King’s General

Systems
Framework
Nursing
Conceptual Model
IMOGENE KING’S THEORY
Imogene King’s Background
• Imogene Martina King was one of the pioneers and most sought nursing theorists for her
Theory of Goal Attainment, which she developed in the early 1960s. The model focuses on
the attainment of certain life goals and emphasizes that the nurse and patient go hand-in-
hand in communicating information, set goals together, and then take actions to achieve
those goals.

 Early Life and Education

• Imogene King was born on January 30, 1923, in West Point, Iowa.
• She received a nursing diploma from St. John’s Hospital School of Nursing in St. Louis, Missouri,
in 1945.
• In 1948, she received Bachelor of Science in Nursing Education from St. Louis University.
• She earned her Master of Science in Nursing from St. Louis University, in the year 1957.
• In 1961, she studied along Mildred Montag at Teacher’s College, Columbia University, New York
and received her EdD.
 Career and Appointments
• From 1947 to 1958, she worked as an instructor in Medical-Surgical nursing and was an assistant
director at St. John’s Hospital School of Nursing.
• King developed a master’s degree program in nursing based on a nursing conceptual framework
from 1961 to 1966 at Loyola University in Chicago.
• Under Jessie Scott, she served as an Assistant Chief of Research Grants Branch, Division of
Nursing at the U.S. Department of Health, Education, and Welfare between 1966 and 1968.

• In 1969, King conducted a World Health Organization nursing research seminar in Manila,
Philippines, where she met Midori Sugimori of Japan.
• From 1968 to 1972, King served as the School of Nursing director at Ohio State University in
Columbus.
• King then returned to Chicago in 1972 as a professor in the Loyola University graduate program
and served from 1978 to 1980 as Coordinator of Research in Clinical Nursing at the Loyola
Medical Center Department of Nursing.
• From 1972 to 1975, King was a member of the Defense Advisory Committee on Women in the
Services for the U.S. Department of Defense.
• She was elected alderman for a 4-year term (1975 to 1979) in Ward 2 at Wood Dale, Illinois.

• In 1980, King was appointed professor at the University of South Florida College of Nursing in
Tampa.
• King retired in 1990 and was named professor emeritus at the University of South Florida.
• King was the keynote speaker at two STTI theory conferences in 1992 and presented her theory at
multiple regional, national, and international STTI conferences.
• King was a long-time member of the American Nurses Association (ANA), first with the Missouri
Nurses Association, and she was also active in Illinois and Ohio.
• King held offices such as the Florida Nurses Foundation president, served on the FNA and the
FNA District IV boards, and was a delegate from the FNA to the ANA House of Delegates.

• In 2000, King was keynote speaker for the 37th Annual Isabel Maitland Stewart Conference in
Research in Nursing at Teachers College, Columbia University
• The King International Nursing Group (K.I.N.G.) was created to facilitate the dissemination and
utilization of King’s conceptual system, the Theory of Goal Attainment, and related theories.
 Published Works
• Imogene King has written numerous articles related
to her conceptual system and theory of goal
attainment.
• She also authored multiple book chapters and
articles in professional journals including “Frey &
Sieloff’s Advancing King’s Systems Framework
and Theory of Nursing” (1995), and “Sieloff and
Frey’s Middle Range Theories for Nursing Practice
Using King’s Conceptual System” (2007), which
highlighted her studies by other authors.

• Some of her works include “Theory for

Nursing: Systems, Concepts, Process”, “The
Language of Nursing Theory and Metatheory”,
“Toward a Theory for Nursing: General
Concepts of Human Behaviour” and
“Curriculum and Instruction in Nursing:
Concepts and Process.”
 Awards and Honors
• Imogene King’s book entitled “Toward a Theory for Nursing: General Concepts of Human
Behavior” received the American Journal of Nursing Book of the Year Award in 1973.
• In 1980, she was awarded an honorary Ph.D. from Southern Illinois University.
• She earned the STTI Elizabeth Russell Belford Founders Award for Excellence in Education in
1989.
• She received the Jessie M. Scott Award in 1996.
• In 1997, King received a gold medallion from Governor 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” is housed.
• In 1999, King was inducted into the Teachers College, Columbia University of Hall of Fame.

• In 2004, she was inducted into the FNA Hall of Fame and the ANA Hall of Fame. She was
inducted as a Living Legend in 2005.
 Death
• Imogene King died at the age of 84, on December 24, 2007, two days after suffering from a
stroke.

