Imogene King's Goal Attainment Theory views humans as open systems interacting with their environment. It focuses on nurse-client interactions, where the nurse and client perceive each other, communicate, set goals, and work to achieve them. The theory consists of three interacting systems - personal, interpersonal, and social. It emphasizes concepts like perception, communication, roles, and stress. The goal of nursing is to help individuals maintain their health to function in roles. The theory is useful for practice, education, and research in nursing.
Virginia henderson's theory of nursingMandeep Gill
Virginia Henderson was born in Kansas City, Missouri in 1897, the fifth of eight children in her family. During the World War 1, Henderson developed an interest in nursing. So in 1918 she entered the Army school of Nursing in Washington D.C. Henderson graduated in 1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse Service in New York. After 2 years, in 1923, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. She has enjoyed a long career as an author and researcher. She is known as, “The Nightingale of Modern Nursing” & “The 20th century Florence Nightingale."
Newman’s theory of health as expanding consciousnessحسين منصور
The theory of health as expanding consciousness stimulated by concern for those for whom health as the absence of disease or disability is not possible, (Newman, 2010).
The theory has progressed to include the health of all persons regardless of the presence or absence of disease, (Newman, 2010).
The theory asserts that every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness, (Newman, 2010).
Florence nightingale’s environment theoryShrooti Shah
The foundation of Nightingale’s theory is the environment- all the external conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or contribute to disease or death.
Her goal was to help the patient retain his own vitality by meeting his basic needs through control of the environment.
Virginia henderson's theory of nursingMandeep Gill
Virginia Henderson was born in Kansas City, Missouri in 1897, the fifth of eight children in her family. During the World War 1, Henderson developed an interest in nursing. So in 1918 she entered the Army school of Nursing in Washington D.C. Henderson graduated in 1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse Service in New York. After 2 years, in 1923, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. She has enjoyed a long career as an author and researcher. She is known as, “The Nightingale of Modern Nursing” & “The 20th century Florence Nightingale."
Newman’s theory of health as expanding consciousnessحسين منصور
The theory of health as expanding consciousness stimulated by concern for those for whom health as the absence of disease or disability is not possible, (Newman, 2010).
The theory has progressed to include the health of all persons regardless of the presence or absence of disease, (Newman, 2010).
The theory asserts that every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness, (Newman, 2010).
Florence nightingale’s environment theoryShrooti Shah
The foundation of Nightingale’s theory is the environment- all the external conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or contribute to disease or death.
Her goal was to help the patient retain his own vitality by meeting his basic needs through control of the environment.
King's theory
Historical background.
Origin of the Conceptual Model
Strategies for Knowledge Development of the system framework.
King's theory Assumptions.
World View
Unique focus of the model
Basic paradigm concepts.
The three dimensional Nursing Process based on King's Theory.
Relationship Among the four Process of nursing .
Propositions of the model.
Concepts and Components of the framework.
Influences from other scholars.
Model of transaction
I'm Sajid Malik, a dedicated healthcare professional with a comprehensive academic background, boasting degrees in Master of Science in Nursing (MSN*), Master of Public Health (MPH), Bachelor of Science in Nursing (BScN), and a credential in Health Informatics and Patient Care (DHIPC). My professional journey has been shaped by a commitment to advancing healthcare and patient outcomes.
In my exploration of nursing theories, I find particular fascination with the Goal Attainment Theory. Originating from the renowned nursing theorist Imogene King, this theory provides a dynamic framework for understanding the nurse-patient relationship and the process of achieving health-related goals.
From the perspective of the Goal Attainment Theory, nursing is not merely a set of tasks but a collaborative endeavor between the nurse and the patient. It emphasizes the importance of setting mutual goals, effective communication, and the establishment of a therapeutic partnership. This theory recognizes the uniqueness of each patient, acknowledging their personal values, beliefs, and aspirations in the pursuit of optimal health.
