Week 7

Theoretical
Foundations
of Nursing
Rodney Paul B. Lagan, RN, MAN(c)
 Table of Contents

01 Martha Rogers
Science of Unitary
Human Beings
Imogene King
Theory of Goal
Attainment
02
 Martha Rogers
Science of Unitary Human Beings
Martha Rogers was a nurse theorist who is the nursing theory proponent
of the “Science of Unitary Human Beings.”
Martha Elizabeth Rogers (May 12, 1914 – March 13, 1994) was an American
nurse, researcher, theorist, and author widely known for developing the
Theory/Science of Unitary Human Beings and her landmark book, An
Introduction to the Theoretical Basis of Nursing.
She believes that a patient can never be separated from their
environment when addressing health and treatment.
Her knowledge about the coexistence of the human and his or her
environment contributed a lot in changing toward better health.
Science of Unitary Human Beings
Introduction
The belief in the coexistence of humans and the environment
significantly influences health and treatment approaches.
This view suggests that a patient cannot be separated from their
environment when addressing health and treatment.
Rogers’ theory helped establish nursing as both an art and a science
within the scientific disciplines.
Nursing, according to Rogers, is a humanistic and humanitarian practice
focused on the unitary human and human development.
The goal of nurses is to participate in and facilitate the process of
change.
Rogers’ theory identifies two dimensions of nursing:
The science of nursing, based on knowledge from scientific research.
The art of nursing, which creatively applies scientific knowledge to
improve patients' lives.
Science of Unitary Human Beings
Assumptions
Man is a unified whole with integrity, exhibiting characteristics that are
more than just the sum of his parts.
Man and the environment are in continuous exchange of matter and
energy.
The life process evolves irreversibly and in one direction along the
space-time continuum.
Pattern and organization define a person and reflect their unique
wholeness.
Man possesses the capacity for abstraction, imagery, language, thought,
sensation, and emotion.
Science of Unitary Human Beings
Major Concepts
Human-Unitary Human Beings
A person is an indivisible, pan-dimensional energy field with unique
characteristics that cannot be understood by analyzing their parts
alone.
Health
Defined as an expression of the life process, resulting from the
interaction between human and environmental fields. Health and illness
are on the same continuum, with health reflecting the achievement of
maximum health potential.
Nursing
Focuses on the study of unitary, irreducible human and
environmental fields. Nursing exists to serve people, with
safe practice relying on the nurse's scientific knowledge.
Science of Unitary Human Beings
Major Concepts
Scope of Nursing
Aims to help people achieve maximum health potential, encompassing
health maintenance, promotion, disease prevention, diagnosis,
intervention, and rehabilitation. Nursing serves all people in various
settings, from homes to hospitals and beyond, even extending into outer
space.
Environmental Field
Described as an irreducible, indivisible, pan-dimensional energy field
that is integral to the human field.
Energy Field
The fundamental unit of both living and non-living entities, representing
people and the environment as irreducible wholes. These energy fields
continuously vary in intensity, density, and extent.
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Science of Unitary Human Beings
Subconcepts
Openness
There are no boundaries limiting energy flow between human and
environmental fields; both are open systems.
Pandimensional
In a non-linear domain without spatial or temporal attributes; human
events are arbitrarily described, with the present being relative and no
fixed temporal order.
Synergy
The unique behavior of whole systems cannot be predicted by examining
individual components; human behavior is synergistic.
Pattern
The distinguishing characteristic of an energy field, seen as a single
wave, which gives identity to the field.
Science of Unitary Human Beings
Subconcepts
Principles of Homeodynamics
A dynamic version of homeostasis, these principles describe the nature
of unitary human beings through three concepts:
Resonance
Continuous change in human and environmental fields, with life as
a symphony of vibrations at varying frequencies.
Helicy
Continuous, innovative change in the human-environment field,
reflecting the constant interchange between the two.
Integrality
The inseparability of humans and their environment, leading to
continuous mutual interaction and change.
Science of Unitary Human Beings
Subconcepts
Principle of Reciprocity
Man and the environment are inseparable, with continuous probabilistic
changes in life processes occurring from their interactions.
Principle of Synchrony
Changes in human behavior are determined by the simultaneous
interaction between the human field and the environmental field at any
given moment.
Principle of Resonancy
Describes the rhythmical vibrations in the life process, with continuous
change from lower to higher frequency wave patterns in human and
environmental fields.
Principle of Helicy
The human-environment field is a dynamic open system, with continuous,
innovative change due to constant interchange, making the system
perpetually new or different.
Science of Unitary Human Beings
Nursing Process
Nursing Process in Rogers’ Theory
Involves three steps: assessment, voluntary mutual patterning, and
evaluation.
Assessment Areas
Total pattern of events at a specific point in space-time.
Simultaneous states of the patient and their environment.
Rhythms of the life process.
Supplementary data.
Categorical disease entities and subsystem pathology.
Pattern appraisal.
A comprehensive assessment of human and environmental fields is
required.
Science of Unitary Human Beings
Nursing Process
Mutual Patterning
Sharing knowledge with the patient.
Offering choices.
Empowering the patient.
Fostering patterning.
Evaluation
Repeat pattern appraisal, focusing on areas such as nutrition,
work/leisure activities, wake/sleep cycles, relationships, pain, and
fears/hopes.
Identify dissonance and harmony.
Validate the appraisal with the patient.
Encourage patient self-reflection.
Science of Unitary Human Beings
Strengths and Weaknesses
Strengths
Martha Rogers’ concepts provide a worldview from which nurses may derive
theories and hypotheses and propose relationships specific to different situations.
Rogers’ theory is not directly testable due to a lack of concrete hypotheses, but it is
testable in principle.
Weaknesses
Rogers’ model does not define particular hypotheses or theories, for it is an
abstract, unified, and highly derived framework.
Testing the concepts’ validity is questionable because its concepts are not directly
measurable.
The theory was believed to be profound and was too ambitious because the
concepts are extremely abstract.
Rogers claimed that nursing exists to serve people. However, nurses’ roles were not
clearly defined.
The purpose of nurses is to promote health and well-being for all persons wherever
they are. However, Rogers’ model has no concrete definition of a health state.
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 Imogene King
Theory of Goal Attainment
Imogene Martina King (January 30, 1923 – December 24, 2007) was one of
the pioneers and most sought nursing theorists for her Theory of Goal
Attainment, which she developed in the early 1960s.
Her work is being taught to thousands of nursing students worldwide
and is implemented in various service settings.
As a recognized global leader, King truly made a positive difference for
the nursing profession with her significant impact on nursing’s scientific
base.
She made an enduring impact on nursing education, practice, and
research while serving as a consummate, active leader in professional
nursing.

