Goal-Attainment Theory by Imogene King

GRACE LYN B.
IMPAS, RN
WESTERN MINDANAO STATE UNIVERSITY
NURSING THEORY & PRACTICE (CN 201)
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GOAL-
ATTAINMENT
THEORY BY
IMOGENE KING
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LEARNING OBJECTIVES
At the end of the discussion, the MAN/MN graduate students will
be able to:
1. Learn Imogene King’s biography.
2. Understand the Interacting System Framework involving

Personal, Interpersonal and Social System.
3. Understand the Nurse-Patient Transactions Model.
4. Comprehend the Metaparadigm, Applications and Critique of

Goal-Attainment Theory.
5. Integrate the 11 Key Areas of Responsibilities in Nursing.

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IMOGENE KING
(January 30, 1923 – December 24, 1997)
 Born in West Point, Iowa.
 She received her nursing diploma from St. John’s

Hospital School of Nursing in St. Louis, Missouri in
1945.
 She earned Bachelor of Science in Nursing from St.
Louis University in 1948 and Masters of Science in
Nursing in 1957.
 She also earned her doctoral degree from Teachers
College, Columbia University in 1961.
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IMOGENE KING
 1947 – 1958: Medical-Surgical Nursing Instructor

and Assistant Director of St. John’s Hospital School
of Nursing.
 1966 – 1968: Assistant Chief, Research Grants

Branch, Division of Nursing, Washington D.C.
 1968 – 1972: Director, School of Nursing at Ohio

State University
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IMOGENE KING
 1961 – 1966: Associate Professor at Loyola University,
Chicago
 1971 – 1980: Professor at Loyola University, Chicago
 1990: Retired with the title Professor Emeritus after

serving as Professor at University of South Florida,
College of Nursing
 December 24, 1997: She died, 2 days after suffering
from stroke
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INTERACTING
SYSTEM
FRAMEWORK
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CONCEPTUAL FRAMEWORK
 Imogene King’s Interacting System
Framework emphasizes the importance of the
interaction between nurses and patients.
 It views this interaction as an open system

which is in constant interaction with a variety
of environmental factors.
 3 Systems:
(1)Personal, (2)Interpersonal and (3)Social

Systems
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I. PERSONAL SYSTEM
1. Perception
2. Self
3. Growth and Development
4. Body Image
5. Space
6. Time
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I. PERSONAL SYSTEM
1. 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.
2. Self— a composite of thoughts and feelings that

constitute a person's awareness of individual
existence, of who and what he or she is.
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I. PERSONAL SYSTEM
3. 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.
4. Body image—a person's perceptions of his or

her body.
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I. PERSONAL SYSTEM
4. Space—the physical area called territory that

exists in all directions.
5. Time—the duration between the occurrence
of one event and the occurrence of another
event.
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II. INTERPERSONAL SYSTEM
1. Interaction
2. Communication
3. Transaction
4. Role
5. Stress
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1. Interactions—the acts of two or more persons in

mutual presence; a sequence of verbal and
nonverbal behaviors that are goal directed.
2. Communication—the vehicle by which human

relations are developed and maintained;
encompasses intrapersonal, interpersonal,
verbal, and nonverbal communication.
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3. Transaction—a process of interaction in which

human beings communicate with the
environment to achieve goals that are valued;
goal-directed human behaviors.
4. Role—a set of behaviors expected of a person

occupying a position in a social system.
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5. 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.
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III. SOCIAL SYSTEM
1. Organization
2. Authority
3. Power
4. Status
5. Decision-making
6. Control
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III. SOCIAL SYSTEM
1. Organization—composed of human beings with

prescribed roles and positions who use resources
to accomplish personal and organizational goals.
2. 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.
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III. SOCIAL SYSTEM
3. Power—the process whereby one or more persons

influence other persons in a situation.
4. Status—the position of an individual in a group or

a group in relation to other groups in an
organization.
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III. SOCIAL SYSTEM
5. 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.
6. Control—being in charge.
INTERACTING SYSTEM FRAMEWORK
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 Among the three systems, the Interpersonal

system had the greatest influence on the
development of her theory
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THEORY ASSERTIONS
 King’s Theory of Goal Attainment focuses on the

interpersonal system and the interactions that take
place between individuals, specifically in the nurse-
patient relationship.
 King developed eight propositions in her Theory of

