Imogene King is one of the most revered theorists in human history. King has significantly contributed to the development of knowledge in the field of nursing. In his theory, King focusses on the dynamic nature of man, whose behavior is greatly influenced by his perception of others, objects, and different events. According to Parker & Smith (2010), t he framework consists of three interacting systems and each has a unique group of concepts and characteristics. King's theory is founded on the underlying assumption that nursing is a process that focusses solely on the provision of care to human beings. Concurrently, health is the core goal of this profession.
Interacting Systems
The personal Interpersonal and social systems make up the three interacting systems in King’s theory. The individual is what is referred to as the personal systems. Some key concepts are essential in promoting an understanding of human beings, in this system. These concepts include time, space, development, perception, image, and growth, among others. According to King, perception is the most crucial variable since it influences behavior. Indeed, a person’s view of themselves, the way they look, their environment, and of course time and space, determines how they behave ( Williams, 2017) . Likewise, the experiences that human beings have as their bodies transform both in structure and function also have a direct influence on an individual’s perceptions of self.
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The second category, which is the interpersonal systems, focusses on the interactions between human beings. King develops the term dyads, triads, and large groups to denote two, three, and four or more people interacting ( Parker & Smith, 2010) with each other, respectively. Just like the personal systems, the interpersonal networks also have some concepts such as communication, interaction, and transaction, among others. For instance, any interactions between a nurse and a patient, otherwise known as dyads, is an example of an interpersonal system. Moreover, the interaction is further categorized as either verbal or non-verbal. Verbal communication is inclusive of both spoken and written words. Nonetheless, non-verbal communication entails facial expressions, gestures, distance, and posture, among others.
The social system is the final category and refers to groups of individual’s v existing in the same community or society, who have one core goal, as well as interests and values. The social systems create a platform for social interaction and relationship development. Additionally, they define the standards of behavior and acceptable courses of actions. The family and church are excellent examples of social systems. Williams (2017) argues that it is through these groups that various beliefs, moral values, and attitudes develop. King claims that status, power, decision-making, and organization are the concepts that directly relate to this system. Comprehensive knowledge on these interactive systems fosters an understanding of human behavior.
Influence on Goal Attainment
King’s interactive systems have a significant impact on goal attainment. Interpersonal systems force two strangers, in this case, the nurse and the patient to collaborate with the aim of attaining one core objective which is to maintain the desired state of health. Apparently, the interaction between these two individual’s outcome a transaction that results in the accomplishment of goals. Interpersonal systems foster the development of a good rapport between the client and the nurse. As a result of the bonds of trust that develop, the patient is able to reveal critical information which may be used in making a valid diagnosis and determine the best treatment intervention for the patient’s ailment. Additionally, such an interaction enables the nurse to provide patients with individualized care, which leads to positive healthcare outcomes, or rather the attainment of health care goals.
Personal systems shape an individual’s attitude and perception towards various services. Furthermore, the experiences that one has in the course of their lives determines whether or not the set healthcare goals will be achieved. For instance, an individual who experiences his/her mother’s pain as she undergoes cancer treatment and hopes that the mother dies to escape from her misery may have a negative attitude towards cancer treatment. Therefore, a person such as this may be reluctant to take the required medication and seek chemotherapy, even when advised by the doctor. In such a case, personal systems inhibit the attainment of health care goals, due to the patient’s attitude and perception, which influence their behavior, which is in this case, the reluctance to receive healthcare.
Likewise, social systems also affect the realization of goals. Social groups such as the church, impart in people various beliefs which may influence their decision making, especially where healthcare is concerned. For instance, an expectant woman who has a lot of faith in God may refuse to undergo surgery even after being informed that the life of her unborn triplets is dependent on the operation just because she feels that God does as He wishes, and it is a sin to go against His will. In such cases, the religious beliefs and faith of such patients are shaped and reinforced by the church. Nurses may, therefore, fail to persuade such an individual to accept the procedure, even if her life and that of her unborn children depend on it. It is therefore crucial for nurses to understand the high impact that social systems have on the accomplishment of health care goals. Moreover, it is also vital for these professionals to be equipped with the knowledge and skills required to handle such cases, to convince patients to accepts the healthcare procedures while still respecting their right to autonomy.
