Imogene King: A Conceptual Framework for Nursing


Christina L. Sieloff Evans

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  • Notes on Nursing Theories


    Chris Metzger McQuiston

    Private Practice

    Adele A. Webb

    College of Nursing, University of Akron

    The purpose of this series of monographs is to provide the reader with a concise description of conceptual frameworks and theories in nursing. It is not intended to replace the primary works of nurse theorists, but to provide direction for their use. Designed for undergraduate students, these monographs will also be helpful guides for graduate students and faculty.

    Due to the complexity of existing books and chapters on nursing conceptual frameworks and theories, students often have difficulty understanding and incorporating nursing theory into their practice. The concise monographs of this series include a biographical sketch of the theorist, origin of the theory, assumptions, concepts, propositions, examples for application to practice and research, glossary of terms, and a bibliography of classic works, critiques, and research. Organization of the information in this manner will facilitate student understanding and use, thereby broadening the base of nursing science.

    Volume 1

    Martha Rogers: The Science of Unitary Human Beings

    Louette R. Johnson Lutjens

    Volume 2

    Imogene King: A Conceptual Framework for Nursing

    Christina L. Sieloff Evans

    Volume 3

    Callista Roy: An Adaptation Model

    Louette R. Johnson Lutjens

    Volume 4

    Dorothea Orem: Self-Care Deficit Theory

    Donna L. Hartweg


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    Nursing science has come of age. The multiple publications of conceptual systems and theories in nursing have demonstrated advance in the scientific movement in nursing. This book by Christina Sieloff Evans presents my conceptual system from which a theory of goal attainment was derived. The author is well qualified to do this. She has demonstrated very clearly the difference between a conceptual system and a theory derived from it and has displayed a thorough understanding of theory construction and testing in research. In addition, she has shown an understanding of the theory and the use of my nursing process of interactions that lead to transactions and then to goal attainment.

    In the past few years, several nurses have published ways in which they have used knowledge of the concepts of the theory and my nursing process in caring for patients. These publications have shown that the theory is useful in caring for patients in critical care units, in oncology units, in psychiatric units, in community health, and in gerontological nursing situations. One group of nurses in Canada published the way they organized all of the nursing diagnoses under the concepts of this theory. Two nurses in Canada published their ideas about how they planned and implemented change in a hospital and used my conceptual system.

    Some of the criteria used by accrediting agencies such as Joint Commission of Accreditation for Healthcare Organizations, indicate an expectation that nurses understand the theoretical basis for their practice. Use of a conceptual system and theory such as mine helps nurses meet this criterion. Several nursing departments in medical centers and community hospitals have used this theory to implement theory-based practice. This monograph increases the focus on nursing science.

    ImogeneM.King, EDD, RN Professor Emeritus University of South FloridaTampa, Florida


    Nurses routinely set goals for, and frequently with, clients. And yet, how often is that process examined from a nursing theory perspective? Dr. Imogene M. King began writing about nursing theory in 1964 and published her first book in 1971. She developed a conceptual framework for nursing and within this framework developed a theory for nursing that focused on the process of mutual goal setting by nurse and client. By developing a systems approach that focused on a holistic view of human beings, Dr. King:

    • identified concepts of relevance to nursing,
    • developed and tested the Theory of Goal Attainment, and
    • developed the Goal Oriented Nursing Record (1981).

    The purpose of this book is to provide a descriptive overview of Dr. King's framework and theory. A brief biography of Dr. King will be presented. The origin of her conceptual framework will be discussed and the framework described. Concepts from the proposed metaparadigm for nursing will then be examined. The Theory of Goal Attainment will be presented and the assumptions and hypotheses discussed. Application of the theory to practice and research will be examined. The bibliography will include publications both by and about Dr. King.


    Biographical Sketch of the Nurse Theorist: Imogene M. King, EdD, RN

    BSN: St. Louis University, St. Louis, Missouri

    MSN: St. Louis University

    PhD: Education, Teacher's College, Columbia University, New York

    Past Professor of Nursing: University of South Florida, Tampa

    Professor Emeritus: University of South Florida

    Member: American Nurses’ Association/Florida Nurses’ Association/District IV

    Board Member: Operation PAR, Inc.

