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Imogene King's Theory of Goal Attainment

Imogene M. King was born January 30, 1923 in West Point, Iowa and received a diploma from St. John Hospital School of Nursing in St Louis, MO in 1945. Until her death, she continued to speak at local, regional, national and international conferences and consulted with undergraduate and graduate students who were using her theory and developing theories from her Systems Framework.

EDUCATION

· Theorist: Imogene King - born in 1923.

· Bachelor in science of nursing from St. Louis University in 1948

· Master of Science in nursing from St. Louis University in 1957

· Doctorate from Teacher’s college, Columbia University.

ACADEMIC APPOINTMENTS

King served as Assistant Chief, Research Grants Branch, Division of Nursing, Washington, D.C. (1966-1968 under Dr. Jessie Scott.). She was director of the Ohio State University, School of Nursing (1968-1972). King was an Associate Professor (1961-66) and Professor (1971-1980) at Loyola University. Chicago. King retired in 1990 after serving as Professor, College of Nursing, University of South Florida.

AWARDS

ANA 1996 Jessie Scott Award and Hall of Fame Inductee).

Sigma Theta Tau International 1989 Elizabeth Russell Founders Award

 American Academy of Nursing (2005 Living Legend Inductee).

INTRODUCTION TO THEORY

109.63.27.1 14:02, June 30, 2013 (UTC)

King has interrelated the concepts of interaction, perception, communication, transaction, self, role, stress, growth and development, time, and space into a theory of goal attainment. Her theory deals with a nurse-client dyad, a relationship to which each person brings personal perceptions of self, role, and personal levels of growth and development. The nurse and client communicate, first in interaction and then in transaction, to attain mutually set goals. The relationship takes place in space identified by their behaviors and occurs in forward-moving time.

Basic assumptions

  • Nursing focus is the care of human being
  • Nursing goal is the health care of individuals & groups
  • Human beings: are open systems interacting constantly with their environment.
  • Basic assumption of goal attainment theory is that nurse and client communicate information, set goal mutually and then act to attain those goals, is also the basic assumption of nursing process
  • “Each human being perceives the world as a total person in making transactions with individuals and things in environment”
  • “Transaction represents a life situation in which perceiver & thing perceived are encountered and in which person enters the situation as an active participant and each is changed in the process of these experiences”

Major Concepts

  • Interacting systems:
    • personal system
    • Interpersonal system
    • Social system
  • Concepts are given for each system

Concepts for Personal System

  • Perception
  • Self
  • Growth & development
  • Body image
  • Space
  • Time

Concepts for Interpersonal System

  • Interaction
  • Communication
  • Transaction
  • Role
  • Stress

Concepts for Social System

  • Organization
  • Authority
  • Power
  • Status
  • Decision making

Propositions of King’s Theory

  • If perceptual interaction accuracy is present in nurse-client interactions, transaction will occur
  • If nurse and client make transaction, goal will be attained
  • If goal are attained, satisfaction will occur
  • If transactions are made in nurse-client interactions, growth & development will be enhanced
  • If role expectations and role performance as perceived by nurse & client are congruent, transaction will occur
  • If role conflict is experienced by nurse or client or both, stress in nurse-client interaction will occur 
  • If nurse with special knowledge skill communicate appropriate information to client, mutual goal setting and goal attainment will occur.

Nursing Paradigms

1. Human being /person

  • Human being or person refers to social being who are rational and sentient.
  • Person has ability to :
    • perceive
    • think
    • feel
    • choose
    • set goals
    • select means to achieve goals and
    • to make decision
  • Human being has three fundamental needs:
    1.  The need for the health information that  is unable at the time when it is needed and can be used
    2. The need for care that seek to prevent illness, and
    3. The need for care when human beings are unable to help themselves.

2. Health

  • Health involves 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.

3. Environment

  • Environment is the background for human interactions.
  • It involves:
    1. Internal environment: transforms energy to enable person to adjust to continuous external environmental changes.
    2. External environment: involves formal and informal organizations. Nurse is a part of the patient’s environment.

