Nursing Conceptual Models (King, Neuman, Johnson)

Imogene King

Born on January 30, 1923

Imogene King

Nursing Diploma from the St. John’s Hospital School of Nursing in St. Louis, Missouri in 1945

Imogene King

BSN from St. Louis University in 1945

Imogene King

MS in Nursing from St. Louis University in 1957

Imogene King

Authored 77 published articles

Imogene King

Doctoral Degree from Teachers College, Columbia University in 1961

Imogene King

Died on December 24, 2007

Imogene King

Assistant Chief of the Research Grants Branch of the Division of Nursing in Washington, D.C. under Dr. Jessie Scott (1966-1968)

Imogene King

Director of the Ohio State University School of Nursing (1968-1972)

Imogene King

Associate Professor, Loyola University (1961-1966)

Imogene King

Professor, Loyola University (1971-1980)

Imogene King

Professor, University of South Florida’s College of Nursing (1980-1990) Retired in 1990 with the title Professor Emeritus

Person (Imogene King)

Rational, sentient social beings who express their thoughts, actions, customs, and beliefs through languages

Person (Imogene King)

Someone who possess shared characteristics that enable them to perceive, think, feel, evaluate alternative courses of action, set goals, select appropriate means to achieve those goals, and make informed decisions

Health (Imogene King)

A dynamic life experience 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 daily living potential

Environment (Imogene King)

serves as the background for human interactions and encompasses factors both internal and external to the individual

Environment (Imogene King)

These internal and external environments continually interact, aiding the person in making necessary adjustments to change

Nursing (Imogene King)

Defined as an “interaction process” between client and nurse where, through perceiving, setting goals, and acting, transactions occur an goals are successfully achieved

Nursing (Imogene King)

It functions as a helping profession that assists individuals and groups in society to attain, maintain, and restore health, or to help individuals die with dignity when health restoration is no longer possible

Goal Attainment Theory

Type of Interaction Theory first introduced in the 1960s

Goal Attainment Theory

The basic concept of the theory is that the nurse and client communicate information, set goals together, and then take actions to achieve those goals

Goal Attainment Theory

Describes as interpersonal relationship that allows a person to grow and develop to attain certain life goals

Goal Attainment Theory

The factors that affect the attainment of goals are roles, stress, space, and time

Personal System, Interpersonal System, Social System

Three interacting system

Personal System

Each individual is this

Body Image, Growth & Development, Self, Space, and Time

Concepts of Personal System

Body Image

how one perceives both one’s body and others’ reactions to one’s appearance

Growth and Development

the processes in people’s lives through which they move from a potential for achievement to the actualization of self

Perception

the processes through which an individual selects, organizes and interprets sensory and experiential data to form an image of reality (most important variable)

Self

a composite of thoughts and feeling which constitute a person’s awareness of his individual existence, his conception of who and what he is

Self

is the total of all he can call his own

Self

Includes a system of ideas, attitudes, values, and commitments

Space

exists in all directions, is the same everywhere, and is defined by the physical area known as “territory” and by the behaviors of those occupying it

Time

a duration between one event and another as uniquely experienced by each human being

Time

It is the relation of one event to another event

Interpersonal System

These are formed by human beings interacting

Interpersonal System

Two interacting individuals from a dyad; three - triad; four or more form small or large groups

Interpersonal System

As the number of interacting individuals increases, so does the complexity of the interactions

Communication, Interactions, Transactions, Role, and Stress

Concepts of Interpersonal System

Communication

a process whereby information is given from one person to another, either directly in a face-to-face meeting or indirectly though telephone, television, or the written word

Interactions

are observable behaviors of two or more individuals in mutual presence

Transactions

a process of interactions in which human beings communicate with the environment to achieve goals that are valued… goal-directed human behaviors

Role

includes reciprocity; a person may be a giver at one time and a taker at another time, with a relationship between two or more individuals functioning in two or more, learned, social, complex, and situational roles

Stress

a dynamic state whereby a human beings communicate 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

Social System

A more comprehensive interacting system consists of groups that make up society, referred to as the social system

Social System

Examples of these include religious, educational, and healthcare systems

Authority, Decision Making, Organization, Power, and Status

Concepts of Social System

Authority

legitimate power vested in a person (role) within an organization or system to make decisions, direct action or assign resources

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

Organization

structured system of roles, rules, relationships and positions within a group of collective

Power

capacity to use resources in organizations to achieve goals; process whereby one or more persons influence other persons in a situation

Status

the position of an individual in a group or a group concerning other groups in an organization

Dynamic Conceptual System

This model demonstrates the conceptual system that provided “one approach to studying systems as a whole rather than as isolated parts of a system and was designed to explain organized wholes within which nurses are expected to function

Betty Neuman

Born on September 11, 1924 in Lowell, Ohio, and grew up on a farm

Betty Neuman

Education (RN Diploma from People Hospital School of Nursing (1947), BS in Public Health and Psychology from UCLA (1957), MS in Mental Health and Public Health Consultation (1966), PhD in Clinical Psychology from Pacific Western University (1985)

Person (Betty Neuman)

An open system in reciprocal interaction with their environment

Person (Betty Neuman)

A layered multidimensional being

Person (Betty Neuman)

Each layer consists of five person variables or subsystems (Physical/Physiological, Psychological, Socio-cultural, Developmental, Spiritual)

Health (Betty Neuman)

is conceptualizes as a continuous spectrum ranging from optimal wellness to illness

Optimal wellness

occurs when an individual’s total system needs are fully met, resulting in a state where available energy exceeds needed energy.

