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.
KING`S CONCEPTUAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT
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.