    President: Florida Nurses’ Foundation

  • Glossary


    Conceptual Framework: “transactional process characterized by active, reciprocal relations in which members’ values, backgrounds, and perceptions play a role in defining, validating, and accepting the [directions] of individuals within an organization” (King, 1981, p. 124).

    Body Image

    Conceptual Framework: “an individual's perceptions of his/her own body, others’ reactions to his/her appearance which results from others’ reactions to self” (King, 1981, p. 33).


    Conceptual Framework: “information processing, a change of information from one state to another” (King, 1981, p. 69).

    Theoretical: “process whereby information is given from one person to another either directly in face-to-face meetings or indirectly through telephone, television, or the written word” (King, 1981, p. 146).

    Decision Making

    Conceptual Framework: “dynamic and systematic process by which a goal-directed choice of perceived alternatives is made, and acted upon, by individuals or groups to answer a question and attain a goal” (King, 1981, p. 132).

    Growth and Development

    Conceptual Framework: “the processes that take place in an individual's life that help the individual move from potential capacity for achievement to self actualization” (King, 1981, p. 31).

    Theoretical: “continuous changes in individuals at the cellular, molecular, and behavioral levels of activities” (King, 1981, p. 148).


    Conceptual Framework: “dynamic life experiences of a human being which implies continued adjustment to stressors in the internal and external environment through optimum use of one's resources to achieve maximum potential for daily living” (King, 1981, p. 5).


    Conceptual Framework: “acts of two or more persons in mutual presence” (King, 1981, p. 85).

    Theoretical: “process of perception and communication between person and environment and between person and person, represented by verbal and nonverbal behaviors that are goal-directed” (King, 1981, p. 145).


    Conceptual Framework: “process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation. A nursing situation is the immediate environment, spatial and temporal reality, in which nurse and client establish a relationship to cope with health states and adjust to changes in activities of daily living if the situation demands adjustment” (King, 1981, p. 2).

    Theoretical: “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” (King, 1981, p. 144).


    Conceptual Framework: “a system whose continuous activities are conducted to achieve goals” (King, 1981, p. 119).

    Operational: “composed of human beings with prescribed roles and positions who use resources to accomplish personal and organizational goals” (King, 1981, p. 119).


    Conceptual Framework: “process of organizing, interpreting, and transforming information from sense data and memory” (King, 1981, p. 24).

    Theoretical: “each person's representation of reality; awareness of persons, objects, and events” (King, 1981, p. 146).


    Conceptual Framework: “capacity to use resources in organizations to achieve goals;” “process whereby one or more persons influence other persons in a situation;” “capacity or ability of a group to achieve goals” (King, 1981, p. 124).


    Conceptual Framework/Theoretical: “set of behaviors expected when occupying a position in a social system” (King, 1981, p. 93).


    Conceptual Framework: “the self is a composite of thoughts and feelings which constitute a person's awareness of his/her individual existence, his/her conception of who and what he/she is. A person's self is the sum total of all he/she can call his/hers. The self includes, among other things, a system of ideas, attitudes, values and commitments. The self is a person's total subjective environment. It is a distinctive center of experience and significance. The self constitutes a person's inner world as distinguished from the outer world consisting of all other people and things. The self is the individual as known to the individual. It is that to which we refer when we say ‘I’” (Jersild, 1952, pp. 9–10).


    Conceptual Framework: “existing in all directions and is the same everywhere” (King, 1981, p. 37).

    Theoretical: “the immediate environment in which nurse and client interact and move to goal attainment” (King, 1981, p. 149).


    Conceptual Framework: “the position of an individual in a group or a group in relation to other groups in an organization” (King, 1981, p. 129).


    Conceptual Framework/Theoretical: “dynamic state whereby a human being interacts with the environment to maintain balance for growth, development, and performance which involves an exchange of energy and information between the person and the environment for regulation and control of stressors” (King, 1981, p. 98).


    Conceptual Framework: “duration between the occurrence of one event and the occurrence of another event” (King, 1981, p. 44).

