy Field
The energy field is the fundamental unit of both the living and the non-
living. It provides a way to view people and the environment as
irreducible wholes. The energy fields continuously vary in intensity,
density, and extent.

Subconcepts:

1. Openness
There are no boundaries that stop energy flow between the human and
environmental fields, which is the openness in Rogers’ theory. It refers
to qualities exhibited by open systems; human beings and their
environment are open systems.

2. Pandimensional
Pan-dimensionality is defined as “non-linear domain without spatial or
temporal attributes.” The parameters that humans use in language to
describe events are arbitrary, and the present is relative; there is no
temporal ordering of lives.
Synergy is defined as the unique behavior of whole systems, unpredicted
by any behaviors of their component functions taken separately.
Human behavior is synergistic.

3. Pattern
Rogers defined the pattern as the distinguishing characteristic of an
energy field seen as a single wave. It is an abstraction and gives
identity to the field.

4. Principles of Homeodynamics
Homeodynamics should be understood as a dynamic version
of homeostasis (a relatively steady state of internal operation in the
living system).
Homeodynamic principles postulate a way of viewing unitary human beings.
The three principles of homeodynamics are resonance, helicy, and
integrality.
5. Principle of Reciprocy
Postulates the inseparability of man and environment and predicts that
sequential changes in life process are continuous, probabilistic
revisions occurring out of the interactions between man and environment.

6. Principle of Synchrony
This principle predicts that change in human behavior will be determined
by the simultaneous interaction of the actual state of the human field
and the actual state of the environmental field at any given point in
space-time.

7. Principle of Integrality (Synchrony + Reciprocy)

Because of the inseparability of human beings and their environment,
sequential changes in the life processes are continuous revisions
occurring from the interactions between human beings and their
environment.
Between the two entities, there is a constant mutual interaction and
mutual change whereby simultaneous molding is taking place in both at
the same time.

8. Principle of Resonancy
It speaks to the nature of the change occurring between human and
environmental fields. The life process in human beings is a symphony of
rhythmical vibrations oscillating at various frequencies.
It is the identification of the human field and the environmental field
by wave patterns manifesting continuous change from longer waves of
lower frequency to shorter waves of higher frequency.

9. Principle of Helicy
The human-environment field is a dynamic, open system in which change is
continuous due to the constant interchange between the human and
environment.
This change is also innovative. Because of constant interchange, an open
system is never exactly the same at any two moments; rather, the system
is continually new or different.
IMOGENE KING

 Imogene Martina King (January 30, 1923 – December 24, 2007) was one
of the pioneers and most sought nursing theorists for her Theory of
Goal Attainment which was developed in the early 1960s. Her work is
being taught to thousands of nursing students from all over the
world and is implemented in a variety of service settings as well.
 As a recognized global leader, King truly made a positive
difference for the nursing profession with her significant impact
on nursing’s scientific base. She made an enduring impact on
nursing education, practice, and research while serving as a
consummate, active leader in professional nursing.

THEORY: Goal Attaintment 

 The Theory of Goal Attainment states that “Nursing is a process of

action, reaction, and interaction whereby nurse and client share
information about their perception in the nursing situation.”
 Imogene King’s Theory of Goal Attainment was first introduced in
the 1960s. From the title itself, the model focuses on the
attainment of certain life goals. It explains that the nurse and
patient go hand-in-hand in communicating information, set goals
together, and then take actions to achieve those goals. The factors
that affect the attainment of goals are roles, stress, space, and
time. On the other hand, the goal of the nurse is to help patients
maintain health so they can function in their individual roles. The
nurse’s function is to interpret information in the nursing
process, to plan, implement, and evaluate nursing care.
 To help nurses understand her work, she defined several terms which
include the patient, defined as a social being who has three
fundamental needs: the need for health information, the need for
care that seeks to prevent illness, and the need for care when the
patient is unable to help him or herself.
 She also explained health as involving life experiences of the
patient, which includes adjusting to stressors in the internal and
external environment by using resources available. The environment,
defined as the background for human interaction. It involves the
internal environment, which transforms energy to enable people to
adjust to external environmental changes, and it involves the
external environment, which is formal and informal organizations. A
nurse is considered part of the patient’s environment.
 There are three interacting systems in the Theory of Goal
Attainment according to King. These are the personal system,
the interpersonal system, and the social system. Each system is
given different concepts. The concepts for the personal system are:
perception, self, growth and development, body image, space, and
time. The concepts for the interpersonal system are: interaction,
communication, transaction, role, and stress. The concepts for the
social system are: organization, authority, power, status, and
decision making.
Major Concepts and Sub-concepts:

The following are the major concepts and subconcepts of Imogene King’s
Theory of Goal Attainment:

1. Nursing
 Nursing is a process of action, reaction, and interaction whereby
nurse and client share information about their perceptions in the
nursing situation. The nurse and client share specific goals,
problems, and concerns and explore means to achieve a goal.

