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In her work, Imogene King defines the four nursing metaparadigms and explains their relevance to both the nursing process and patient care. The four nursing paradigms are person, health, environment, and nursing.
The first metaparadigm, person, focuses on the patient. She defines person as “a personal system that interacts with interpersonal and social systems” (Masters, 2015, p. 92). This involves every aspect of the patient’s self. It is important for the nurse to look at the whole person, including spiritual, emotional, and financial state. This metaparadigm furthers patient care by understand where the patient is coming from and what is most important to him or her. The second metaparadigm is health.
Imogene King defines health as ““Dynamic life experiences 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 potential for daily living” (Masters, 2015, p. 92). This is especially important to King’s theory of goal-attainment because to achieve goal-attainment one must also take into consideration the height at which the patient’s health can be fulfilled. Health, to the extent possible for the patient, is the goal for ill patients and their nurse alike.
The next metaparadigm is environment. King states environment “can be both external and internal. The external environment is the context ‘within which human beings grow, develop and perform daily activities’; the internal environment of human beings transforms energy to enable them to adjust to continuous external environmental changes” (Masters, 2015, p. 92). The distinction between internal and external environment is incredibly important. If the internal environment is unable to adjust to the changing external environment, growth and development externally will be inhibited. Finally, Imogene King defines nursing as “a process of human interactions with the goal of helping patients achieve their goal” (Masters, 2015, p. 92). This also is vital to her formulation of her theory of goal-attainment.
According to her theory, goal-attainment is achieved when both the nurse and the patient have the same goal in mind and are able to communicate freely to achieve the goal. King’s theory is made up of three interacting systems. The first is personal systems made up of individuals, the second, interpersonal systems made up of groups, and social systems, defined as society (Blais & Hayes, 2016). “The client and nurse are personal systems or subsystems within interpersonal and social systems” (Blais & Hayes, 2016).
While King places her theory in the system of personal interaction, any type of patient, from any group or population can be a part of this system. The theory is also applicable across the continuum of care. However, it has been implemented in certain areas more so than others. According to the “Professional Nursing Practice”, King’s theory is being put into practice in the care of “families with children or adolescents with chronic mental illness, families of children with chronic illness, and patients with COPD” (Blais & Hayes, 2016).
While this is an example of secondary, and possibly tertiary care, King’s theory can be applied to all levels of the continuum of care. The nurse-patient goal setting and communication is as relevant when the patient has a common health problem as when he or she has a chronic illness.
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