TFN IMOGENE KING’s GOAL ATTAINMENT THEORY & TRANSACTIONAL PROCESS

CONCEPTUAL SYSTEM & THEORY OF GOAL ATTAINMENT & TRANSACTIONAL PROCESS

King’s theory evolved from early writings about theory development. In her first book in 1071, she synthesized scholarship from nursing & related disciplines into a theory for nursing. (King, 1971). She wrote the theory of Goal attainment in 1980. The most recent edition (King, 1995) contains further refinements and more detailed explanation of the general nursing framework and the theory.

early writings

King’s theory evolved from ________ about theory development. In her first book in 1071, she synthesized scholarship from nursing & related disciplines into a theory for nursing. (King, 1971). She wrote the theory of Goal attainment in 1980. The most recent edition (King, 1995) contains further refinements and more detailed explanation of the general nursing framework and the theory.

King’s theory

________ evolved from early writings about theory development. In her first book in 1071, she synthesized scholarship from nursing & related disciplines into a theory for nursing. (King, 1971).

theory for nursing

King’s theory evolved from early writings about theory development. In her first book in 1071, she synthesized scholarship from nursing & related disciplines into a ________. (King, 1971).

theory of Goal attainment

She wrote the _________ in 1980. The most recent edition (King, 1995) contains further refinements and more detailed explanation of the general nursing framework and the theory.

general nursing framework and the theory

She wrote the theory of Goal attainment in 1980. The most recent edition (King, 1995) contains further refinements and more detailed explanation of the __________ and the ————.

PHILOSOPHICAL UNDERPINNINGS OF THE THEORY

The von Bertalanffy General Systems Model is acknowledged to be the basis for King’s work. She stated that the science of wholeness elucidated in that model gave her hope that the complexity of nursing could be studied “as an organized whole” (King, 1995, p. 23)

von Bertalanffy General Systems Model

The _______________________ is acknowledged to be the basis for King’s work. She stated that the science of wholeness elucidated in that model gave her hope that the complexity of nursing could be studied “as an organized whole” (King, 1995, p. 23)

“as an organized whole”

The von Bertalanffy General Systems Model is acknowledged to be the basis for King’s work. She stated that the science of wholeness elucidated in that model gave her hope that the complexity of nursing could be studied ___________ (King, 1995, p. 23)

Nursing

Health

Person

Environment

METAPARADIGM

Nursing

a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation. The nurse and client share specific goals, problems, and concerns and explore means to achieve a goal.

nurse and client

Nursing is a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation. The ____ and _____ share specific goals, problems, and concerns and explore means to achieve a goal.

achieve a goal

Nursing is a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation. The nurse and client share specific goals, problems, and concerns and explore means to __________.

Health

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.

Person

Individuals are social beings who are rational and sentient. Humans communicate their thoughts, actions, customs, and beliefs through language. _____ exhibit common characteristics such as the ability to perceive, to think, to feel, to choose between alternative courses of action, to set goals, to select the means to achieve goals, and to make decisions.

Environment

the background for human interactions.

Environment

both external to, and internal to the individual. it is the process of balance involving internal and external interactions inside the social system.

Environment

Reactions from the interactions between the internal and external __________ can be biological, psychological, physical, social or spiritual. External ________ is the factor that exists outside the boundary of the open system while the internal __________ is the exact opposite as adapted by Neuman’s Systems model.

Reactions

_________ from the interactions between the internal and external environment can be biological, psychological, physical, social or spiritual.

biological, psychological, physical, social or spiritual.

Reactions from the interactions between the internal and external environment can be ________, _______, _____, _____ or _____.

External environment

_____________ is the factor that exists outside the boundary of the open system while the internal environment is the exact opposite as adapted by Neuman’s Systems model.

Neuman’s Systems model

External environment is the factor that exists outside the boundary of the open system while the internal environment is the exact opposite as adapted by _______________.

environment

The _________ has a direct exchange of information between the internal & external environment.

Assumptions

INDIVIDUALS:

• are social, sentient, rational, reacting beings.

• Are controlling, purposeful, action-oriented, and time-oriented in their behavior (King, 1995b)

• are social, sentient, rational, reacting beings.

• Are controlling, purposeful, action-oriented, and time-oriented in their behavior (King, 1995b)

INDIVIDUALS:

The Theory states that “Nursing is a process of action, reaction, & interaction by which the nurse and client share information about their perception in a nursing situation” and “a process of human interactions between the nurse and the client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve the goals.”

The domain of the nurse “includes promoting, maintaining, and restoring health, and caring for thesick, injured and dying.” The function of a professional nurse is “to interpret information in the nursing process to plan, implement, and evaluate nursing care.”King states that the goal of a nurse is to help individuals to maintain their health so they can function in their roles.

