King’s Conceptual System Theory in Clinical Practice

Introduction

Imogene M. King coined conceptual system theory to help nurses care for patients. The theory is known as the goal attainment theory and was introduced in 1968-1971 and then expanded since 1981, focusing on the nurse-patient relationship to obtain set health goals (Friend & Sieloff, 2014). The theory contains three systems that influence goal attainment:

1. personal,

2. interpersonal,

3. social.

Conceptual system theory addresses healthcare quality improvement, and healthcare providers can implement the theory in clinical practice.

Conceptual Systems of the Goal Attainment Theory

The first system is personal, which King attributes to the nurse-patient relationship as the relationship between two individuals. King allocates “body image, growth, development, perception, self, space, and time” in the system description (Gonzalo, 2021, Personal Systems section, para. 1). Perception and self are how an individual perceives his surroundings and himself. Self includes awareness of one’s existence, ideas, attitudes, values, experience, etc. (Gonzalo, 2021). Perception and self are the central concepts of the personal system, shaping responses in other system concepts.

Consequently, body image is one’s perception of his body and responses to external reactions to his body. Space and time define where, when, and how long events occur and how participants perceive them. Growth and development are readiness to improve to achieve set goals. The potential for improvement and its actual results are connected to the process of learning (Gonzalo, 2021). An example of the personal system is the nurse’s understanding of the patient’s attitude towards himself and presented health issues, efficient time-management not to bother the patient more than needed, and mutual respect for personal boundaries.

The interpersonal system is defined as individuals interacting to attain goals. King highlights “communication, interaction, role, stress, and transaction” as the main concepts of the system (Gonzalo, 2021, Interpersonal Systems section, para. 1). Communication as the direct or indirect exchange of information is the basis for interactions, how individuals behave in the presence of each other (Gonzalo, 2021). The individuals take on specific roles in communication, giving or receiving information, while the transaction is an outcome, namely actions to achieve set goals. The last concept is stress which is, simply put, the “regulation and control of stressors” in the individual’s communication with the environment (Gonzalo, 2021, Interpersonal Systems section, para. 6). The interpersonal system covers all forms of communication between healthcare providers and patients and helps avoid miscommunication, therefore adverse healthcare outcomes. One example of the system is a patient interview during which healthcare providers attain the patient’s medical, family, personal, and social history and the patient’s perception of his health issue.

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The final system is social; it encompasses groups in the society, enabling social communication within these groups and between them. The system includes such concepts as “authority, decision making, organization, power, and status” (Gonzalo, 2021, Social Systems section, para. 1). Status in a group determines authority and power to use the group’s resources and influence the group’s members to achieve goals (Gonzalo, 2021). Authority and power also determine a group’s permissibility to pursue set objectives. The organization grants status to each member of a group and allocates resources. The organizational framework enables control over a group’s activities and goals. Each member of a group partakes in decision-making depending on their status. King (1990) states that decision-making involves a “goal-directed choice” that “is made and acted upon by individuals or groups to … attain a goal” (as cited in Gonzalo, 2021, Social Systems section, para. 4). An example is the nurse’s organizational power to assess patients’ responses to health conditions, evaluate risks and create a nursing care plan. The nurse should understand their status within a healthcare facility to efficiently implement nursing care and appropriately react to possible complications during treatment.