King’s Conceptual Framework and Theory of Goal Attainment
Within each discipline of science lie conceptual frameworks, which addresses general and abstract concepts of phenomena and postulations that delineate them (Butts & Rich, 2018, p. 96). Conceptual frameworks have practical value as they guide research and practice. In nursing, they enable unique perspectives of the metaparadigm concept and provide a path for concrete theories (Butts & Rich, 2018, p. 96-97). A conceptual framework that can be used in advanced practice nursing is King’s Conceptual System.
King’s Conceptual System
Imogene King’s Conceptual System scrutinizes the interrelationship between human beings and their environment, which then defines the physical and social conditions for them to function (Sieloff, Frey, & King, 2007, p. 5). Human beings are seen as interacting open systems (Butts & Rich, 2018, p. 466). The environments in which they constantly interact are both internal and external (Sielfoff et al., 2007, p. 5). Understanding these interactions enable the nurse to organize his/her knowledge, skills, and values in adequately assessing the patient and their needs (Butts & Rich, 2018, p. 466). Every patient-nurse interaction is considered a transaction, facilitating the patient’s goal(s) to be met (Butts & Rich, 2018, p. 466). King’s model reflects the general systems theory of nursing by encompassing the metaparadigm concepts of human beings, environment, health, and nursing.
Human Beings (Persons)
Three interacting systems of personal, interpersonal, and social systems comprise the human beings concept of the metaparadigm. “Personal system is defined as ‘a unified, complex whole self who perceives, thinks, desires, imagines, decides, identifies goals, and selects means to achieve them’” (Fawcett, 2017, p. 63). The personal system embodies the individual that interacts and reacts to stimuli from others and the environment, and influencing said individual’s function (Butts & Rich, 2018, p. 467).
The interpersonal system occurs between the individual and groups of people and may include the nurse (Butts & Rich, 2018, p. 467). Paramount to the patient-nurse transaction is communication. The nurse must believe in the patient’s speech, have the willingness to listen, and be self-conscious of both his/her verbal and non-verbal language. Borges, Moreira, da Silva, Loureiro, & de Meneses (2017) exclaimed, “communication is the means by which learning happens and, to be effective, it has to happen in an atmosphere of mutual respect and one has to want to be understood” (p. 1774).
The social system is the broader interactions that occur within and between groups, in which boundaries, social roles, behaviors, and practices are set (Shanta & Connolly, 2013, p. 175). These groups share commonalities in terms of interests, goals, and values, and include concepts of organization, power, status, authority, and decision-making (Butts & Rich, 2018, p. 467).
Environment consists of both internal and external elements. The internal environment is found within the individual, whereas the external occurs outside of the individual’s control. This is transformative as one is able to continuously adjust to changes based on his/her environment. Silefoff et al. (2007) “is an essential factor in one’s adaptation to life and health” (p. 5).
Health is defined as the process of growth and development, and the way in which individuals cope with their stressors and function in their environment (Butts & Rich, 2018, p. 467). It is dynamic and constantly changing, requiring continuous adjustments to maintain physiological and psychological soundness (Butts & Rich, 2018, p. 468). It can be optimized through obtaining appropriate resources in dealing with such stressors as identified in the patient-nurse interpersonal transactions.
Nursing is the helping of individuals to maintain their health in order for them to function within their roles, regardless of age and socioeconomic backgrounds. They help persons maintain their daily lives and satisfy basic needs. Sielfoff et al. (2007) elaborate, “The domain of nursing includes promotion of health, maintenance and restoration of health, care of the sick and injured, and care of the dying” (p. 7).
The value of King’s Conceptual System is its ability to guide nursing practice. Derived from her conceptual framework, King developed the Theory of Goal Attainment. This middle-range theory focuses on the interactional process that is the nature of nursing, guiding individuals in goal attainment of their health. These goals can then be used as criteria in measuring the effectiveness of nursing (Butts & Rich, 2018, p. 469). Moreover, “King’s theory exemplifies respect for patients and places importance on information exchange, goal setting, and patient-centered care” (de Leon-Demara, MacDonald, Gregory, Katz, & Halas, 2015, p. 632)
In conclusion, King’s Conceptual System provides a unique perspective of the nursing discipline as abstracted from the metaparadigm concepts. King’s model focuses on the individual and emphasizes the patient-nurse relationship in identifying and overcoming barriers to health, with an underlying holistic theme. Based on her conceptual system, King was able to derive the Theory of Goal Attainment to further advance nursing research and practice.
- Butts, J.B., & Rich, K.L. (2018). Philosophies and Theories for Advanced Nursing Practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
- de Leon-Demare, K., MacDonald, J., Gregory, D.M., Katz, A., & Halas, G. (2015). Articulating nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 27, 631-636.
- Fawcett, J. (2017). Applying Conceptual Models of Nursing: Quality Improvement, Research, and Practice. New York, NY: Springer Publishing Company. Retrieved from http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=nlebk&AN=1422818&site=eds-live
- Pereira Borges, J. W., Magalhães Moreira, T. M., Braz da Silva, D., Oliveira Loureiro, A. M., & Bezerra de Meneses, A. V. (2017). Adult nursing-patient relationship: Integrative Review oriented by the King Interpersonal System. Journal of Nursing UFPE / Revista de Enfermagem UFPE, 11(4), 1769–1778. https://doi.org/10.5205/reuol.9763-85423-1-SM.1104201727
Shanta, L.L., & Connolly, M. (2013). Using King’s interacting systems theory to link emotional intelligence and nursing practice. Journal of Professional Nursing, 29(3), 174-180.
Sieloff, C. L., Frey, M. A., & King, I. M. (2007). Middle Range Theory Development Using King’s Conceptual System. New York: Springer Publishing Company. Retrieved from http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=e000xna&AN=194785&site=ehost-live