Running head: DISCUSSION 3.

1: APPLICATION OF A GRAND THEORY 1

Discussion 3.1: Application of a Grand Theory

Two grand theories will be discussed today, one by Imogene King and one by Margaret

Newman. King’s theory of goal attainment has to do with the nurse-patient relationship and the

ways that satisfaction and goal attainment occurs in that relationship. The theory of goal

attainment has a process of interaction, reaction, and action where the patient and the nurse talk

about the way that the nursing care is happening, should happen, and the goals of the care

(Meleis, 2018). The framework of King’s theory includes personal, interpersonal, and social

systems; these systems interact to meet the patient’s health needs (Fronczek, Rouhana, &

Kitchin, 2017). Newman’s theory of health as expanding consciousness is a model based on a

caring partnership between the nurse and the patient. Nurses should recognize how a person

relates to their environment and help people use their inner power to raise their level of

consciousness; the theory sees health and disability as manifestations that go beyond the physical

and exist on a level of human energy (Petiprin, 2016). This paper will compare and contrast the

way that people have used these theories in healthcare.

King’s theory was used in a school to help form a telehealth program and to help educate

undergraduate and graduate students on how to appropriately use telehealth. King believed that

healthcare professionals need to stay on top of technological advancements; in this way, the

school was following King’s theory (Fronczek et al., 2017). Students learn how to use

technology in a therapeutic manner while displaying practical listening skills, which is a

distinctive feature of King’s theory (Fronczek et al., 2017). The school uses King’s framework of

personal, interpersonal, and social systems as part of their course in telehealth. The personal and

interpersonal system is used to teach nurses how to communicate to patients and listen

effectively in such a manner that they can get a proper assessment done and to make goals with
DISCUSSION 3.1: APPLICATION OF A GRAND THEORY 2

the patient (Fronczek et al., 2017). The social system is addressed through working with

regulatory agencies for licensing; it is also addressed when students identify and analyze the

clinical information system to recommend improvements in the technology that is being used

(Fronczek et al., 2017). The theory was used successfully to teach students how to use telehealth

in many different aspects.

Newman’s theory was utilized on a patient with cancer who had not been open with her

family on what was happening to her and had been closed off to the medical staff (Fujiwara &

Endo, 2017). The nurse researcher who worked with the patient encouraged the patient to share

her story and entered a partnership with her to help the patient understand why she had been

closed off and what she could do to communicate with her family in a more effective way

(Fujiwara & Endo, 2017). The theory was used successfully by the nurse and the patient to help

the patient and her family communicate their feelings and needs to each other.

These two theories have many differences, but also some similarities. For these two

articles, Newman’s theory was used in a more personal manner, while King’s theory was used in

a more system-wide manner. Both theories focus on the importance of nurse-patient

communication, but King’s theory was used as a way for the patient and the nurse to progress

forward with goals whereas Newman’s was used to help the patient transcend to a new level of

understanding about herself and her situation. King’s theory incorporates more outside structures

than Newman’s does through King’s use of social systems. Newman’s theory does involve

environmental factors (Petiprin, 2016), but her theory seems to focus mostly on a person’s

energy system and the way that it interacts with health and illness. The difference between

King’s and Newman’s theories makes sense as Newman’s theory was initially conceived as a

theory for people who had chronic illness or disability from which they would never be free
DISCUSSION 3.1: APPLICATION OF A GRAND THEORY 3

(“Health As Expanding Consciousness,” 2011) and King’s theory began when she started

questioning how nurses make decisions on a daily basis and how the act of nursing could be

defined (Meleis, 2018). The fact that these two theories come from such different places explains

their differences.
DISCUSSION 3.1: APPLICATION OF A GRAND THEORY 4

References

Fronczek, A. E., Rouhana, N. A., & Kitchin, J. M. (2017). Enhancing telehealth education in

nursing: Applying King's conceptual framework and theory of goal attainment. Nursing

Science Quarterly, 30(3), 209-213. http://dx.doi.org/10.1177/0894318417708418

Fujiwara, Y., & Endo, W. (2017). A patient with cancer and her family in caring partnership

based on Margaret Newman's theory of health as expanding consciousness. Asia-Pacific

Journal of Oncology Nursing, 4, 265-268. http://dx.doi.org/10.4103/apjon.apjon_20_17

Health as expanding consciousness: Margaret Newman. (2011). Retrieved September 10, 2019,

from

http://currentnursing.com/nursing_theory/Newman_Health_As_Expanding_Consciousne

ss.html

Meleis, A. I. (2018). Theoretical nursing: Development and progress (6th ed.). Philadelphia, PA:

Wolters Kluwer Health.

Petiprin, A. (2016). Health as expanding consciousness. Retrieved from http://nursing-

theory.org/theories-and-models/newman-health-as-expanding-consciousness.php