Introduction to the Theorist
Majority of individuals chase nursing profession with the aim of being involved in assisting patients to get well. However, this was not the case with Imogene King. Her dream had been to be a teacher. When she grew up, her uncle offered her the opportunity to train as a nurse. She could not resist the offer, as it would allow her to escape from her small hometown known as West Point, Lowa. As she left for Missouri, she never figured that she would eventually become a pioneer and adored nurse theorist (Pamela, 2009).
History and Overview of the Theorist
The nursing theorist was born Imogene King in 1923. She was the lastborn in a family of three children. She studied in the small village of West Point called Lowa. Her childhood dream to become a teacher was sustained until she completed her pre-college school. King was not comfortable in her town setting despite the motivation to become a teacher. The offer by her uncle to train as a nurse presented the timely chance to move out of West Point. King received her Nursing Diploma at the age of twenty-two years. When she received the diploma from St. Johns Nursing Hospital in Missouri, she had no idea that three decades down the line she would be the most esteemed Nursing Theorist. At the age of twenty-five years, she received a Bachelor of Science in Nursing and Education. This includes minors in Philosophy and Chemistry from the same nursing hospital.
King practiced as a nurse for the next nine years while pursuing a Master of Science in Nursing at the hospital university. The challenges that she faced did not deter her from pursuing Doctorate in Education at Teachers College in Columbia University. She received the doctorate in 1961 after which she fully engaged in her career as a professional nurse. Her tenacity to be a teacher was reflected when she was appointed as the Superintendent Director of the Ohio State University specifically the School of Nursing. Between 1961 and 1980, she was appointed an Educator at St. Johns University, South Florida University and Loyola University thus further demonstrating her urge to be a teacher (Pamela, 2009). She demonstrated her prowess in nursing education when she published Toward a Theory for Nursing: General Concepts of Human Behavior. This was followed by A Theory for Nursing: Systems, Concepts, Process. King’s Theory of Goal Attainment developed when she sought to respond to her own concerns including “The goal of nursing, roles of a nurse and the expansion of nurses understanding to offer quality care.” After receiving multiplicity of honors during practice, King passed on 24 December 1997.
Major Components of the Theory
The major components of the theory are discussed below.
Man
The theory begins with the individuals having health needs that are categorized into three. First, it is necessary to have health information, which is functional. Second, there is need for healthcare to aim at the prevention of sickness. Third, there is need for healthcare when individuals lack the capacity to assist themselves. The individual’s discernment of the needs is influenced by a variety of factors including the consciousness that one exists, growth and maturity, body image as well as knowledge. In this concept, the objective of the individual is to gratify the needs. For the individual to achieve this one ought to ask for assistance from other sources. When the individual opts to consult a nurse, the perception of the nurse is influenced through the constituents present in the individual. This develops interaction between the individual and the practitioner whether verbal or non-verbal.
Health
According to King, health is the state of being complete and functional. These include being communal, conscious, coherent, reactive, purposeful, perceptive, action and tome oriented. The interference of the said holistic and practical state results in illness. King acknowledges the capacity of an individual to “constantly regulate to the interior and exterior stressors” through the optimization of accessible resources to attain “the optimum potentiality for daily existence”. King held the position that the objective of nursing is to assist persons in maintaining their wellness in order to function properly.
Nursing
King viewed nursing as the process of consistent and active human interaction between the individual and the nurse via verbal and non-verbal communication. The communication should be targeted at establishing the common objectives of attaining care for the individual (Clarke et al., 2009). This can be attained by agreeing upon the methods of attaining the objectives founded on the common discernment of the prevailing nursing situation. King conceptualized this as the interpersonal system under the Theory of Goal Attainment.
Environment
This aspect forms the foundation for the interactions between the patient, the nurse and the surroundings. The surroundings include social settings, school, and church that the individual is in contact with throughout lifetime. The interior surroundings change energy thus allowing the individual to adapt to the exterior surrounding changes. The exterior surroundings include formal and informal societies. The nurse is part of the exterior surroundings. Through communication between individuals, his nurse and his environment, the perceptions of the nurse and the surrounding are influenced via the same aspects that influenced him in creating his perceptions. By interacting with the patient, the nurse and the environment are able to realize accurately a representation of the patient’s perception. This allows the nurse and the environment to discover the means through which the objective is to be realized. The connection between the nurse and the individual allows the attainment of a mutually agreeable upon goal by those involved (Lavin & Killeen, 2008).
Conceptual Model
The interpretive method was selected for this study. It was selected as it enables one to examine the position and applicability of King’s theory to the nursing practice. Nurses pursue the career with the aim of becoming instrumental in assisting individuals to get healthy. In order to achieve this, it is imperative to set health objectives with the individual patient. Consequently, the nurse takes appropriate measures to realize the goals. In healthcare settings, it has been proved that communication between a nurse and an individual patient while collaborating towards the mutually agreed objectives makes the realization of the goals feasible. King’s model focuses on several techniques to assist nurses in the nurse-client relationship. She utilized a ‘systems’ perspective in developing the dynamic interactive system frameworks and the resulting Goal Attainment Theory (Davis, 2008). The theory entails the significance of interacting, perception, development, self, personal time, privacy, role and communication. King held that both the client and the nurse contribute essential awareness and information to the interaction as they collaborate to attain the set objectives.
