DR.

CARLOS LANTING COLLEGE

COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING
BIOGRAPHY

 Born in 1923
 Bachelor of Science in Nursing from St. Louis University in 1948
 Master of Science in Nursing from St. Louis University in 1957
 Doctorate from Teacher’s College, Columbia University

BRIEF BACKGOUND

Some people consider their “success” after being hired in a great and well-known
institution. But when someone decides to pursue a career in nursing, one
should set his or her mind that he or she should be an instrument in helping
patients get healthy. And to achieve that, it’s important to set health goals
with the patient, then take steps to achieve those goals.

Imogene M. King’s Theory of Goal Attainment focuses on this process to guide

and direct nurses in the nurse-patient relationship, going hand-in-hand with
their patients to meet the goals towards good health.

King’s Theory of Goal Attainment was first introduced in the 1960s. From the title
itself, the model focuses on the attainment of certain life goals. It explains that
the nurse and patient go hand-in-hand in communicating information, set goals together, and then take actions to
achieve those goals.

King has interrelated the concepts of interaction, perception, communication, transaction, self, role, stress, growth and
development, time, and space into a theory of goal attainment. Her theory deals with a nurse-client dyad, a
relationship to which each person brings personal perceptions of self, role, and personal levels of growth and
development. The nurse and client communicate, first in interaction and then in transaction, to attain mutually set
goals. The relationship takes place in space identified by their behaviors and occurs in forward-moving time.

CONCEPTUAL SYSTEM

Purposes of conceptual system:

1. Name concepts necessary to nursing as a discipline
2. Provide for the derivation of theories that are tested through research as part of the development of the scientific
base for nursing knowledge
3. Provide an organizing structure for nursing curricula
4. Lead to nursing practice based in theory that supports quality care in all settings in which nursing occurs

The conceptual system includes:

Goal
The conceptual system has health as the goal for nursing.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING

Structure
It is represented by three open system

Functions
These are demonstrated in reciprocal
relations of individuals in interactions
and transactions.

Resources
These include both people (health
professionals and their clients),
money, goods, and services for items
needed to carry out specific
activities.

Decision Making
It occurs when choices are made in
resource allocation to support
attaining system goals.

The unit of analysis for the conceptual

system is the behavior of humans in
various social environments.

CONCEPTUAL SYSTEM’S THREE

INTERACTING SYSTEMS

Personal Systems
Each individual is a personal system. King designated an example of a personal system as a patient or a nurse. King
specified the concepts of body image, growth, and development, perception, self, space, and time in order to
comprehend human beings as persons.

 Self  is a composite of thoughts and feelings which constitute a person’s awareness of his individual existence,
his conception of who and what he is. A person’s self is the sum total of all he can call his. The self includes,
among other things, a system of ideas, attitudes, values, and commitments. The self is a person’s total subjective
environment. It is a distinctive center of experience and significance. The self constitutes a person’s inner world
as distinguished from the outer world consisting of all other people and things. The self is the individual as known
to the individual. It is that to which we refer when we say “I.”
 Growth and development can be defined as the processes in people’s lives through which they move from a
potential for the achievement to the actualization of self.
 Body image is the way one perceives both one’s body and others’ reactions to one’s appearance.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING
 Space includes that space exists in all directions, is the same everywhere, and is defined by the physical area
known as “territory” and by the behaviors of those occupying it.
 Time is defined as “a duration between one event and another as uniquely experienced by each human being; it
is the relation of one event to another event.”
 Learning was added as a subconcept in the personal system but was not further defined.

Interpersonal Systems
These are formed by human beings interacting. Two interacting individuals form a dyad; three form a triad, and four or
more form small or large groups. As the number of interacting individuals increases, so does the complexity of the
interactions. Understanding the interpersonal system requires the concepts of communication, interaction, role, stress,
and transaction.

 Interactions are defined as the observable behaviors of two or more individuals in mutual presence.
 Communication is “a process whereby information is given from one person to another either directly in a face-
to-face meeting or indirectly through telephone, television, or the written word.”
 Transaction is “a process of interactions in which human beings communicate with the environment to achieve
goals that are valued… goal-directed human behaviors.
 Characteristics of the role include reciprocity in that a person may be a giver at one time and a taker at another
time, with a relationship between two or more individuals who are functioning in two or more roles that learned,
social, complex, and situational.
 Stress is “a dynamic state whereby a human being interacts with the environment to maintain balance for growth,
development, and performance, which involves an exchange of energy and information between the person and
the environment for regulation and control of stressors.”

