Question

The progression from conceptual model to middle-range theory can be identified by reviewing King’s theory of goal attainment (middle-range theory) which is derived from King’s conceptual system (conceptual model). Explain how the concepts of the conceptual model and Patricia Benner's middle-range theory are consistent and are linked.

Answer 1

The Theory of Goal Attainment states that “Nursing is a process of action, reaction, and interaction whereby nurse and client share information about their perception in the nursing situation.”

Imogene King’s Theory of Goal Attainment was first introduced in the 1960s. From the title itself, the model focuses on the attainment of certain life goals. It explains that the nurse and patient go hand-in-hand in communicating information, set goals together, and then take actions to achieve those goals. The factors that affect the attainment of goals are roles, stress, space, and time. On the other hand, the goal of the nurse is to help patients maintain health so they can function in their individual roles. The nurse’s function is to interpret information in the nursing process, to plan, implement, and evaluate nursing care.

To help nurses understand her work, she defined several terms which include the patient, defined as a social being who has three fundamental needs: the need for health information, the need for care that seeks to prevent illness, and the need for care when the patient is unable to help him or herself

She also explained health as involving life experiences of the patient, which includes adjusting to stressors in the internal and external environment by using resources available. The environment, defined as the background for human interaction. It involves the internal environment, which transforms energy to enable people to adjust to external environmental changes, and it involves the external environment, which is formal and informal organizations. A nurse is considered part of the patient’s environment.

There are three interacting systems in the Theory of Goal Attainment according to King. These are the personal system, the interpersonal system, and the social system. Each system is given different concepts. The concepts for the personal system are: perception, self, growth and development, body image, space, and time. The concepts for the interpersonal system are: interaction, communication, transaction, role, and stress. The concepts for the social system are: organization, authority, power, status, and decision making.

Benner proposed that a nurse could gain knowledge and skills without actually learning a theory. ... The theory identifies five levels of nursing experience: novice, advanced beginner, competent, proficient, and expert.

One approach is the direct derivation of a middle-range theory from a conceptual model. For example, two theories of family health have been directly derived from King's Conceptual System .This approach assures a logical linkage between the conceptual model and the middle-range theory.

Summary of the theories: Benner, P. (1984). From
novice to expert and Key to providing competent cost
effective health care delivery depends on nurses’ understanding of research and the ability to link
concepts in a model to make sense of the research.
This is essential because consumers of health care are
demanding evidence-based quality healthcare services
at affordable rate especially with a shift towards the
model of health promotion. The aim of this paper
therefore is to evaluate two middle range theories
abilities to test the concept of reflective practice for the
practice question: Do nursing students engage in
reflective practice to improve academic performance
and professional development?
The theories evaluated are identified to have
characteristics that maintain the definitions of the key
concepts throughout the explanation of the theories and
have congruence of use of terms, interpretation,
principles and methods. Internal critisms show that the
topics are completely addressed as claimed. The clarity
of the concepts is seen as the main components are
clearly stated with logical development of the line of
thought of previous work shown to be true and
argument well supported. The theories are also
consistent with the conceptualization of the middle
range theories.
External criticism shows that the theories can
be understood without lengthy description and
explanations. The uses of these theories make
hypothesis easily understood and have précised and
clear boundaries and definitive parameters of the
subject matters. The theories underlying assumptions
are true and represent the real world and world of
nursing in particular. Based on this premise, innovative
ways of learning to develop the nurse (using methods
like reflective practice, theory evaluation, and literature
review for evidence) should be encouraged.