Chapter 9

Imogene Kings Theory of Goal

Attainment
Developed by S. Gordon (2010)
Updated by D. Gullett (2014)

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On completion of this chapter, students will be

able to:
1. Describe the evolution of Kings theory from her personal writings.
2. Identify and discuss a variety of literature related to Kings theory.
3. Describe various settings and populations in which Kings
Conceptual System (KCS) and Middle Range theory have been
applied.
4. Discuss future applications of KCS and Middle Range theory as it
relates to evidence based practice.

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Theory of Goal Attainment Initial

Ideas
Identify problems and prospect of knowledge
development in nursing
Lack of professional nursing language
Atheoretical nursing phenomena
Limited concept development

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Original Levels of Interaction

Human being (or individual or person)

Perception
Communication
Interpersonal relations
Health
Social institutions

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Philosophical Underpinning
Von Bertalanffys General Systems Theory
Wholeness, systems in interaction
Organized complexity as whole systems

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Conceptual System
A concept is an organization of reference points
Provides structure for organizing multiple ideas
into meaningful wholes
Shows unity and relationships among concepts
Consists of individual systems, interpersonal
systems, and social systems

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Developing a Concept
1) Review, analyze, and synthesize researched
literature related to concept.
2) From the review, identify the characteristics
(attributes) of the concept.
3) From the characteristics, write a conceptual
definition.
4) Review literature to select an evaluation
instrument or develop an instrument.

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Developing a Concept

(continued)

Design a study to measure the characteristic

or concept.
6) Select the population to be sampled.
7) Collect data.
8) Analyze and interpret data.
9) Write results of findings and conclusions.
10) State implications for adding to nursing
knowledge.
5)

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Kings Conceptual System Personal System

Substantive knowledge about human beings

Self
Perception
Time
Growth and
development

Body image
Learning style
Personal space

Kings Conceptual System Interpersonal Systems

Related to small groups

Interaction
Communication
Roles
Transactions
Stress

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Kings Conceptual System Social System

Related to large groups

Decision making
Organization
Power
Status
Authority

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Theory of Goal Attainment

Derived from the goal of nursing:
Help individuals maintain or regain health (King,
1990)
Uses the following concepts:
Self, perception, communication, interaction,
transaction, role, growth and development, stress,
time, personal space

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Transaction Process Model

Describes a human process that can be
observed when two or more people interact.
Information is exchanged, goals are set, and
transactions are made during the process.
Nurses should document their conversations
and determine if goals were met.

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Documentation System
Implements the nurse-patient transaction process
leading to goal attainment
Method used is generally nursing process:
Assess, diagnose, implement, and evaluate

Nurse and patient agree to goals, by what means,

and evaluation method :
Entered into patients chart
Eliminates need for multiple forms

Documents patient involvement in care decisions

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Instrument Development
Goal Attainment Scale (King, 1989b)
Nurse Performance Goal Attainment (NPGA) (Kameoka,
Funashima & Sugimori, 2007)

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Examples of Practice Applications r/t

Kings Conceptual System (KCS)

Development of Middle-Range Theories from:

Kings Interacting Systems Framework
1.Theory of Perceptual Awareness (Brooks & Thomas,
1997)
Interpersonal System
2.Family Health Theory (Doornbos, 2007)
3.Model for collaboration through reciprocation in heath
care organizations (Thomason & Lagowski, 2008)

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Examples of Practice Applications (cont)

Development of Middle-Range Theories from:
Interpersonal Systems
1.Theory of Group Empowerment within Organizations
(Sieloff & Bularzik (2011).

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Examples of Practice
Applications

Mid-Range theory used in several categories

Used across the life span
Used in different client systems
Focus on phenomena of concern to clients

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Examples of Practice
Applications

Used with different nursing specialties

Used in varied work settings
Multicultural applications
Evidence based practice

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References
Brooks, E. M., & Thomas, S. (1997). The perception and judgment of senior baccalaureate student nurses in
clinical decision making. Advances in Nursing Science, 19(3), 5069.
Doornbos, M. M. (2007). Kings conceptual system and family health theory in the families of adults with
persistent mental illnessAn evolving conceptualization. In C. L. Sieloff & M. A. Frey (Eds.),
Middle range theory development using Kings conceptual system (pp. 31-49). New York:
Springer.
Kameoka, T., Funashima, N., & Sugimori, M. (2007). If goals are attained, satisfaction will occur in nursepatient interaction: An empirical test. In C. L. Sieloff & M. A. Frey (Eds.), Middle Range Theory
Development Using Kings Conceptual System (pp. 261-272). New York: Springer.

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References
King, I. M. (1989b). Kings systems framework for nursing administration. In B. Henry (Ed.),
Dimensions of nursing administration: Theory, research, education (p. 35). Cambridge, UK:
Blackwell Scientific.
King, I. M. (1990). Health as a goal for nursing. Nursing Science Quarterly, 3, 123128.
Sieloff, C. L., & Bularzik, A. M. (2011). Group power through the lens of the 21st century and beyond:
further validation of the Sieloff-King Assessment of Group Power within
Organizations. Journal Of Nursing Management, 19(8), 1020-1027. doi:10.1111/j.13652834.2011.01314.x
Thomason, D., & Lagowski, L. (2008, December). Business and leadership. Sustaining a healthy
work

force in the 21st century -- a model for collaborating through reciprocation. AAOHN
Journal, 56(12), 503-513.

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