Imogene King’s History and Background

Imogene King is a nursing theorist who has made significant contributions to the
development of nursing knowledge. This paper gives an overview of King’s Conceptual
Framework and Theory of Goal Attainment and applies the theory to emergency and rural
nursing. While all of King’s concepts may not be applicable to emergency and rural nursing,
applicable concepts are discussed. Specific clinical examples are presented to support King’s
work in practice. The concepts of self, body image, growth and development, time,
communication, and interaction are the concepts from King’s theory that the author identifies
as being most useful when working with clients in the emergency room and in the rural
environment.

Imogene King received her diploma in nursing from St. john’s Hospital School of
Nursing in St. louis, Missouri, in 1945 and her bachelor and Master of Science degree in
nursing from St. louis University in 1948 and 1957, respectively. In 1961, she graduated with
a Doctor of Education degree from the Teachers College of Columbia University, and in 1980,
she received an honorary Doctor of Philosophy degree from Southern Illinois University. In
1996, Dr. King received the American Nurses Association (ANA) Jessie M. Scott Award for
her contributions to demonstrating the interrelationships among nursing practice, education,
and research.

Dr. King’s contributions to NANDA International span 40 years. She was a participant
at the First National Conference on the Classification of Nursing Diagnoses in St. Louis in
1973.

Dr. King died on December 24, 2007 at the age of 84.

About King’s Theory

Imogene King postulated the “System Framework and Goal Attainment Theory”.
She described nursing as a helping profession that assists individuals and groups in society to
attain, maintain, and restore health. If this is not possible, nurses help individuals die with
dignity. In addition, King viewed nursing as an interaction process between client and nurse
whereby during perceiving, setting goals, and acting on them, transactions occur, and goals are
achieved.
Overview of Imogene King’s “Conceptual System and Theory of Goal Attainment”

King’s conceptual system is based on the assumption that human beings are the focus
of nursing. The goal of nursing is health promotion maintenance, and restoration; care
of the sick or injured; and care of the dying (King, 1992).
King states that “nursing’s domain involves human beings, families, and communities
as a framework within which nurses make transactions in multiple environments with
health as a goal” (p. 61)
The link between interactions and health is behavior, or human acts. Nurses must have
the knowledge and skill to observe and interpret behavior and intervene in the
behavioral realm to assist individuals and groups cope with health, illness, and crisis
(King, 1981).
Human beings have three fundamental health needs:
1. The need for health in formation that is usable at the time when it is needed and
can be used,
2. The need for care that seeks t prevent illness, and
3. The need for care when human beings are unable to help themselves

Propositions of King’s Theory

From the theory of goal attainment, King developed predictive propositions, which include:

a. If perceptual interaction accuracy is present in nurse-client interactions, transaction will

occur.
b. If nurse and client make transaction, goal will be attained.
c. If goals are attained, satisfaction will occur.
d. If transactions are made in nurse-client interactions, growth and development will be
enhanced.
e. If role expectations and role performance as perceived by nurse and client are
congruent, transaction will occur.
f. If nurse with social knowledge and skill communicate appropriate information to client,
mutual goal setting and goal attainment will occur.
Theory of Goal Attainment

Basic assumption of goal attainment theory is that nurse and client communicate
information, set goal mutually and then act to attain those goals. This is also the basic
assumption of nursing process.

Assessment

King indicates that assessment occur during interaction. The nurse brings
special knowledge and skills whereas client brings knowledge of self and perception of
problems of concern, to this interaction. During assessment, nurse collects data
regarding the client. Perception is the base for collection and interpretation of data. And
communication is required to verify accuracy of perception, for interaction and
transaction.

Nursing diagnosis

The data collected by assessment are used to make nursing diagnosis in nursing
process. According to King, in process of attaining goal the nurse identifies the
problems, concerns and disturbances about which person seeks help.

Planning

After diagnosis, planning for interventions to solve those problems is done. In

goal attainment, planning is represented by setting goals and making decisions about
and being agreed on the means to achieve goals. This part of transaction and client’s
participation is encouraged in making decision on the means to achieve goals.

Implementation

In nursing process, implementation involves the actual activities to achieve

goals. In goal attainment, it is the continuation of transaction.

Evaluation

It involves the finding out whether goals are achieved or not. In King’s
description, evaluation speaks about attainment of goal and effectiveness of nursing
care.