Who Is Imogene King? Nursing Theory Explainer

Imagine a nurse working with a diabetic patient to develop a personalized plan for managing blood sugar levels. How can this interaction lead to better health outcomes? That’s where the Imogene King nursing theory comes in — it’s all about teamwork and collaborative goal setting between nurses and patients. King believed that when patients actively participate in decision-making about their health, they’re more likely to stick to care plans and see real, lasting improvements.

Want to know how Imogene King’s goal attainment theory can help you maximize your patients’ outcomes? In this article, we’ll break down what this nursing theory is, walk you through its main concepts, and share tips for using it in everyday practice.

What Is Imogene King’s Nursing Theory?

Imogene King’s goal attainment theory is a conceptual framework that emphasizes effective communication between nurses and patients to achieve mutual goals. King developed this theory in the 1960s, emphasizing that recovery is a collaborative process, where the patient is an active participant in their care journey.

Imogene King. Source: Nurse Key

Wondering about the famous nurse behind this nursing theory? Imogene King was born in 1923 in West Point, Iowa. She received her nursing degree in 1945 and later pursued advanced studies in education and nursing, earning master’s and doctorate degrees. Over the years, she worked in various roles, including those as an educator, researcher, and consultant, advocating for the importance of collaboration in nursing practice.

In addition to developing her groundbreaking Theory of Goal Attainment, King published numerous articles, wrote books, and traveled the world teaching and consulting nurses. She earned several awards, including being named a Living Legend by the American Academy of Nursing. Even with all her honors, she always said that teaching students was her biggest achievement. She continued working passionately until her death in 2007.

King’s legacy lives on. Today, nursing schools incorporate the nursing theory of Imogene King to teach students how to build effective, goal-oriented relationships with their patients.

Major Concepts of the Imogene King Nursing Theory

The Theory of Goal Attainment is a middle-range theory focused on holism, meaning it emphasizes the interaction between two human beings — a nurse and a patient. It’s a practical theory that addresses both the process and the outcome, focusing on setting goals and measuring whether those goals were achieved.

This theory is structured around four major concepts, emphasizing the dynamic relationship between the nurse and the patient:

1. Personal System

This concept refers to the unique characteristics of both the nurse and the patient, including their values, beliefs, and experiences. Nurses should consider these individual differences to ensure care is tailored to each patient’s needs and goals.

Key areas to focus on to better understand your patient include the following:

• Perception is one’s interpretation and understanding of the world and experiences.
• Self refers to a person’s sense of identity, self-worth, and personal value.
• Body image is one’s perception and feelings about their physical appearance.
• Growth and development describe a person’s physical, emotional, and psychological changes throughout life.
• Personal space refers to a person’s preferred physical distance from others to feel comfortable.
• Learning is the process of acquiring knowledge or skills, shaped by past experiences.
• Coping is one’s ability to manage stress, challenges, and difficult situations.
• Time refers to one’s awareness of the passage of events, including their sense of past, present, and future.

King pointed out that perception is key to effective nurse-patient relationships. When nurses have a strong sense of self, they’re better able to relate to and understand others.

2. Interpersonal System

The interpersonal system in the Imogene King nursing theory centers on the relationships between the nurse and patients. King believed that effective communication is the backbone of a successful nurse-patient relationship and leads to better health outcomes.

Here are some of the important parts of the interpersonal system:

• Interaction refers to a sequence of goal-directed behaviors (verbal and nonverbal) between 2 or more people.
• Communication is sharing information, thoughts, and feelings to establish mutual understanding.
• Transaction refers to a mutual goal-setting process where nurse and patient agree on objectives and a plan of action.
• Role is a set of behaviors expected of a person occupying a certain professional or social role.
• Stress refers to the dynamic process where a person works with their environment to stay balanced, using energy and information to manage challenges and support growth.
• Stressors are the events or circumstances that trigger stress responses, which impact a person’s health.

3. Social System

The social system in King’s theory recognizes that people are not isolated in their health journeys. It emphasizes the broader context of the patient’s environment, including their roles, relationships, and interactions within family, community, and society.