Illness

this arises when the energy needed to maintain stability exceeds the available energy

Environment (Betty Neuman)

Encompasses all internal and external factors surrounding and influencing the client system

internal, external, and created

3 distinct components of Neumann’s environmental framework

Nursing (Betty Neuman)

is defined as a unique profession concerned with the holistic well-being of individuals

Nursing (Betty Neuman)

It stands out for its comprehensive approach that considers all variables affecting a person’s response to stress

Nursing (Betty Neuman)

Within these framework, nurses play a pivotal roles in shaping the caregiving process by actively understanding both the patient’s perceptual field and their own

System

According to Neuman, this is defined as a pervasive order that binds its components together

Neuman’s Systems Model

Nursing can be conceptualized as a comprehensive whole composed of identifiable smaller components or parts

Neuman’s Systems Model

The client and environment can reciprocally influence each other, and there is an inherent inclination within any system to sustain a state of equilibrium or balance amid various disruptive forces

Wholistic Approach

Clients, viewed as holes, have dynamic interactions between physiological, psychological, sociocultural, developmental, and spiritual variables

Open System

A system is open when there is a continuous flow of input, processes, output, and feedback

Function/Process

The client as a system exchanges energy, information, and matter with the environment and other parts of the system

Input and Output

The matter, energy, exchanged between the client and the environment

Feedback

System output in the for of matter, energy, and information serves as feedback for future input

Negentropy

The process of energy conservation that assists the system in progressing toward stability or wellness

Stability

The dynamic and desirable state of balance in which energy exchanges can take place without disruption, pointing toward optimal health an integrity

Lines of Resistance

Broken rings surrounding the basic cores structure are called ___________, representing resource factors that help the client defend against stressors

Normal Line of Defense

The model’s outer solid circle represents __________, indicating the adaptational level of health

Flexible Line of Defense

The model’s outer broken ring acts s a protective buffer preventing stressors from breaking through the normal line of defense

Stressors

are tension-producing stimuli that have the potential to disrupt system stability, leading to an outcome that may be positive or negative

Degree of Reaction

signifies system instability when stressors invade the normal line of defense

Prevention as Intervention

are purposeful actions to help the client retain, attain, or maintain system stability

Primary, Secondary, Tertiary

Classes of Prevention

Primary Prevention

is employed when a stressor is suspected or identified but has not yet caused a reaction

Secondary Prevention

involves interventions initiated after symptoms from stress have occurred

Tertiary Prevention

occurs after active treatment or secondary prevention

Reconstitution

occurs after treatment for stressor reactions, representing the return of the system to stability, possibly at a higher or lower level of wellness that before stressor invasion

Dorothy Johnson

Born August 21, 1919 in Savannah, Georgia

Dorothy Johnson

Education — [Associate’s degree - Armstrong Junior College (1938), BSN - Vanderbilt University (1942), Master’s in Public Health - Harvard University (1948)]

Dorothy Johnson

Career — [Staff nurse - Chatham-Savannah Health Council (1943-1944), Instructor and Assistant Professor of Pediatric Nursing - Vanderbilt University, Assistant, Associate, and Professor of Nursing - UCLA (1949-1978), Pediatric Nursing Advisor - Christian Medical College School of Nursing, Vellore, India (1955-1956), Chairperson, California Nurses Association committee on clinical specialist specification (1965-1967)]

Dorothy Johnson

Publications — Authored 4 books and over 30 journal articles, Wrote numerous, papers, reports, and monographs

Dorothy Johnson

Honors and Awards (1975 Faculty Award from graduate students, 1977 Lulu Hassenplug Distinguished Achievement Award (California Nurses Association), 1981 Vanderbilt University School of Nursing Award for Excellence in Nursing)

Dorothy Johnson

developed the Behavioral System Model, widely used in nursing theory and practice, finding greatest satisfaction in its real-world impact

Dorothy Johnson

Died on February 1999, at age 80

Person (Dorothy Johnson)

is a behavioral system composed of interrelated, patterned subsystems that function together in an organized, integrated, and independent manner

Person (Dorothy Johnson)

This model encompasses two major systems—biological and behavioral—where human behavior is driven by fundamental biological needs but is continually shaped by learning, experience, and environmental factors

Person (Dorothy Johnson)

constantly strives for balance through automatic adjustments and adaptations to internal and external forces

Imbalance

may come from problems with—Drives/goals, lack of functional needs, or environmental changes

Health (Dorothy Johnson)

is a dynamic and changing state influenced by biological, psychological, and social factors

Health (Dorothy Johnson)

reflects how well the behavioral subsystems are organized, integrated, and balanced; Individuals attempt to maintain some balance or equilibrium