Theory of Goal Attainment By King’s
King’s Conceptual System and Theory,Concepts of Theory,Paradigms of Theory,Focus of Theory,Extensions and Adaptations in Theory,Outcomes of Theory.
King’s Conceptual System and Theory
Imogene
King’s initial interest in theory was to develop a conceptual frame of
reference to focus and organize nursing knowledge with the goal of identifying
a systems theory for nursing (King, 1981).
Introduced in 1981, King’s theory
focused on individuals as personal systems, two or more individuals as
interpersonal systems, and organized boundary systems that regulate roles,
behaviors, values, and roles as social systems. Interactions within and across
systems influence human acts, or behavior, and subsequently, health outcomes.
According to King, systems, and interactions are best understood by concepts,
the building blocks of theory. Concepts for understanding personal systems are
perception, self, growth and development, body image, learning, time, personal
space, and coping.
Concepts important for understanding interpersonal systems
are interaction, communication, role stress/stressors, and transaction.
Concepts useful for understanding social systems are organization, authority,
power, status, and decision making.
King identified that concepts and
relationships are interrelated both within and between systems, which is
consistent with general systems theory.
Interpersonal systems are composed of
personal systems, and interactions with social systems influence both
interpersonal and personal. Interactions influence behavior, attitudes,
beliefs, values, and customs.
Concepts of Theory
Perception,
interaction, and organization are comprehensive concepts for personal,
interpersonal, and social systems, respectively. Perception is a process of
organizing, interpreting, and transforming information from sense data and
memory (King, 1981, p. 24).
Interaction is defined as two or more persons in
mutual presence and includes a sequence of goal-directed behaviors (King, p.
85). Organization is a system whose continuous activities are conducted to
achieve goals (King, p. 119).
Paradigms of Theory
The metaparadigm concepts of person, health,
environment, and nursing are well-defined and explicitly linked: “The
focus of nursing is human beings interacting with their environments leading to
a state of health for individuals, which is the ability to function in social
roles “ (King, p. 143).
There have been few changes to the conceptual
system since it was first published. King has, however, provided clarification,
explanation, and expansion of concepts through multiple publications; addressed
concerns and questions raised by others; and explicated the philosophical and
ethical basis of the conceptual system (Frey, 2004).
Focus of Theory
As a
grand level theory, King’s Conceptual System provides a distinct focus for the
discipline, the process of nursing, and a frame work for deriving middle range
theories. The first middle range theory derived from the conceptual system was
King’s Theory of Goal Attainment (King, 1981).
The theory of goal attainment
was derived from personal and interpersonal system concepts and focused on
nurse client interactions that lead to transactions and goal attainment.
A
descriptive study of nurse-client interactions by King resulted in the Model of
Transactions and a classification system of behaviors in nurse patient
interactions that lead to transactions and goal attainment.
Key behaviors in
the process of transactions include mutual goal setting, exploration of means
to achieve goals, and agreement on means to achieve goals. The theory of goal
attainment specifies the process of nursing. In addition, it clearly reflects
King’s historical emphasis on nursing outcomes.
Outcomes are defined as goals
achieved and can be used to evaluate the effectiveness of nursing care.
Extensions and Adaptations in Theory
In
the past 2 decades there has been a considerable extension and application of
King’s Conceptual System and Theory of Goal Attainment (Frey & Sieloff,
1995; Sieloff, Frey, & Killeen, in press). Sieloff, Frey, and Killeen
present a state-of-the-art perspective by reviewing application of the
conceptual system and theory of goal attainment across systems.
Client
concerns, patient populations, nursing specialties, and work settings;
implementation in hospitals and community settings; the fit of the conceptual
system and theory of goal attainment with evidence based practice, nursing
process, standardized nursing languages, performance improvement, and
technology; and middle range theories derived from the conceptual system.
In
addition to King’s theory of goal attainment, middle range theories derived by
others address family (Doornbos, 2000; Wicks, 1995), health outcomes in
children with chronic conditions (Frey, 1995), empathy (Alligood, 1995), and
nursing department power (Sieloff, 2003). Each theory represents an ongoing
program of research.
Outcomes of Theory
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King is a strong advocate for theory-based education and practice for nursing.
Her conceptual system for nursing provides a broad and enduring framework to
guide nursing practice, derive middle range theories, and integrate ongoing
changes in nursing and the health care system.