Imogene King Interacting Systems Theory and Theory of

Imogene King Interacting Systems Theory and Theory of Goal Attainment Erin Swartz, Megan Childers and Elizabeth Mitchell

Introduction � Personal, Interpersonal, Social Relationships and Goal Attainment � The patient’s perspective

Background � 1945 � 1948 � 1957 � 1961 � 1981 Nursing Education BSN MSN Doctor of Education Published “A theory for nursing: Systems, concepts, process. ”

Theory � The nurse-patient relationship � Setting � King’s goal of nursing

Values and Knowledge � Value of working together � Nurse contribution � Patient contribution � Definition of nursing

Nursing Knowledge � Collecting data � Evaluating the patient including personal, interpersonal and social systems � Encouraging � Importance patient participation of communication

Influences � Nursing � Nurse in the 1970 -1980’s Practice Act � General Systems Theory � Kaufman, Orlando and Peplau

Four Global Concepts Human Beings, Environment, Health and Nursing � Personal System � Interpersonal � Social System � Definition of Nursing

Interpretation and Implication � 3 fundamental needs � Nurse-patient relationship � Stress � Goal Attainment and Nursing Process

Clarification of Origin � Review of literature � Systems � Goal: structure; diving whole into parts Health � Unique to Nursing � Personal, Interpersonal and Social

Content � Review of global concepts � Environment � Health � Nursing � Focus on the person

Concepts and View � Inclusive theory � Conceptual framework abstract � Theory is specific � Similar beliefs in other models

Model in Practice � Conceptual � Goal attainment addition � Useful � An System in a variety of healthcare settings example

Case Study Joan was a patient assigned to registered nurse Cindy. Joan was spending her remaining days in a locked Alzheimer’s unit. Cindy was her primary care nurse and new to the Alzheimer’s unit. Cindy’s previous experience was in the rehab unit. In rehab, she easily worked within the framework of Kings Goal Attainment theory. Cindy interacted with her patients developing mutual purposeful goals. Cindy and her patients implemented these plans to achieve these goals. In the Alzheimer’s unit, Cindy felt lost in providing care to Joan.

Case Study continued Joan was unable to verbally communicate her needs. Joan’s disease was degenerative and terminal. Joan occasionally would throw items or attempt to hit other patients and staff when her environmental stimuli was hectic. To complicate Cindy’s dilemma, Joan’s family was quite distraught over the condition of their mother. Once a thriving mother who planned family gatherings, loved to cook, and spoiled her grandchildren, now Joan didn’t appear to recognize her family. Joan’s inability to communicate her needs or desires created a barrier in determining what goal(s), if any, could be mutually decided upon, and implemented.

How could Cindy provide care to Joan in the context of King’s Goal Attainment Theory? A. Arrange her personal space so that she is able to view pictures of her family, place a quilt she designed on her bed, and narrate stories from her life to her. B. Have nurse aides provide care because Joan can’t self-perform her ADL’s. C. Communicate with family members putting together a plan of care that identifies Joan’s current abilities, preferences, and triggers in her behavior. Then develop interventions that promote Joan’s quality of life. D. Recognize Joan’s abilities, such as the ability to self -ambulate, and develop a plan of care that centers on her capabilities. E. Ensure Joan has a peaceful quiet surrounding by permanently separating her from other people and activities.

What interventions can you suggest for this scenario that would represent King’s theory and provide a positive outcome? Who can/should be involved in the planning process for interventions for Joan?

References Chitty, K. K. , & Black, B. P. (2011). Professional nursing concepts and challenges (6 th ed. ). Maryland Heights, MO: Saunders Elsevier. Clark, P. N. , Killeen, M. B. , Messmer, P. R. , & Sieloff, C. L. (2009, April). Imogene M. King’s scholars reflect on her wisdom and influence on nursing science. Nursing Science Quarterly, 22(2), 128 -133. doi: 10. 1177/0894318409332568. King, I. M. (1981). A theory for nursing: Systems, concepts, process. New York: Wiley.

References Plummer, M. , & Malzahm, A. (2009, April). Quality of life in contemporary nursing theory: A conceptual analysis. Nursing Science Quarterly, 22(2), 134 -140. doi: 10. 1177/0894318409332807 Sieloff, C. L. (1991). Imogene King: A conceptual framework for nursing. Newbury Park, CA: SAGE. Williams, L. A. (2001). Imogene King’s interacting systems theory: Application in emergency and rural nursing. Online Journal of Rural Nursing and Health Care, 2(1). Retrieved from: http: //www. rno. org/journal/index. php/onlinejournal/article/view. File/93/89