The interactive methods utilized by King to develop the model include personal approach, interpersonal approach and social approach. The model is feasible and failure to integrate the concepts may lead to substandard nursing practice.
Relationship between the Key Elements of the Theory
The key elements of the Goal of Attainment Theory are inherently realized in the interpersonal system. This is where two individuals’ who are often unfamiliar persons collaborate in a health care setting to assist or to be assisted to attain the state of wellness that allows the affected individual to function properly. The elements focus on transactions, contact and interactivity between Dyads (two persons), the nurse and the client. For a nurse to help the patient effectively, the two must interact. This interaction is built on communication. Such communication can be either verbal or non-verbal. The two must come to terms with the goal of the interaction being agreed between the two. Failure to establish communication is detrimental to the health of the client. These elements fit together as the absence of one element is crippling to the theory and consequently the health of the patient.
Evaluation of the Model
King’s Theory has been integrated in many nursing curricula worldwide. It holds an essential position in the nurse training and practice fraternity. It is critical in achieving desirable health statuses for individuals and consequently the society. The theory is fundamentally founded on the nurse-client interactions and the arrangement (environment) in which they occur as vital to the achievement of the client’s health goals. A client and the nurse create a team and concur on objectives. Eventually, they execute the mutually agreed objectives to realize the goals. In order to evaluate the effectiveness of the model, it is important to review how each of the systems that form the theory fits in the attainment of client health.
Personal system
The system is founded on the individual. The concepts involved include space, time, development, growth, perception and the self. These are essential in understanding individuals as they focus on how the nurse views the individual client. The perception is the most essential as it determines behavior through learning and self-image (King, 2009). In evaluating this system, it will be observed that the patient requires personal space, time, development, growth and the opportunity to come to terms with the self. This allows the person to be able to relate to the situation and appreciate that he requires help if he cannot help himself to attain and maintain health.
Interpersonal system
This system is related to a number of concepts including relations, role and transactions. It is indicative of the relationship between the client and the nurse in the care provision setting. The relationship between the nurse and the client in King’s context referred to as Dyads is fundamental in order to attain the agreed upon objectives. In this regard, the system fits well as it is imperative for the patient to create a mutual connection with the nurse. This will allow the nurse to assess the needs of the patient effectively. By so doing the patient will understand his role in attaining wellness (King, 2009). The role of the nurse will also be established. It is important that the connection be maintained to allow transactions to take place. The model fits well with real life application as the nurse’s role may be limited in helping the patient if a connection is not established. Without an agreement, the goals may not be realized.
Social System
The system indicates how the practitioner relates to the coworkers and the client surroundings in general (Barrett, 2009). The client surroundings in this context refer to the people in the client’s society that have common goals, interests and values regarding health. The system forms the basis of social interactivity and relations (King, 2009). It forms the foundation for the establishment of guidelines for behavior and actions. The model is important in making the patient realize that he needs that support his environment including relatives, family, the society and the nurse. Irrespective of whether or not the patient can help himself, the environment is important given that social connections are important in maintaining individual health.
Application of the Model
Nursing Education
According to King, the fundamental basis of a nursing curriculum should be the vibrant nurse-patient interaction. The programs should train participants to become valuable and productive professional nurses as they accumulate knowledge and skills in the nursing profession. It should involve conditions to the nursing training such as biophysical sciences and arts. Training experiences should help the perception of the trainee regarding the position of health and possible disruptions in the state of health.
Nursing Research
The final intention of study is to resolve the impacts of common objectives setting and implementing the appropriate nurture interventions associated with the objectives on goal accomplishment. The event of interest in exploration should be interactions and wellness. King proposed that the exact challenges to be researched should be real or possible disturbances in the patient’s capacity to be productive in social roles. The essential role of research in nursing is intrinsic in all her discussions regarding nursing theory and skill enhancement.
Nursing Practice
Founded on King’s principles, the objective of nursing practice is to facilitate persons to achieve and maintain their health. Whenever there are some disturbances to the health status including sicknesses or disability, the practice should have the ability to resolve all these (Gianfermi & Buchholz, 2011). King asserted that nursing practice should take place in severe or chronic healthcare settings. It should also take place in suitable surroundings when giving healthcare in order to ensure wellness.
References
Barrett, M. (2009). Nursing environment for clients’ health. Journal of Nursing Measurement, 16 (2), 13–24.
Clarke, S. et al. (2009). The role of symptom distress and goal attainment in promoting aspects of psychological recovery for consumers with enduring mental illness. Journal of Mental Health, 18(5), 389-397.
Davis, L. (2008). Middle range theory development using king’s conceptual system. Nursing Philosophy, 9(4), 283-284.
Gianfermi, R. & Buchholz, S. (2011). Exploring the relationship between job satisfaction and nursing group outcome attainment capability in nurse administrators. Journal of Nursing Management, 19 (3), 1012-1019.
King, M. (2009). King’s conceptual system, theory of goal attainment, and transaction process in the 21st century. Nursing Science Quarterly, 20(2), 89–108.
Lavin, M. & Killeen, M. (2008). Tribute to Imogene King. International Journal of Nursing Terminologies and Classifications, 19(2), 44-47.
Pamela, C. (2009). Imogene M. King’s scholars reflect on her wisdom and influence on nursing science. Nursing Science Quarterly, 22(2), 128-133.