Imogene King

Interacting Systems Framework and Goal Attainment Theory

Background:
Had her diploma in nursing from St. John’s Hospital of Nursing in St. Louis, Missouri in 1945  Received her BS in Nursing Education in St. Louis University in 1948  Earned an M.S.N. in 1957  Earned a Doctor of Education in 1961 from Teachers College, Columbia University, NY  Awarded an honorary Ph.D. From Southern Illinois University in 1980

From 1968- 1972, her book Toward a Theory in Nursing was published  Was awarded the American Journal of Nursing Book of the Year Award in 1973  A Theory for Nursing: Systems, Concepts, Process was published in 1981  Curriculum and Instruction in Nursing was also published in 1986

Theory (King):
“A set of concepts, which, when defined, are interrelated and observable in the world of nursing practice.”  Theory serves to build “scientific knowledge for nursing.”

2 methods for developing theory (King):
A theory can be developed and tested through research  Research can provide data from which a theory may be developed
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King’s opinion is that “in today’s world of building knowledge for a complex profession such as nursing, one must consider these two strategies.”

Development of Interacting Systems Framework:
Personal systems (individuals), individuals exist within personal systems. An example is being the patient or the nurse.  Interpersonal systems are formed when two or more individuals interact, forming dyads or triads.  Social system is referred to as a comprehensive interacting system consists of groups that make up society.

Development of Goal Theory of Goal  In 1981, King derived the Attainment Theory: Attainment from her interacting systems

framework.  The question that motivated her was: “What is the nature of nursing?”. The answer: “the way in which nurses, in their role, do with and for individuals that differentiates nursing from other health professionals”, guide the development of GAT.

Mutual goal setting is based on:
A. Nurses’ assessment of client’s concerns, problems, and disturbances in health  B. Nurses’ and client’s perception interference  C. Their sharing of information whereby each functions to help the client attain the goals identified. In addition, nurses interact with family members when clients cannot verbally participate in the goal setting.

Major Concepts and Definitions:

Health is defined as dynamic life experiences 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.  Nursing is defined as a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation.

The self is a composite of thoughts and feelings which constitute a person’s awareness of his/ her individual existence, his/ her conception of who and what he/ she is. A person’s self is the total of all he/ she can call his/ hers. 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 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”.

Perception: a process in which data obtained through the senses and from memory are organized, interpreted, and transformed Self: made up of thoughts and feelings related to one’s awareness of being a person separate from others and influencing one’s view of who and what he or she is

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Growth & development: processes in people’s lives through which the move from a potential for achievement to actualization of self  Body Image: includes both the way one perceives one’s body and others’ reactions to one’s appearance  Space: physical area known as territory and by the behaviours of those who occupy it  Time: an interval between the two events that is experienced differently by each person
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Interactions: observable behaviours of two or more persons in mutual presence  Communication: verbal and non verbal situational, perceptual, transactional, irreversible, or moving fwd in time, personal, and dynamic  Transactions: a series of exchanges between human beings and the environment that include observable behaviours that seek to reach goals of worth to the participants

Role: characteristic of role include reciprocity in that a person may be a giver at one time and a taker at another time, with a relationship b/t two or more individuals who are functioning in two or more roles that are learned, social, complex, and situational  Stress: an ever changing condition in which an individual, through environmental interaction, seeks to keep equilibrium to support growth and development and activity
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Organization: made up of individuals who have prescribed roles and positions and who make use of resources to meet goalsboth personal and organizational Authority: active, reciprocal process of transaction in which the actors’ experience, understanding, and values influence the meaning, legitimacy and acceptance of those in organizational positions associated with authority

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Status: the relationship of one’s place in a group to others in the group or of a group to other groups Decision Making: changing and orderly process through which choices related to goals are made among identified possible activities and individual or group actions are taken to move toward the goal

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Major Assumptions:

Nursing is an observable behavior found in the health care systems in society. The goal of nursing “is to help individuals maintain their health so they can function in their roles”. Nursing is an interpersonal process of action, reaction, interaction, and transaction. Perceptions of a nurse and a patient also influence the interpersonal process.

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Individuals are spiritual beings Individuals have the capacity to think, to know, to make choices, and to select alternative courses of action Individuals have the ability through their language and other symbols to record their history and to preserve their culture Individuals are open systems in transaction with the environment Individuals are unique and holistic and are of intrinsic worth who are capable of rational thinking and decision making in most situations Individuals differ in their needs, wants, and goals

Health according to King, health involves dynamic life experiences 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

Environment is the background for human interactions.

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