Understanding the Goal Attainment Theory is crucial for nurses as it guides their practice, encouraging them to tailor care plans that align with individual patient needs. It fosters a holistic approach, emphasizing the interconnectedness of the nurse, patient, and environment in the pursuit of health objectives. As I delve into this theory, I aim to contribute to the broader conversation within the nursing community about its application and relevance in contemporary healthcare settings.
Appraise the component of various nursing theories; description, purpose, concepts, definition.
Discuss the application of nursing theories in nursing practice.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
2. Imogene King
• born in 1923.
• Earned a diploma in nursing from St.
John’s Hospital of Nursing in St Louis
in 1945.
• Worked as office nurse, staff nurse,
school nurse, and private duty nurse
to support herself while studying for a
baccalaureate degree.
• Bachelor of Science in Nursing from
St. Louis University in 1948
• Masters of Science in Nursing from
St. Louis University in 1957
• Doctorate from Teacher’s college,
Columbia University, New York in
1961.
4. THEORETICAL SOURCES
• King: “A search for literature in nursing and other
behavioral science fields, discussion with
colleagues, attendance at numerous
conference, inductive and deductive reasoning,
and some critical thinking about the information
gathered, lead me to formulate my own
theoretical framework.”
5. THEORETICAL SOURCES
• The general systems theory from the behavioral
sciences led to the development of her dynamic
interacting systems.
• King: “If the goal of nursing is concern for the health of
individuals and the health care of groups, and if one
accepts the premise that human beings are open
systems interacting with the environment, then a
conceptual framework for nursing must be organized to
incorporate these ideas.
7. • King developed a general systems framework
and a theory of goal attainment where the
framework refers to the three interacting
systems - individual or personal, group or
interpersonal, and society or social, while the
theory of goal attainment pertains to the
importance of interaction, perception,
communication, transaction, self, role, stress,
growth and development, time, and personal
space.
8.
9.
10. Personal System
• The concepts for the personal system are:
perception, self, growth and development,
body image, space, and time. These are
fundamentals in understanding human
being because this refers to how the nurse
views and integrates self based from
personal goals and beliefs. Among all
these concepts, the most important is
perception, because it influences behavior.
11. Personal System
• Personal systems are individuals, who are regarded as
rational, sentient, social beings. Concepts related to the
personal system are:
• Perception— a process of organizing, interpreting, and
transforming information from sense data and memory that
gives meaning to one's experience, represents one's image
of reality, and influences one's behavior.
• Self— a composite of thoughts and feelings that constitute
a person's awareness of individual existence, of who and
what he or she is.
12. Personal System
• Growth and development— cellular, molecular, and
behavioral changes in human beings that are a function of
genetic endowment, meaningful and satisfying experiences,
and an environment conducive to helping individuals move
toward maturity.
• Body image—a person's perceptions of his or her body.
• Time—the duration between the occurrence of one event
and the occurrence of another event.
• Space—the physical area called territory that exists in all
directions.
• Learning—gaining knowledge.
13. Interpersonal System
• The concepts associated for the interpersonal
system are: interaction, communication, transaction,
role, and stress. King refers to two individuals as dyads,
three as triads and four or more individuals as small
group or large group (King, 1981). This shows how the
nurse interrelates with a co-worker or patient, particularly
in a nurse-patient relationship. Communication between
the nurse and the client can be verbal or nonverbal.
Collaboration between the Dyads (nurse-patient) is very
important for the attainment of the goal.
14. Interpersonal System
• Interactions—the acts of two or more persons in mutual
presence; a sequence of verbal and nonverbal behaviors
that are goal directed.
• Communication—the vehicle by which human relations
are developed and maintained; encompasses intrapersonal,
interpersonal, verbal, and nonverbal communication.
• Transaction—a process of interaction in which human
beings communicate with the environment to achieve goals
that are valued; goal-directed human behaviors.
15. Interpersonal System
• Role—a set of behaviors expected of a person
occupying a position in a social system.
• Stress—a dynamic state whereby a human being
interacts with the environment to maintain balance for
growth, development, and performance, involving an
exchange of energy and information between the person
and the environment for regulation and control of
stressors.
