KING’S GENERAL SYSTEMS
FRAMEWORK THEORY
James Madison University
NSG 463
Ashley Simon
IMOGENE KING, RN, MSN, EDD, FAAN
• Born: January 30, 1923 in West
Point, Iowa
• The youngest of three children
• Died: December 24, 2007 in Saint
Petersburg two days after
suffering from a stroke. ¹
IMOGENE KING’S EDUCATION
• 1945-Completed her diploma in nursing education at St. John’s Hospital in St. Louis,
Missouri
• 1948-Received her BS in Nursing from St. Louis University
• 1957-Obtained her MS in Nursing from St. Louis University
• 1961-Obtained her Doctorate in Education(Ed.D.) from Teacher’s College in
Columbia University, N.Y.¹
• 1971- Published “Toward a theory of nursing: general concepts of human
behavior”
• 1980-Honoary Ph. D from Southern Illinois University
• Postdoctoral study in research design, statistics and computer²
KING’S EXPERIENCE
• Practiced as an office nurse, staff nurse, school nurse, nurse educator, and
nurse administrator
• Administrator at Ohio State University
• Educator at St. John’s Hospital School of Nursing, Loyola University, and the
University of South Florida
• Adult Medical-Surgical Nursing Practitioner
• Assistant chief of the Research Grants Branch, Division of Nursing,
Department of Health, Education and Welfare
• Professor emeritus at the University of South Florida³
IMOGENE KING CONT’D
• Formulated her theory while she was an associate professor at Loyola
University in Chicago³
“A search for literature in nursing and other behavioral science fields,
discussion with colleagues, attendance at numerous conference,
inductive and deductive reasoning, and some critical thinking about
the information gathered, lead me to formulate my own theoretical
framework.”
• During this time nursing was emerging as a profession and some sought to
challenge the existing role of nurses.
JOURNEY TOWARDS THE THEORY
• According to King humans have
three fundamental needs
• Information on health that can be
accessed and utilized
• Care that aims to prevent illness
• Care in times of need or illness²
• In 1981 King refined her concepts into a
nursing theory that consisted of:
• 1. An open system framework as the
basis of goal attainment
• 2. Nursing as a major system within
the health care system
• 3. Nursing process emphasis on
interpersonal processes⁴
• Used a “systems” approach in the
development of her Dynamic
Interacting Systems Framework and in
her subsequent goal attainment theory.
JOURNEY CONT’D
• Interacting Systems Framework
included three systems:
• Personal System-the individual
• Interpersonal System -individuals
interacting with one another
• And Social system-groups of people
in a community or society sharing
common goals, interests and
values.³
• King studied the systems as a whole
rather than as isolated parts
SYSTEMS FRAMEWORK
• The three systems included:
• Personal system concepts includes: coping, spirituality, perception, self, body
image, growth and development
• Interpersonal system concepts includes: interaction, communication,
transaction, role, stress and coping
• Social system concepts includes: organization, authority, power, status, and
decision making⁵
• In order to identify problems and establish goals, the nurse and patient has
to perceive one another, act and react, interact, and transact.
THEORY OF GOAL ATTAINMENT
• Describes the importance of the participation of all individuals in decision
making as well as choices, alternatives, and outcomes of nursing care.
• It pertains to the importance of interaction, perception, communication,
transaction, self, role, stress, growth and development, time, and personal
space.
• Reflects King’s belief that the practice of nursing is differentiated from other
healthcare professions by what nurses do with and what they do for
individuals
• The nurse and patient/client communicates information in order to set goals
mutually and then acts to attain those goals.
SEVEN HYPOTHESIS IN
GOAL ATTAINMENT
1. Perceptual congruence in nurse-patient interactions increases mutual goal
settings
2. Communication increases mutual goal setting between nurses and
patients which leads to satisfaction
3. Satisfaction in nurses as well as patients increases goal attainment
4. Goal attainment decreases stress and anxiety in nursing situations
5. Goal attainment increases patient learning and coping in nursing situations
6. Role conflict experienced by nurses, patients, or both decreases
transactions in nurse-patient interactions
7. Congruence in role expectations and role performance increases
transactions in nurse-patient interactions.⁵
PUTTING THE THEORY TO USE
• King believed that if nursing students are taught the theory of goal
attainment and it is used in nursing practice, then goal attainment can be
measured and the effectiveness of nursing care can be demonstrated.
• This theory focuses on all aspects of nursing process: assessment, planning,
implementation, and evaluation.
• King believed that a nurse must assess in order to set mutual goals, plan to
provide alternative means to achieve goals, and evaluate to determine if
the goal was reached. ³
PUTTING THE THEORY TO USE
CONT’D
• It is useful in nursing practice to create individualized plans of care while
encouraging active participation from clients in decision making
• One current way in practice of doing this is Bedside report-this allows for the
patient to interact and know their plan of care during the stay at the hospital.
• This theory has also been used fro curriculum design in nursing programs and
used as frameworks for books. ³
• It provides a systematic means of viewing nursing as a profession, organizing
a body of knowledge for nursing, and clarifying nursing as a discipline.
THEORY ANALYSIS
• Not a perfect theory but easily understood
• Clear and conceptual defined from research literature at the time of
development
• Some has critiqued the theory to have limited application to nursing
especially in patients who are unable to competently interact with the nurse.
KING’S RESPONSE TO CRITIQUE
• 70% of communication is non-verbal
• It is impossible for a theory to address every person, event, and situation⁴
SUMMARY
• King presented an open systems framework from which she derived a theory
of goal attainment. The framework consists of 3 systems including personal,
interpersonal, and social.
• The major concepts of the theory are interaction, communication,
transaction, role, stress, growth and development, space and time.
• This theory is useful, testable, and applicable to nursing practice, although it
is not a perfect theory.
KING’S THEORY APPLIED IN
CURRENT PRACTICE
• In current practice the use of this theory relies on participation of both the
nurse and the patient for effectiveness
• It can be used in most any practice
• Reviewing the patient’s plan of care and providing the patient with
information as well as education each day
• Providing the patient with options for their plan of care
• Keeping the patient “in the loop” during their process of care
• Making decisions with the patient rather than for the patient
• Bedside report is a good start to this theory.
REFERENCES
• 1. Texas Woman’s University (2014). Nursing Theorist. Retrieved from
http://libguides.twu.edu/content.php?pid=387632&sid=3179434
• 2. George, J.B. (Ed.) (2008). Nursing theories: the base for professional nursing
practice. Upper Saddle River, N.J.:Prentice Hall.
• 3- Retrieved from:
http://www.nurses.info/nursing_theory_person_king_imogene.htm
• 4. Nursing theories. (2008). Retrieved October 2, 2014 from
http://www.currentnursing.com/nursing_theory.
• 5. Blais, K. & Hayes, J. (2011). Professional nursing practice: concepts and
perspectives. Boston: Pearson.