Imogene King: Goal Attainment Theory

IMOGENE KING
Goal Attainment Theory

“A professional nurse, with special
knowledge and skills, and a client in need of
nursing, with
knowledge of self and perception of
personal problems, meet as strangers in
natural environment. They interact
mutually, identify problems, establish and
achieve goals.”
Getting to know the Theorist
 Imogene King was born in West Point, Iowa on
January 30, 1923, youngest of three children.
 She completed her diploma in nursing education
in 1945, at St. John's Hospital in St. Louis,

Missouri.
 She received her BS and MS in nursing from St.
Louis University in 1957,

 She obtained her Doctorate in Education from
Columbia University, N.Y.

 She has practiced as a staff nurse, nurse educator, and
nurse administrator.
 She formulated her theory while she was an associate
professor of nursing at Loyola University in Chicago.
 This was at the time nursing was emerging as a
profession and some nurses sought to challenge the
existing role of nurses.
 King began her work in nursing theory with a
conceptual framework.
 King considers her theory as a deviation from systems
theory, with emphasis on interaction theory.
 In 1981 she refined her concepts into a nursing theory
that consisted of the following basis:
1. An open system framework as the basis of goal
attainment.
2. Nursing as a major system within the health care
system.
3. Nursing process emphasis on interpersonal
processes.
 She Died on December 24, 1997, 2 days after suffering
from stroke.
Theoretical Sources
 1971, 1981: students, academic colleagues, nurse
researchers, and clinicians
thinking
 1981: General System Theory (Von Bertalanffy)
conceptual framework
 1988:Kaufman, Orlando and Peplau
thinking
Use of Empirical Evidence
King used a “systems” approach in the development of her Dynamic Interacting
Systems
Framework and in her subsequent Goal-Attainment Theory.
INTERACTING SYSTEMS FRAMEWORK
Three systems in the conceptual
framework:
Personal System (the individual)
Interpersonal System (individuals
interacting with one another)
Social System (groups of people in
a community/society sharing
common goals, interests, and
values)
Study systems as a whole rather
than as isolated parts of a system.
THEORY OF GOAL
ATTAINMENT
 Elements are seen in the interpersonal systems in
which two people, who are usually strangers, come
together in a health care organization to help and be
helped to maintain a state of health that permits
functioning of roles.
 Reflects King’s belief that the practice of nursing is
differentiated from other healthcare professions by
what nurses do with and for individuals
 Nurse and client communicate information, set goal
mutually and then act to attain those goals
Metaparadigm in Nursing:
1.Person:
Imogene 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 goal
According to Imogene King, human being
has three fundamental needs:
 Information on health that can be
accessed and utilized when needed

 Care that aims to prevent illness
 Care in times of illness/helplessness

2.Health :
According to Imogene King, 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.
3.Environment :
It is the background for human interactions.
It involves:
a. Internal environment – transforms energy to
enable person to adjust to continuous external
environmental changes.
b. External environment – involves formal and
informal organizations. Nurse is a part of the patient’s
environment.
4. Nursing:
Nursing for Imogene King is an act wherein the nurse
interacts and communicates with the client. The nurse
helps the client identify the existing health condition,
exploring and agreeing on activities to promote
health. The goal of the nurse in Imogene King’s
theory is to help the client maintain health through
health promotion and maintenance, restoration, and
caring for the sick and dying.
Acceptance by the Nursing Community
 Research:
Basis for development of middle-range nursing
theories:
 Model for Multicultural Nursing Practice (Rooda,
1992)
 Theory of Personal System Empathy (Alligood &
May, 2000)
 Theory of Family Health (Doornbos, 2000)
Education:
 Framework for the baccalaureate program (Ohio State
University School of Nursing)

 Educational reform resulting in nursing education (Sweden)
Practice:
 A model for bedside nursing practice in the hospital
setting (Coker & Schreiber, 1990)

 Managed care program in hospital settings (Hampton,
1994)Goal-Oriented Nursing Record system for

documentation
 Structure of Quality Assurance Program
Analysis
Clarity:
 Clear and conceptually derived from research
literature at the time the theory was developed.

Generality:
 It has been criticized for having limited
applications in areas of nursing in which patients

are unable to competently interact with the nurse.
 King has responded that 70% of communication is
nonverbal.
Empirical Precision:
 From a study of 17 patients, goals were attained in 12 cases (70%).
 King believes that if nursing students are taught the theory of goal
attainment and it is used in nursing practice, goal attainment can be

measured and the effectiveness of nursing care can be
demonstrated.
Derivable Consequences:
 It focuses on all aspects of the nursing process: assessment,
planning, implementation and evaluation.

 King believes that nurses must assess to set mutual goals, plan to
provide alternative means to achieve goals, and evaluate to

determine if the goal was attained.

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IMOGENE KING

Goal Attainment Theory

in 1945, at St. John's Hospital in St. Louis,

Louis University in 1957,

Columbia University, N.Y.

accessed and utilized when needed

 Care in times of illness/helplessness

According to Imogene King, health involves

University School of Nursing)

setting (Coker & Schreiber, 1990)

1994)Goal-Oriented Nursing Record system for

literature at the time the theory was developed.

applications in areas of nursing in which patients

attainment and it is used in nursing practice, goal attainment can be

planning, implementation and evaluation.

provide alternative means to achieve goals, and evaluate to

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