KING'S GENERAL SYSTEM
FRAMEWORK NURSING
CONCEPTUAL MODEL
Imogene Martina King
(January 30, 1923 – December 24, 2007)
I. ABOUT THE THEORIST
 Imogene Martina King was born in
West Point, lowa on January 30, 1923
 She completed her diploma in nursing
education in 1945, at St. John's
Hospital in St. Louis, Missouri.  by researchers and practitioners to identify and
 1947-1958, King work as an instructor
in medical-surgical nursing and as an
assistant director at St. John’s Hospital
School of Nursing
 1957- She earned an M.S.N. from St.
Louis University and a Doctor of
Education (1961) from Teachers
College, Columbia University, New
York.
 1961-1966, King was an associate
professor of nursing at Loyola
University in Chicago
 King served as Assistant Chief of
Research Grants Branch, Division of
Nursing, in the United States
Department of Health, Education, and
Welfare.
 King was the director of the School of
Nursing at The Ohio State University
in Columbus. While at Ohio State, her
book Toward a Theory for Nursing
was published
 She provides community service and
help plan care through her framework
and theory at various healthcare
organizations.
 She keynoted two Sigma Theta Tau
theory conferences in 1992
 King has been an active member of
the American Nurses Association, the
Florida Nurses' Association, and
Sigma Theta Tau International.
 She is one of the founding members of
a nursing organization, the King
International Nursing Group (KING),
 Established to facilitate the
dissemination and utilization of her
interacting systems framework,
Theory of Goal Attainment
 King died as the result of a stroke on
December 24, 2007 at the age of 84
OVERVIEW OF THE THEORY
THEORETICAL SOURCES
King describes the purpose of her first book
as: proposing a conceptual frame of reference
for nursing. It is intended to be utilized
specifically by students and teachers, and also
analyze events in specific nursing situations.
 The framework suggests that the
essential characteristics of nursing are
those properties that have persisted in
spite of environmental changes.
 It is a way of thinking about the real
world of nursing
 An approach for selecting concepts
perceived to be fundamental for the
practice of professional nursing and
shows a process for developing
concepts that symbolize experiences
within the physical, psychological, and
social environment in nursing
MAJOR CONCEPTS AND DEFINITIONS
 HEALTH
"Health is defined as 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"
● NURSING
"Nursing is defined as a process of action,
reaction, and interaction whereby nurse and
client share information about their
perceptions in the nursing situation.
● SELF
"The self is a composite of thoughts and
feelings which constitute a person's awareness
of his individual existence, his conception of individual or personal, group or
who and what he is. interpersonal, and society or social
● The theory of goal attainment pertains
to the importance of interaction,
perception, communication,
transaction, self, role, stress, growth
and development, time, and personal
space.
USE OF EMPIRICAL EVIDENCE
● King speaks of concepts as abstract
ideas that gives meaning to our sense
perceptions, permit generalizations
and tend to be stored in our memory
for recall and use at a later time in new
and different situations.
● King defines theory as a set of
concepts, which, when defined, are
interrelated and observable in the
world of nursing practice. Theory
serves to build scientific knowledge
for nursing.
● King identifies at least two methods
for developing theory:
1) a theory can be developed and then Personal system
tested in research
Personal system are individuals, who are
2) research can provide data from which regarded as rational, sentients and social
a theory may be developed. beings. Concepts related to the personal
system are:
● Regarding patient care, King notes
that, "most studies have centered on ● Perception - a process of organizing,
technical aspects of patient care and of interpreting, and transforming
the health care systems rather than on information from sense data and
patient aspects directly. Few problems memory that gives meaning to one’s
have been stated that begin with what experience, represents one’s image of
the patient's condition demands or reality, and influences one’s behavior.
what the patient wants."
● Self - a composite of thoughts and
In her 1981 book, King further discusses that, feelings that constitute a person’s
awareness of individual existence, of
"several theoretical formulations about
who and what he is or she is
interpersonal relations and nursing process
have been described in nursing situations." • Growth and development - cellular,
molecular, and behavioral changes in
• King developed a general systems
human beings that are a function of
framework and a theory of goal
genetic
attainment where the framework refers
to the three interacting systems -
 endowment, meaningful and satisfying
experiences, and an environment conducive to
helping individuals
move toward maturity.
• Body image - a person's perceptions
of his or her body.
• Time - the duration between the
occurrence of one event and the
occurrence of another event.
