Imogene King’s Theory of Goal Attainment is one of the most significant mid-range nursing theories, emphasizing the interpersonal relationship between nurses and patients as they work together to attain health-related objectives.
This article examines King’s life, theory, components, strengths, shortcomings, and applications in nursing practice.
Early Life of Imogene King
Imogene M. King was born January 30, 1923, in West Point, Iowa, United States. Growing up in a nurturing familial environment, King developed a strong sense of purpose and commitment to helping others. Her early interests in health and education paved the way for her later contributions to nursing philosophy.
King pursued formal education in nursing and academia, which helped shape her understanding of nursing practice and theory:
- Diploma in Nursing: In 1945, King earned her nursing diploma from St. John’s Hospital School of Nursing in St. Louis, Missouri.
- Bachelor of Science in Nursing: She received her BSN in 1948 from St. Louis University.
- Master’s Degree: King completed her Master’s degree in Nursing in 1957, also at St. Louis University.
- Doctorate: In 1961, King earned a Doctor of Education degree (EdD) from Teachers College, Columbia University.
Career
- King began her career as a staff nurse, later transitioning to teaching and administration.
- She served in various academic roles, including professor and director of nursing at institutions like Loyola University and the University of South Florida.
- In 1980, King published her seminal work, “A Theory for Nursing: Systems, Concepts, Process,” which introduced her Theory of Goal Attainment.
- King’s dedication to advancing nursing science earned her numerous awards and recognition throughout her career.
Description of the Theory of Goal Attainment
The Theory of Goal Attainment focuses on the dynamic interactions between nurses and patients as they strive to attain mutually agreed-upon health goals. King saw the nurse-patient interaction as an interpersonal process in which communication, perception, and shared goals are essential.
The theory is built on three interrelated systems:
- Personal System: Focuses on the individual (e.g., self, perception, growth).
- Interpersonal System: Focuses on interactions between two or more individuals (e.g., communication, role, transaction).
- Social System: Focuses on the larger systems influencing individuals, such as organizations or communities (e.g., authority, status, decision-making).
Propositions of the Theory
King proposed the following key ideas:
- If nurses and patients interact, goals can be established.
- If goals are established, transactions will occur.
- If transactions occur, goals will be achieved.
- If goals are achieved, satisfaction and effective nursing care are the outcomes.
Assumptions of the Theory
- Nurses and patients communicate through interactions.
- Perception influences behavior, and behavior impacts goal attainment.
- Nurses and patients share information, set goals, and work together to achieve those goals.
- Health is a dynamic process influenced by the patient’s perceptions and life experiences.
- The nurse’s role is to assist individuals and groups in achieving their health goals.
Major Concepts and Subconcepts
- Health: A dynamic state in the life cycle that requires adjustments to stressors to achieve an optimal level of functioning.
- Environment: The background against which human interactions occur, including personal and external factors.
- Nursing: A process of action, reaction, and interaction where nurses help individuals maintain or regain health.
- Person: Individuals (nurses and patients) are open systems interacting with their environment to achieve goals.
Subconcepts
- Perception: The way individuals interpret reality.
- Communication: Verbal and nonverbal exchange of information between nurse and patient.
- Interaction: Observable behaviors of two individuals involved in the process of perception and communication.
- Transaction: A purposeful interaction where nurses and patients work together to achieve goals.
- Role: Behaviors expected of individuals in specific social situations.
- Stress: An external or internal factor affecting the interaction and achievement of goals.
The Interacting Systems and Goal Attainment
King’s interacting systems are central to the Theory of Goal Attainment:
- Personal System: The individual’s thoughts, feelings, and perceptions.
- Interpersonal System: The interactions between the nurse and patient that involve communication, transactions, and goal setting.
- Social System: The larger context influencing the nurse-patient relationship, such as hospital policies or cultural norms.
Process of Interaction
King described a process of interaction that occurs between the nurse and patient, consisting of:
- Perception: Both the nurse and patient perceive each other and the situation.
- Judgment: Each evaluates the situation based on their perceptions.
- Action: They engage in communication and exchange information.
- Reaction: A response occurs, leading to transactions.
- Transaction: The nurse and patient agree on goals and work collaboratively to achieve them.
Strengths and Weaknesses
Strengths
- Practical Application: The theory provides clear, actionable steps for nurse-patient interactions.
- Patient-Centered Care: Emphasizes collaboration and mutual goal-setting.
- Holistic View: Considers personal, interpersonal, and social systems affecting health.
- Versatility: Applicable in various nursing settings, including clinical practice, education, and research.
Weaknesses
- Overemphasis on Interaction: The theory heavily focuses on nurse-patient interactions, potentially overlooking other aspects of care.
- Generalization: The broad concepts may lack specificity for unique or complex situations.
- Subjectivity of Perceptions: Differences in perceptions between nurses and patients may hinder effective communication and goal attainment.
Application of the Theory in Nursing
The Theory of Goal Attainment is widely applied in nursing practice, education, and research:
- Clinical Nursing Practice:
- Nurses establish trust, communicate effectively, and work with patients to set achievable health goals.
- For example, in patient education, nurses collaborate with patients to create a plan for managing chronic illnesses.
- Nursing Education:
- The theory guides nursing curricula to emphasize interpersonal skills, communication, and goal setting.
- Community Health Nursing:
- Nurses work with individuals, families, and groups to achieve community health goals, such as vaccination programs or health promotion activities.
- Research:
- The theory provides a framework for studies examining nurse-patient communication, goal setting, and health outcomes.
Conclusion
Imogene King’s Theory of Goal Attainment is still a valuable contribution to nursing, providing a structured framework for good nurse-patient interactions. By emphasizing collaboration, communication, and reciprocal goal setting, the approach emphasizes the role of relationships in obtaining better health outcomes.
Despite significant limits, its practical application and holistic approach ensure that it remains relevant in clinical practice, education, and research. King’s approach encourages nurses to actively connect with their patients, encouraging empowerment and happiness in the pursuit of health and well-being.
References
- King, I. (2007). King’s structure, process, and outcomes in the 21st century. In C. L. Sieloff, & M. A. Frey (Eds.), Middle range theory development using King’s conceptual system (pp. 3–11). New York: Springer.
- King, I. M. (1988). Measuring health goal attainment in patients. In C. F. Waltz & O. L. Strickland, Measurement of Nursing Outcomes: Volume One: Measuring Client Outcomes. New York: Springer, pp. 108 –127.
- King, I. M. (2006). A system approach in nursing administration: Structure, process, and outcome. JONA 30(2), 100–104.
