Kamis, 06 Januari 2011

Imogene King's Theory of Goal Attainement

Imogene King's Theory of Goal Attainement

This page was last updated on November 4, 2010
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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 Conceptual Framework

It includes:

  • Several basic assumptions
  • Three interacting systems
  • Several concepts relevant for each system

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

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

Major Theses of King’s conceptual framework

  • “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”

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

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
  • Proposition cont…
  • 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.

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.

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 goaI 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 and client

Planning

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

Implementation

Transaction made

Evaluation

Goal attained

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.

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