\nApplication to Practice of King\u2019s Goal Attainment Theory\n<\/p>\n
\nAt a time when nursing was in its early stages of being considered as a science discipline, Imogene King conceptualized her theory with an approach to building a relationship between the discipline and research to build scientific knowledge.\u00a0 King was focused on expanding the knowledge base of the practice and began formulating her theory while working as a Professor at Loyola University. \u00a0Her theory is coined from the idea of Karl Ludwig von Bertalanffy\u2019s general theory system, a theory of interrelatedness to show how each system connects to tell a story.\u00a0 As such, the conceptual system\u2019s background was the study of systems as a whole and not in parts, to gain a better understanding of the bigger picture.\u00a0 First presentation of Imogene King\u2019s theory of goal attainment was in the 1960s. The theory defines an interpersonal relationship between a nurse and a client, wherein the client learns to develop and attain specific goals.\u00a0 This theory is based on the affiliation formed between a nurse and her client, with a notion that the care of human beings is the focus of nursing.\u00a0 \u201cAn overall assumption is that the focus of nursing is human beings interacting with their environment leading to health\u201d (King 2007, p. 109).\u00a0 The individuals involved in the relationship diligently work together and communicate information, congruently set desired goals that are mutually acceptable.\u00a0 Together, they work as a team to formulate a plan to accomplish those goals.\u00a0 The association of each member is unique, and they each play an active role, and each party brings their own varied perception and level of comprehension to the bond.\u00a0\n<\/p>\n
\nThe purpose of this paper is to show an approach to using the goal attainment theory in practice.\u00a0 Interactions of each member of the relationship allows for growth and development; However, the concepts of theory inform its readers of factors that can affect the trajectory of attaining goals.\u00a0 Factors such as, roles, stress, space, and time are hurdles that need to be overcome to achieve a desire outcome.\u00a0 One major concern of this theory is functional status of the nurse in relation to patients.\u00a0 With the well-being of each patient remaining a concern for nurses; the understanding and development of this theory helps nurse to gain light on helping patients to realize and achieving their goals.\u00a0 In gaining an understanding of this application, a case study will be utilized to show how this theory can be put into action.\u00a0\n<\/p>\n
\nTheory Description<\/strong>\n<\/p>\n \nKing\u2019s aim in developing her theory was to prove that nursing is a multifaceted role that is firmly rooted on research, she worked to expand the paradigms of nursing concepts.\u00a0 King\u2019s theory of goal attainment is based on a philosophical concern of human beings and their interaction with their environment.\u00a0 This system consists of three concepts, which was collective to the role of nursing: Social system, health perception and interpersonal relationships.\u00a0 King\u2019s theory detailed the vitality of the participation of each party within the relationship in actively making decisions and is reflective on interaction, perception, and communication.\u00a0 Effective communication helps to gather pertinent information to set mutual goals.\u00a0 As such, King\u2019s belief in the practice is detailed in her theory.\u00a0 She believed that nursing is varied from other health discipline by the tasks performed by nurses, their goal is the care of the patient as well as well-being maintenance.\u00a0 The role of nursing, as seen by King is achieved by \u201cHelping individuals to attain, maintain, or restore health.\u00a0 To achieve this outcome nurses and clients engage in interactions of verbal and nonverbal communication\u201d (Sitzman and Eichelberge, 2017, p. 145).\u00a0 She had values and beliefs that were strongly upheld by the nursing profession.\u00a0 Values of strength, honesty, truth and morality all of which commiserates with King\u2019s belief, rings true to those honored by the American Nurses Association.\u00a0 \u201cKing\u2019s values and beliefs include honesty, integrity, justice, and respect for every human being.\u00a0 There are three basic rights relative to the autonomy of the nurse and the autonomy of the patient: privacy, self-determination, and information to make informed choices\u201d (King 2007, p. 109).\u00a0 Each person in a therapeutic relationship is autonomous, and they ought to make their voices heard.\u00a0 \u201cThe focus of nursing is the care of people, with explicit goals.\u00a0 This goal is health, meaning that nursing phenomena are concerned with the health of individuals, the health of groups and the health of society\u201d (King 1997, p. 180).\n<\/p>\n \nAnalysis and Assessment<\/strong>\n<\/p>\n \nNurses work within domains of families, individuals and communities to conduct transactions with the aim of goal attainment to maintain a state of well-being for clients.\u00a0 Dr. Imogene King four levels of meta-paradigm within her theory; health, person, environment and nursing.