    Theoretical: “sequence of events moving onward to the future” (King, 1981, p. 148).


    Conceptual Framework: “process of interaction in which human beings communicate with the environment to achieve goals that are values” (King, 1981, p. 82).

    Theoretical: “observable behaviors of human beings interacting with their environment” (King, 1981, p. 147).

    Operational: “one member of the nurse-patient dyad initiates behavior. Opposite member of the nurse-patient dyad responds with behavior. Disturbance (or problem) is noted in the dyadic situation if a state or condition is identified. Some goal is mutually agreed upon by members of the dyad. Exploration of means to achieve goals is initiated by one member of dyad, or behavior is exhibited by member of dyad that moves toward goals. Other member agrees with means to achieve goal. Both move toward goal” (King, 1981, pp. 150–151).


    Ackermann, M.L., Brink, S.A., Jones, C.G., Moody, S.L., Perlich, G.L., & Prusinski, B.B. (1986). Imogene King: Theory of goal attainment. In A.Marriner (ed.), Nursing theorists and their work (pp. 231–245). St. Louis: C. V. Mosby.
    Bertalanffy, L. von (1968). General system theory: Foundations, development, applications. New York: George Braziller.
    Catanzaro, M., & Woods, N.F. (1988). Developing nursing theory. In N.F.Woods & M.Catanzaro (eds.), Nursing research: Theory and practice (pp. 18–34). St. Louis: C. V. Mosby.
    Daubenmire, M.J., & King, I.M. (1973). Nursing process models: A systems approach. Nursing Outlook, 21 (8), 512–517.
    Fawcett, J. (1984). Analysis and evaluation of conceptual models of nursing. Philadelphia: F. A. Davis.
    Gulitz, E.A., & King, I.M. (1988). King's general systems model: Application to curriculum development. Nursing Science Quarterly, 1 (3), 128–132.
    Jersild, A.T. (1952). In search of self. New York: Teachers College Press.
    King, I.M. (1964, October). Nursing theory: Problems and prospects. Nursing Science, 394–403.
    King, I.M. (1971). Toward a theory for nursing: General concepts of human behavior. New York: John Wiley.
    King, I.M. (1975a). A process for developing concepts for nursing through research. In P.J.Verhovick (ed.), Nursing research I (pp. 25–43). Boston: Little, Brown.
    King, I.M. (1975b). Patient aspects. In L.J.Shuman, R.D.Speas, Jr., & J.P.Young (eds.), Operations research in health care: A critical analysis (pp. 3–20). Baltimore: The Johns Hopkins University Press.
    King, I.M. (1981). A theory for nursing: Systems, concepts, process. New York: John Wiley.
    King, I.M. (1988). Measuring health goal attainment in patients. In C.F.Waltz & O.L.Strickland (eds.), Measurement of nursing outcomes: Measuring client outcomes (Vol. 1, pp. 108–127). New York: Springer.
    King, I.M. (1989a). King's general systems framework and theory. In J.P.Riehl-Sisca (ed.), Conceptual models for nursing practice (
    3rd ed.
    , pp. 149–158). Norwalk, CT: Appleton & Lange.
    King, I.M. (1989b). King's systems framework for nursing administration. In B.Henry, C.Arndt, M.Di Vincenti, &A.Marriner-Tomey (eds.), Dimensions of nursing administration: Theory, research, education, practice (pp. 35–45). Cambridge: Blackwell Scientific Publications.
    King, I.M. (1990, July). Speech presented at the Wayne State University College of Nursing Summer Research Conference, Detroit, MI.
    Meleis, A.I. (1985). Theoretical nursing: Development and progress. Philadelphia: J. B. Lippincott.
    Smith, M.J. (1988). Perspectives on nursing science. Nursing Science Quarterly, 1 (2), 80–85.
    Woods, N.F., & Catanzaro, M. (1988). Nursing research: Theory and practice. St. Louis: C. V. Mosby.


