Imogene Martina King 1923-2007

Imogene Martina King 1923-2007

Biography

 Born on January 30, 1923 in West Point, Iowa.

 Nursing diploma ,St. John's Hospital School of Nursing in

St. Louis, Missouri, In 1945.

 In 1948 BSN Diploma , St. Louis University

 Master's of Science in Nursing, St. Louis University in

1957.

 Doctoral degree from Teachers College, Columbia

University in 1961.

 King died on December 24, 2007.

Theory of Goal Attainment

 Roles

 Stress

 Space

 Time

Nursing

 is a process of action, reaction and interaction by

which nurse and client share information about their perception

in a nursing situation”

 “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.”

 The domain of the nurse “includes promoting, maintaining, and

restoring health, and caring for the sick, injured and dying.”

 The function of a professional nurse is “to interpret information

in the nursing process to plan, implement, and evaluate nursing

care.”

Human

refers to a social being who is rational and

sentient. He or she has the ability to perceive, think, feel,

choose, set goals, select means to achieve goals, and make

decisions.

3 fundamental needs:

1. the need for health information

2. the need for care that seeks to prevent illness; and

3. the need for total care when he or she is unable to help

him or herself.

3 fundamental needs:

1. the need for health information

2. the need for care that seeks to prevent illness; and

3. the need for total care when he or she is unable to help

him or herself.

Health

is a dynamic life experience 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.

 “Nursing is a process of action, reaction and interaction by

which nurse and client share information about their

perception in a nursing situation”

 “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.”

Environment

is the background for human interaction. It

involves the internal and external environments.

 The internal environment transforms energy to enable a

person to adjust to continuous external environment

changes.

 The external environment involves formal and informal

organizations.

In this model, the nurse is part of the patient's environment.

Action

is defined as a sequence of behaviors involving mental and physical action. The

sequence is first mental action to recognize the presenting conditions; then physical action

to begin activities related to those conditions; and finally, mental action in an effort to

exert control over the situation, combined with physical action seeking to achieve goals.

Reaction

is not specifically defined but might be considered to be included in the

sequence of behaviors described in action.

Interaction

, as defined by King, is any situation wherein the nurse relates and deals with a

clientele.

Transaction

: A process of interaction in which human beings communicate with the

environment to achieve goals that are valued and goal-directed human behaviors.

Open system

is the absence of boundary existence, where a dynamic interaction between

the internal and external environment can exchange information without barriers or

hindrances.

Assumptions

Individuals

(1) are social, sentient, rational, reacting beings and

(2) are controlling, purposeful, action oriented, and time oriented in their

behavior (King,1995b)

Nurse-client interactions

(1) perception of the nurse and client influence the interaction process;

(2) goals, needs, and values of the nurse and client influence the

interaction process;

(3) individuals have a right to knowledge about themselves;

(4) individuals have a right to participate in decisions that influence their

lives, health, and community services;

(5) individuals have a right to accept or reject care;

(6) goals of health professionals and goals of recipients of health care may

not be congruent.

Individuals

(1) are social, sentient, rational, reacting beings and

(2) are controlling, purposeful, action oriented, and time oriented in their

behavior (King,1995b)

Nurse-client interactions

(1) perception of the nurse and client influence the interaction process;

(2) goals, needs, and values of the nurse and client influence the

interaction process;

(3) individuals have a right to knowledge about themselves;

(4) individuals have a right to participate in decisions that influence their

lives, health, and community services;

(5) individuals have a right to accept or reject care;

(6) goals of health professionals and goals of recipients of health care may

not be congruent.

Nursing

(1) Nursing is the care of human beings;

(2) Nursing is perceiving, thinking, relating, judging, and

acting vis-à-vis the behavior of individuals who come to a

health care system;

(3) a nursing situation is the immediate environment in which

two individuals establish a relationship to cope with

situational events; and

(4) the goal of nursing is to help individuals and groups attain,

maintain, and restore health. If this is not possible, nurses

help individuals die with dignity.

Personal Systems

 perception

 self

 growth and

development

 body image

 space

 time

Interpersonal Systems

 interaction

 communication

 transaction

 role

 stress

Social Systems

 organization

 authority

 power

 status

 decision making

Practice

 Developed the Goal Oriented Nursing Record (GONR) and

have been useful in documenting the outcomes of care that

was performed by nurses.

 It helps nurses to easily facilitate the present problem from

careful assessment of the client gathered through the

interactive communication process between the nurse and

the client. Her record management facilitates proper and

correct range for the use of evaluation system.

 The significance of King’s Goal Attainment Theory have

been applied to different professional practice setting such

as in nursing administration, theory-based practice in the

emergency department, in tertiary hospitals and in the

community.

Education

 King’s interacting system has

been used to design the

nursing curriculum in

different schools and

universities and framework

for nursing education.

 It provides a systematic

means of viewing the nursing

profession, organizing

nursing knowledge and

clarifying the nursing

discipline.

Research

 King’s theory has been one of

theoretical basis of some

researches that helped in

formulating a system view of the

application of the nursing practice.

 Some researchers have

formulated a middle range theory

out of King’s theory such as

patient’s satisfaction from nursing

care, clients with chronic illness

and family health.

 The theory can also help set a

framework for nursing studies

which can further prove the use

and advantages of the nursing

practice

Theory of Goal Attainment and The Nursing Process

1. Assessment takes place during interaction.

2. The nursing diagnosis is developed using the data

collected in the assessment.

3. The nurse and other health care team members create a

care plan of interventions to solve the problems

identified.

4. The implementation phase of the nursing process is the

actual activities done to achieve the goals. In this model

of nursing, it is the continuation of transaction.

5. Evaluation involves determining whether or not goals

were achieved. The explanation of evaluation in King's

theory addresses meeting goals and the effectiveness of

nursing care.

Assessment

takes place during interaction

Nursing diagnosis

is developed using the data collected in the assessment.

care plan

The nurse and other health care team members create a______ of interventions to solve the problems identified.

implementation

phase of the nursing process is the actual activities done to achieve the goals. In this model

of nursing, it is the continuation of transaction.

Evaluation

involves determining whether or not goals were achieved. The explanation of evaluation in King's theory addresses meeting goals and the effectiveness of nursing care.

Strengths

 A major strong point of King’s

conceptual system and Theory of Goal

Attainment is the ease with which it

can be understood by nurses.

 The theory of goal attainment also

does describe a logical sequence of

events.

 For most parts, concepts are

concretely defined and illustrated.

 King’s definitions are clear and are

conceptually derived from research

literature. Her Theory of Goal

Attainment presents ten major

concepts, and the concepts are easily

understood and derived from research

literature, which clearly establishes

King’s work as important for

knowledge building in the discipline of

nursing.

Weaknesses

 Theory of Goal Attainment has been criticized for

having limited application in areas of nursing in which

patients are unable to interact competently with the

nurse. King maintained the broad use of the theory in

most nursing situations.

 Another limitation relates to the lack of development

of application of the theory in providing nursing care

to groups, families, or communities.

 King’s theory also contains some 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.