What is the theory of goal attainment?

Interacting system framework

Personal and social systems are important to the quality of care a patient receives, but the interpersonal system links two strangers, usually a nurse and patient, together to work towards a goal that maintains a state of health, while still defining the individual’s roles.

Personal and social systems

______ and ________ are important to the quality of care a patient receives, but the interpersonal system links two strangers, usually a nurse and patient, together to work towards a goal that maintains a state of health, while still defining the individual’s roles.

interpersonal system

Personal and social systems are important to the quality of care a patient receives, but the ___________ links two strangers, usually a nurse and patient, together to work towards a goal that maintains a state of health, while still defining the individual’s roles.

maintains a state of health

Personal and social systems are important to the quality of care a patient receives, but the interpersonal system links two strangers, usually a nurse and patient, together to work towards a goal that ______________, while still defining the individual’s roles.

• Personal system/framework

• Interpersonal system/framework

• Social system/framework

King proposed that the nurse interacts in the system simultaneously at three different levels, namely….

Personal system/framework

how the nurse views and integrates self-based from personal goals and beliefs.

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

Concepts for Personal System:

Interpersonal system/framework

How the nurse interrelates with a co-worker or patient, particularly in a nurse-patient relationship

Interpersonal system/framework

one with the most impact on the development of Kings Theory of goal attainment

Interaction, Communication, Transaction, Role, Stress

Concepts for Interpersonal System:

Social system/framework

how the nurse interacts with co-workers, superiors, subordinates and the client’s environment in general.

Organization, Authority, Power, Status, Decision making

Concepts for Social System:

The nurse and patient to have effective communication, set acceptable goals and work toward those goals together

Focus of theory goal attainment:

“Theory of Goal Attainment is a theory of nursing [that] deals with phenomena called process and outcomes.

The main purpose of her theory

King “defines outcomes in the form of the goals to be attained.

The main purpose of her theory

nurse and the patient

The essence of goal attainment theory is that the _____ and the _____ work together to define and reach goals that they set together.

perceive, judge, and act

The patient and nurse each ____, ____ and _____ and together the patient and nurse react to each other and interact with each other.

react and interact

The patient and nurse each perceive, judge, and act, and together the patient and nurse ____ to each other and _____ with each other.

communication and perceiving

At the end of this process of _______ and ________, if a goal has been set a transaction is said to have occurred.

nurse and patient

The ____ and _____ also decide on a way to work toward the goal that has been decided upon, and put into action the plan that has been agreed upon.

action

The nurse and patient also decide on a way to work toward the goal that has been decided upon, and put into _____ the plan that has been agreed upon.

increase or to restore the health of the patient

King believes that the main function of nursing is to __________________, so then, transactions should occur to set goals related to the health of the patient.

transactions

King believes that the main function of nursing is to increase or to restore the health of the patient, so then, _______ should occur to set goals related to the health of the patient

transactions

After _______ have occurred and goals have been defined by the nurse and patient together, both parties work toward the stated goals. This may involve interactions with other systems, such as other healthcare workers, the patient's family, or larger systems.

interactions with other systems

After transactions have occurred and goals have been defined by the nurse and patient together, both parties work toward the stated goals. This may involve ___________, such as other healthcare workers, the patient's family, or larger systems.

healthcare workers, the patient's family, or larger systems

After transactions have occurred and goals have been defined by the nurse and patient together, both parties work toward the stated goals. This may involve interactions with other systems, such as other ____________, ______________, ___________.

good documentation

After the transaction has occurred, and the goal has been set, King believes that it is important for ________ to be practiced by the nurse.

streamline

She believes that documenting the goal can help to ________ the process of goal attainment, making it easier for nurses to communicate with each other and other healthcare workers involved in the process.

communicate

She believes that documenting the goal can help to streamline the process of goal attainment, making it easier for nurses to ________ with each other and other healthcare workers involved in the process.

provide a way to determine

It also helps to ____________ if the goal is achieved. This assessment of whether or not the goal has been successfully achieved plays an important. end stage in King's goal attainment theory.

assessment

It also helps to provide a way to determine if the goal is achieved. This _________ of whether or not the goal has been successfully achieved plays an important end stage in King's goal attainment theory.

end stage in King's goal attainment theory

It also helps to provide a way to determine if the goal is achieved. This assessment of whether or not the goal has been successfully achieved plays an important ______________________.

purposeful interacting systems

Nurse and client are ________________.

perceptions, judgments, and actions

Nurse and client _____, _______, and ________, if congruent, lead to goal-directed transactions.

