GOVERNMENT COLLEGE OF

NURSING CIVIL HOSPITAL

CAMPUS
AHMEDABAD - 16

SUB :- ADVANCED NURSING PRACTICE

TOPIC :- KING’S GOAL ATTAINMENT THEORY

SUBMITTED TO :-
Mrs Minaxi patel
Lecturer Sr Scale ( cl-
I) Govt. College of
nursing Ahmedabad

SUBMITTED BY :-
Ms. Yesha H. Pomal
F. Y. M.sc Nursing
Govt College of
Nursing

1
 Imogene King's Theory of Goal Attainment

Introduction
 Imogene King was born in 1923.
 Completed her Bachelor in science of nursing from St. Louis University in
1948
 Completed her Master of science in nursing from St. Louis University in
1957
 Completed her Doctorate from Teacher’s college, Columbia University
 King’s theory offers insight into nurses’ interaction with individuals and
groups within the environment
 It highlights the importance of client’s participation in decision that
influences care and focuses on both the process of nurse-client interaction

Objectives :-

➢ to assess the patient condition by the various methods explained by the

nursing theory
➢ to identify the needs of the patient
➢ to demonstrate an effective communication and interaction with the patient
➢ to select a theory for the application according to the need of the patient
➢ to apply the theory to solve the identified problems of the patient
➢ to evaluate the extent to which the process was fruitful.

King’s Conceptual Framework

It includes:
 Several basic assumptions
 Three interacting systems
 Several concepts relevant for each system

King’s Theory of Goal Attainment

 Theory of goal attainment was first introduced by Imogene King in the
early 1960’s.
 Theory describes a dynamic, interpersonal relationship in which a person
grows and develops to attain certain life goals.
 Factors which affects the attainment of goal are: roles, stress, space & 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
 Interacting systems:
 personal system
 Interpersonal system
 Social system
 Concepts are given for each system

Major concepts of king’s theory

1. Human being /person: is 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
According to King, human being has three fundamental needs:
(a) The need for the health information that is unable at the time when it is
needed and can be used
(b) The need for care that seek to prevent illness, and
(c) The need for care when human beings are unable to help themselves.

2. Health
According to King, 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:
 (a) Internal environment: transforms energy to enable person to adjust to
continuous external environmental changes.
(b) 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: not specified, but might be 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. King said in her
theory, “A professional nurse, with special knowledge and skills, and a
client in need of nursing, with knowledge of self and perception of personal
problems, meet as strangers in natural environment. They interact mutually,
identify problems, establish and achieve goals.

Concepts for Personal System

 Perception:
 According to King it includes the import and
transformation of energy, and processing, storing
and exporting information. Perceptions are
related to past experiences, concept of self, socio
economic group, biological inheritance and
educational background.
Perception is a process in which data obtained
through the senses and form memory are
organized, interpreted and transformed.

 Self:
The self is a composite of thought and feelings which constitutes a person’s
awareness of his individual existence, his conception of who and what he is.
The self includes a system of ideas, attitudes, values and commitments.
The self constitutes a person’s inner world.

 Growth & development:

It is defined as a continual change in individuals at the cellular, molecular,
and behavioral levels of activities conducive to helping individuals to move
towards maturity.
These changes usually occur in an orderly manner.

 Body image:
It is characterized as very personal and subjective, acquired or learned,
dynamic and changing as the person redefines self.
Body image is part of each stage of growth and development.
King defines body image as the way one perceives both one’s body and
other’s reactions to one’s appearance.

 Space:
Space is characterized as universal because all people have some concept of
it. It may be personal or subjective individual situational and dependent on
the relationships in the situation dimensional as a function of voluntary
area, distance and time and transactional or based on individual perception
of situation.

 Time:
 It is defined as a sequence of events moving onwards to the future. It is
duration between one event and another as uniquely experienced by each
human being; it is the relation of one event to another event.

Concepts for Interpersonal System

 Interaction:
King defines interaction as a process of perception and communication
between person and environment and between person and person,
represented by verbal or nonverbal behaviors that are goal directed.

 Communication:
King defines communication as a process whereby information is given
from one person to another either directly in face to face meeting or
indirectly through telephone, television or the written word.
Communication can be verbal or nonverbal.

 Transaction:
Transactions are purposeful interaction that leads to goal attainment.
Transactions are unique because each individual has a personal world of
reality.

 Role:
It is defined as a set of behavior expected and persons occupying a position
in a social system, rules that define rights and obligations in a position.

 Stress:
Stress is a dynamic state whereby, a human being interacting with
environment to maintain balance of growth, development, and performance
which involves an exchange of energy and information between the persons
and the environment for regulation and control of stressors.
Concepts for Social System
 Organization:
King defines organization as being made up of human beings who have
prescribed roles and positions and who make use of resources to meet both
personal and organizational goal.

