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268 UNIT III Nursing Conceptual Models

Goal Attainment presents ten major concepts, and Karlin’s (2011) intrapartum nurse’s perspective of
the concepts are easily understood and derived from King’s Theory of Goal Attainment.
research literature.
Importance
Generality King’s (1981) middle-range Theory of Goal Attainment
King’s (1981) Theory of Goal Attainment has been focused on all aspects of the nursing process: assess-
criticized for having limited application in areas of ment, planning, implementation, and evaluation. The
nursing in which patients are unable to interact compe- body of literature clearly establishes King’s work as
tently with the nurse. King maintained the broad use important for knowledge building in the discipline of
of the theory in most nursing situations. In support of nursing.
King’s perspective, health care professionals have docu- In addition to the United States and Canada,
mented examples of the application of the Theory of health care professionals have used and continue to
Goal Attainment with patients with diabetes (Maloni, use King’s conceptual system and middle-range The-
2007) and surgical patients (Sivaramalingam, 2008; ory of Goal Attainment to implement theory-based
Bruns, Norwood, Bosworth, & Hill, 2009). Kameoka, practice in Asia (Chugh, 2005; Li, Li, & Xu, 2010),
Funashima, and Sugimori (2007) tested a proposition Australia (Khowaja, 2006), Brazil (Marziale & de
of the theory and explored “the characteristics of nurses Jesus, 2008), China (Cheng, 2006), India (Abraham,
whose degree of goal attainment and satisfactions in 2009; George, Roach, & Andrade, 2011), Japan
interactions with patients were both high” (p. 261). (Kameoka, Funashima, & Sugimori, 2007), Portugal
Abraham (2009) used the Theory of Goal Attainment (Chaves & de Araujo, 2006; Costa, Santos, Martinho,
in research within a workplace. Langford (2008) used et al., 2007; Firmino, de Fatima, Cavalcante & Celia,
the Theory to guide research with women with weight 2010), Slovenia (Harih & Pajnkihar, 2009), Sweden
problems. Alligood (2010) reported the use of the (Rooke, 1995a, 1995b), and West Africa (Nwinee,
theory in research with families. Smithgall (2010) 2011). King’s work has been a structured framework
examined the relationships between the “perceptions for curriculum development at various educational
of maternal stress and neonatal patient outcomes in a levels.
single private room versus open room neonatal inten-
sive care unit environments.”
Summary
Accessibility Imogene King contributed to the advancement of
King gathered empirical data on nurse-patient inter- nursing knowledge through the development of her
action that led to goal attainment. A descriptive study conceptual system and middle-range Theory of Goal
was conducted to identify the characteristics of trans- Attainment. By focusing on the attainment of goals,
action and whether nurses made transactions with or outcomes, by nurse-patient partnerships, King
patients. With a sample of 17 patients, goals were at- provided a conceptual system and middle-range the-
tained in 12 cases or 70% of the sample. King (1981) ory that has demonstrated its usefulness to nurses.
believed that, if nursing students were taught the Nurses working in a variety of settings with patients
transactional process in the Theory of Goal Attain- from around the world continue to use King’s work to
ment and used it in nursing practice, goal attainment improve the quality of patient care.
could be measured and evidence of the effectiveness of
nursing care demonstrated.
The Theory of Goal Attainment guided Jewell’s CASE STUDY
(2007) dissertation that explored “the physical sensa- Upon receiving an assignment at the start of the
tion of dyspnea that obese women feel and how its shift, Colin Jennings, RN, makes initial rounds of
effects their functioning,” Sivaramalingam’s (2008) the patients. One patient, Amed Kyzeel, as reported
study of “surgical patients’ perceptions of nurses’ by nurses on the previous shift, has been difficult to
roles and responsibilities,” Alligood’s (2010) report work with, demanding the attention of staff through-
of exemplar researchers in family health care, and out the shift.