goal-directed transactions

Nurse and client perceptions, judgments, and actions, if congruent, lead to _________________.

perceptual accuracy

If ______________ is present in nurse-client interactions, transactions will occur.

transactions

If perceptual accuracy is present in nurse-client interactions, _______ will occur.

transactions

If nurse and client make ________, goals will be attained.

satisfaction

If goals are attained, _______ will occur.

effective nursing care

If goals are attained, ____________ will occur.

transactions

If ________ are made in nurse-client interactions, growth & development will be enhanced.

growth & development

If transactions are made in nurse-client interactions, ____ & _______ will be enhanced.

role expectations & role performance

If ___________ & _____________ as perceived by nurse and client are congruent, transactions will occur.

role conflict

If ________ is experienced by nurse or client or both, stress in nurse-client interactions will occur.

stress in nurse-client interactions

If role conflict is experienced by nurse or client or both, _______________ will occur.

special knowledge and skill communicate appropriate information to clients

If nurses with ___________________________, mutual goal setting & goal attainment will occur (King, 1981, pp. 61, 149).

mutual goal setting & goal attainment

If nurses with special knowledge and skill communicate appropriate information to clients, ________ & __________ will occur (King, 1981, pp. 61, 149).

PROPOSITONS

• Nurse and client are purposeful interacting systems.

• Nurse and client perceptions, judgments, and actions, if congruent, lead to goal-directed transactions.

• If perceptual accuracy is present in nurse-client interactions, transactions will occur.

• If nurse and client make transactions, goals will be attained.

• If goals are attained, satisfaction will occur.

• If goals are attained, effective nursing care will occur.

• If transactions are made in nurse-client interactions, growth & development will be enhanced.

• If role expectations & role performance as perceived by nurse and client are congruent, transactions will occur.

• If role conflict is experienced by nurse or client or both, stress in nurse-client interactions will occur.

• If nurses with special knowledge and skill communicate appropriate information to clients, mutual goal setting & goal attainment will occur (King, 1981, pp. 61, 149).

• Perceptions of the nurse & client influence the interaction process;

• Goals, needs, & values off the nurse & client influence the interaction process

• Individuals have a right to knowledge about themselves

• Individuals have a right to participate in decisions that influence their lives, health, & community services.

• Individuals have a right to accept or reject care.

• Goals of health professionals & goals of recipients of health care may not be congruent.

ASSUMPTIONS REGARDING NURSE-CLIENT INTERACTION

Perceptions

_________ of the nurse & client influence the interaction process;

Goals, needs, & values

____, _____, & ______ off the nurse & client influence the interaction process

Individuals

________ have a right to knowledge about themselves

participate in decisions

Individuals have a right to ____________ that influence their lives, health, & community services.

accept or reject

Individuals have a right to _____ or _____ care.

health professionals, recipients of health care

Goals of ___________ & goals of __________ may not be congruent.

• Nursing is the care of human beings.

• Nursing is perceiving, thinking, relating, judging, and acting vis-à-vis the behavior of individuals who come to health care system.

• A nursing situation is the immediate environment in which two individuals establish a relationship to cope with situational events.

• 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.

ASSUMPTIONS WITH REGARDS TO NURSING:

Nursing

the care of human beings.

Nursing

is perceiving, thinking, relating, judging, and acting vis-à-vis the behavior of individuals who come to health care system.

nursing situation

A ___________ is the immediate environment in which two individuals establish a relationship to cope with situational events.

goal of nursing

The __________ is to help individuals and groups attain, maintain, and restore health. If this is not possible, nurses help individuals die with dignity.

attain, maintain, and restore health

The goal of nursing is to help individuals and groups ____, _______, and __________. If this is not possible, nurses help individuals die with dignity.

• Assessment

• Nursing Diagnosis

• Planning

• Implementations

• Evaluation

Nursing process

Assessment

occurs during interaction.

Assessment

The nurse brings special knowledge and skills whereas client brings knowledge of self and perception of problems of concern, to this interaction.

Assessment

During _________ nurse collects data regarding client (his/her growth & development, perception of self and current health status, roles etc.

Assessment

Perception is the base for collection and interpretation of data.

Assessment

Communication is required to verify accuracy of perception, as well as for interaction and transaction.

Nursing Diagnosis

The data collected by assessment are used to make nursing diagnosis in nursing process.

Nursing Diagnosis

In process of attaining goal the nurse identifies the problems, concerns and disturbances about which person seek help.

Planning

After diagnosis, _______ for interventions to solve those problems is done.

Planning

In goal attainment _______ is represented by setting goals and making decisions about and being agreed on the means to achieve goals.

Planning

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.

Implementations

In goal attainment it is the continuation of transaction.