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CHAPTER 15 Imogene M. King 267

Goodwin, Kiehl, and Peterson (2002). Fairfax (2007) In 2007, Sieloff and Frey reported the status of
derived a theory of quality of life of stroke survivors. middle-range theory development from within
Nwinee (2011) used King’s work to develop the King’s conceptual system. Fawcett (2007) again ex-
Nwinee Socio-Behavioral Self-Care Management amined the development of middle-range theory,
Nurse Model. from within King’s conceptual system, and made
Maloni (2007) examined a cognitive interactive recommendations:
nursing intervention and health outcomes with pa- a) The credibility of King’s conceptual system
tients with type 2 diabetes. Ritter (2008) studied bene- could be further supported through “a meta-
fits from participation by academically at-risk students analysis or other integrative review of the re-
in a mentor/tutor program. Sivaramalingam (2008) sults obtained from empirical tests of . . . the
studied perceptions of surgical nurses held by surgical middle range theory propositions” (Fawcett,
patients. Stevens (2009) examined the relationships 2007, p. 301).
among structural empowerment, collaboration with b) “Additional metatheoretical research is needed
physicians and team work, and patient safety culture. to specify the relations between the concepts
Alligood (2010) examined exemplars of King-based within the personal, interpersonal, and social
research in family health care. Bond and colleagues systems” (Fawcett, 2007, p. 301).
(2011) conducted a “univariate descriptive analysis of c) Continued empirical testing of all middle-range
five years’ research articles” (p. 404). theories is also needed.
d) Additional research instruments need to be
developed to measure middle-range theory
Further Development concepts. The utility of those instruments then
Over the years, King consistently demonstrated her needs to be evaluated in terms of their utility
belief in the need for further testing of the Theory of for practice (Fawcett, 2007).
Goal Attainment. “Any profession that has as its pri- Graduate students continue to use King’s con-
mary mission the delivery of social services requires ceptual system and Theory of Goal Attainment for
continuous research to discover new knowledge that their research, including thirteen master’s students
can be applied to improve practice” (King, 1971, p. 112). (Zimmerman, 2007; Bialachowski, 2008; Ritter,
In 1995, Fawcett and Whall identified five major 2008; Sivaramalingam, 2008; Talbert, 2008; Egbert,
areas in which further development of King’s work 2009; Weg, 2009; Boyd-Jones, 2011; Colchin, 2011;
would be helpful: Draaistra, 2011; Karlin, 2011; Mardis, 2007; Wolf,
1. The concept of environment would benefit from 2011) and fifteen DNP or PhD doctoral students
additional definition and clarification. (Jewell, 2007; Maloni, 2007; Crump, 2008; Woo,
2. King’s views of illness, health, and wellness would 2008; Bularzik, 2009; Davidson, 2009; Esquibel,
benefit from additional clarification and discussion. 2009; Stevens, 2009; Taha, 2009; Aboshaiqah, 2010;
3. Future linkages between King’s (1981) conceptual Smithgall, 2010; Talbott, 2010; Jones-Zeigler, 2011;
system and other existing middle-range theories Lewis, 2011; Reck, 2011).
should continue in a manner that ensures con-
gruency between the conceptual system and the Critique
specific middle-range theory.
4. Empirical testing should continue for the Theory of Clarity
Goal Attainment (King, 1981) and other middle- A major strong point of King’s conceptual system and
range theories developed within King’s conceptual Theory of Goal Attainment is the ease with which it
system (Fawcett & Whall, 1995) (e.g., Sieloff & can be understood by nurses. Concepts are concretely
Dunn, 2008; Sieloff, & Bularzik 2011). defined and illustrated.
5. Middle-range theories that are implied rather than
explicit, such as those of Rooke (1995b), would Simplicity
benefit from development into formal theories King’s definitions are clear and are conceptually de-
(e.g., Nwinee, 2011). rived from research literature. King’s (1978) Theory of