• King’s memorial services were held on January 4 in St. Pete Beach, Florida, and January 19
in Fort Madison, Iowa, where she was buried.

Patricia Quigley, Ph.D., ARNP, CRRN, FAAN, announced King’s passing to nursing colleagues
with these words: “May we all burn a candle today for the light that Imogene shined on us with her smile,
laughter, knowledge, and passion for each day. We all shared in our love for her. Combining religion and
science through nursing, her inspired voice was never weak—but strong with passion and conviction.”

During both services, Patricia Messmer read the Nightingale Tribute, which included a synopsis of
King’s career and a poem, “Imogene Was There.” Seven green Irish roses symbolized the seven decades
of her nursing career. A Nightingale Lamp from the University of Pittsburgh, her graduation picture from
St. John’s Hospital School of Nursing, and a current photo were also displayed for the memorial services.
The Theory of
Goal
Attainment
 “Nursing is a process of action,
reaction, and interaction by which
nurse and client share information
about their perception in a nursing
situation”

Theory of Goal Attainment

 The Theory of Goal Attainment

• Imogene M. King’s Theory of Goal Attainment focuses on this process to

guide and direct nurses in the nurse-patient relationship, going hand-in-
hand with their patients to meet good health goals.

• King’s Theory of Goal Attainment was first introduced in the 1960s. It

comes from the title itself, as 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.
 Assumptions
King’s conceptual system 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.

The assumptions are:

1. The focus of nursing is the care of the human being or patient.

2. The goal of nursing is the health care of both individuals and groups.
3. Human beings are open systems interacting with their environments constantly.
4. 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.
5. Patients perceive the world as a complete person making transactions with individuals and
things in the environment.
6. The 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.
 Major Concepts and Subconcepts
The following are the major concepts and subconcepts of Imogene King’s Theory of Goal Attainment:

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 how to achieve a goal.

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 daily living potential.

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, think, feel, choose between alternative courses of action, set goals, select the means to achieve
goals, and make decisions.
 Major Concepts and Subconcepts
The following are the major concepts and subconcepts of Imogene King’s Theory of Goal Attainment:

ENVIRONMENT
The environment is the background for human interactions. It is both external to, and internal to, the
individual.

ACTION
Action is defined as a sequence of behaviors involving mental and physical activity. 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 to exert control over the situation, combined with physical
action seeking to achieve goals.

REACTION
The reaction is not specifically defined but might be considered in the sequence of behaviors
described in action.
Interacting
Systems of Theory
of Goal
Attainment
 Personal Systems Interpersonal Systems Social Systems
 Each individual is a  It is are formed by interaction of  It is a more comprehensive
personal system. King human being. Two interacting interacting system consists of
designated an example of a individuals form a dyad; three form groups that build society.
personal system as a a triad, and four or more form small
 An extended family’s
patient or a nurse. or large groups.
influential behavior on an
 King specified the 7  As the number of interacting individual’s growth and
dimensions to comprehend individuals increases, so does the development is an social
human beings as persons. complexity of the interactions. system example.
• Body image  Understanding the interpersonal  Within a social system, this
• Growth system requires the concepts of: concepts guide system
• Development understanding:
• Perception • Communication
• Interaction • Authority
• Self
• Role • Decision making
• Space
• Stress • Organization
• Time
• Transaction • Power
• Status
 Dynamic
A picture always Conceptual
reinforces System
the concept King has interrelated the
Images reveal large amounts of data, so
concepts of interaction, perception,
remember: use an image instead of a long
communication, transaction, self,
text. Your audience will appreciate it
role, stress, growth and
development, time, and space into a
goal attainment theory.
 Process of Interaction
“The human process
of interactions formed the
basis for designing a model
of transactions that
depicted theoretical
knowledge used by nurses
to help individuals and
groups attain goals.”
-Imogene King
Interaction
Interaction is a process of perception and communication between a person and environment and
between person and person represented by verbal and nonverbal behaviors that are goal-directed.

Transaction
The transaction is a process of interactions in which human beings communicate with the
environment to achieve valued goals; transactions are goal-directed human behaviors.
Perception is “each person’s representation of reality.”

Communication
Communication is defined as “a process whereby information is given from one person to another
either directly in face-to-face meetings or indirectly through telephone, television, or the written word.”

Role
The role is defined as “a set of behaviors expected of persons occupying a position in a social
system; rules that define rights and obligations in a position; a relationship with one or more individuals
interacting in specific situations for a purpose.”
Stress
Stress is “a dynamic state whereby a human being interacts with the environment to maintain balance
for growth, development, and performance… an energy response of an individual to persons, objects, and
events called stressors.”