    Other Publications by Imogene King
    1964, October. Nursing theory: Problems and prospects. Nursing Science, 394–403.
    1968. A conceptual frame of reference for nursing. Nursing Research, 17 (1), 27–31.
    1971. Toward a theory for nursing: General concepts of human behavior. New York: John Wiley.
    1976. The health care systems: Nursing intervention subsystem. In H.H.Werley, A.Zuzich, M.Zajkowski, & A.D.Zagornik (eds.), Health research: The systems approach (pp. 50–51). New York: Springer.
    1978. The “why” of theory development. In Theory development: What, why, how? (pp. 11–16). New York: National League for Nursing.
    1982. The effect of structured and unstructured pre-operative teaching: A replication. Nursing Research, 31 (6), 324–329.
    1984. Effectiveness of nursing care: Use of a goal oriented nursing record in end stage renal disease. American Association of Nephrology Nurses and Technicians Journal, 11 (2), 11–17, 60.
    1987. King's theory of goal attainment. In R.R.Parse (ed.), Nursing science: Major paradigms, theories, and critiques (pp. 107–113). Philadelphia: W. B. Saunders.
    1988. Concepts: Essential elements of theories. Nursing Science Quarterly, 1 (1), 22–25.
    1990. Health: The goal for nursing. Nursing Science Quarterly, 3 (3), 123–128.
    Publications About Imogene King
    Austin, J.K., & Champion, V.L. (1983). King's theory for nursing: Explication and evaluation. In P.L.Chinn (ed.), Advances in nursing theory development (pp. 49–61). Rockville, MD: Aspen Systems Corporation.
    Brown, S.T., & Lee, B.T. (1980). Imogene King's conceptual framework: A proposed model for continuing nursing education. Journal of Advanced Nursing, 5 (5), 467–473.
    Elberson, K. (1989). Applying King's model to nursing administration. In B.Henry, C.Arndt, M.Di Vincenti, &A.Marriner-Tomey (eds.), Dimensions of nursing administration: Theory, research, education, practice (pp. 47–53). Cambridge: Blackwell Scientific Publications.
    Fawcett, J. (1984). Analysis and evaluation of conceptual models of nursing. Philadelphia: F. A. Davis.
    George, J.B. (1985). Imogene M. King. In J.B.George (ed.), Nursing theories: The base for professional nursing practice (pp. 235–256). Englewood Cliffs, NJ: Prentice-Hall.
    Gonot, R.J. (1983). Imogene M. King: A theory for nursing. In J.Fitzpatrick & A.Whall (eds.), Conceptual models of nursing: Analysis and application. Bowie, MD: Robert J. Brady.
    Hanchett, E.S. (1988). Nursing frameworks and community as client: Bridging the gap. Norwalk, CT: Appleton & Lange.
    Hanucharurnkul, S. (1989). Comparative analysis of Orem's and King's theories. Journal of Advanced Nursing, 14 (5), 365–372.
    Meleis, A.I. (1985). Theoretical nursing: Development and progress. Philadelphia: J. B. Lippincott.
    Pearson, A., & Vaughan, B. (1986). Nursing models for practice. London: Heinemann Nursing.
    Torres, G. (1986). Theoretical foundations of nursing. Norwalk, CT: Appleton-Century-Crofts.

    About the Author

    Christina L. Sieloff Evans, RN, MSN, CNA, received her BSN in 1970 from Wayne State University's College of Nursing, Detroit, Michigan. In 1977, she returned to Wayne State for her MSN (major: Nursing Administration; minor: Psychiatric/Mental Health Nursing with Children and Adolescents). At the time of publication, she is a doctoral student in nursing at the same university. The focus of her dissertation will be the development of an instrument to estimate a nursing department: power. This instrument will be developed to test her theory of departmental system power that was conceptualized following Dr. King's framework.

    Certified by ANA as a Nurse Administrator, Ms. Sieloff is the Clinical Director of an in-patient adult psychiatric unit at Oakland General Hospital, Madison Heights, Michigan. A member of the Detroit District of the Michigan Nurses’ Association, American Nurses’ Association, she is active at the district, state, and national levels. She is also a member of Sigma Theta Tau and the Wayne State University Alumni Association and has written several publications that focus on psychiatric nursing and nursing administration.

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