IMOGEN KING
(January 30, 1923 – December 24,
2007)
Her Early Life
Imogene King was born on Jan.
30, 1923, in West Point, Iowa.
During her early high school
years, she decided to pursue a
career in teaching. However, her
uncle, the town surgeon, offered
to pay her tuition to nursing
school. She eventually accepted
the offer, seeing nursing school as
a way to escape life in a small
town. Thus began her remarkable
career in nursing.
Her Education
Imogene King excelled in her nursing studies even though it was not her first choice to
consider.
• 1945 - she received a nursing diploma from St. John’s Hospital School of Nursing in St.
Louis, Missouri.
• 1948 - while working in various staff nurse roles, King started coursework toward a
Bachelor of Science in Nursing Education, which she received from St. Louis University
• 1957 - she received a Master of Science in Nursing from St. Louis University.
• 1961 - she went on to study with Mildred Montag as her dissertation chair at Teacher’s
College, Columbia University, New York and received her EdD.
King’s Conceptual System and Theory of Goal Attainment
Conceptual System
- In 1971, King wrote her first textbook, which outlined a conceptual framework, later
called a conceptual system, that nurses could use to identify and analyze nursing
situation.
- King’s framework was a “way of thinking about the real world of nursing”(King,1971.
p.125)
- King defined a system as a set of components linked by communication that exhibit
directed behaviors for the purpose of attaining goals, thus giving rise to her Theory of
Goal Attaintment (King,1997).
Concepts
- King’s conceptual model identifies the domain of nursing as a composite of
the following three major interacting systems: personal systems (indivisuals),
interpersonal systems (groups), and social systems(society). These three
systems provided the basis for King’s Theory of Goal Attainment.
1) Personal System
- perception, self-growth and development, body, image, space and
time
- If perceptual interaction accuracy is present in nurse-patient
interactions, transaction will occur
- If the goal or goals are achieved, satisfaction will occur
2) Interpersonal System
- interaction, communication, transaction, role, and stress
- If role conflict is experience by either the nurse or the patient (or
both), stress in the nurse-patient interaction will occur
3) Social System
- Organization, authority, power, status, and decision making
A s s ump t ion s
- King’s model and Theory of Goal Attainment are based on her
overarching belief that the focus of nursing is people interacting with
their environment, which leads to a state of health and the ability to
function in social roles ( King, 1981)
- A basic assumption of King’s theory of Goal Attainment is that the
nurse and client communicate information, set mutual goals, and then
act to attain those goals.
Nursing Metaparadigms
• Person
- Social beings that are rational and sentient
- Focus of nursing care
- Has the ability to perceive, think, feel, choose, set goal, select ways to achieve goals, and make
decisions
- Requires three basic needs:
I. Need for health information that can be used when needed
II. Need for care to prevent illness
III. Need for care when a person is unable to help themselves
• Environment
- Is consistently changing
- Is the background for human interaction
- Involves two types of environment
1. Internal environment - transforms energy to allow the person to
adjust to the continuous external environment changes
2. External nvironmnet - includes formal and informal organozations
with the nurse being part of the patien’s environment
• Health
- Implies continuous adjustment to stressors in the internal and external
environment
- Through optimum use of one’s resource to achieve maximum potential
for daily living
• Nursing
-
SISTER
CALLISTA ROY
(October 14, 1939)
Her Early Life
Sister Callista Roy was born on
October 14, 1939 in Los Angeles,
California. She was raised in a
family with strong Catholic ties.
Her mother was a liscensed
vocational nurse who influenced
her choce of career. At the age of
14, she began working in a
kitchen at a local hospital and
later became a nursing assistant.
After she graduated highschool,
she decided to join the Sisters of
Saint Joseph of Carondelet.
Her Education
1963 - she earned a Bachelor of Arts in Nursing (BAN) from Mount St. Mary’s College in Los
Angeles
1966 - earned a Master’s Degree in pediatric nursing
1968 -returned to work after being forced to leave due to encephalomyelitis
1970 - St. Mary’s College aopted her model as part of the teching curriculum
1971 - she was appointed as chair of the nursing department until 1982
1977 - she earned a Ph.D. in sociology from UCLA. She then took postdoctoral studies in
neuroscience nursing at the University of California. She expanded her knowledge of the
holistic person as an adaptive system
1981 - her model of nursing practice was well known
Roy’s Adaptation Model of Nursing
Sr.Callista Roy’s Adaptation Model of Nursing was developed by
Sister Callista Roy in 1976. The prominent nursing theory aims to
explain or define the provision of nursing. In her theory, Roy’s model
sees theindividual as a set of interrelated systems that aintain a
balance between these various stimuli.