• Coping—a way of dealing with stress.
16.
17. Social System
• The final interacting system is the social system. This
shows how the nurse interacts with co workers,
superiors, subordinates and the client environment in
general. These are groups of people within the
community or society that share a common goals, values
and interests. It provides a framework for social
interaction and relationships and establishes rules of
behavior and courses of action (King, 1971). Social
systems are organized boundary systems of social roles,
behaviors, and practices developed to maintain values
and the mechanisms to regulate the practices and roles.
18. Social System
• Authority—a transactional process characterized by
active, reciprocal relations in which members' values,
backgrounds, and perceptions play a role in defining,
validating, and accepting the authority of individuals within
an organization.
• Power—the process whereby one or more persons
influence other persons in a situation.
• Status—the position of an individual in a group or a
group in relation to other groups in an organization.
19. Social System
• Decision making—a dynamic and
systematic process by which goal-directed
choice of perceived alternatives is made
and acted upon by individuals or groups to
answer a question and attain a goal.
• Control—being in charge.
20. • Among the three systems, the conceptual
framework of Interpersonal system had the
greatest influence on the development of her
theory. She stated that “Although personal systems
and social systems influence quality of care, the
major elements in a theory of goal attainment are
discovered in the interpersonal systems in which
two people, who are usually strangers, come
together in a health care organization to help and
to be helped to maintain a state of health that
permits functioning in roles” ( King, 1981 p. 142).
21.
22. • King believed that the goal of nursing “is to
help individuals maintain their health so
they can function in their roles” (King,
1981), transactions occur to set goals
related to the health of the patient.
• Nursing's focus is on the care of the
patient, and its goal is the health care of
patients and groups of patients.
23. MAJOR ASSUMPTIONS
• King’s conceptual framework and theory of
goal attainment “are based on an overall
assumption that the focus of nursing is
human beings interacting with their
environment leading to a state of health for
individuals, which is an ability to function in
social roles”
24. Assumptions
• Nursing focus is the care of human being
• Nursing goal is the health care of individuals &
groups
• Human beings: are open systems interacting
constantly with their environment.
• Basic assumption of goal attainment theory is that
nurse and client communicate information, set
goal mutually and then act to attain those goals, is
also the basic assumption of nursing process
25. Assumptions
• “Each human being perceives the world as a
total person in making transactions with
individuals and things in environment”
• “Transaction represents a life situation in which
perceiver & thing perceived are encountered
and in which person enters the situation as an
active participant and each is changed in the
process of these experiences”
26. Nursing
• “A process of action, reaction
and interaction by which nurse
and client share information
about their perception in
nursing situation.” and “a
process of human interactions
between nurse and client
whereby each perceives the
other and the situation, and
through communication, they
set goals, explore means, and
agree on means to achieve
goals.”
27. • Action: is defined as a sequence of behaviors involving mental and
physical action.
• Reaction: which is considered as included in the sequence of behaviors
described in action.
• In addition, king discussed:
– (a) goal
– (b) domain and
– (c) functions of professional nurse
• Goal of nurse: “To help individuals to maintain their health so they can
function in their roles.”
• Domain of nurse: “includes promoting, maintaining, and restoring health,
and caring for the sick, injured and dying.
• Function of professional nurse: “To interpret information in nursing
process to plan, implement and evaluate nursing care.
28. Person
• Human being or person
refers to social being who
are rational and sentient.
• Person has ability to :
– perceive
– think
– feel
– choose
– set goals
– select means to achieve
goals and
– to make decision
29. Person
• Human being has three
fundamental needs:
1. The need for the
health information
that is unable at the
time when it is needed
and can be used
2. The need for care that
seek to prevent illness,
and
3. The need for care when
human beings are
unable to help
themselves.
30. Health
• Health involves dynamic
life experiences of a
human being, which
implies continuous
adjustment to stressors
in the internal and
external environment
through optimum use
of one’s resources to
achieve maximum
potential for daily living.
31. Environment
• Environment is the
background for human
interactions.
