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Nursing Theorists Dr. Imogene King EdD, MSN, RN, FAAN. Dr. Imogene King Bio. Born Jan. 30, 1923 in West Point, Iowa. Received a diploma in nursing from St. John's Hospital School of Nursing in St. Louis, Mo. in 1945; A bachelor's degree in science in nursing education in 1945;
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Dr. Imogene King Bio • Born Jan. 30, 1923 in West Point, Iowa. • Received a diploma in nursing from St. John's Hospital School of Nursing in St. Louis, Mo. in 1945; • A bachelor's degree in science in nursing education in 1945; • A master's degree in science in nursing from St. Louis University in 1957; • A doctorate in education from the Teacher's College at Columbia University in 1961.
Dr. Imogene King Bio • Professor at Loyola University in Chicago, Ill. • Director of Nursing at Ohio State University. • Professor at University of South Florida.
King developed the theory of goal attainment in 1981, after creating her interacting system framework.
She began thinking “what is the nature of nursing,” and used this to guide her to develop her theory.
Dr. King used different criteria to confirm that her theory posed questions that could be researched and verified. Some of the other criteria were to make sure that the concepts were clearly recognized and defined, and to recognize the rational assumptions (Alligood & Tomey, 2006, p.302).
King tested her theory by describing how the nurses & patients interact and how this can lead to goal attainment, which is a little different than how she normally performed her studies.
She was determined to see if nurses made transactions. She broke her groups into the volunteer group and the non-participant group.
King then trained the non-participant group before collecting any of her data. She observed nonverbal and verbal interactions from both groups that helped to form her theory of goal attainment.
She then was able to answer her question as to “what the nature of nursing” was by stating that it is “the way in which nurses, in their role, do with and for individuals that differentiates nursing from other health professions” (Alligood & Tomey, 2006, p. 302).
King used her own assumptions and experiences to help create her theory. She used nursing, individuals, health, environment and the nurse-client interaction to help form these ideas. King stated that her interaction framework and Theory of Goal Attainment were “‘based on an overall assumption that the focus of nursing is human beings interacting with their environment leading to a state of health for individuals, which is an ability to function in social roles’” (Alligood & Tomey, 2006, p. 303).
Nursing This is the behavior between nurses and their patients that helps the patients to be able to function independently in their role in life. King recognized that there is a process being used in the nurse-to-patient interaction. This process is action, reaction, interaction and transaction. Each step in this process can be subject to change depending on the interaction between the nurse and patient (Alligood & Tomey, 2006, p. 303).
Person • King had many different ideas about individuals that were very empowering. She believed that each individual: • Has the ability to make their own decisions that will result in different actions. • Has a spiritual component. • Can record their history and culture using different forms of communication. • Has their own necessities and goals that they are trying to obtain. • Has a distinctive way of thinking in each situation. • Is connected with their environment. (Alligood & Tomey, 2006, p. 303)
Health Health is an important part in each individual’s life and everyone is different. Each individual’s body is constantly adjusting itself depending on the internal and external atmosphere. According to King, our health depends on using the resources available to us to maintain a healthy lifestyle (Alligood & Tomey, 2006, p. 303).
Environment King believes that it is critical for nurses to understand how individuals work together with their environment to preserve their health. As the environment changes, each individual needs to be able to make changes as well to control their health. Nurses need to be able to adjust to these changes in order to provide the best care possible for each individual (Alligood & Tomey, 2006, p. 303).
“King clearly identifies that the concepts in the framework are not limited to only one of the dynamic interacting systems but cut across all three systems”. (Tomey, 2006, p. 301)
Dr. King’s Philosophy On Nursing “Nursing is an observable behavior found in the health care systems in society. It is a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation. The goal of nursing is to help individuals maintain their health so they can function in their roles.” Imogene King (1998). Quoted in Nursing Theorist and Their Work
Individual’s Perception Self Growth and Development Body Image Time Space
The Individual’s Perception The primary feature of the personal system because it influences all other behaviors. This refers to a person’s representation of reality. It is universal, yet highly subjective and unique to each person.
Self The person’s subjective: • Values • Ideas • Attitudes • Commitment
Growth and Development Involves all the changes that occur: Cellular Molecular Behavioral These changes are usually orderly and predictable, but may very with individuals.
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 changes physically and emotionally.
Example Clinical A patient with a traumatic amputation of an extremity. After meeting the physical requirements to care for this patient, a nurse should assess the patient’s perception of self and the resulting self esteem. The treatment plan should be adapted accordingly to the nurse’s assessment.
Example Pt Assessment When assessing a pt with body image changes, the nurse must keep in mind that some pt my have a difficult time dealing with their loss or feeling of disfigurement. Support groups are a good way for pt to see other people and how the deal with the loss or change in their body appearance.
Space The immediate physical territory occupied by person and person’s behavior.
Time The order of events and their relationship to each other.
“King emphasized that waiting makes time even longer” (Williams, 2001, p. 26)
Example Clinical A patient who is waiting for the physician to return with an important test result. For the case of example, let’s presume it is a value that determines whether the patient’s cancer has returned or not.
Example Pt Assessment Patient is waiting to go for a procedure i.e., cath lab, open heart surgery, etc. Intervention and planning should focus on distractions to help the patient and family pass time until the procedure. Some interventions may include medication, education video or just simply talking with the patient and family to reduce worry and frustration.
Dr. King’s Philosophy On Health “Health implies continuous adjustment to stress in the internal and external environment through optimum use of one’s resources to achieve potential for daily living.” Imogene King (1998). Quoted in Nursing Theorist and Their Work
Communication Role Transaction Interaction Stress
Interaction The belief that each individual brings a different set of values, ideas, attitudes, and perception to each interaction. The individuals will come together for a purpose, make a judgment, take action, and react to the individual and situation.
Transaction Interaction between a person and another person or a person and the environment for purpose of goal attainment.
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 people.
Stress The exchange of energy is either positive or negative between a person and the environment, object, events and persons can serve as stressor.
Imogene King’s Assumptions of the Individual are: • Individualsare spiritual beings. • Individualshave the capacity to think, to know, to make choices, and to select alternative courses of action. • Individualshave the ability through their language and other symbols to record their history and to preserve their culture.
Individualsare open systems in transaction with environment. • Individualsare unique and holistic and are of intrinsic worth who are capable of rational thinking and decision making in most situations. • Individualsdiffer in their needs, wants, and goals. Imogene King (1998). Quoted in Nursing Theorist and Their Work
Organization Authority Decision Making Status
Organization A group of people with similar interests who have prescribed roles and positions who use resources to achieve personal and organizational roles.
Authority Refers to the observable behavior of providing guidance and order for actions. It is active and reciprocal.
