Imogene M. King’s Theory of Attainment

Mary Gathaiya

Aspen University

Concepts and Theories in Nursing

Teresa Olin, MSN, BSN, RN

Introduction

In nursing career, one should be always ready to be an instrument of helping a patient get well or maintain their health. Therefore, it is very important to set care goals with the patient and ensure that the goals are achieved. Thus this paper will mainly focus on King’s theory which has being of great use to the nursing career. King a theorist born in 1923 developed a theory whose aim was on the process that would guide and direct nurses in their nurses patient relationship, and how to attain the goals of good health. The theory was introduced in the nursing industry in 1960s. It focuses mainly on how best the goals can be achieved through involving the patient while setting the goals, methods of communication and when choosing the action to take in attaining the goals. (Wayne, 2014)King’s theory states that; nursing involves a process of action, reaction and the interaction between the nurse and patients that is they share their perceptions, situation and therefore they end up agreeing on the goals to set and the methods of achieving the goals (Wayne, 2014)

King also gives some assumptions that would help while putting the theory into practice. These assumptions includes, first, that the nursing is care of human being. Second, nursing goals should be health care for both individual and group. Third, human are open and can interact with the environment easily. Fourth, both the nurse and the patient communicate, share information and set goals and the method of achieving good health care. Fifth, a patient sees the environment as a complete human making transaction with individuals and the environment. Lastly, the transaction involves both the perceiver and the perceived individuals (Gonzalo, 2011). King, defined some concepts such as, nursing which he said it is a process of action, reaction, and interaction between the nurse and the patient e.t.c. in addition, King also identified interacting systems which involves, personal systems, interpersonal systems and social systems. The process of interaction involves interaction, transaction, communication, role, stress, growth and development, time and space.

King’s Conceptual System

King’s Interacting Systems

King three interacting systems involve;

Personal systems

The main concept in this system of interaction involves perception, self, growth and development, body image, space and interaction. King theory says that each an individual is a personal system. Self is mainly composed of thoughts and feelings, which involves a person’s awareness of his or her individual existence, conception of who and what he is (Wayne, 2014). Growth and development is process an through which an individual moves from potential achievement to self actualization (Gonzalo, 2011). King defines body image as how an individual sees their body and that of others. Space is the physical area and the behaviors of the components in the area. Time is the duration or relation of one event to another (King, 1986 ) An example of personal system is a nurse or a patient

Interpersonal systems

According to King these system normally formed by the human beings interactions. That it can be interaction between two or three or group of individuals. The increase of the number of interacting individuals leads to complexity in the interaction. King (1990) define the following concepts, first, interaction is the behaviors of two or more persons in a mutual where their behaviors can be physically seen. Second, communication is the mode transfer of information from one person to another either directly or indirectly through television, telephone or written word. Third, transaction is process of interaction that individuals communicate with the environment to achieve valued goals. Fourth, role is the part played by an individual at a certain time while communicating. Lastly, stress is active state whereby an individual interacts with the surroundings to maintain balance for growth, development and performance, which mainly involve an exchange of both information and energy between the person and the environment for regulation and control of stressors. (King 1990)

Social systems

In order to have a more functional interacting system, groups are always involved thus making up a society referred to as social system. Under this system, the following concepts guides it performance. First, power is the ability to use the available resources in a certain settings of the environment without any restrictions. Second, status is the position of an individual in a group accompanied by his or her duties. Lastly, decision-making is the process by which ideas are gathered from each an individual in the group and thus a goal-directed idea is chosen. (King, 1990)

Goal Attainment

The interaction between the three interacting systems is very beneficial to goal achievement that is to say the systems are dependent on the other system for interaction to be successful. While developing this theory, interpersonal systems were of great influence (King, 1981). Overall, personal systems and social systems influence patient care. In order to ensure goal attainment, the interpersonal systems plays a vital role because in most cases both the patient and the nurse (at the beginning) are strangers and plays a role of helping and been helped. Therefore, King believed that the interaction of both the nurse and the patient resulted to transactions that will enhance goal attainment. Kings also said that through mutual goal setting and goal attainment, transaction could also result in enhancing growth and development of the client (King, 1981).

