The Essense of Nursing According to Imogene M. King

What is the essence of nursing? This is the question that Imogene M. King posed when she created a conceptual frame of reference for nursing. “King’s conceptual system included twelve concepts that were identified from her analysis of nursing literature – self, body image, role perception, communication, interaction, transaction, growth and development, power authority, organization, and decision making” (King, 1981). The concepts of self, perception, communication, interaction, transaction, role and decision making were selected to represent how individuals and groups in the health care system interact to achieve goals. This transaction model developed to represent the process whereby individuals interact to set goals that result in goal attainment” (King, 1981). The theory of goal attainment, developed by Imogene M. King, is based on the “assumption that human beings are the focus of nursing…. the goal of nursing is health: its promotion, maintenance, and/or restoration; the care of the sick or injured; and the care of the dying” (Khowaga, 2006). King's model consists of three interacting systems: personal, interpersonal, and social.

The three interacting relationships involve the individual, nurse-client interaction and nursing. Nurse-client interactions are thought to be individual perceptions which influence the process of goal attainment. Nursing’s goal is to assist the individual and the communities achieve, preserve, and reclaim health. The theory emphasizes the importance of knowledge and information that the nurse and the client both bring to the relationship, working together to achieve goals. Imogene M. King’s conceptual framework is best described as a holistic view of the complexity in nursing and multiple health care systems.

King stated, “This framework differs from other conceptual schema in that it is concerned not with fragmenting human beings and the environment but with human transactions in different types of environments” (King, 1995). The theory of goal attainment is in practice each time the nurse and patient interact throughout the course of treatment. King’s conceptual system has three systems that interact with each other. The first one being “The Personal Systems”, which is composed of the perception of self, growth and development, body image, space and time.

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The concepts within the personal system and fundamental in understanding human beings are perception, self, body image, growth and development, time, and space (King, 1981). King viewed perception as the most important variable because perception influences behavior. King stated that, individuals grow and develop through the life p; experiences with changes in structure and function of their bodies over time influence their perceptions of self. The second system is the “Interpersonal Systems”, which involves the interaction of a person, communication skills, role and stress.

Interpersonal systems involve individuals interacting with one another. King refers to two individuals interacting as dyads, three individuals as triads, and four or more individuals as small or large groups (King, 1981). The concepts associated with interpersonal systems are interaction, transaction, communication, role and stress. The interactions and transactions that occur between the nurse and the client, or the dyad, represent an example of an interpersonal system. Communication between the nurse and the client can be classified as verbal or nonverbal. The third one is “The Social Systems”.

This engages the process where a person is able to make decisions. The status of an individual is measured as well as authority. Social systems provide a framework for social interaction and relationships, and establish rules of behavior and courses of action (King, 1981). Examples of social systems include the family, the school, and the church. It is within these organizations that individual's beliefs, attitudes, values and customs are formed. The concepts that King identified as relating to social systems are organization, authority, power, status, and decision-making.

These three systems interact with each other to make one mega system. This one system views the client as he/she relates to the environment. As a professional nurse, an assessment is needed of the client involved. It is necessary to have an initial baseline of how the client see himself/herself in relation to whatever the problem is. The nurse must make sure that the client(s) is ready to participate in his or her own health regime. Any concerns or misconceptions must be addressed. The nurse-client relationship must therapeutic. High levels of stress impede the client from having proper decisions technique.

This theory of goal attainment can measure the outcomes of any client’s care. At the same it would also measure the nursing interventions implemented. King’s goal attainment brings two strangers to get the nurse whose offering the client help, and the client whose needs the help together for the purpose of reaching health. This theory can be used at any patient interview. Once the medical problem is presented a nurse can assess the client’s perception. Any fears or stressors can be addressed. The goal attainment theory develops good communication skills.

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