King Theory of Nursing
King Theory of Nursing
The King theory of nursing was developed by Imogene King and encompasses a conceptual framework of interacting systems (personal, interpersonal, and social systems), and a theory of goal attainment based on King's transaction process model.
King's theory of nursing refers to both a conceptual framework and a goal attainment theory developed by Imogene King. King graduated from St. John's Hospital School of Nursing in 1945 with a degree in nursing, and received a Bachelor's of Science degree from St. Louis University, also in nursing, in 1948, and a Master's of Science in Nursing from the same institution in 1957. In 1961 King graduated with a doctor of education degree from Teachers College, Columbia University. Imogene King has taught at many universities including Loyola University in Chicago, Ohio State University, and the University of South Florida. She also has many years of nursing experience including nursing in hospitals, physician's offices, and schools.
The conceptual framework that King developed involves three interacting sets of systems. On the smallest level are personal systems, comprised of individuals. Examples of personal systems are individual nurses and patients. The second level of systems are interpersonal systems, or groups. These are generally small groups. A family is an interpersonal system, and when a nurse and patient interact they also form an interpersonal system. The largest systems are social systems, or societies. Examples of social systems are religious organizations, universities, and hospitals.
The theory of goal attainment, which lies at the heart of King's theory of nursing, exists in the context of her conceptual framework. The essence of goal attainment theory is that the nurse and the patient work together to define and reach goals that they set together. The patient and nurse each perceive, judge, and act, and together the patient and nurse react to each other and interact with each other. At the end of this process of communication and perceiving, if a goal has been set a transaction is said to have occurred. The nurse and patient also decide on a way to work toward the goal that has been decided upon, and put into action the plan that has been agreed upon. King believes that the main function of nursing is to increase or to restore the health of the patient, so then, transactions should occur to set goals related to the health of the patient. After transactions have occurred and goals have been defined by the nurse and patient together, both parties work toward the stated goals. This may involve interactions with other systems, such as other healthcare workers, the patient's family, or larger systems.
After the transaction has occurred, and the goal has been set, King believes that it is important for good documentation to be practiced by the nurse. She believes that documenting the goal can help to streamline the process of goal attainment, making it easier for nurses to communicate with each other and other healthcare workers involved in the process. It also helps to provide a way to determine if the goal is achieved. This assessment of whether or not the goal has been successfully achieved plays an important end stage in King's goal attainment theory.
Many people believe King's theory of goal attainment to be a productive and empowering way for nurses and patients to interact. There has been some discussion about how well the theory applies across all groups of patients, as it is necessary for the patient to be able to interact with the nurse to develop and agree on goals, and on ways to work toward those goals. Others contend that King's theory can be applied to all groups because a large portion of communication involves nonverbal behavior, so being able to communicate through spoken language is not a prerequisite for transactions to occur.
King believes that many nurses actually use the theory of goal attainment when interacting professionally with patients, although they may not know it as such. King believes, however, that it is very important for nurses to have an understanding of the theoretical basis for their behaviors and nursing actions. A nurse basing his or her behavior on King's theory would engage the patient in discussion to set goals and agree on the ways both the nurse and patient are going to work toward those goals. The nurse would also document both the goals and the steps being taken toward them, and then review the goals to determine if they had been successfully achieved.
King's theory of goal attainment and her conceptual framework has been applied in many different situations. Literature documents its application across various age groups, from infants through children and adults to the elderly. The theory of goal attainment has also been applied to various patient groups including patients with cancer, diabetes, and HIV. It has also been used as a tool to address the concerns of various patients including those expressing concerns about birth, body weight, and stress. It has also been applied in various health care settings such as hospitals, clinics, and nursing homes.
King, Imogene. A Theory for Nursing : Systems, Concepts, Process. New York, NY: Wiley, 1981.
Parker, Marilyn E. Nursing Theories and Nursing Practice. Philadelphia, PA: E.A. Davis Company, 2001.
Murray, Ruth L.E. and Marjorie Baier. "King's Conceptual Framework Applied to a Transitional Living Program." Perspectives in Psychiatric Care 32 (Jan-March 1996): 15-20.
American Nurses Association. 8515 Georgia Ave., Ste. 400, Silver Spring, MD 20910. (800) 274 4ANA. 〈http://www.nursingworld.org〉.
"Nursing Theory Page." USD Hahn School of Nursing 2003. 〈http://www.sandiego.edu/nursing/theory〉 (November 10, 2005).