Imogene M.

King
Conceptual System and Middle Range Theory of Goal Attainment

I. Background and Theorist Credentials

A. Imogene King
1. Birthdate: January 30, 1923
2. Birthplace: West Point, Iowa, United States of America
3. Date of Death: December 24, 2007
B. Credentials
1. Education:
a) Diploma in Nursing (1945)
b) BS Nursing Education (1948)
c) Masters of Science in Nursing (1957)

2. Notable Experience:
a) Staff Nurse Roles (1945)
b) St. John’s Hospital (1947-1958)
(1) Medical-Surgical Nursing Instructor
(2) Assistant Director
c) World Health Organization (1969)
(1) Conducted an international nursing research seminar
(a) Connected with Midori Sugimori who translated her works to
Japanese, these translations influenced much of Japanese
Nursing
d) Ohio State University (1968-1972)
(1) Director of School of Nursing
e) University of South Florida
(1) Retired and retained moniker: Professor Emeritus
(a) Means that even if she retired, she is permitted to retain her title
3. Notable Works:
a) Article contribution to: Nursing Science (1964)
b) A Conceptual Frame of Reference for Nursing
(1) ^Article in Nursing Research (1968)
c) Toward a Theory for Nursing: General Concepts of Human Behavior (1971)
(1) received the American Journal of Nursing Book of the Year Award in
1973.
d) A Theory for Nursing: Systems, Concepts, Processes (1981)
4. Awards:
a) American Journal of Nursing Book of the Year Award (1973)
(1) Toward a Theory for Nursing: General Concepts of Human Behavior
b) Inducted in American Academy of Nursing and served on the Expert Theorist
Panel (1994)
c) Considered teaching students as he most important accomplishment

II. Major Concepts and Definitions

Concepts and Definitions:
1. Health
- Is always adjusting depending on the internal and external environment while using the
available resources during the patient's care.
2. Nursing
- the nurse must always report the patient's status in the medical chart. The nurse must
always inform, share and communicate about the situation for the care to be provided.
3. Environment (Same as the views on metaparadigms)
4. Self
- the person is aware of its existence as an individual and has thoughts and feelings which
gives a conception on its personal identity about who and what he/she is. The self refers to
itself as "I"
- Defined as a composite of thoughts and feelings which constitutes a person’s awareness
of one’s existence and their conception of what he/she is. She refers to self as a
person’s subjective environment.
- This concept involves ideas, attitudes, values, and commitments.
 5. Action
- sequence of behaviors involving mental and physical action
- Starts with mental action (recognize the presenting conditions), followed by physical
action (begin activities related to those conditions) then mental action (exert control over
the situation) combined with physical action (seeking to achieve goals)
6. Reaction
- No particular definition
- Considered as part of the sequence of behaviors described in action

Theory of Goal Attainment

- Focuses on the interpersonal system and the interactions that take place between individuals,
specifically in the nurse-patient relationship
- “focuses on the 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” (Gonzalo, 2019)
- “Nursing is a process of action, reaction, and interaction whereby nurse and client share
information about their perception in the nursing situation.”

Propositions of the theory:

1. If perceptual congruence is present in nurse-client (client refers to patient) interactions,
transaction will occur
2. If nurse and client/patient make transactions, goals will be attained
3. If goals are attained, satisfaction 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
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 or 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 and goal attainment will occur

Assumptions made in the model:

1. The focus of nursing is the care of the human being/patient.
2. The goal of nursing is the health care of both individuals and groups.
3. Human beings are open systems interacting with the environment constantly.
4. The nurse and the patient communicate information, set goals, and act to achieve those
goals.
5. Patients perceive the world as a complete person making transactions with individuals
and things in the environment.
6. Transaction presents a life situation in which the perceiver and the things perceived are
encountered. It also represents a life situation in which a person enters the situation as
an active participant.

Conceptual System - the three interacting systems in the Theory of Goal Attainment
1. Personal
- Example: person or nurse
- Concepts to guide understanding this system: body image, growth and
development, perception, self, space, time, coping and learning

2. Interpersonal
- Forms when two or more individuals interact, forming dyads or triads
- e.g. dyad of a nurse and a patient, families in small groups
- Concepts to guide understanding this system: communication, interaction, role,
stress and transaction

3. Social
- A more comprehensive interacting system that consists of groups that make up
society
- E.g. religious, educational, and health care systems, influential behavior of an
extended family on an individual’s personal growth
 - Concepts to guide understanding this system: authority, decision making,
organization, power, and status

III. Metaparadigms
Health
1. Health is a dynamic state in the life cycle, whereas illness interferes with that process. Health
implies continuous adjustment to stressors in the internal and external environment through the
optimum use of one's resources to achieve the maximum potential for daily living.
2. Health is especially important to King’s theory of goal-attainment because to achieve goal-
attainment one must also take into consideration the height at which the patient’s health can be
fulfilled.
3. Health, to the extent possible for the patient, is the goal for ill patients and their nurses alike

Nursing
- “An observable behaviour in the healthcare system”
- A nurse’s goal is to help individual patients maintain or return to a healthy state in order for the
individual to achieve their social function in society
- Defined as the intrapersonal process of the action, reaction, interaction and transaction of nurse
and the patient (related to King’s Theory on Goal Attainment)
- The perceptions, judgement, actions and influence of the patient/client and the nurse affect the
intrapersonal process

Person

- Focuses on the patient. Imogene King defined person metaparadigm as a personal system that
interacts with interpersonal and social systems. This metaparadigm performs patient care by
understanding where the patient is from and what is important to the patient.

Environment

- Environment is the background for human interaction. “Adjustments to life and health are influenced
by an individual's interaction with the environment.”
- King believed that (1981) “ an understanding of the ways that human beings interact with their
environment to maintain health was essential for nurses.”

King’s Assumptions:
 - Individuals are spiritual beings
- Individuals have the ability through their language and other symbols to record their history and
preserve their culture.
- Individuals are unique and holistic, of intrinsic worth, and capable of rational thinking and
decision making in most situations
- Individuals differ in their needs, wants and goals

References:

Aligood, M. R. (2018). Nursing Theorists and their Work (9th ed.). Singapore: Elsevier

Alligood, M. R. (2017). Nursing theorists and their work-e-book. Elsevier Health Sciences.

Gonzalo, A. (2019, September 12). Imogene King: Theory of Goal Attainment. Retrieved on October 5, 2020,
from https://nurseslabs.com/imogene-m-kings-theory-goal-
attainment/#what_is_theory_of_goal_attainment

GradeFixer. (2019, February 27). Nursing metaparadigms by Imogene King. Retrieved on October 5, 2020,
from https://gradesfixer.com/free-essay-examples/nursing-metaparadigms-by-imogene-king/

Yongque, F. (2015). Imogene King. Retrieved from https://www.slideshare.net/sagefy/imogene-king-

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