\u00a0 Human beings are unique in their own way and are capable of making decisions, they think, feel and perceive.\u00a0 Each human being has three central needs, these establish the need for health information, the need for preventative measures, and Helpance with self-care deficits when needed.\u00a0 Health, she explains, is life experiences which is a continuous alteration and adaptation to stressors of the environment.\u00a0 The Environment is the realm of human interactions, it allows nurses to perceive the clients and their ability to adapt to the stressors of the environ. Stressors can either be internal or external, and humans have the capability to adjust to stressors and the continuous changes that often occur.\u00a0 Nursing is a role where actions and interactions help to Help clients in attaining and maintaining ideal health.\n<\/p>\n \nThe theory assumes explicitly that the care of human beings is the focus of nursing, with a goal of health for the consort.\u00a0 Human beings interact constantly with their environment.\u00a0 As such, each person understands their environment and can make transactions within that environment.\u00a0 An assumption is made that nurse and client communicate, interact, set goals and frame transactions to achieve those goals.\u00a0 With these assumptions being identified, the theory proposes that once an accurate interaction is achieved within the nurse-client dyad, a transaction will ultimately occur.\n<\/p>\n \n Communication is vital in achieving a goal, when people interact, an understanding or misunderstanding occur, this is dependent on the level of interference.\u00a0 \u201cMutual goals are based on the identification of problems, changes in health, perceptions of problems and sharing of information in order to achieve goals\u201d (Ara\u00fajo, Silva, Moreira, Almeida, Freitas, & Guedes 2018, p. 1095).\u00a0 The process of interacting with patients follows the trend of the nursing process (as depicted in chart #1: nursing process), with a system of interrelated actions.\u00a0 Assessment is the perception of the client and nurse, the initial meet.\u00a0 The diagnostic phase is the communication process between both parties where both parties interact with each other and concerns are identified, judgement is made.\u00a0 Judgement leads to reaction and if both parties are not in congruence with each other.\u00a0 The planning phase is where a decision-making action pertaining to implied and desire goals is determined (when possible).\u00a0 Agreement to ways of achieving goals are made and a transaction is initiated.\u00a0 Implementation phase constitutes continuation of a transaction, one that is made between the nurse and client.\u00a0 Assessment is used to determined if goals are attained or not.\u00a0 If not, then the transaction needs to be reevaluated and a new plan is then developed.\u00a0 Goal attainment is achieved when a service is offered to patient by a nurse, the goal developed is one formulated through a reciprocal relationship, where mutual and purposeful interactions are evident.\u00a0\n<\/p>\n \nIn shaping the goals with patient, a series of actions are determined by the nurse.\u00a0 These strategies guide the nurse in organizing information about the patient\u2019s care.\u00a0 In table #1, the nurse uses information and data that are individualized to the patient and tailored to meet the specific needs of the client. In developing a careful, specific and precise plan of care the nurse first needs to collect data by assessing the patient. Next, this data is analyzed and organized to help with the formulation of nursing diagnoses.\u00a0 The nurse then needs to set priorities in determining the best steps to take.\u00a0 By doing this, the nurse along with the patient establishes a goal and set desired outcomes to achieve.\u00a0 The interventions that are essential to fulfill the goals are then determined.\u00a0 To give clarity, rationales are sought out, this helps the nurse to evaluate the plan and make any adjustments that may be required.\u00a0\n<\/p>\n \nNurses communicate with their patients daily, and without realizing it, their role provides them with the opportunity to form a bond with patent.\u00a0 This theory was chosen as communication on my part as a nurse is vital in helping the patients achieve an amicable outcome.\u00a0 Before reading and understanding the concepts of Dr. King\u2019s theory, I would consider myself a novice in the comprehension of this theory.\u00a0 The familiarity that each person has a role of health maintenance and a level well-being to accomplish was understandable.\u00a0 However, the direction and how to effectively help these patients was somewhat lacking.\u00a0 The nurse does not control outcomes but work together with the clients to achieve the desired goals.\u00a0 Clients are autonomous and are therefore, responsible for their own well-being.\u00a0 This theory helped me gain clarity on the trajectory to help a patient develop their goals.\u00a0 It helped me to understand how perception can miscue meanings, lead to bad judgement and ineffective planning.\u00a0 Building a bond and remaining true to the needs of the client is vital, as learned from this theory. This bond is a part of a therapeutic relationship, one that helps both parties to gain a better understanding of the situation.