Imogene King

Goal Attainment Theory

• Theory of goal attainment was first introduced by Imogene King in the early 1960’s.
• Theory describes a dynamic, interpersonal relationship in which a person grows and develops to attain certain life goals.
• Factors which affect the attainment of goal are: roles, stress, space & time

From the theory of goal attainment king developed predictive propositions, which includes:

• If perceptual interaction accuracy is present in nurse-client interactions, transaction will occur
• If nurse and client make transaction, goal will be attained
• If goal are attained, satisfaction will occur
• If transactions are made in nurse-client interactions, growth & development will be enhanced
• If role expectations and role performance as perceived by nurse & client are congruent, transaction will occur
• If role conflict is experienced by nurse or client or both, stress in nurse-client interaction will occur
• If nurse with special knowledge skill communicate appropriate information to client, mutual goal setting and goal attainment will occur.

         Many people believe King's theory of goal attainment to be a productive and empowering way for nurses and patients to interact. There has been some discussion about how well the theory applies across all groups of patients, as it is necessary for the patient to be able to interact with the nurse to develop and agree on goals, and on ways to work toward those goals. Others contend that King's theory can be applied to all groups because a large portion of communication involves nonverbal behavior, so being able to communicate through spoken language is not a prerequisite for transactions to occur.

Goal Attainment Theory Conceptual Framework

It includes:

• Several basic assumptions
• Three interacting systems
• Several concepts relevant for each system

Basic assumptions

• Nursing focus is the care of human being.
• Nursing goal is the health care of individuals & groups.
• Human beings: are open systems interacting constantly with their environment.
• Interacting systems: Personal system, Interpersonal system, Social system
• Concepts are given for each system:

1. Concepts for Personal System: Perception, Self, Growth & development, Body image, Space, Time
2. Concepts for Interpersonal System: Interaction, Communication, Transaction, Role, Stress
3. Concepts for Social System: Organization, Authority, Power, Status, Decision making

         The theory of goal attainment, which lies at the heart of King's theory of nursing, exists in the context of her conceptual framework. The essence of goal attainment theory is that the nurse and the patient work together to define and reach goals that they set together. The patient and nurse each perceive, judge, and act, and together the patient and nurse react to each other and interact with each other. At the end of this process of communication and perceiving, if a goal has been set a transaction is said to have occurred. The nurse and patient also decide on a way to work toward the goal that has been decided upon, and put into action the plan that has been agreed upon. King believes that the main function of nursing is to increase or to restore the health of the patient, so then, transactions should occur to set goals related to the health of the patient. After transactions have occurred and goals have been defined by the nurse and patient together, both parties work toward the stated goals. This may involve interactions with other systems, such as other healthcare workers, the patient's family, or larger systems.

After the transaction has occurred, and the goal has been set, King believes that it is important for good documentation to be practiced by the nurse. She believes that documenting the goal can help to streamline the process of goal attainment, making it easier for nurses to communicate with each other and other healthcare workers involved in the process. It also helps to provide a way to determine if the goal is achieved. This assessment of whether or not the goal has been successfully achieved plays an important end stage in King's goal attainment theory.