The Definition of Clinical Quality Problem
King's theory emphasizes the vitality of nurse-patient relationships. Indeed, the approach creates an understanding of the factors that deter medical professionals from achieving the healthcare goals they have set for their patients. The theory is therefore useful in the identification of interactional flaws that may jeopardize the quality of health care services provided or rather quality care problems. The application of this framework in clinical setups can bring more attention to the types of interpersonal interactions that exist between nurses and their patients. Moreover, the assessment would also create an opportunity to make comparisons of patient outcomes as a result of the different types of interpersonal relationships that exists between various nurses and their patients. Concurrently, the data that would be obtained from such a comparative analysis is essential in determining whether a good rapport between patients and their nurses influences positive health outcomes. Concurrently, a proper definition of the clinical quality problem would be made.
Application of the Theory to Quality Improvement Initiatives in Clinical Practice
One of the quality improvement initiatives that has been embraced at St. Augustine’s memorial is high-touch care. Excessive emphasis is put on the provision of high-touch care to patients, to foster the establishment of emotional connections and healthy relationships between patients and nurses. King's theory is very applicable to this initiative. Meyer et al. (2018) argue that n urses and other medical practitioners have detached themselves from patients and become very cold since they no longer feel the need to connect on an emotional level with their patients. Nurses should embrace King's theory and strive to develop a connection and bonds of trust with their patients. Most importantly, medical professions should be sensitive to the needs of patients and attempt to understand various beliefs, customs, and values that may influence the realization of the set goals. Interpersonal relationships are critical drivers of health and should, therefore, be prioritized.
The Alignment of Outcomes with Kings Conceptual Systems Theory
The quality committee can employ some strategies to align its outcomes with King’s conceptual systems framework. Notably, the committee should ensure that nurses undergo extensive interpersonal training before they start attending to patients. As a result, this would ensure that they can establish a good rapport with the sick, which is critical for the attainment of the most desirable health outcomes. Additionally, the committee should motivate nurses in developing these relationships by giving them rewards or acknowledging their achievements in meetings. As a result, other nurses would gain the morale to achieve this simple task, leading to the provision of quality care to the sick. In doing this, the committee will have aligned outcomes with the King’s theory.
Nurse-Patient Relationship Theory
The nurse-patient relationship theory could also align with the improved quality of practice initiative. According to Parker & Smith (2010) n ursing is defined as a necessary therapeutic and interpersonal procedure. Peplau argues that nursing care cannot be administered at all if there is no relationship between the dyads. The nurse contributes professional expertise to the relationship. It is further argued that this relationship is objective and focused primarily on the patient’s needs. The theory poses similar arguments to King's conceptual systems theory. Most importantly it stresses the vitality of high-touch care which is a critical driver of goal realization in nursing practice.
In summation, the quality of healthcare has dramatically declined due to the lack of sustainable nurse-relationships. Medical practitioners focus more on high-tech care as opposed to high touch care. The achievement of healthcare goals is contingent on the development of lasting interpersonal relationships between nurses and their patients. Emphasis should be put on high-touch care and training programs developed to instill interpersonal skills in nurses. Concurrently, the health of the ailing population in the society would be promoted,
References
Meyer, E. D., Hugo, J. F., Marcus, T. S., Molebatsi, R., & Komana, K. (2018). Why high
Tech needs high touch: Supporting continuity of community primary healthcare. African Journal of Primary Health Care & Family Medicine , 10 (1), 6.
Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice . Philadelphia: F.A. Davis Co
Williams, L. A. (2017). Imogene King’s interacting systems theory: Application in
emergency and rural nursing. Online Journal of Rural Nursing and Healthcare , 2 (1), 40- 50.
