Lewin’s Change Theory has three concepts that includes “driving forces,” “restraining forces,” and “equilibrium.” As the driving force implies, there are forces that push or cause things to change, shifting the equilibrium. Restraining forces fight against the driving forces which also causes shifts in equilibrium. Equilibrium can be described when no changes occur due to equal amount of force applied. There are three stages in his theory and that is “unfreezing,” “change,” and “refreezing.” Unfreezing is getting out of the rut of behaviors that are not healthy or productive. This requires fortitude to break out of the individual mindset and group conformity. This can be accomplished by either increasing the driving forces that direct behaviors away from the current norm or by decreasing the restraining forces that negatively affect movement away from equilibrium. A third alternative would be a combination of both. The change stage is producing growth and moving to a new level. It is evidenced by new thought, feeling and/or behavior changes. The refreezing stage is making the new patterns set as the new normal. Once they are “frozen,” it helps to prevent falling back into old unhealthy patterns (Change Theory, 2011).
Imogene King: Goal Attainment Theory has an emphasis on interaction theory vs systems theory. The concepts are based on an open system framework that honors nursing as a major system within the health care system, and places high emphasis on interpersonal processes. In the conceptual framework are three systems; the Personal (individual), Interpersonal (individuals interacting with each other) and the Social where groups of people in a community or society share common goals, interests, and values and is studied as a whole vs isolated parts. The practice of nursing is differentiated from other healthcare professions in that interpersonal systems are in place and this is reflected in the nurse-client relationship. The individual is viewed as a spiritual being, rational thinker, and records own history through own language, and expresses individual needs, wants, and goals. Humans have three fundamental needs: access to health information, illness prevention, care in times of illness. Health is dependent on continuous adjustment to stressors in the internal and external environments with use of ones resources to achieve maximum potential (Gragera, 2013).
Theory for EBP Project
The Goal Attainment Theory seems to be the best fit for the Capstone project. Results of screening and referrals develop into IHPs and IEPs that are tailored to the individual’s needs. This would seem to fit best with engaging the entire interprofessional team in working with the student and the family in implementing interventions.
Theory Used by Mentor
“I suppose I engage some level of nursing theory with each response in the work setting, protocol development, policy revision, and the like. When looking at the two theories you shared, I would probably most closely align myself with Imogene King’s Goal Attainment Theory. Nursing is a major system within the health care system, with vast and significant impact on individuals, families/groups, and communities (local, regional, national, and world)” (P. Anderson, personal communication, August 19, 2019).
“I’ve consistently landed on the historical (and I think still relevant) dimensions of health: physical, social, emotional, intellectual, spiritual. The individual, embracing, reflecting, and continuously balancing these five dimensions, can engage in self-responsibility and decision-making relative to the three fundamental needs identified in King’ theory: health information, illness prevention, and care in times of illness ~ expressing needs, wants, and goals” (P. Anderson, personal communication, August 19, 2019).
Change Theory. (2011). Retrieved from http://currentnursing.com/nursing_theory/change_theory.html
Gragera, Jen. Imogene King: Goal Attainment Theory. (2013). Retrieved from https://www.slideshare.net/jen316/imogene-king-23548267