• Space - the physical area called
territory that exists in all directions.
• Learning - gaining knowledge.
Interpersonal system
-Individuals interacting with one another
• Interactions - the acts of two or more
persons in mutual presence; a
sequence of verbal and nonverbal
behaviors that are goal directed.
• Communication - the vehicle by
which human relations are developed
and maintained; encompasses
intrapersonal, interpersonal, verbal,
and nonverbal communication.
• Transaction - a process of interaction
in which human beings communicate
with the environment to achieve goals
that are valued; goal-directed human
behaviors.
• Role - a set of behaviors expected of a
person occupying a position in a social
system.
• Stress - a dynamic state whereby a
human being interacts with the
environment to maintain balance for
growth, development, and
performance, involving an exchange
of energy and information between the
person and the environment for
regulation and control of stressors.
• Coping - a way of dealing with stress.
Social system
Shows how the nurse interacts with co
workers superiors, subordinates and the client
environment in general.
• Authority - a transactional process
characterized by active, reciprocal
relations in which members' values,
backgrounds, and perceptions play a
role in defining, validating, and
accepting the authority of individuals.
• Power-the process whereby one or
more persons influence other persons
in a situation.
• Status - the position of an individual
in a group or a group in relation to
other groups in an organization.
• Decision making - a dynamic and
systematic process by which goal-
directed choice of perceived
alternatives is made and acted upon by
individuals or groups to answer a
question and attain a goal.
• Control - being in charge.
THEORY OF GOAL ATTAINMENT
•Elements are seen in the interpersonal
systems in which two people, who are usually
strangers, come together in a healthcare
organization to help and be helped to maintain
a state of health that permits functioning of
roles.
• Reflects King's belief that the practice
of nursing is differentiated from other
healthcare professions by what nurses
do with and for individuals
• Nurse and client communicate
information, set goal mutually and
then act to attain those goals.
MAJOR ASSUMPTIONS
• King's conceptual framework and
theory of goal attainment are based on
an overall assumption that the focus of
nursing is human beings interacting
with their environment leading to a
 state of health for individuals, which is
an ability to function in social roles
• Nursing focus is the care of human
being.
• Nursing goal is the health care of
individuals & groups.
spiritual being and rational thinker
who makes choices, selects alternative
courses of action, and has the ability to
record their history through their own
language and symbols, unique, holistic
and have different needs, wants and
goals.

• Human beings: are open systems According to Imogene King, human being has
interacting constantly with their three fundamental needs:
environment.
● Information on health that can be
• Basic assumption of goal attainment accessed and utilized when needed
theory is that nurse and client ● Care that aims to prevent illness
communicate information, set goal
mutually and then act to attain those ● Care in times of illness/helplessness
goals, is also the basic assumption of
C. Health:
nursing process
● According to Imogene King, health
• •“Each human being perceives the
involves dynamic life experiences of a
world as a total person in making
human being, which implies
transactions with individuals and
continuous adjustment to stressors in
things in environment”
the internal and external environment
through optimum use of one's
•“Transaction represents a life
resources to achieve maximum
situation in which perceiver & thing
potential for daily living.
perceived are encountered and in
which person enters the situation as an D. Environment:
active participant and each is changed
in the process of these experiences” ➢ It is the background for human
interactions. It involves:
III. METAPARADIGM OF THE THEORY
A. Internal environment - transforms
A. Nursing: energy to enable person to adjust to
● Nursing for Imogene King is an act continuous external environmental
wherein the nurse interacts and changes.
communicates with the client. B. External environment - involves
● The nurse helps the client identify the formal and informal organizations.
existing health condition, exploring Nurse is a part of the patient's
and agreeing on activities to promote environment
health.
● The goal of the nurse in Imogene
King's theory is to help the client
maintain health through health
promotion and maintenance,
restoration, and caring for the sick and
dying.
B. Person:
● Imogene King described a person
existing in an open system as a

E. Model
Theoretical Assertion
From the theory of goal attainment Imogene
King developed predictive propositions, which
includes:
● If perceptual interaction accuracy is
present in nurse-patient interactions, a
transaction will happen.
● If nurse and client make transaction,
goal will be attained.
● If goal are attained, satisfaction will
occur.
● If goals are met, efficient nursing care
will happen.