\u00a0 This level of understanding is communicated in chart #2 (goal attainment transaction diagram).\u00a0 As nurses we each need to help our client maintain an optimal level of health, by doing this we use proficient communication skills to develop an understanding to help each patient recognize their need.\u00a0 The theory of goal attainment helps us gain skills necessary to guide our patients.\u00a0 The era of healthcare is focused on a patient-centered care.\u00a0 \u201cKing\u2019s theory is even more relevant as healthcare has placed an increased emphasis on client needs and preferences. Thus, providing an important lens through which to evaluate the nurse-client dyads\u2019 implications for goal-setting and client satisfaction related to functional status\u201d (Caceres, B. A. 2015, p. 151).\u00a0 Communication is vital in all aspects of nursing and nurses communicate with their client to gain an understanding of their needs, as such, the theory of goal attainment can be applied in a variety of nurse-client settings.\u00a0 Whether inpatient or outpatient use, the theory is readily understood.\u00a0 It is broken down in term that does not speak complexity.\n<\/p>\n \nWith the theory having multiple concepts, it is complex, however, it is easily understood and clearly defined as Dr. King sought to portray the theory development.\u00a0 The theorist maintains consistency with her breakdown of each layer of the theoretical concepts and showing connectedness to each level.\u00a0 Its adequate, as the author gave an extensive general idea of expected standards required by each party involved.\u00a0 The role of the nurse was clearly defined as well as that of the patient.\u00a0 It is therefore, logically relevant for the practice of nursing. There is reality convergenceas the basic premise of this theory is accepted and the author builds on her idea of patients and nurses working together to achieve a mutual goal.\u00a0\n<\/p>\n \nIn conclusion, the Theory of goal attainment focuses on the nurse-patient relationship.\u00a0 Mutual goal setting can be attained while incorporating the models of the interrelated systems. The nursing paradigms and nursing process outline methods by which goals are attained by the patient and nurse together.\u00a0\n<\/p>\n \nCase Study\n<\/p>\n \nKim is a 30-year-old female who was admitted for Assessment after palpating a lump in her left breast.\u00a0 She noticed an unusual drainage from the breast and started feeling moderate pain.\u00a0 A mammogram and biopsy were done, which revealed stage three (3) breast cancer.\u00a0 Kim\u2019s breast tumor is 8 cm, and there is fixed lymph node involvement in the axillary. Kim was noted to have infiltrating ductal carcinoma of the left breast.\u00a0 Kim underwent a total mastectomy to her left breast, soon after the diagnosis.\u00a0 Her medical history revealed that she infrequently visited her primary physician.\u00a0 Kim was oblivious to her medical condition, and only noticed the lump after the other symptoms were present.\u00a0 She stands at 5 feet, 8 inches tall and weighs 115 lbs. She normally weighs roughly 130 lbs.\u00a0 She is married, and currently lives with her husband and three children in her mother-in-law\u2019s home. she doesn\u2019t appear to be happy about the living arrangements and states that the house is unsanitary.\u00a0 She is a stay-at-home mother, and her husband is currently unemployed.\u00a0 Kim is stable after surgery and doing well but has issues emptying her bladder.\u00a0 She has 2 JP tubes in place for drainage.\u00a0 She complains of constant\u00a0postoperative pain and rates her pain scale at 6-7\/10 and is also experiencing nausea and emesis.\u00a0 She will need to perform intermittent self-catheterization as well as empty and record her JP drainage once discharged.\u00a0 She is prescribed a prophylactic antibiotic, an analgesic as needed for pain and an antiemetic for nausea. She will also be receiving chemotherapy on an outpatient basis. Kim is tearful and upset and expresses concern over her future and the future of her three children.\u00a0 She is distraught about her relationship with her husband and her current living arrangements.\u00a0 Kim states that she believes this cancer is a punishment for\u00a0her past life.\n<\/p>\n \n \nASSESSMENT\n<\/p>\n<\/td>\n \nDIAGNOSIS\n<\/p>\n<\/td>\n \nPLANNING\n<\/p>\n<\/td>\n \nINTERVENTION\n<\/p>\n<\/td>\n \nRATIONALE\n<\/p>\n<\/td>\n \nAssessment\n<\/p>\n<\/td>\n<\/tr>\n \nWeight loss from 130 to 115 pounds.\n<\/p>\n \nConstant report of post-operative pain.\u00a0 Report of pain level on a scale of 6-7\/10\n<\/p>\n \nKim is tearful, and expresses concerns about her future and that of her children\n<\/p>\n \n \nInability to empty bladder and retaining urine\n<\/p>\n<\/td>\n \nImbalanced nutrition as evidenced by a drop in weight from 130 to 115\n<\/p>\n \nAcute pain related to left breast mastectomy as evidence by Kim\u2019s complains of pain\n<\/p>\n \nFear related to medical diagnosis as characterized by feelings of self-doubt and concerns of her children\u2019s future.