2. Health
 Health is a dynamic life experience of a human being, which implies
continuous adjustment to stressors in the internal and external
environment through optimum use of one’s resources to achieve
maximum potential for daily living.

3. Individual
 Individuals are social beings who are rational and sentient. Humans
communicate their thoughts, actions, customs, and 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, and to make decisions.

4. Environment
 Environment is the background for human interactions. It is both
external to, and internal to, the individual.

5. Action
 Action is defined as a sequence of behaviors involving mental and
physical action. The sequence is first mental action to recognize
the presenting conditions; then physical action to begin activities
related to those conditions; and finally, mental action in an
effort to exert control over the situation, combined with physical
action seeking to achieve goals.

6. Reaction
 Reaction is not specifically defined but might be considered to be
included in the sequence of behaviors described in action.

Interacting Systems of Theory of Goal Attainment:

 According to King, there are three interacting systems in the

Theory of Goal Attainment. These are the personal system,
the interpersonal system, and the social system. Each system is
given different concepts. The concepts for the personal system are:
perception, self, growth and development, body image, space, and
time. The concepts for the interpersonal system are: interaction,
communication, transaction, role, and stress. The concepts for the
social system are: organization, authority, power, status, and
decision making.
 1. Personal Systems

 Each individual is a personal system. King designated an example of

a personal system as a patient or a nurse. King specified the
concepts of body image, growth, and
development, perception, self, space, and time in order to
comprehend human beings as persons
 “The self is a composite of thoughts and feelings which constitute
a person’s awareness of his individual existence, his conception of
who and what he is. A person’s self is the sum total of all he can
call his. The self includes, among other things, a system of ideas,
attitudes, values, and commitments. The self is a person’s total
subjective environment. It is a distinctive center of experience
and significance. The self constitutes a person’s inner world as
distinguished from the outer world consisting of all other people
and things. The self is the individual as known to the individual.
It is that to which we refer when we say “I.”
 Growth and development can be defined as the processes in people’s
lives through which they move from a potential for the achievement
to the actualization of self.
 King defines body image as the way one perceives both one’s body
and others’ reactions to one’s appearance.
 Space includes that space exists in all directions, is the same
everywhere, and is defined by the physical area known as
“territory” and by the behaviors of those occupying it.
 Time is defined as “a duration between one event and another as
uniquely experienced by each human being; it is the relation of one
event to another event.”

2. Interpersonal Systems

 These are formed by human beings interacting. Two interacting

individuals form a dyad; three form a triad, and four or more form
small or large groups. As the number of interacting individuals
increases, so does the complexity of the interactions.
Understanding the interpersonal system requires the concepts
of communication, interaction, role, stress, and transaction.
 Interactions are defined as the observable behaviors of two or more
individuals in mutual presence.
 King (1990) defines communication as “a process whereby information
is given from one person to another either directly in a face-to-
face meeting or indirectly through telephone, television, or the
written word.”
 King defines transactions as “a process of interactions in which
human beings communicate with the environment to achieve goals that
are valued… goal-directed human behaviors.
 The characteristics of the role include reciprocity in that a
person may be a giver at one time and a taker at another time, with
a relationship between two or more individuals who are functioning
in two or more roles that learned, social, complex, and
situational.
 Stress is “a dynamic state whereby a human being interacts with the
environment to maintain balance for growth, development, and
performance, which involves an exchange of energy and information
between the person and the environment for regulation and control
of stressors.”

3. Social Systems

 A more comprehensive interacting system consists of groups that

make up society, referred to as the social system. Religious,
educational, and health care systems are examples of social
systems. The influential behavior of an extended family on an
individual’s growth and development is another social system
example. Within a social system, the concepts
of authority, decision making, organization, power,
and status guide system understanding.
 Power is the capacity to use resources in organizations to achieve
goals… is the process whereby one or more persons influence other
persons in a situation… is the capacity or ability of a person or a
group to achieve goals… occurs in all aspects of life and each
person has potential power determined by individual resources and
the environmental forces encountered. Power is a social force that
organizes and maintains society. Power is the ability to use and to
mobilize resources to achieve goals.
 Status is “the position of an individual in a group or a group in
relation to other groups in an organization” and is identified that
status is accompanied by “privileges, duties, and obligation.”
 Decision making is “a dynamic and systematic process by which goal-
directed choice of perceived alternatives is made and acted upon by
individuals or groups to answer a question and attain a goal”
(King, 1990).
 King (1986) added control as a subconcept in the social system but
did not further define the concept.