Goal Attainment. These propositions are the
following:
1. If perceptual congruence is present in nurse-
client interactions, transactions will occur.
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THEORY ASSERTIONS
2. If nurse and client make transactions, goals will be
attained.
3. If goals are attained, satisfactions will occur.
4. If goals are attained, effective nursing care will

occur.
5. If transactions are made in nurse-client

interactions, growth and development will be
enhanced.
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THEORY ASSERTIONS
6. If role expectations and role performance as
perceived by nurse and client are congruent,
transactions will occur.
7. If role conflict is experienced by nurse and client or

both, stress in nurse-client interactions will occur.
8. If nurses with special knowledge and skills

communicate appropriate information to clients,
mutual goal setting (transactions) and goal
attainment will occur.
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NURSE-PATIENT TRANSACTION
MODEL
 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.
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MODEL
 Reaction is not specifically defined but might be

considered to be included in the sequence of
behaviors described in action.
 Interactionis 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.
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MODEL
 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.
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METAPARADIGM: Person
 King described a person existing in an open

system as a spiritual being and rational thinker who
makes choices, selects alternative courses of
action, and has the ability to record their history
through their own language and symbols, unique,
holistic and have different needs, wants and goals.
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METAPARADIGM: Person
 King’s theory of goal attainment identified three
basic health needs of man/person:
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.
3. The need for care when human beings are

unable to help themselves.
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METAPARADIGM: Health
 It is a dynamic state in the life cycle; illness

interferences with that process.
 Health implies continuous adjustment to stress in

the internal and external environment through
optimum use of one’s resources to achieve
maximum potential for daily living.
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METAPARADIGM: Environment
 King defined Environment as the process of

balance involving internal and external interactions
inside the social system.
 Reactions from the interaction between the internal

and external environment can be biological,
psychological, physical, social or spiritual.
 It has a direct exchange of information between the

internal and external.
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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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METAPARADIGM: Nursing
 In addition, King also discusses the following:
 GOAL of a NURSE: To help individuals to maintain

their health so they can function in their roles.
 DOMAIN of a NURSE: Includes promoting,

maintaining, and restoring health, and caring for the
sick, injured and dying.
 FUNCTIONS of a NURSE: To interpret information

in nursing process to plan, implement and evaluate
nursing care.
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APPLICATIONS OF THE
THEORY
Practice:
 Professionals have used King’s theory in different

specialized area with the use of dynamic interactive
communication between the nurse and the client as
proof.
 Professionals need communication to successfully

and correctly make decisions for their plan of care.
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 King also developed the Goal Oriented Nursing

Record (GONR) from her theory. GONR 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.
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 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.
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APPLICATIONS OF THE
THEORY
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.
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APPLICATIONS OF THE
THEORY
Education:
 Based on King’s guidelines, the focus of a Nursing
curriculum must be the dynamic nurse-client
interaction.
 Nursing education programs must prepare nursing

students to become useful, productive, and
relatively happy citizens as well as professional
practitioners as they acquire knowledge, values
and skills in the practice of nursing.
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APPLICATIONS OF THE
THEORY
Research:
 King’s theory has been one of the theoretical basis
of some researches that helped in formulating a
system view of 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.
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APPLICATIONS OF THE
THEORY
Research:
 Here are two of out of the many researches which based
upon King’s Goal Attainment Theory and Interacting System:
 Application of King's Theory of Dynamic Interacting
Systems to the Study of Child Abuse and the
Development of Alcohol Use/Dependence in Adult
Females by Mckinney and Dean
 Imogene King's Interacting Systems Theory: Application
to Emergency and Rural Nursing by Williams
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INTEGRATION OF THE
11 KEY AREAS OF
RESPONSIBILITIES IN
NURSING
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11 KEY AREAS OF RESPONSIBILITIES IN NURSING
1.Safe & Quality Nursing Care
 Through constant interactions and transactions between the

patient and the nurse, the nurse could identify health needs and
problems of the patient so that mutual goals are attained.
 Both the utilization of the King’s theory and the GONR, nurses
could provide individualized plans of care.
 Thorough assessment of the patient’s need, nurses could

prevent unnecessary actions and mistakes in giving safe and
quality nursing care to the patients.
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2.Management of Resources and Environment
 King’s theory somehow may not be relevant or applicable in

matters of resource management.
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3.Health Education
 In the Goal Attainment Model, interaction between nurse and

patient occurs, transaction is achieved or goal is attained
furthermore the theory encourages feedback especially from the
patient in order for the nurse to determine if methods are
effective or not.
 Learning is a two-way process and one of the ways that the

nurse could educate his/her patient is through mutual interaction
which could possibly lead to goal attainment.
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4.Legal Responsibility
 King’s theory somehow may not be relevant or applicable in

matters of legal responsibilities.
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5.Ethico-Moral Responsibility
 In respecting patient’s rights, King’s theory encourages the

importance of interaction between nurses and patients so that
there is an active participation of patients in the decision-making
phase of the nursing care plan.
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6.Personal and Professional Development
 King’s theory provides enough direction to how nurses should

be able to behave or act in the presence of patients.
 Since majority of nursing activities involve direct interaction with

