How do you define

“success”?
 Imogene King:
Conceptual System and
Theory of Goal Attainment

Carla DC. Parong, RN

Imogene King (1923 – 2007)
• Developed a conceptual model for nursing in the mid 1960’s with the
idea that human beings are open systems interacting with the
environment (King 1981)

• King’s work is considered a conceptual model because it comprises

both a conceptual framework and a theory ( Fawcett, 2000).

• The central focus of King’s framework is a man as a dynamic human

being whose perceptions of objects, persons, and events influence
his behaviour, social interaction, and health.
King’s Dynamic Conceptual
System
King’s Interacting
Systems
Personal System
• refers to the individual
• Concepts:
 Perception – person’s representation of reality
 Self – individual’s conception on who and what he is
 Body image – the way one perceives one’s body & other’s reaction
 Growth and development – processes in people’s lives
 Time – duration between one event and another
 Space – “territory”

“An individual’s perceptions of self, of body image, of time and space influence
the way he or she responds to persons, objects, and events in his/her life. As
individuals grow and develop through the life span, experiences with changes in
structure and function of their bodies over time influences their perceptions of
self.”
Interpersonal Systems
• involve individuals interacting with one another
 two individuals – dyads
 three individuals – triads
 Four or more individuals – small or large groups

• Concepts:
 Interaction – observable behaviors
 Transaction – goal-directed behaviour
 Communication – information exchange; verbal or non verbal
 Role – reciprocal relationship (giver and taker)
 Stress – dynamic state to maintain balance
Social Systems
• are groups of people within a community or society that share
common goals, interests, and values
• provide a framework for social interaction and relationships, and
establish rules of behaviour and course of action

• Concepts:
 Organization
 Authority
 Power – capacity to use resources in organization to achieve goals
 Status – individual’s position in a group
 Decision making – dynamic and systematic process to attain a goal
King’s Theory of Goal
Attainment
Theory of Goal Attainment
• The relationships between the three systems led to King’s Theory of
Goal Attainment

• The conceptual framework of the interpersonal system had the

greatest influence on the development of this theory

• She stated, “Although personal systems and social systems

influence quality of care, the major elements in a theory of goal
attainment are discovered in the interpersonal systems in which two
people, who are usually strangers, come together in a health care
organization to help and to be helped to maintain a state of health
that permits functioning in roles”
Theory of Goal Attainment
• Nursing is a process of action, reaction and interaction by which nurse
and client share information about their perception in a nursing
situation. The nurse and the client share specific goals, problems, and
concerns and explore means to achieve a goal.

• King used ten major concepts from the personal and interpersonal
systems to support the Theory of Goal Attainment
> Interaction > Time
> Perception > Space
> Communication > Growth and development
> Role > Self
> Stress > Transaction
Propositions in Theory of Goal Attainment
1. If perceptual interaction accuracy is present in nurse-patient
interactions, transaction will occur.
2. If the nurse and patient make transaction, the goal or goals will be
achieved.
3. If the goal or goals are achieved, satisfaction will occur.
4. If the goal or goals are achieved, effective nursing care will occur.
5. If transactions are made in nurse-patient interactions, growth and
development will be enhanced.
Propositions in Theory of Goal Attainment
6. If role expectations and role performance as perceived by the nurse
and patient are congruent, transaction will occur.
7. If role conflict is experienced by either the nurse or the patient (or
both), stress in the nurse-patient interaction will occur.
8. If a nurse with special knowledge communicates appropriate
information to the patient, mutual goal-setting and goal
achievement will occur.
Process of Interaction
Theory of Goal Attainment and
The Nursing Process
1. Assessment
 Takes place during interaction
 Nurse gathers data about the patient
 Perception is the base for the collection and interpretation of data
 Communication is required to verify the accuracy of the perception, as well as
for interaction

2. Nursing Diagnosis
 Developed using the data collected in the assessment
 In the process of attaining goals, the nurse identifies problems, concerns, and
disturbances about which the patient is seeking help
Theory of Goal Attainment and
The Nursing Process
3. Planning
 Nurse and other health care team create a care plan of interventions
 Represented by setting goals and making decisions on how to achieve goals
 Part of transaction and patient’s participation is encouraged

4. Implementation
 Actual activities done to achieve the goals
 Continuation of transaction
Theory of Goal Attainment and
The Nursing Process
5. Evaluation
 Involves determining whether or not the goals were achieved
 In King’s theory, evaluation addresses meeting goals and the effectiveness of
nursing care

• In the healthcare field, the final goal in the nurse-patient relationship is to help
the patient achieve his or her goals for getting healthy. By using the nursing
process in King’s Theory of Goal Attainment, a nurse can be more effective in
working with a patient to achieve those goals, and can truly help patients.
Applications in the Nursing Profession

• Hospital setting

• Community setting

• Academe