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CHAPTER 15 Imogene M. King 263

(p. 153) and determines whether nurses made trans- • Individuals are unique and holistic, of intrinsic
actions. King used a method of nonparticipant obser- worth, and capable of rational thinking and decision
vation to collect information about nurse-patient making in most situations (King, 1995b).
interactions on a patient care unit in a hospital setting • Individuals differ in their needs, wants, and goals
with patients and nurses volunteering to participate (King, 1995b).
in the study. King trained graduate students in non-
participant observation technique to collect data. She Health
examined multiple interactions and recorded verbal Health is a dynamic state in the life cycle, while ill-
and nonverbal behaviors data. King further tested ness interferes with that process. Health “implies
her Criterion-Reference Measure of Goal Attainment continuous adjustment to stress in the internal and
Tool, a measure of functional abilities and goal attain- external environment through the optimum use of
ment in the University of Maryland Measurement of one’s resources to achieve the maximum potential for
Nursing Outcomes project. She reported the instru- daily living” (King, 1981, p. 5).
ment to have a CVI of .88 and reliability of .99 for
assessing functional abilities of patients in making Environment
decisions about goal setting with and for patients to King (1981) believed that “an understanding of the
measure goal attainment (King, 1988, 2003). ways that human beings interact with their environ-
ment to maintain health was essential for nurses” (p. 2).
Open systems imply that interactions occur constantly
Major Assumptions between the system and the system’s environment.
King’s personal philosophy about human beings and Furthermore, “adjustments to life and health are influ-
life influenced her assumptions related to environment, enced by [an] individual’s interaction with environ-
health, nursing, individuals, and nurse-patient interac- ment . . . Each human being perceives the world as a
tions. King’s conceptual system and Theory of Goal total person in making transactions with individuals
Attainment were “based on an overall assumption that and things in the environment” (King, 1981, p. 141).
the focus of nursing is human beings interacting with
their environment, leading to a state of health for indi-
viduals, which is an ability to function in social roles” Theoretical Assertions
(King, 1981, p. 143). King’s Theory of Goal Attainment (1981) focuses on
the interpersonal system and the interactions that
Nursing take place between individuals, specifically in the
“Nursing is an observable behavior found in the nurse-patient relationship. In the nursing process,
health care systems in society” (King, 1971, p. 125). each member of the dyad perceives the other, makes
The goal of nursing “is to help individuals maintain judgments, and takes actions. Together, these activi-
their health so they can function in their roles” ties culminate in reaction. Interactions result and, if
(King, 1981, pp. 3–4). Nursing is an interpersonal perceptual congruence exists and disturbances are
process of action, reaction, interaction, and transac- conquered, transactions will occur. The system is
tion. Perceptions of a nurse and a patient influence open to permit feedback because each phase of the
the interpersonal process. activity potentially influences perception.
King (1981) developed eight propositions in her
Person Theory of Goal Attainment that describe the relation-
King detailed specific assumptions related to persons ships among the concepts detailed in Box 15–1. Dia-
in 1981 and in subsequent works: grams follow each proposition. When the propositions
• Individuals are spiritual beings (I. King, personal were analyzed, 23 relationships were not specified,
communication, July 11, 1996). 22 relationships were positive, and no relationship was
• Individuals have the ability through their language negative (Austin & Champion, 1983) (Figure 15–3).
and other symbols to record their history and pre- King (1981) also derived seven hypotheses from the
serve their culture (King, 1986). Theory of Goal Attainment.