Social Systems
A more comprehensive interacting system consists of groups that make up society, referred to as the social system.
Religious, educational, and health care systems are examples of social systems. The influential behavior of an
extended family on an individual’s growth and development is another social system example. Within a social system,
the concepts of authority, decision making, organization, power, and status guide system understanding.

 Power is the capacity to use resources in organizations to achieve goals… is the process whereby one or more
persons influence other persons in a situation… is the capacity or ability of a person or a group to achieve goals…
occurs in all aspects of life and each person has potential power determined by individual resources and the
environmental forces encountered. Power is a social force that organizes and maintains society. Power is the
ability to use and to mobilize resources to achieve goals.
 Status is “the position of an individual in a group or a group in relation to other groups in an organization” and is
identified that status is accompanied by “privileges, duties, and obligation.”
 Decision making is “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” (King, 1990).
 Control was added as a subconcept in the social system but was not further defined.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING
THEORY OF GOAL ATTAINMENT

Process of Interaction

The figure above represents a process of human interactions that lead to transactions: A model of transaction. According
to King, “The human process of interactions formed the basis for designing a model of transactions that depicted
theoretical knowledge used by nurses to help individuals and groups attain goals.”

Interaction
Interaction is a process of perception and communication between person and environment and between person and
person represented by verbal and nonverbal behaviors that are goal-directed.

Transaction
Transaction is a process of interactions in which human beings communicate with the environment to achieve goals that
are valued; transactions are goal-directed human behaviors.
Perception is “each person’s representation of reality.”

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING
Action
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
Reaction is not specifically defined but might be considered to be included in the sequence of behaviors described in
action.

Communication
Communication is defined as “a process whereby information is given from one person to another either directly in face-
to-face meetings or indirectly through telephone, television, or the written word.”

Role
Role is defined as “a set of behaviors expected of persons occupying a position in a social system; rules that define rights
and obligations in a position; a relationship with one or more individuals interacting in specific situations for a purpose.”

Stress
Stress is “a dynamic state whereby a human being interacts with the environment to maintain balance for growth,
development, and performance… an energy response of an individual to persons, objects, and events called stressors.”

Growth and Development

Growth and development can be defined as the “continuous changes in individuals at the cellular, molecular, and
behavioral levels of activities… the processes that take place in the life of individuals that help them move from potential
capacity for achievement to self-actualization.”

Time
Time is “a sequence of events moving onward to the future… a continuous flow of events in successive order that implies
a change, a past and a future… a duration between one event and another as uniquely experienced by each human
being… the relation of one event to another.”

Space
Space exists in every direction and is the same in all directions. Space includes that physical area called territory. Space
is defined by the behaviors of those individuals who occupy it

NURSING METAPARADIGM

Nursing
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 achieve a goal.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING
Health
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.

Individual
Individuals are social beings who are rational and sentient. Humans communicate their thoughts, actions, customs, and
beliefs through language. Persons 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
Environment is the background for human interactions. It is both external to, and internal to, the individual.

THEORY OF GOAL ATTAINMENT AND NURSING PROCESS

Assessment
 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.
 In process of attaining goal 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 whether goals are achieved or not.
 In King description evaluation speaks about attainment of goal and effectiveness of nursing care.

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 DR. CARLOS LANTING COLLEGE
COLLEGE OF NURSING

SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT

IMOGENE M. KING
NURSING PROCESS AND THEORY OF GOAL ATTAINMENT NURSING PROCESS
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

Agreement on the means to attain the goals

Implementation Transaction made

Evaluation Goal attained

THEORY ANALYSIS

 The social systems portion of the open systems framework is less clearly connected to the theory of goal
attainment than are the personal and interpersonal systems.
 The citation of the individual being in a social system was not clearly explained considering that the social system
encompasses other concepts and subconcepts in her theory.
 The model presents interaction which is dyadic in nature which implies that its applicability cannot be adapted to
unconscious individuals.
 Multitude of views and definition is confusing for the reader. Because of multiple views on one concept such as
what have been discussed in her concept of power blurs the point that the theorist is trying to relate to the
readers.

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