Imogene King’s

Goal Attainment
Theory
IMOGENE KING
• born in 1923.
• Earned a diploma in nursing from St.
John’s Hospital of Nursing in St Louis
in 1945.
• Worked as office nurse, staff nurse,
school nurse, and private duty nurse
to support herself while studying for
a baccalaureate degree.
• Bachelor of Science in Nursing
from St. Louis University in 1948
• Masters of Science in Nursing from
St. Louis University in 1957
• Doctorate from Teacher’s college,
Columbia University, New York in
1961.
GOAL ATTAINMENT
THEORY
- Grand Theory
 THEORETICAL SOURCES
• King: “A search for literature in nursing and other
behavioral science fields, discussion with
colleagues, attendance at numerous
conference, inductive and deductive reasoning,
and some critical thinking about the information
gathered, lead me to formulate my own
theoretical framework.”
 THEORETICAL SOURCES
• The general systems theory from the behavioral
sciences led to the development of her
dynamic interacting systems.

• King: “If the goal of nursing is concern for the health of

individuals and the health care of groups, and if one
accepts the premise that human beings are open
systems interacting with the environment, then a
conceptual framework for nursing must be organized to
incorporate these ideas.
 MAJOR
CONCEPTS
AND
DEFINITIONS
• King developed a general systems framework
and a theory of goal attainment where the
framework refers to the three interacting
systems - individual or personal, group or
interpersonal, and society or social, while the
theory of goal attainment pertains to the
importance of interaction, perception,
communication, transaction, self, role, stress,
growth and development, time, and personal
space.
 PERSONAL SYSTEM

• The concepts for the personal system

are: perception, self, growth and
development, body image, space, and
time. These are fundamentals in
understanding human being because this
refers to how the nurse views and
integrates self based from personal goals
and beliefs. Among all these concepts,
the most important is perception, because
it influences behavior.
 PERSONAL SYSTEM
• Personal systems are individuals, who are regarded as
rational, sentient, social beings. Concepts related to the
personal system are:

• Perception— a process of organizing, interpreting, and

transforming information from sense data and memory that
gives meaning to one's experience, represents one's image
of reality, and influences one's behavior.

• Self— a composite of thoughts and feelings that constitute

a person's awareness of individual existence, of who and
what he or she is.
 PERSONAL SYSTEM
• Growth and development— cellular, molecular, and
behavioral changes in human beings that are a function of
genetic endowment, meaningful and satisfying experiences,
and an environment conducive to helping individuals move
toward maturity.
• Body image—a person's perceptions of his or her body.
• Time—the duration between the occurrence of one event
and the occurrence of another event.
• Space—the physical area called territory that exists in all
directions.
• Learning—gaining knowledge.
 INTERPERSONAL
SYSTEM
• The concepts associated for the interpersonal
system are: interaction, communication, transaction,
role, and stress. King refers to two individuals as dyads,
three as triads and four or more individuals as small
group or large group (King, 1981). This shows how the
nurse interrelates with a co-worker or patient, particularly
in a nurse-patient relationship. Communication between
the nurse and the client can be verbal or nonverbal.
Collaboration between the Dyads (nurse-patient) is very
important for the attainment of the goal.
 INTERPERSONAL
SYSTEM
• Interactions—the acts of two or more persons in mutual
presence; a sequence of verbal and nonverbal behaviors
that are goal directed.

• Communication—the vehicle by which human relations

are developed and maintained; encompasses
intrapersonal, interpersonal, verbal, and nonverbal
communication.

• Transaction—a process of interaction in which human

beings communicate with the environment to achieve goals
that are valued; goal-directed human behaviors.
 INTERPERSONAL
SYSTEM
• Role—a set of behaviors expected of a person
occupying a position in a social system.

• Stress—a dynamic state whereby a human being

interacts with the environment to maintain balance for
growth, development, and performance, involving an
exchange of energy and information between the person
and the environment for regulation and control of
stressors.

• Coping—a way of dealing with stress.