Growth and Development

Growth and development can be defined as the “continuous changes in individuals at the cellular,
molecular, and behavioral levels of activities. The processes that take place in the life of individuals that
help them move from potential capacity for achievement to self-actualization.”

Time
Time is “a sequence of events moving onward to the future, a continuous flow of events in
successive order that implies a change, a past and a future, a duration between one event and another as
uniquely experienced by each human being the relation of one event to another.”

Space
Space exists in every direction and is the same in all directions. Space includes that physical area
called territory. Space is defined by the behaviors of those individuals who occupy it.
 Propositions
The following propositions are made in Imogene King’s Theory of Goal Attainment:

1. If perceptual interaction accuracy is present in nurse-patient interactions, the transaction will

occur.
2. If the nurse and patient make the transaction, the goal or goals will be achieved.
3. If the goal or goals are achieved, satisfaction will occur.
4. If the goal or goals are achieved, effective nursing care will occur.
5. If transactions are made in nurse-patient interactions, growth and development will be enhanced.
6. If role expectations and role performance perceived by the nurse and patient are congruent, the
transaction will occur.
7. If role conflict is experienced by either the nurse or the patient (or both), stress in the nurse-
patient interaction will occur.
8. If a nurse with special knowledge communicates appropriate information to the patient, mutual
goal-setting and goal achievement will occur.
 Theory of Goal Attainment and the Nursing Process
Imogene King emphasizes the nursing process in her model of nursing. The steps of the nursing
process are:

 The theory explains that assessment takes place during the interaction. The nurse uses his or her
special knowledge and skills while the patient delivers knowledge of him or herself and the
perception of problems of concern to the interaction. During this phase, the nurse gathers data about
the patient, including their growth and development, the perception of self, and current health
status. Perception is the basis for the collection and interpretation of data. Communication is
required to verify the accuracy of the perception, as well as for interaction and translation.

 Nursing diagnosis is developed using the data collected in the assessment. In attaining goals, the
nurse identifies problems, concerns, and disturbances about which the patient is seeking help.
  The planning phase arises after the diagnosis. The nurse and other health care team members
create a care plan of interventions to solve the problems identified. This phase is represented by
setting goals and making decisions about the means to achieve those goals. This part of the
transaction and the patient’s participation are encouraged in making decisions on the means to
achieve the goals.
 The actual activities done to achieve the goals make up the implementation phase of the nursing
process. Whereas in this model of nursing, it is the continuation of transaction.

 Finally, in the evaluation phase, the nurse evaluates the patient to determine whether the goals were
achieved. Evaluation involves determining whether or not goals were achieved. The explanation of
evaluation in King’s theory addresses meeting goals and the effectiveness of nursing care.

In the healthcare field, the nurse-patient relationship’s final goal is to help the patient achieve his or
her goals for getting healthy. Using the nursing process described in King’s Theory of Goal Attainment, a
nurse can be more effective in working with a patient to achieve those goals and truly help patients.
“Nursing is a process of human
interactions between nurse and client
whereby each perceives the other and the
situation, and through communication,
they set goals, explore means, and agree
on means to achieve goals.”

Theory of Goal Attainment

 Strengths

 A major strong point of King’s conceptual system and Theory of Goal Attainment is
how nurses can understand goal attainment theory and 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 the research literature.
Her Theory of Goal Attainment presents ten major concepts. The concepts are easily
understood and derived from the research literature, which clearly establishes King’s
work as important for knowledge building in nursing.
 Weaknesses

 Theory of Goal Attainment has been criticized for having limited application in
nursing areas 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 applying 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 groups’ health care 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 the importance of
health maintenance.
 Conclusion

In conclusion, Imogene King contributed to the advancement of nursing

knowledge through the development her conceptual system and middle-range
Theory of Goal Attainment. She also provided a conceptual system and
middle-range theory that has illustrated its usefulness to nurses by focusing on
attaining goals or outcomes by nurse-patient partnership. Nurses working in
various settings with patients from around the world continue to use King’s
work to improve the quality of patient care.
King’s General
Systems
Framework
Nursing
Conceptual Model
IMOGENE KING’S THEORY
THANK
YOU!
PRESENTER:
Balagot, Haidie P.
Ballesteros, Blessed Eunice I.
Basilio, Patricia Nichole S.