Application of Goal Attainment Theory/ Acceptance by the Nursing Community
Individuals decide to pursue a profession in nursing because they want to be contributory in helping patients get healthy. Some children will utter “Gusto ko magpagaling, gusto ko maging Nars”. In order to do that, it's necessary to set health goals with the patient, and then take steps to achieve those goals. Imogene King's Theory of Goal Attainment focuses on this process to aid nurses in the nurse-patient relationship, helping their patients meet the goals they set for their health.
Nursing 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.
The content of a Nursing education curriculum must include a sequence of related theory and practicum courses. It shall also include prerequisites to the nursing major subjects such as courses in the behavioral and biophysical sciences and the humanities. It should emphasize expansion of knowledge of individuals regarding each dimension of the personal, interpersonal, and social systems, and then knowledge about families and health-care systems.
Learning experiences in nursing schools should facilitate the perception of the student from the state of health to disturbances in the state of health, and back to health. Teaching strategies may include lecture and discussion; group discussion; role playing; demonstrations of interviewing techniques, participant and nonparticipant observation techniques, and structured observations; and individual and group conferences between students and teachers.
According to her, nursing education can occur in hospital-based diploma programs; in formal degree-granting programs in community colleges, senior colleges, or universities; and in continuing education programs. However, preparation for entry into professional nursing should take place in universities in post baccalaureate Doctor of Nursing (ND) programs.
Learning experiences in nursing schools should facilitate the perception of the student from the state of health to disturbances in the state of health, and back to health. Teaching strategies may include lecture and discussion; group discussion; role playing; demonstrations of interviewing techniques, participant and nonparticipant observation techniques, and structured observations; and individual and group conferences between students and teachers.
According to her, nursing education can occur in hospital-based diploma programs; in formal degree-granting programs in community colleges, senior colleges, or universities; and in continuing education programs. However, preparation for entry into professional nursing should take place in universities in post baccalaureate Doctor of Nursing (ND) programs.
Case in point
The undergraduate curriculum at Ohio University in 1989 was explained by Daubenmire on how King’s conceptual framework was used. The curriculum was developed using the conceptual framework. They allowed a grant for research to support her framework and firmly supported by related literature. They used the research strategies and statistical treatment. Team-teaching was selected as a major strategy whereas each students need to be keen with the concept of the conceptual framework.
Graduate curriculum in Loyola University in Chicago used her conceptual framework.
Nursing Research
According to King, the ultimate purpose of research is to determine the effects of mutual goal setting and implementation of the nursing interventions related to goals on goal attainment. The phenomena of interest in research must be transactions and health. She suggested that the precise problems to be studied are actual or potential disturbances in the client’s ability to function in social roles.
King’s Conceptual System-based research findings shall enhance understanding of factors that affect health as the ability to function in social roles.
King’s Conceptual System-based research findings shall enhance understanding of factors that affect health as the ability to function in social roles.
Case in point
There are about 43 master theses and 20 doctoral dissertations as identified by Fawcett, although 100% of master thesis and 72% of doctoral research were not published. This would present difficulties among those nurses who are interested in the advancement of knowledge about Imogene King’s work.
The critical role of research in nursing is inherent in all of King’s discussions of nursing theory and knowledge development.
Nursing Practice
Based on King’s guidelines, the purpose of nursing practice is to help individuals attain and maintain their health, and if there is some disturbance such as illness or disability. Therefore, the nurses’ actions must be goal directed to help individuals regain health or live with a chronic illness or a disability.
According to her, Nursing practice can occur in acute and chronic care settings, as well as those appropriate to delivery of care for the maintenance of health. Opportunities for health promotion exist wherever people are in their communities, regardless of their age and health state. Participants in nursing are people who can actively participate in decisions that influence their care, as well as clients who have family members with whom nurses can make transactions until the clients can participate.
King’s conceptual framework system and Theory of Goal Attainment fits the current trends in nursing. In her recent publications of journals and presentations, she made revisions which include addition of coping to personal system and spirituality as basic assumption of human being. She also changed the conceptual framework to conceptual system where she relates the use of minimum data use, common language for nurses and computerized patient system important in organizing, applying and communicating knowledge.
She linked the Conceptual system with the Theory of Goal Attainment. The three systems that she constitutes to her conceptual systems are personal, interpersonal and social which eventually provide the basis for her Theory of Goal Attainment. The combination of those theories was used in 36 nursing specialties, 10 different cultures and 20 different work settings. It became also relevant to the other areas such as advocacy and case management.
Case in point
In her Rural Nursing theory, nursing can also be applied in rural areas however, some concepts may not be applicable due to limitation in setting goals that would only be effective if the client knows that they would benefit from them without fear that it may interrupt with their daily lives.
King also developed a documentation system, the goal-oriented nursing record (GONR), to complement the Goal Attainment Theory, this also to record goals and outcomes. The GONR is a method of collecting data, recognizing problems, and implementing and evaluating care in a patient care setting. The strength of this is that the nurses can formulate individualize plans of care with the active participation of the client.
References:
Williams, Ann, Leigh, Imogene King’s Interacting Systems Theory: Application in Emergency and Rural Nursing Retrieved from http://www.rno.org/journal/index.php/online
Frey, Maureen, A., Seiloff, Cristina,L.,Norris, Dianne, M., King’s Conceptual System and Theory of Goal Attainment: Past, Present and Future, Retrieved from http://www.sagepub.com/holt/articles/Frey.pelf
Conceptual models and theories of nursing.(2010). Taber's Cyclopedic Medical Dictionary, 21st Ed, Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=nrc&AN=t0hAPP20&site=nrc-live; http://www.fadavis.com
Killeen MB, & King IM. (2007). Viewpoint: Use of king's conceptual system, nursing informatics, and nursing classification systems for global communication. International Journal of Nursing Terminologies and Classifications : The Official Journal of NANDA International, 18(2) Retrieved from /z-wcorg/ database.
Marriner-Tomey, A., & Alligood, M. R. (2006). Nursing theorists and their work. St. Louis, Mo.: Mosby/Elsevier. Retrieved from /z-wcorg/
Khurshid Khowaja. UTILIZATION OF KING’S INTERACTING SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT WITH NEW MULTIDISCIPLINARY MODEL: CLINICAL PATHWAY.2006
Fawcett, J. (1997). Conceptual models of nursing, nursing theories, and nursing practice: Focus on the future. In M. R. Alligood & A. Marriner-Tomey (Eds.), Nursing theory: Utilization and application (pp. 211-221). St. Louis: Mosby-Yearbook
Fawcett, J. (2005) Contemporary nursing knowledge : analysis and evaluation of nursing models and theories (2nd ed.), PA: F. A. Davis Company.
