The middle-range theory selected for this discussion is Imogene King’s theory of goal attainment. In the mid-1960s King asserted that nursing needed ‘to focus on and organize existing knowledge’ in the field as well as expanding the existing knowledge base for practice (Frey, Sieloff, & Norris, 2002, p. 108). In the late 1960s the theorist identified several concepts as being ‘universal to the discipline of nursing,’ namely ‘social systems, health, interpersonal relationships, and perceptions,’ which represent a ‘frame of reference for the domain of nursing’ (Frey, Sieloff, & Norris, 2002, p. 108). However, it was not until the 1980s that King’s theory of goal attainment emerged from King’s larger conceptual system (Alligood, 2013). King deliberately applied her theories to a variety of settings and populations and introducing their applications to clinical practice (Sieloff & Frey, 2015). The theory of goal attainment advances the notion that ‘perceptual congruence and transactions in the nurse-patient interaction lead to goal attainment’ (Alligood, 2013, pp. 46-47).
Given that this theory is based on ‘personal, interpersonal, and social systems’ and contains concepts such as ‘communication, interpersonal relationships, information, energy, social organizations, role, and status’ (Frey, Sieloff, & Norris, 2002, p. 108), it seems to be an appropriate middle-range theory to apply to managerial and administrative concerns. When King refined the theories that essentially gave rise to goal attainment theory, she included additional concepts pertaining to the personal system such as ‘perception, self, growth and development, body image, learning, time, personal space, and coping’ (Frey, Sieloff, & Norris, 2002, p. 108).
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Interpersonal system concepts added were ‘interaction, communication, role, stress/stressors, and transactions,’ and social systems concepts included ‘organization, authority, power, status, and decision making’ (Frey, Sieloff, & Norris, 2002, p. 108). Therefore, though the theory of goal attainment was initially developed as a framework for understanding nurse-patient interactions, it most certainly can be applied to nurse leaders or nurse managers as a means of effectively dealing with administrative issues. This seems to be particularly the case when one considers the social systems concepts of authority, decision-making, organization, power, and status. In fact, definitions that King herself developed identified specific examples of social systems which include ‘health care settings, workplaces, educational institutions, religious organizations, and families [emphasis added]’ (Gunther, 2013, p. 163). Therefore, the theory of goal attainment may be applied to administration and managerial scenarios.
The literature mostly contains applications of the theory of goal attainment as developed between nurse and patient/client. My own experiences do not yield a particular experience that would reflect the application of the theory. However, I can imagine a situation in which the theory could be applied to an administrative issue, particularly a staffing/staffing performance issue, depending on how one looks at it. Hypothetically, if a nurse appears to have a problem with tardiness, a nurse manager may approach that nurse to communicate with the nurse about the issue. It is possible that something in the nurse’s personal life may be affecting her, but she believes she can manage it on her own. The manager will need to consider the personal, interpersonal, and social systems aspects in the discussion with the nurse.
The personal aspect of the discussion will need to address coping, with the nurse manager indicating that the nurse’s tardiness represents some deficiencies in coping. Interpersonal elements will include interaction, communication, role, stress/stressors, and transactions, with the manager acknowledging that the nurse may have multiple roles and stressors to manage. However, the nurse also has an obligation to the organization and their colleagues. The nurse manager also has an obligation to the organization and other nurses, too, and must utilize their authority to address the issue.
- Alligood, M.R. (2013). Philosophies, models, and theories: Critical thinking structures. In M.R.
Alligood (ed.), Nursing theory: Utilization and application. Elsevier Mosby. - Frey, M. A., Sieloff, C. L., & Norris, D. M. (2002). King’s conceptual system and theory of goal
attainment: Past, present, and future. Nursing Science Quarterly, 15(2), 107-112. - Gunther, M. (2013). King’s conceptual system and theory of goal attainment in nursing practice.
In M.R. Alligood (ed.), Nursing theory: Utilization and application. Elsevier Mosby. - Sieloff, C.L. & Frey, M.A. (2015). In M.C. Smith & M.E. Parker (eds.), Nursing theories and
nursing practice. F.A. Davis Company.