● If transactions are made in nurse-
client interactions, growth and
development will be enhanced
● If role expectations and role
performance as perceived by nurse
and client are congruent, transaction
will occur
● If role conflict is experienced by nurse
or client or both, stress in nurse-client
interaction will occur
● If nurse with special knowledge and
skill communicate appropriate
information to client, mutual goal
setting and goal attainment will occur.
IV. ACCEPTANCE BY NURSING
COMMUNITY
A. PRACTICE
● King's early publication led to nursing
curriculum development and practice
application at Ohio State and other
universities.
● In her 1981 book, King identifies that
theory,
because it is abstract, cannot be immediately
applied to nursing practice or to concrete
nursing education programs. When empirical
referents are identified, defined and described,
theory is useful and can be applied in concrete
situations.
● Professionals in most specialty areas
have used the concepts of King's
Theory of Goal Attainment in nursing
practice. Its relationship to practice is
obvious because the profession of
nursing functions primarily through
interactions with individuals and
groups within the environment.
● Healthcare professionals have
implemented King's interacting
systems framework and Theory of
Goal Attainment in various national
and international practice settings.
B. EDUCATION
● Nursing faculty at several universities
(Ohio State Loyola in Chicago, and
University of Texas in Houston) have
used King's interacting systems
framework to design curricula in
nursing programs
● King's framework and theory also
have application for nursing education
internationally as described by Rooke
for a Swedish educational setting
● Provide a systematic means of
viewing the nursing profession,
organizing a body of knowledge for
nursing. and clarifying nursing as a
discipline.
● In 1980, Brown and Lee reported that
King's concepts were useful in
developing a framework for use in
 nursing education, nursing practice,
and for generating hypotheses for
research.
C. RESEARCH
● Many researchers have used concepts
from King's interacting systems
framework.
● Other researchers have used King's
framework" as a theoretical base. This
group of research includes the
following studies:
1. Kemppainen analyzed a case study of a
patient who had HIV and was also
experiencing psychotic symptoms
2. Alligood, Evans, and Wilt developed the
concept of empathy within King's framework.
3. Hobdell used King's framework" to work
with parents of children with neural tube
defects.
4. Sharts-Hopko explored the perceived health
status of women during the transition to
menopause.
5. Doornbos used King's framework to explore
the health of families with young people who
are chronically mentally ill
V. APPLICATION OF THE THEORY
Mr.Sy (74 years) was admitted in L3 ward of
Hospital, for a herniorrhaphy on his left
indirect inguinal hernia and was expecting
discharge from hospital.
• The theory of goal attainment was
used in his nursing process.
Assessment
• The first process in nursing process is
nurse meets the patient and
communicates and interacts with him.
Assessment is conducted by gathering
data about the patient based on
relevant concepts.
Nursing diagnosis
• 1. Acute pain related to surgical
incision.
• 2. Risk for infection related to surgical
incision.
• 3. Risk for constipation related to bed
rest, pain medication and NPO or soft
diet.
• 4. Deficient knowledge regarding the
treatment and home care.
• 5. Ineffective health maintenance.
Planning
Goal 1:
• Assess the characteristics of pain.
• Administration of prescribed
medicine.
• Monitor the responses to drug therapy.
• Provide calm, efficient manner that
reassures the client and minimizes
anxiety.
• Provide a comfortable position as per
client’s requests.
Goal 2:
● Monitor vital signs
● Use aseptic techniques while
changing dressing
● Kept the surgical wound site clean
Goal 3:
• Ensure that the client has adequate
bulk in diet and adequate fluid intake
• Instruct the client on prevention of
straining and avoiding valsalva
maneuvers
• Consult treating physician regarding
medications
Implementation
In nursing process implementation involves
the actual activities to achieve the goals.
• Am I doing what the patient and I
have agreed upon? Yes
 • How am I carrying out the actions?
On a mutually acceptable manner in
accordance with the goals set.
• When do I carry out the action?
According to priority, a few
interventions require immediate
attention. Other interventions are
carried out during the period of
hospitalization
• Is it reasonable to think that the
identified goals will be reached by
carrying out the action? Yes
Evaluation
In King’s description evaluation speaks about
attainment of goal and effectiveness of nursing
care.
• Are my actions helping the patient
achieve mutually defined goals? Yes
• What is patient’s response to my
actions? Patient is satisfied with
your actions
• How should the plan be changed to
achieve goals?Health teaching can be
modified according to
developmental stage.Involvement of
family member in care of the
patient.