 Authority:
It is observable through provision of order, guidance and responsibility of
actions, universal essential in formal organization; reciprocal because it
requires co-operation, resides in a holder who must be perceived as
legitimate situational essential to goal achievement and associated with
power.

 Power:
It is the capacity to use resources in organizations to achieve goals.
 Status:
Status refers to the position of an individual in a group or groups in relation
to other groups in and organization and identifies that status is accompanied
by privileges duties and obligations.

 Decision making:
A dynamic and systematic process in which goal-directed choices of
perceived alternatives is made and acted upon by individuals or groups to
answer a question or achieve a goal

Propositions of King’s Theory

From the theory of goal attainment king developed predictive propositions, which
includes:
  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.

Theory of Goal Attainment and Nursing

Process Assumptions
 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

Assessment
 King indicates that assessment occur 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.
 Acc. to king 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 weather 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 & client
Planning Decision making about the goals . be
agree on the means to attain the goals.
Implementation Transaction made
Evaluation Goal attained
Advantages:
1. Adequacy
2. Clarity
3. Consistency
4. Logical developments
5. Level of theory development
6. Discrimination
7. Reality convergence
8. Pragmatic
9. Scope
10.Significance
11.Utility
Disadvantages:

1. Complexity
2. Confusion

Application:
This theory is applicable to most practice areas except for those
in which the patient is incapable of interacting with his
environment due to some sort of disability or mental
impairment.
In Fawcett’s (2005) evaluation, she asserts that “King’s
Conceptual System provides direction for nursing research,
education, administration and practice”. The theory, at first
reading, would appear to be only for the field of nursing.
However, the major components could be used in the Social
Sciences field, especially the Behavioral Sciences, for planning
interventions.

PRACTICE:
The theory has found great application to nursing practice since
the theory focuses on concepts relevant to all nursing situations
– the attainment of client goals.
The application of the theory is documented in several
categories:
1. General application of the theory
2. Exploring a particular concept within the concept of the
theory
3. Exploring a particular concept related to the theory
4. Application of the theory in nonclinical nursing
situations
5. Application of the theory in nursing specialty and in
work settings like hospital, community and at home.

ADMINSITRAION:
Also in case management (improve overall quality and cost
effectiveness of care provided), advocacy and managed care

NURSING EDUCATION:
King’s framework continues to provide a viable curriculum
strategy. A curriculum model which is conceptually based
allows for updating content and skills without the necessity for
major curriculum change.

RESEARCH:
Several nurses have tested the theory in research on aging,
parenting, psychiatric - mental health and ambulatory care.

Schematic Diagram of a theory of Goal Attainment

Classification system of nurse-patient interaction that lead to

Transaction which includes the elements in interaction :-

 Action
 Reaction
 Disturbance
 Mutual Goal setting
 Explore means to achieve goal
 Agree on means to achieve goal
  Transaction
 Goal(s) achieved

The above figure combines some factors from the

classification system and the process of human
interaction.
Both client and nurse perceive throughout the process;
they communicate, thus creating action
Actions result in reaction, and if there is a disturbances
goals may be set. At this point, means for goal
achievement are explored and agreed upon transaction are
made, and goal attainment results.
The patient is a personal system within the environment
who coexists with other personal systems. Individuals form
groups that compromise interpersonal systems and interpersonal
systems contribute to social systems. Thus patient and nurse are
composed of personal systems as subsystems within
interpersonal and social systems. The nurse must understand
given aspects of all three systems. Concepts identified for each
system affect total system function.

There are three comprehensive concepts ;-

 Perception for the personal system

 Organization for the social system
 Interaction for the interpersonal systems.
BLIOGRABHY :-
 1) Brennan P..F. “ NURSING PRACTICE
MODELS : IMPLICATIONS FOR
INFORMATION SYSTEM DESIGN “ journal of
nursing Administration, 1998,

2) Craven R F “ FUNDAMENTAL OF NURSING-

HUMAN HEALTH

FUNCTION, “ 5th edition, 2007 Philadelphia;

Lippincott Williams and Wilkins ;

3) Lahey Clinic Foundation, Inc (2010), retrived

March 17, 2010

4) Parker Marlilyn E. “ NURSING THEORIES &

NURSING PRACE”

2ND Edition, 2007. Jaypee Brothers, Medical

Publishers pvt ltd.

New Delhi.

Current Nursing (2010), Nursing Theories, Retrived

March 21, 2010
Fromhttp:/ / currentnursing.com/ nursing_theory/
king”s theory
BIBLIOGRAPHY :