Roy’s Adaptation Model of Nursing
Roy conceptualizes the person in a holistic perspective. individual
aspects of parts act together to form a unified being. Additionally, as
living systems, persons are in constant interaction with their
environments. Between the system and the environment occurs an
exchange of information, matter, and energy. Chracteristics of a
system include inputs, outputs, controls, and feedback.
• Person
“Human systems have thinking and feeling capacities, rooted in cosciousness and
meaning, by which they adjust effectively to changes in the environment and, in urn, affect
the environment.”
- holistic beings that ar in constant interaction with their environment
- humans use a system of adaptation, boh innate and acquired, to respond to the
environmental stimuli the experience
- can be individuals or groups, such as families, organizations, and the whole global
community
• Environment
“The conditions, circumstances and influences surrounding and affecting the development
and behavior of persons or groups with particular consideration of the mutuality of person
and health resources that includes focal, contextual and residual stimuli.”
- defined as conditions, circumstances, and influences that affect humans’ development
and behavior as an adaptive system
- stimulus or input that requires the person to adapt (stimulus can be negative or positive)
Focal stimuli - confront the human system and require he most attention
Contextual stimuli - rest of the stimuli present with the focal stimuli
Residual stimuli - additional environmental factors present with the situation but
whose effect is unclear
• Health
“Health is not freedom from the inevitability of death, unhappiness, and stress, but the
ability to cope with them in a competent way.”
- state where humans can continually adapt to stimuli
- results from a process where health and illness can coexist
- If a human can continue to adapt holistically, they will maintain health to reach
completeness and unity within themselves. If they cannot adapt accordingly, the integrity
of the person can be affected negatively.
• Nursing
“[The goal of nursing is] the promotion of adaptation for individuals and groups in each of
the four adaptive modes, thus contributing to health, quality of life, and dying with dignity.”
- are facilitators of adaptation
- assess the patient’s behaviors for adaptation, promote positive adaptation by enhancing
enironment interactions and helping patients react positively to stimuli
- eliminate ineffective coping mehaniss and eventually lead to better outcomes.
• ADAPTATION - “process and outcome whereby thinking and feeling persons as
individuals or in groups use conscious awareness and choice to create human and
environmental integration.”
• REGULATOR - the regulator subsystem is a person’s physiolgical coping mechnism
• COGNATOR - the cogator subsystem is a person’s coping mechanism
• FOUR ADAPTIVE MODES
1. PHYSIOLOGICAL-PHYSICAL MODE
- this mode’s basic need is composed of the needs associated with oxygenation,
nutrition, elimination, activity and rest, and protection.
- this model’s complex processes are associated with the senses, fluid and
electrolytes, neurologic function, and endocrine function.
• FOUR ADAPTIVE MODES
2. SELF-CONCEPT GROUP IDENTITY MODE
- The goal of coping is to hav a sense of unity, meaning and purposefulness in the
universe, and a sense of identity integrity.
- includes body image and self-ideals
• FOUR ADAPTIVE MODES
3. ROLE FUNCTION MODE
- focuses on the primary, secondary, tertiary roles that a person occupies in society
and knowing where they stand as a member of society.
• FOUR ADAPTIVE MODES
4. INTERDEPENDENCE MODE
- focuses on attaining relational integrity through the giing and receiving of love,
respect and value
- achieved with effective communication and relations
• LEVELS OF ADAPTATION
INTEGRATED PROCESS
COMPENSATORY PROCESS
COMPROMISED PROCESS
• SIX-STEP NURSING PROCESS
A nurse’s role in Adaptaion Model is to manipulate stimuli by removing, decreasing,
increasing, or altering stimuli for the patient.
1. Assess the behaviors manifested from the four adaptive modes.
2. Assess the stimuli, categorize them as focal, contextual, or residual.
3. Make a statement or nursing diagnosis of the person’s adaptive state.
4. Set a goal to promote adaptation.
5. Implement interventions aimed at managing the stimuli.
6. Evaluate whether the adaptive goal has been met.
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