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KINGS GENERAL SYSTEMS FRAMEWORK THEORY James Madison University NSG 463 Ashley Simon

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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.

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IMOGENE KINGS EDUCATION 1945-Completed her diploma in nursing education at St. Johns 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 Teachers College in Columbia University, N.Y. 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 computer

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KINGS EXPERIENCE Practiced as an office nurse, staff nurse, school nurse, nurse educator, and nurse administrator Administrator at Ohio State University Educator at St. Johns 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 Florida

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IMOGENE KING CONTD Formulated her theory while she was an associate professor at Loyola University in Chicago 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.

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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 illness 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 processes Used a systems approach in the development of her Dynamic Interacting Systems Framework and in her subsequent goal attainment theory.

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JOURNEY CONTD 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. King studied the systems as a whole rather than as isolated parts

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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 making In order to identify problems and establish goals, the nurse and patient has to perceive one another, act and react, interact, and transact.

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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 Kings 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.

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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.

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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.

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PUTTING THE THEORY TO USE CONTD 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. It provides a systematic means of viewing nursing as a profession, organizing a body of knowledge for nursing, and clarifying nursing as a discipline.

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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. KINGS RESPONSE TO CRITIQUE 70% of communication is non-verbal It is impossible for a theory to address every person, event, and situation

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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.

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KINGS 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 patients 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.

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REFERENCES 1. Texas Womans University (2014). Nursing Theorist. Retrieved from http://libguides.twu.edu/content.php?pid=387632&sid=3179434 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. http://www.currentnursing.com/nursing_theory 5. Blais, K. & Hayes, J. (2011). Professional nursing practice: concepts and perspectives. Boston: Pearson.