Imogene M. King

King's Theory of Goal Attainment

This article presents an overview of the meaning of the terms concept, theory, and conceptual system. It gives a detailed description of Kings conceptual system including personal systems, interpersonal systems, and social systems, and a description of the theory of goal attainment. A discussion of the philosophical assumptions underpinning Kings theory as well as the concepts of the theory are also included. Research (both completed and ongoing) and changes that have taken place in her theory are examined.

Health as the Goal for Nursing

Health is a basic concept in the discipline and profession of nursing. A review of literature from several disciplines revealed that health is viewed as a multidimensional concept. Several approaches to categorize health were presented by various authors. An overview of Kings concep tual framework and theory of goal attainment related to her concept of health was discussed. The need to develop reliable and valid instruments to measure the dimensions of health was identified. Several instruments developed by nurses were reviewed. The importance of deriving a con ceptual and operational definition of health was related to advancing nursing science. The purpose of this paper is to discuss the meaning of health and its relevance for nursing science. A synthesis of the literature will be discussed first, then Kings concept of health will be presented along with the relevance of this knowledge for nursing science and the nursing profession.

A Theory of Goal Attainment: Philosophical and Ethical Implications

Increased knowledge and contemporary technology have brought to the healthcare scene methods to control human liv ing, dying, and experimentation to prolong life or to gain knowledge. This kind of control over life and death means that professionals have a different kind of responsibility today than in the past. This responsibility requires participative de cision making about another person’s life, health, and func tional ability to perform in the various roles as a person. The quality of life is a major issue being discussed in communi ties, in healthcare systems, and in nursing. Three ethical is sues being debated currently revolve around rationing healthcare, that is, restricting resources because of a policy of cost containment in the system, end-of-life decisions, and care by incompetent workers. Problems arise in specific patient situations when decision making involves choosing between legal and ethical consequences of the decisions. Nurses’ legal right to practice is given in the Nurse Practice Act in each state in the United States. Knowledge of ethical theories and principles is essential to help nurses make professional decisions in healthcare. If ethical principles are to be useful in decision making by professional nurses, norms that deal with standards of human behavior must be known by all nurses, especially with in creased recognition of human rights of all persons in health care systems. The American Nurses Association (ANA) Code for Nurses(1985) andStandards of Clinical Nursing Practice(1998) provide the foundation for ethical decision making in nursing situations. How does nursing theory pro vide knowledge to use in ethical decisions, especially when confronted by ethical issues in practice? This question re quires an overview of one’s philosophy of science and beliefs about human beings. For example, what is human nature? The relationship between one’s philosophy and theory of goal at tainment is relevant because the concepts of the theory repre sent substantive knowledge used by nurses in deliberating ethical issues and making decisions.

Quality of Life and Goal Attainment

Kings conceptual framework of three dynamic interacting systems (personal, interpersonal, social) provides a structure for observing the interacting elements that enhance or impinge on quality of life. Interactions and transactions with the nurse lead to goal-setting for individuals, families, and society. Goal-setting usually leads to goal attainment, which produces satisfaction with self and improves ones ability to achieve future success. The goal of Kings theory (which is derived from her conceptual system) is health for individuals, groups, and society. This article explores the use of Kings theory of goal attainment in maintaining and promoting health, which influences quality of life.

Concepts Essential Elements of Theories

One approach to building nursing knowledge is the identification of relevant concepts that describe the structure of the discipline. The development and validation of concepts in nursing build scientific knowl edge of the discipline. Concepts are essential elements of theories. The ories provide an approach to describe, explain, and predict phenomena to strengthen the scientific basis of nursing. Concepts are the categories of a theory that serve as guides for making observations in the empirical world. The focus of this article is the nature and function of concepts. A process for developing concepts is presented and one of the critical concepts in the authors theory of goal attainment, transactions, is used to demonstrate the process of concept development through research.

King's Theory of Goal Attainment in Practice

Kings conceptual system provides a comprehensive view of three dynamic interacting systems-personal, interpersonal, and social. Her theory of goal attainment has been used as the basis for practice, education, research, and administration, examples of which are presented here.

The Theory of Goal Attainment in Research and Practice

Kings conceptual system may be used to build a world community of nurses who respect cultural differences and share the mutual goal of health in each nation. The concepts in this systems framework have been the basis for research and practice and for developing theories such as the theory of goal attainment. This theory includes a human process of interactions that lead to transactions and to goal attainment (outcomes). This process is useful in any nursing situation and in any culture. Knowledge of the concepts of the theory have been applied in practice in the United States, Canada, Sweden, and Japan. An example of implementing theory-based practice in a hospital is discussed.

King's General Systems Model: Application to Curriculum Development

Kings general systems model provides a useful way to organize and implement a curriculum in nursing. The model clarifies the relationship of individuals and families to communities by using concepts that define personal, interpersonal, and social systems. A model has been developed that uses concepts, axioms, skills, and values as the central components of the curriculum.