King used ten concepts that are from both personal and interpersonal systems to support this theory. The concept includes, human interaction, perception, communication, role, stress, time, space, growth and development and transaction. Therefore, in order to enhance goal attainment, first, communication is regarded as the verbal and non-verbal communication between the nurse and patient that is information is shared and interpreted. Second, transaction is whereby values, needs, and wants of each individuals of maybe a group are shared. Third, perception of both the patient and the nurse shares their perception on a certain issue. Fourth, role both the nurse and the patient identifies their self-role. Fifth, stress is whereby the factors influencing each person is identified in terms of time and space (King, 1981). Therefore, the ten factors influence goal attainment in one way or another. If one of the concepts is dysfunctional, it could be difficult to attain the goals.

King’s Theory on Clinical Quality Problem

Concerning a case of communication breakdown, King’s theory would be of great use while dealing with such situations. Communication breakdown can due to lack of nurse- patient trust. Therefore, to enhance a proper communication, Kings Theory could be used since communication is one of the concepts of the interacting systems. In addition, good communication skills are always important in most of the emergency rooms. Most of the nursing environments require the nurses to be responsive and reactive; patients always regard nurses as too busy. King theory (1981) encourages the nurse to consider their behaviors and communication that is; how they present themselves to the patient, (nurse’s first impression to the patient is a great factor to communication breakdown). Poor communication skills lead to poor transaction and the interaction between both the nurse and the patient. King theory will enable the nurse identify when the patient is willing to interact. In addition, if communication breaks, it could be difficult to set and attain good health goals. Therefore, Kings Theory is important while identifying the communication breakdown and the procedure to use to enhance communication. (Leigh Ann, 2001)

Application of the Theory

King’s theory is among the theories that have being helpful in my nursing careers. Working in a medical surgical ward requires mostly interaction with the patient. Therefore, using King’s interacting systems, I have being able to ease the tension between the patients and me. Consider a case of Mrs. W, who is a post operation patient; she has undergone a cholecystectomy surgery and complained much on her deteriorating health. Therefore to aid her in healing, the first thing should do is to identify if we have a mutual perception of her condition. Second, I ask her questions that could lead to determination to enable the patient realize the risks that could arise from her condition and how she views herself as a post operation patient. Third, both of us should be able to identify the problem. In her case, I identified that she has no interest walking and operation exercises. Fourth as a nurse, I would teach her on the implications and complications that could result from of her actions. Fifth, after teaching her we then set a goal that is for him to be free from complications. Sixth, we should agree on the selected goals and the method to uses in order to attain the goals set. Therefore, I played a role of helping the nurse perform the appropriate actions for example, deep breathing exercise, ambulation etc. By using King’s goal attainment theory, it will enable both Mrs. W and I attain our set goals and may be after four to three day care, Mrs. W will be discharged free from complication. (Octaviano, Balita, 2008).

Use of King’s theory while setting a Quality Committee

While setting a functional committee, King’s theory can be used. Using the three interacting systems the committee will be able to get ideas of each member role, communication method, the stressing factors, powers, decision -making process, individual status etc. committee formation involves, first, identifying the individuals with mutual interests through interacting with them under interpersonal system. Therefore, using King’s interacting systems, individuals are able to identify the communication method to be used, the roles, stressing factors etc. Second, the committee will use the King’s interacting system under social system to identify the powers of each member, setting committee goals, making appropriate decisions and evaluating whether the committee goal have being attained. The committee will benefit from King’s theory while determining the power or the leadership system the committee will use.

A theory that can be aligned with Quality practice

King’s conceptual theory is almost similar to Orem’s Self-care deficit. Orem’s theory has three interrelated part same as King’s theory. For example in Orem’s theory, the theory of Self- care can be related to King’s personal system. King’s theory focuses on enhancing communication between the nurses and the patients where the talk about their plans and goals that would aid in goal attainment whereas Orem’s theory identifies the deficit of patients and therefore develop plans to help the patient achieve good health. Both theories aim at enhancing better communication and empowering patients. In addition, both theories are goal oriented and accommodate different settings e.g. a hospital, clinic e.t.c. therefore concerning the similarities; Orem’s theory can be used to improve the quality of nursing practice. (Alligood, Tomey, 2002).

Conclusion

King’s conceptual system theory has helped me understand the interaction systems. In addition, Kings’ theory will enable know how to relate with patients at all care departments and thus enable both the patient and I attain our goals. Overall, King’s theory can be applied in all industries either in companies while setting up a committee or in nursing industry during nurse-patient interaction.