Essential elements within the social system include the following:

• Organization is the structured environment in which nursing care takes place, such as healthcare institutions.
• Authority refers to the right to make decisions and direct actions in the care process.
• Power is the ability to influence or control decisions and outcomes in healthcare.
• Control involves managing resources and ensuring the safety and effectiveness of care.
• Status refers to one’s position or role in the healthcare setting, which can affect interactions.
• Decision-making is the process of collaboratively making care choices that align with the patient’s needs.

4. Goal Attainment

Goal attainment is the ultimate aim of the nurse-patient interaction according to the Imogene King nursing theory. She believed that the process of achieving these goals is dynamic and requires continuous communication, mutual respect, and adaptability. The nurse and patient must work together to define specific objectives that address the patient’s health needs and personal preferences while creating actionable steps to achieve them.

Imogene King’s Goal Attainment Theory: Application to Nursing

Imogene King’s nursing theory is not just a theoretical framework; it offers a practical, dynamic approach to nursing practice. It is widely applied in healthcare settings to improve patient outcomes. Here are some ways this theory can be applied in everyday nursing practice:

• Set collaborative goals. Engage patients in goal setting, empowering them to take ownership of their health and recovery journey.
• Focus on individualized care. Assess each patient’s unique values, beliefs, and perceptions and tailor care plans to meet their specific needs.
• Communicate effectively. Work on enhancing your communication skills, using techniques like active listening and therapeutic communication. Remember, clear and honest communication, both verbal and nonverbal, is at the heart of this theory.
• Consider the social system. Recognize the larger social context in which patients live, incorporating their family and community resources into the goal-setting process.
• Empower patients. Encourage patients to actively participate in decisions about their health, helping them feel more in control.
• Address stressors. Identify and address factors that may hinder goal attainment, such as emotional, physical, or environmental stressors.
• Consider time awareness. Take into account the patient’s perception of time when setting goals. For example, understanding whether a patient sees recovery as a long-term process or an immediate need can shape the goals and timelines.
• Consider role expectations. Recognize how societal or cultural roles — like a patient’s sense of family responsibility — influence health decisions to set culturally sensitive and achievable goals.

FAQs: Imogene King’s Nursing Theory

What’s an example of this theory in a specific care setting?

How can you use Imogene King’s theory of goal attainment? Example instances might involve a nurse working with a patient recovering after orthopedic surgery. Here are the steps you can implement during your nursing assessment:

• Personal system: Assess the patient’s perceptions, including body image, coping, and time. For example, ask about their previous experiences with injury recovery and if they have any body image concerns after surgery, such as scars or changes in appearance.
• Interpersonal system: Build rapport with the patient by using open communication and active listening. This helps you understand their needs, concerns, and readiness to engage in the recovery process.
• Social system: Understand the patient’s role in their family and community. Are they the primary caregiver? How might these responsibilities affect their recovery goals?

Where can I learn more about Imogene King’s theory?

To dive deeper into King’s theory, you can explore several resources:

• Books and articles: King has written extensively on her theory. Some key texts include A Theory for Nursing: Systems, Concepts, Process and Toward a Theory for Nursing: General Concepts of Human Behavior.
• Research databases: Websites like PubMed feature numerous research articles and publications that delve into the application of King’s theory in nursing practice.
• Video interviews: You can find online videos featuring Imogene King and other experts in nursing discussing goal attainment theory.
• Online journals: Websites like the National Library of Medicine (NIH) and online nursing journals may also offer accessible resources and research studies applying King’s theory.

Can Imogene King’s nursing theory be applied in all areas of nursing?

Yes, King’s theory can be applied across nursing fields, including critical care, pediatrics, and geriatrics. Its focus on collaboration and goal attainment is universally relevant to patient care in any nursing specialty.

What challenges might nurses face when applying Imogene King’s theory?

In today’s fast-paced healthcare environment, nurses may face challenges like limited time with patients, insufficient resources, or difficulty fully understanding and addressing the patient’s personal, interpersonal, and social systems.

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