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Theory of Goal Attainment
Introduction
Theory Overview
Imogene King’s Theory of Goal Attainment emphasizes setting health
goals with patients and working together to achieve them.
Focus on Nurse-Patient Relationship
The theory guides nurses to work closely with patients in setting and
achieving health goals.
Key Concepts
Interaction, perception, communication, transaction, self, role, stress,
growth and development, time, and space are interrelated in the theory.
Nurse-Client Dyad
The theory emphasizes a relationship where both nurse and client bring
personal perceptions and work together through communication to
achieve mutually set goals.
Theory of Goal Attainment
Introduction
Theory Definition
Nursing is a process of action, reaction, and interaction between nurse
and client.
Both nurse and client share information, set goals, and agree on
methods to achieve those goals.
Nurse’s Role
The nurse’s goal is to help patients maintain their health to function in
their roles, and the nurse’s domain includes promoting, maintaining, and
restoring health, as well as caring for the sick, injured, and dying.
Professional Nurse’s Function
Involves interpreting information in the nursing process to plan,
implement, and evaluate nursing care.
Theory of Goal Attainment
Propositions
Perceptual Interaction Accuracy
If present in nurse-patient interactions, a transaction will occur.
Transaction Achievement
If the nurse and patient make a transaction, the goals will be achieved.
Goal Achievement and Satisfaction
If goals are achieved, satisfaction will result.
Effective Nursing Care
Achieving goals leads to effective nursing care.
Growth and Development
Transactions in nurse-patient interactions enhance growth and development.
Role Expectations and Performance
If congruent between nurse and patient, a transaction will occur.
Role Conflict and Stress
Role conflict experienced by either party leads to stress in nurse-patient interactions.
Special Knowledge and Communication
If a nurse with special knowledge communicates effectively, mutual goal-setting and
goal-achievement will occur.
Theory of Goal Attainment
Assumptions
The primary focus of nursing is the care of the patient.
The goal of nursing is to provide health care for both individuals and
groups.
Human beings are open systems constantly interacting with their
environments.
Nurse and patient communicate, set mutual goals, and act together to
achieve those goals—this is also the basic assumption of the nursing
process.
Patients perceive the world as complete persons making transactions
with individuals and things in their environment.
Transactions represent life situations where individuals actively
participate and are changed through the experience.
Theory of Goal Attainment
Major Concepts and Subconcepts
Nursing
A process involving action, reaction, and interaction where nurse
and client share information, goals, problems, and explore ways to
achieve goals.
Health
A dynamic life experience involving continuous adjustment to
internal and external stressors, using resources to achieve
maximum daily living potential.
Individual
Social, rational, and sentient beings who communicate thoughts,
actions, customs, and beliefs through language, and have the
ability to perceive, think, feel, choose, set goals, select means, and
make decisions.
Theory of Goal Attainment
Major Concepts and Subconcepts
Environment
The background for human interactions, encompassing both
external and internal aspects of the individual.
Action
A sequence of behaviors involving mental and physical activity,
starting with recognizing conditions, followed by activities related
to those conditions, and exerting control over the situation to
achieve goals.
Reaction
Not specifically defined, but related to the sequence of behaviors
in action.
Theory of Goal Attainment
Major Concepts and Subconcepts
Interaction
Process of perception and communication between a person and
their environment, and between individuals.
Represented by goal-directed verbal and nonverbal behaviors.
Transaction
Process where humans communicate with the environment to achieve
valued goals.
Goal-directed human behaviors.
Perception
Each person’s representation of reality.
Theory of Goal Attainment
Major Concepts and Subconcepts
Communication
Process of giving information from one person to another, either
directly (face-to-face) or indirectly (telephone, television, written word).
Role
Set of expected behaviors for individuals in a social system.
Defines rights, obligations, and relationships in specific situations.
Stress
Dynamic state involving interaction with the environment to maintain
balance for growth, development, and performance.
An energy response to stressors (persons, objects, events).
Theory of Goal Attainment
Major Concepts and Subconcepts
Growth and Development
Continuous changes at cellular, molecular, and behavioral levels.
Processes that help individuals move from potential achievement to
self-actualization.
Time
Sequence of events moving toward the future.
Continuous flow of events indicating change, with a past and future.
Duration between events as experienced by each individual.
Space
Exists in every direction and is consistent.
Includes physical territory and is defined by behaviors of those who
occupy it.
Theory of Goal Attainment
Interacting Systems in Theory of Goal Attainment
Personal Systems
Individuals are personal systems (e.g., patient or nurse).
Concepts include perception, self, growth and development, body image,
space, and time.
Self is a composite of thoughts and feelings, representing a person’s
awareness and inner world.
Growth and development involve moving from potential achievement to
self-actualization.
Body image refers to how one perceives their body and others' reactions.
Space is the physical area known as "territory" and behaviors within it.
Time is the unique duration between events as experienced by each
individual.
Learning is an added subconcept but not defined further.
Theory of Goal Attainment
Interacting Systems in Theory of Goal Attainment
Interpersonal Systems
Formed by interactions between individuals (dyads, triads, groups).
Concepts include communication, interaction, role, stress, and
transaction.
Interaction is the observable behaviors of two or more individuals.
Communication is the process of exchanging information directly or
indirectly.
Transaction is the goal-directed interaction between humans and the
environment.
Role includes reciprocity, functioning in social, complex, and situational
roles.
Stress is a dynamic state involving interaction with the environment to
maintain balance.
Theory of Goal Attainment
Interacting Systems in Theory of Goal Attainment
Social Systems
Composed of groups within society (e.g., religious, educational,
healthcare systems).
Concepts include authority, decision-making, organization, power, and
status.
Power is the ability to use resources to achieve goals and influence
others.
Status is the position of an individual or group within an organization,
accompanied by privileges, duties, and obligations.
Decision Making is a systematic process of choosing and acting on
perceived alternatives to achieve goals.
Control is an added subconcept but not further defined.
Theory of Goal Attainment
Dynamic Conceptual System