patients, nurses should understand the basic implications of the
action-reaction- interaction-transaction model of nurse- client
relationships.
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7.Quality Improvement
 The theory emphasizes interaction between the nurse and client

with that the nurse encourages the patients to verbalize relevant
changes and concerns regarding his/her care.
 The nurse could gather and analyze data, implement proper

actions and evaluate care through the use of King’s theory and
possibly through GONR.
 If goals are attained, patient satisfaction occurs and quality

improves.
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8.Research
 The theory can help set a framework for nursing studies which
can further prove the use and advantages of the nursing
practice.
 The nurse can also utilize King’s GONR which is a method of

collecting data, identifying problems, implementing and
evaluating care that has been used effectively in patient
settings.
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9.Records Management
 King developed a documentation system, Goal-Oriented

Nursing Record (GONR) which documents the effectiveness of
nursing care.
 The major elements in this record system are: database,

nursing diagnosis, goal list, nursing orders, flow sheets,
progress notes and discharge summary.
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10.Communication
 Communication is a vital concept in the Theory of Goal

Attainment because it emphasizes the importance of the
interaction between nurses and patients.
 Through this, the nurse could establish rapport with the patients,
folks and also colleagues in order for them to achieve their
goals in a mutual setting.
 If there is no communication, there is no interaction and it

follows that transactions can’t occur, therefore, no goals are
attained.
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11.Collaboration and Teamwork
 King’s theory and the GONR are useful in practice because

nurses have the ability to provide individualized care plans while
encouraging active participation from the patients and
colleagues in the decision-making phase.
 Through this theory, we could achieve good interpersonal

relationship with clients, folks and colleagues as well.
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REFERENCES
 Tomey, AM & Alligood, MR (2008) Nursing Theorists and their Work, 6th Edition,
Mosby and Philadelphia
 Octaviano, E. & Balita, C. (2008) Theoretical Foundations of Nursing: The

Philippine Perspective, Ultimate Learning Series
 Bautista, J. (2009) Theoretical Foundations of Nursing: A Beginner’s Journey into

Professional Nursing, Revised Edition
 http://imogenekingtheory.blogspot.com
 http://nursingtheories.weebly.com/imogene-m- king.html
 http://currentnursing.com/nursing_theory/goal_attain ment_theory.html
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THANK YOU!

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GRACE LYN B.

1. Learn Imogene King’s biography.

2. Understand the Interacting System Framework involving

3. Understand the Nurse-Patient Transactions Model.

4. Comprehend the Metaparadigm, Applications and Critique of

5. Integrate the 11 Key Areas of Responsibilities in Nursing.

 She received her nursing diploma from St. John’s

 1947 – 1958: Medical-Surgical Nursing Instructor

 1966 – 1968: Assistant Chief, Research Grants

 1968 – 1972: Director, School of Nursing at Ohio

 1990: Retired with the title Professor Emeritus after

 It views this interaction as an open system

(1)Personal, (2)Interpersonal and (3)Social

3. Growth and Development

1. Perception— a process of organizing,

2. Self— a composite of thoughts and feelings that

3. Growth and Development— cellular, molecular,

4. Body image—a person's perceptions of his or

4. Space—the physical area called territory that

1. Interactions—the acts of two or more persons in

2. Communication—the vehicle by which human

3. Transaction—a process of interaction in which

4. Role—a set of behaviors expected of a person

5. Stress—a dynamic state whereby a human

1. Organization—composed of human beings with

2. Authority—a transactional process characterized

3. Power—the process whereby one or more persons

4. Status—the position of an individual in a group or

5. Decision making—a dynamic and systematic

 Among the three systems, the Interpersonal

 King’s Theory of Goal Attainment focuses on the

 King developed eight propositions in her Theory of

3. If goals are attained, satisfactions will occur.

4. If goals are attained, effective nursing care will

5. If transactions are made in nurse-client

7. If role conflict is experienced by nurse and client or

8. If nurses with special knowledge and skills

 Action is defined as a sequence of behaviors

 The sequence is first mental action to recognize the

 Reaction is not specifically defined but might be

 Interactionis a process of perception and

 Transaction is a process of interactions in which

 King described a person existing in an open

3. The need for care when human beings are

 It is a dynamic state in the life cycle; illness

 Health implies continuous adjustment to stress in

 King defined Environment as the process of

 Reactions from the interaction between the internal

 It has a direct exchange of information between the

 Nursing is a process of action, reaction, and

 The nurse and client share specific goals,

 GOAL of a NURSE: To help individuals to maintain

 DOMAIN of a NURSE: Includes promoting,

 FUNCTIONS of a NURSE: To interpret information

 Professionals have used King’s theory in different

 Professionals need communication to successfully

 King also developed the Goal Oriented Nursing

 It helps nurses to easily facilitate the present