 SOCIAL SYSTEM

• The final interacting system is the social system. This

shows how the nurse interacts with co workers,
superiors, subordinates and the client environment in
general. These are groups of people within the
community or society that share a common goals, values
and interests. It provides a framework for social
interaction and relationships and establishes rules of
behavior and courses of action (King, 1971). Social
systems are organized boundary systems of social roles,
behaviors, and practices developed to maintain values
and the mechanisms to regulate the practices and roles.
 SOCIAL SYSTEM
• Authority—a transactional process characterized by
active, reciprocal relations in which members' values,
backgrounds, and perceptions play a role in defining,
validating, and accepting the authority of individuals within
an organization.

• Power—the process whereby one or more persons

influence other persons in a situation.

• Status—the position of an individual in a group or a

group in relation to other groups in an organization.
 SOCIAL SYSTEM

• Decision making—a dynamic and

systematic process by which goal-directed
choice of perceived alternatives is made
and acted upon by individuals or groups to
answer a question and attain a goal.

• Control—being in charge.
 • Among the three systems, the conceptual
framework of Interpersonal system had the
greatest influence on the development of her
theory. She stated that “Although personal systems
and social systems influence quality of care, the
major elements in a theory of goal attainment are
discovered in the interpersonal systems in which
two people, who are usually strangers, come
together in a health care organization to help and
to be helped to maintain a state of health that
permits functioning in roles” ( King, 1981 p. 142).
• King believed that the goal of nursing “is to
help individuals maintain their health so
they can function in their roles” (King,
1981), transactions occur to set
goals related to the health of the
patient.

•Nursing's focus is on the care of the

patient, and its goal is the health care
of
patients and groups of patients.
 MAJOR ASSUMPTIONS
• King’s conceptual framework and theory of goal attainment “are based
on an overall assumption that the focus of nursing is
• human beings interacting with their environment leading to a state of
health for individuals, which is an ability to function in social roles”
 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.

• 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
 ASSUMPTIONS
• “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”
NURSING

• “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: which is considered as included in the sequence of behaviors

described in action.

• In–addition,
goalking discussed:
(a) domain and
– functions of professional nurse
(b)
• Goal
– of nurse: “To help individuals to maintain their health so they can
function
(c) 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.
PERSON

• Human being or person

refers to 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
PERSON

• Human being has three

fundamental needs:
1. The need for the
health information
that is unable at the
time when it is
needed and can be
used
2. The need for care that
seek to prevent illness,
and
3. The need for care when
human beings are
unable to help
themselves.
HEALTH

• 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.
ENVIRONMENT
• Environment is the
background for human
interactions.

• It involves:
1. Internal environment:
transforms energy to enable
person to adjust to continuous
external environmental
changes.
2. External environment: involves
formal and informal
organizations. Nurse is a part of
the patient’s environment.
THEORETICAL
ASSERTIONS /
PROPOSITIONS
 PROPOSITIONS OF KING’S
THEORY
• 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.
 LOGICAL FORM
• Inductive and deductive reasoning
ACCEPTANCE BY
THE NURSING
COMMUNITY
 PRACTICE

• The theory’s relationship to practice is

obvious because the profession of nursing
functions through individuals and groups
within the environment.

• Useful in practice – individualized plans of

care while encouraging active participation
from clients in decision making.
 EDUCATION

• Has been used for curriculum design in

nursing programs and framework for
books

• It provides a systematic means of viewing

the nursing profession, organizing a
body of knowledge for nursing, and
clarifying nursing as a discipline.
 RESEARCH

• Research can be designed and conducted

to implement this system in a hospital
unit, in ambulatory care, in community
nursing, and home care.
 CRITIQUE

• Simplicity – has nine major concepts, making it

complex; easily understood because they are defined to
show interrelations in nursing practice.; clear concepts
conceptually derived from identified characteristics

• Generality – has limited applications in areas of nursing;

King believes critics are assuming that a theory will
address every person, event, and situation, which is
impossible.
 CRITIQUE

• Empirical Precision – goal attainment could be

measured along the effectiveness of nursing
care

• Derivable Consequences – theory deals with

choices, alternatives, participation of all
individuals in decision-making and specifically
deals with outcomes of nursing care.
 REFERENCES

• www.currentnursing.com

• http://imogenekingtheory.blogspot.com/p/k
ey-concepts.html

• Tomey, A.M., (1994). Nursing Theorists

and Their Work. 3rd ed. Missouri: Mosby
THANK YOU!