1st Year M.Sc. Nursing Advance Nursing Practice

1. Presented by:-
HIMANI S. VARIYA
F.Y M.Sc Nursing
Roll No. 25

2. Imogene King-theorist
 Born in 1923 in west point, Lowa.
 Completed her diploma nursing education in 1945, at St.
John's Hospital in St Louis, Missouri.
 Completed her B.sc nursing from St. Louis University in
1948
 Completed her M.sc nursing from St. Louis University in
1957
 Completed her ph.D from Teacher’s college, Columbia
University
 She has practiced as a staff nurse, nurse educator, and
nurse administrator.
 She formulates her theory when she was an associated
professor of nursing at Loyola c in Chicago.

3. King’s Theory of Goal Attainment
 Imogene King’s concepts focus on these methods
to help nurses in the nurse-patient relationship.
 King used a “systems” approach in the
development of her dynamic interacting systems
framework and in her subsequent Goal-
Attainment Theory.
 King emphasizes that both the nurse and the client
bring important knowledge and information to the
relationship and that they work together to
achieve goals.

4. King’s Conceptual Framework
1. Several basic assumptions
2. Three interacting systems
3. Several concept relevant for each
system

5. 1.BASIC ASSUMPTION
 Nursing focus is the care of human being
 Nursing goal is the health care of individuals &
groups
 Interacting systems: personal system,
Interpersonal system, Social system
 Concepts are given for each system: concept for
personal system, concept for interpersonal
system, and concept for social system.

6. Conceptual framework

7. 3 Interacting systems:
The conceptual system is composed of
3 interacting systems:
THE
PERSONAL
SYSTEM
THE INTER
PERSONAL
SYSTEM
THE SOCIAL
SYSTEM

8. Personal
system
Perception
Self
Growth &
Developm
ent
Body
Image
Space
Time
Several concepts relevant for each system
A.Concepts for Personal System

10. Inter-
personal
system
Interaction
Communicatio
n
Transactio
n
Role
Stress
B. CONCEPTS FOR INTERPERSONAL
SYSTEM

11. 3.CONCEPTS FOR SOCIAL
SYSTEM
Social
system
Organizatio
n
Authority
Decision
makingStatus
Power

12. King’s theory of goal attainment
 Original concepts:- interaction,
perception, communication,
transaction, self role, stress, growth
and development, time and space.
 In 2001, king added decision making
and omitted growth and development,
stress, time and space.

13. Concept of king’s theory

14. Transaction process model

15. Nursing paradigms
Human
being
/person
Health
Environmen
t
Nursing

16. Human being /person
 Is social being who are rational and sentient.
Person has ability to:
Perceive
Think
Feel
Choose
Set goals
Select means to achieve goals and
To make decision

17. According to King, human being has three
fundamental needs:
A
• The need for the health information that is
unable at the time when it is needed and can
be used
B
• The need for care that seek to prevent illness
C
• The need for care when human beings are
unable to help themselves

18. Health
 According to King, health involves dynamic
life experiences of a human being, which
implies continuous adjustment to stressors in
the internal and external environment through
optimum use of one’s resources to achieve
maximum potential for daily living.

19. Environment
 Environment is the background for human
interactions.
It involves:
 (a) Internal environment: transforms energy
to enable person to adjust to continuous
external environmental changes.
 (b) External environment: involves formal and
informal organizations. Nurse is a part of the
patient’s environment.

20. Nursing
 Definition: “A process of action,
reaction and interaction by which nurse
and client share information about their
perception in nursing situation.” and “ a
process of human interactions between
nurse and client whereby each
perceives the other and the situation,
and through communication, they set
goals, explore means, and agree on
means to achieve goals.”

21. Propositions of King’s Theory
If nurse and client make transaction, goal
will be attained
If goal are attained, satisfaction will occur
If transactions are made in nurse-client
interactions, growth & development will
be enhanced
If role expectations and role performance
as perceived by nurse & client are
congruent, transaction will occur

22. Continue……….
If role conflict is experienced by nurse or
client or both, stress in nurse-client
interaction will occur
If perceptual interaction accuracy is
present in nurse-client interactions,
transaction will occur
If nurse with special knowledge skill
communicate appropriate information to
client, mutual goal setting and goal
attainment will occur.

23. THEORY OF GOAL ATTAINMENT AND
NURSING PROCESS
Nursing process method Nursing process theory
A system of oriented actions
A system of oriented concepts
Assessment
Perception, communication and
interaction of nurse and client
Planning Decision making about the goals.
Be agree on the means to attain
the goals
Implementation Transaction made
Evaluation Goal attained

24. Assumption
 Nurse and client communicate
information
 Set goal mutually
 Act to attain those goals

25. Assessment
 Occur during interaction
 Collects data regarding growth and
development, perception of self and current
health status
 Perception is the base for collection and
interpretation of data
 Communication required to verify accuracy of
perception, for interaction and transaction

26. Nursing diagnosis
Data collected are used to make nursing
diagnosis
1. Acute pain related to surgical incision
2. Risk for infection related to surgical
incision
3. Bed rest related constipation, narcotic pain
relievers and nil by mouth or soft diet
4. Deficient knowledge regarding the
treatment and home care
5. Health maintenance, ineffective

27. Planning
 Planning for intervention to solve
problems
 In goal attainment planning is
represented by setting goals and
making decision

28. Implementation
 Implementation involves actual activities to
achieve goal
 In goal attainment it is continuation of
transaction

29. Evaluation
 Finding out whether goals are attained
or not
 Evaluation speaks about goal
attainment of goal and effectiveness of
nursing care

30. APPLICATION OF THEORY
PRACTICE
ADMINSITRAION
NURSING EDUCATION
RESEARCH

31. STRENGTHS OF THEORY
 Easily understood
 Clear and conceptually defined from
research literature at the time when the
theory was developed.

32. King’s theory presents nine major concepts, thus making
theory complex
Kings theory has been criticized for having limited
application in areas of nursing where patients are unable
to interact competently with the nurse in case of
unconscious and psychiatric patients
King’s took learning and control as a sub-concept but
does not define it
OF THEORY

33. ANY QUESTIONS???