• It involves:
1. Internal environment:
transforms energy to enable
person to adjust to continuous
external environmental
changes.
2. External environment: involves
formal and informal
organizations. Nurse is a part of
the patient’s environment.
33. Propositions of King’s Theory
• If perceptual interaction accuracy is
present in nurse-client interactions,
transaction will occur
• If nurse and client make transaction,
goal will be attained
• If goal are attained, satisfaction will
occur
34. • If transactions are made in nurse-client
interactions, growth & development will be
enhanced
• If role expectations and role performance as
perceived by nurse & client are congruent,
transaction will occur
• If role conflict is experienced by nurse or
client or both, stress in nurse-client
interaction will occur
• If nurse with special knowledge skill
communicate appropriate information to
client, mutual goal setting and goal
attainment will occur.
38. PRACTICE
• The theory’s relationship to practice is
obvious because the profession of nursing
functions through individuals and groups
within the environment.
• Useful in practice – individualized plans of
care while encouraging active participation
from clients in decision making.
39. EDUCATION
• Has been used for curriculum design in
nursing programs and framework for
books
• It provides a systematic means of viewing
the nursing profession, organizing a body
of knowledge for nursing, and clarifying
nursing as a discipline.
40. RESEARCH
• Research can be designed and conducted
to implement this system in a hospital unit,
in ambulatory care, in community nursing,
and home care.
41. CRITIQUE
• Simplicity – has nine major concepts, making it
complex; easily understood because they are defined to
show interrelations in nursing practice.; clear concepts
conceptually derived from identified characteristics
• Generality – has limited applications in areas of nursing;
King believes critics are assuming that a theory will
address every person, event, and situation, which is
impossible.
42. CRITIQUE
• Empirical Precision – goal attainment could be
measured along the effectiveness of nursing
care
• Derivable Consequences – theory deals with
choices, alternatives, participation of all
individuals in decision-making and specifically
deals with outcomes of nursing care.
King used a “systems” approach in the development of her dynamic interacting systems framework and in her subsequent Goal-Attainment Theory.
King emphasizes that both the nurse and the client bring important knowledge and information to the relationship and that they work together to achieve goals.
The relationship of three interacting systems led to King’s Theory of Goal Attainment are the personal system (individual), the interpersonal system (nurse-patient dialogue), and the social system (the family, the school, and the church). Each system is given different concepts.
A process of human interactions
King summarized the connections among these concepts as “An individual Perception of self, of body image, of time, of space influences the way he or she responds to object and events in his/her life. As individual grow and develop trough the lifespan,experiences with changes in structure and function of their bodies over time influence their perceptions of self” (King, 1981, p. 19).
Elements found in King’s Goal Attainment Theory originated from the elements or concepts in her Interacting Systems Framework. But it focuses on the Interpersonal System and the interactions, communications and transactions between two individuals, the nurse and the patient. The essence of her theory is that the nurse and the patient come together, communicate, and make transactions – they set goals and work to achieve the goals they set. They each have a purpose, they perceive, judge, act and react upon each other. At the end of their communication, a goal will be set and with this transactions are made.
Furthermore, King proposed that through mutual goal setting and goal attainment, transactions result in enhanced growth and development for the client (Woods, 1994). King used ten major concepts from the personal and interpersonal systems to support the Theory of Goal Attainment. Those concepts include human interactions, perception, communication, role, stress, time, space, growth and development, and transactions. To capture the essence of these interrelated concepts, King stated that “nurse and client interactions are characterized by verbal and nonverbal communication, in which information is exchanged and interpreted; by transactions, in which values, needs, and wants of each member of the dyad are shared; by perceptions of nurse and client and the situation; by self in role of client and self in role of nurse; and by stressors influencing each person and the situation in time and space” (King, 1981, p. 144).
Inductive – personal approach to synthesizing knowledge was to use data and information available from research in nursing and related fields and from her 25 years in active practice, teaching, and research
Deductive – breakdown of ideas from different concepts
Ohio State University
Shirley Steel’s Child, Health, and the Family