\n<\/p>\n \nImpaired urinary elimination related to retention as evidenced by the need for catheterization\n<\/p>\n<\/td>\n \nEnsure that Kim is sustaining or gaining weight. By the date of discharge, Kim will increase her caloric intake.\n<\/p>\n \nKim will be consuming less opioids by the date of her discharge.\n<\/p>\n \nMaintain a tolerable pain scale.\n<\/p>\n \nMaintain a calm environment, offer encouragement and guidance.\u00a0 Ensures that Kim will agree to participate in outpatient social services or group therapy with others who have gone through similar situations.\n<\/p>\n \nKim demonstrates proper technique of self catheterizations. Show proper hand washing\n<\/p>\n<\/td>\n \nRefer Kim to dietician.\u00a0 Offer supplements to increase caloric intake.\u00a0 Encourage Kim to start increasing her dietary intake before discharge.\n<\/p>\n \nProvide analgesic as needed.\u00a0 Encourage patient to reposition self as well as the use of music and calming scenery to relieve discomfort.\n<\/p>\n \n \nProvided reassurance that help is imminent. Maintain a relaxed and accepting demeanor while communicating with Kim.\u00a0 Show empathy. Have social workers and counsellors speak with Kim before discharge.\n<\/p>\n \nMeasure post void residual.\u00a0 Encourage adequate fluid intake.\n<\/p>\n<\/td>\n \nDietician can help daily nutrient requirements to promote nutritional intake.\u00a0 Added calories help with weight gain.\n<\/p>\n \nThe discomfort of pain can alter the patient\u2019s response to care and willingness to participate\n<\/p>\n \nReassure patient that seeking help is a step towards a resolution.\u00a0 A none-threatening environment can promote stability.\n<\/p>\n \nAdequate hydration promotes urinary output and limits UTI.\n<\/p>\n<\/td>\n \nDetermine if Kim is following the dietician\u2019s recommendation.\u00a0 Ascertain if dietary intake has increased.\u00a0 Weight patient regularly.\n<\/p>\n \nAs the patient pain level decreased.\u00a0 Is patient managing the pain well.\u00a0 Determine what methods of pain management works best for Kim. Has the demand for opioid decreased\n<\/p>\n \nDetermine whether Kim participated in social service meetings.\u00a0 Evaluate Kim\u2019s thoughts, seek to determine if her level of self-doubt has subsided or increases.\n<\/p>\n \nKim should be able to show proper demonstration of self-catheterization before discharge.\n<\/p>\n<\/td>\n<\/tr>\n<\/table>\n \n \nchart #1: NURSING PROCESS\n<\/p>\n<\/p>\n \nPerception<\/u><\/strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nurse understands the Kim is fearful, unsure about her future and she is unhappy with her marriage and living situation. She is pain.\n<\/p>\n \nJudgement<\/u><\/strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kim needs guidance to help her through her struggles.\n<\/p>\n \nAction<\/u><\/strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Make arrangement for social service visit.\u00a0 Inform Kim outpatient community resources and plan for Kim to participate in outpatient care.\u00a0 Reduce pain, and bladder discomfort.\u00a0 Reduce anxiety and help to alleviate or reduce stressors.\n<\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" Study Bay Coursework Assignment Writing Help Application to Practice of King\u2019s Goal Attainment Theory At a time when nursing was in its early stages of\u2026<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7641,8827,10535,10533,10534,10531,10529,6744,10532,10530,7741],"tags":[10553,10549,10616,10615,7687,10254,10627,10104,10247,8857,10552,10295,10900,2984,3903,10548,10622,8901,10551,8907],"class_list":["post-129148","post","type-post","status-publish","format-standard","hentry","category-australia-essay-writers","category-australia-essays","category-do-my-university-assignment-for-me","category-essay-pro-dissertation-writers","category-homework-help-services-best-websites","category-i-need-help-writing-a-page-paper-assignment","category-masters-essays","category-nursing-studybay","category-pay-someone-to-write-a-paper-for-you","category-website-that-writes-assignments","category-studybay","tag-1-assignment-help-online-service-for-students-in-the-usa","tag-ai-plagiarism-free-essay-writing-tool","tag-australian-best-tutors","tag-best-trans-tutors","tag-buy-essay-uk","tag-can-someone-write-my-assignment-for-me","tag-cheap-dissertation-writer","tag-essypro","tag-help-me-write-my-dissertation","tag-help-with-writing-an-essay","tag-help-write-my-paper-ai-free","tag-homework-for-you","tag-nursing-bay","tag-nursing-essay","tag-nursing-study-bay","tag-online-essay-writers","tag-phd-essays","tag-studbay","tag-write-my-assignment-help-for-college-students","tag-write-my-essay-for-me"],"_links":{"self":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/129148","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/comments?post=129148"}],"version-history":[{"count":0,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/129148\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/media?parent=129148"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/categories?post=129148"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/tags?post=129148"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/images.ukdissertations.com\/101\/0486550.001.png\")
Table #1: care plan
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