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Theory of Goal Attainment
Process of Interaction
Theory of Goal Attainment
Nursing Process
Assessment
Occurs during interaction between nurse and patient.
Nurse uses specialized knowledge; patient provides self-knowledge and
perceptions.
Data gathered includes growth, development, self-perception, and health
status.
Perception and communication are key for data collection,
interpretation, and verification.
Nursing Diagnosis
Developed from assessment data.
Identifies problems, concerns, and disturbances the patient seeks help
for.
Theory of Goal Attainment
Nursing Process
Planning
Involves creating a care plan with interventions based on the diagnosis.
Includes setting goals and deciding on means to achieve them.
Encourages patient participation in decision-making.
Implementation
Involves carrying out activities to achieve the set goals.
Continuation of the transaction phase in the nursing process.
Evaluation
Determines if goals were achieved and evaluates the effectiveness of
nursing care.
Addresses the success in meeting goals and overall care effectiveness.
Theory of Goal Attainment
Analysis
The social systems portion of the open systems framework is less clearly
connected to goal attainment than personal and interpersonal systems.
The citation of the individual being in a social system was not clearly
explained, considering that the social system encompasses other
concepts and subconcepts in her theory.
The model presents dyadic interaction in nature which implies that its
applicability cannot be adapted to unconscious individuals.
A multitude of views and definitions is confusing for the reader.
Because of multiple views on one concept, such as what has been
discussed in her concept of power, it blurs the point that the theorist is
trying to relate to the readers.

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Theory of Goal Attainment
Strengths and Weaknesses
Strengths
Logical Sequence
Provides a clear and logical sequence of events for understanding
and applying goal attainment theory.
Concrete Definitions
Concepts are well-defined and illustrated.
Research-Based
Concepts are derived from research literature, establishing the
theory's significance in nursing knowledge.
Theory of Goal Attainment
Strengths and Weaknesses
Weaknesses
Limited Application
Criticized for limited applicability in situations where patients cannot
interact effectively with the nurse.
Group and Community Care
Lacks development for application in nursing care for groups,
families, or communities.
Inconsistencies
Focuses on dyadic relationships while addressing concerns about
group health care.
Contradicts itself by describing nurses and clients as strangers but
emphasizing their collaborative goal-setting and health maintenance.
Thanks for
Listening
Do you have any questions.