4.     Nursing

  • Definition: “A process of action, reaction and interaction by which nurse and client share information about their perception in nursing situation.” and “ a process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve goals.”
  •  Action: is defined as a sequence of behaviors involving mental and physical action.
  • Reaction: which is considered as included in the sequence of behaviors described in action.
  • In addition, king discussed:
    • (a)    goal
    • (b)   domain and
    • (c)    functions of professional nurse
  • Goal of nurse: “To help individuals to maintain their health so they can function in their roles.”
  • Domain of nurse: “includes promoting, maintaining, and restoring health, and caring for the sick, injured and dying.
  • Function of professional nurse: “To interpret information in nursing process to plan, implement and evaluate nursing care..

Theory of Goal Attainment and Nursing Process

Assessment

  • Assessment occurs during interaction.
  • The nurse brings special knowledge and skills whereas client brings knowledge of self and perception of problems of concern, to this interaction.
  • During assessment nurse collects data regarding client (his/her growth & development, perception of self and current health status, roles etc.)
  • Perception is the base for collection and interpretation of data.
  • Communication is required to verify accuracy of perception, for interaction and transaction.

Nursing diagnosis

  • The data collected by assessment are used to make nursing diagnosis in nursing process.
  • In process of attaining goal the nurse identifies the problems, concerns and disturbances about which person seek help.

Planning

  • After diagnosis, planning for interventions to solve those problems is done.
  • In goal attainment planning is represented by setting goals and making decisions about and being agreed on the means to achieve goals.
  • This part of transaction and client’s participation is encouraged in making decision on the means to achieve the goals.

Implementations

  • In nursing process implementation involves the actual activities to achieve the goals.
  • In goal attainment it is the continuation of transaction.

Evaluation

  • It involves to finding out whether goals are achieved or not.
  • In king description evaluation speaks about attainment of goal and effectiveness of nursing care.

Nursing Process and Theory of Goal Attainment

Nursing process method

Nursing process theory

A system of oriented actions

A system of oriented concepts

Assessment

Perception, communication and interaction of nurse and client

Planning

Decision making about the goals
Be agree on the means to attain the goals

Implementation

Transaction made

Evaluation

Goal attained

 

Strengths/Weaknesses

Strengths:
King’s theory of goal attainment does describe a logical sequence of events.
For the most part, concepts are clearly defined.
Although the presentation appears to be complex, King’s theory of goal attainment is relatively simple.
King formulated assumptions that are testable hypotheses for research.
Weaknesses:
King’s theory contains major inconsistencies:
(1) She indicates that nurses are concerned about the health care of groups but concentrates her discussion on nursing as occurring in a dyadic relationship.
(2) King says that the nurse and client are strangers, yet she speaks of their working together for goal attainment and of the importance of health maintenance.
The major limitation in relations to this characteristic is the effort required of the reader to sift through the presentation of a conceptual framework and a theory with repeated definitions to find the basic concepts.
Another limitation relates to the lack of development of application of the theory in providing nursing care to groups, families, or communities.
It is not parsimonious, having numerous concepts, multiple assumptions, many statements, and many relationships on a number of levels.

 

Analysis

The social systems portion of the open systems framework is less clearly connected to the theory of goal attainment than are the 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 sub concepts in her theory
The model presents interaction which is dyadic in nature which implies that its applicability cannot be adapted to unconscious individuals.
Multitude of views and definition is confusing for the reader. Because of multiple views on one concept such as what have been discussed in her concept of power blurs the point that the theorist is trying to relate to the readers.

 

References

1.     Alligood M.R, Tomey. A.M. Nursing theory utilization and application. 2nd Ed. Mosby,  Philadelphia, 2002.

2.     George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed. Norwalk, Appleton & Lange.

3.     Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins.

4.     Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia,  Lippincott.

5.     Taylor Carol,Lillis Carol (2001)The Art & Science  Of Nursing Care 4th ed. Philadelphia,  Lippincott.

6.     Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.

7.      Tomey AM, Alligood. MR. Nursing theorists and their work. (5th ed.).  Mosby,  Philadelphia, 2002.

8.     http://nursingtheories.weebly.com/imogene-m-king.html

9.     http://www.reflectionsonnursingleadership.org/Pages/Vol34_1_Messmer_Palmer.aspx

10.  http://king.clubexpress.com/content.aspx?page_id=22&club_id=459369&module_id=59920

11.  http://currentnursing.com/nursing_theory/goal_attainment_theory.html