Efficacy of Imogine King’s Interacting System and Theory of Goal Attainment-Based Structured Teaching Programme to Improve Knowledge regarding the prevention of Neonatal Hypothermia
Neha Pundir1, Achala Aggarwal2, Shashi Kiran Singh3
1Nursing Officer, Paediatric Surgery Operation Theatre, Advanced Paediatrics Centre, PGIMER, Chandigarh.
2Senior Nursing Officer, PGIMER, Chandigarh.
3Medical Officer, Department of Paediatrics, G.M.S.H., Sector 16, Chandigarh.
*Corresponding Author Email: nehapundir296@gmail.com
ABSTRACT:
Nursing as a scientific field, is based on professional expertise. To develop advancement in nursing practices and skills, continuous acquisition of knowledge is advocated. The application of nursing theories to impart new knowledge in the nursing profession plays an important role in the research. The objective of the current study is to evaluate the effectiveness of a structured teaching programme on knowledge regarding the prevention of neonatal hypothermia among nurses. Methods- The framework preferred for the study is the Imogine Kings interacting system and the Goal Attainment model. This model focuses on the interpersonal relationship between the client and the nurse, and this interaction is influenced by the perception of both the client and the nurses. This interaction leads to mutual goal setting that is to be subjected by the participants and then transaction to attain the goal. Result and Conclusion-The application of Imogine King's interacting system and goal attainment model served as the incentive for the selection of the conceptual framework where the interaction takes place between the investigator and the client for the achievement of the goal. The King’s interacting system and goal attainment model were relevant to the present study. It focuses on the interpersonal relationship between the investigator and the client and the interaction between the two leads to mutual goal setting which ultimately contributes to the attainment of the goal in the end.
KEYWORDS: King’s Conceptual Framework, Goal Attainment Model, Structured Teaching Programme, Neonatal Hypothermia, Knowledge, Nurse.
INTRODUCTION:
Neonatal hypothermia is the major contributing factor to neonatal mortality and morbidity in both developed and developing countries. The thermal stability of the neonate is crucial but challenging and awareness of the importance of the warm environment has resulted in the better care of the newborn. Therefore, education and pieces of training serve as an approach to amend the knowledge and understanding of the nurses. Thus, the present study was planned to evaluate the effectiveness of a structured teaching programme on knowledge regarding the prevention of neonatal hypothermia among nurses. The conceptual framework of the study was based on King’s interacting system and goal attainment model.
Miles and Huberman (1994) defined the conceptual framework as a “written or visual presentation that explains the main things to be studied in either graphically or narrative form- the key factors, concepts, or variables and the presumed relationship among them.” The Conceptual framework presents a series of logically drawn concepts to give an overall explanation of the relationships between research study concepts without referring to any specific theories.1 It is a system of concepts and principles that may be applied to guide assessments and decisions. It may also be considered a structure or frame into which the different components of an object can be placed and attached to give it a certain appearance. Every research project needs a theoretical, Conceptual or study framework, and accordingly, it has to be integrated into the methodology.2
Imogine King (1964) first discussed the necessity of concentrating on organizing and widening the understanding of the nurses for nursing practice. She recognized social systems, health, and interpersonal relationships and perceptions are fundamental to the nursing profession. A Conceptual Framework for nursing based on personal, interpersonal, and social systems was published by King in 1971.3 King (1981) proposed a middle-range theory derived from the conceptual system called the theory of goal attainment. King explicates each system: personal, interpersonal and social into various concepts in the theory of goal attainment. The main key concepts involved in the theory of goal attainment are perception, interaction, communication, transaction, growth and development, self, role, stressors/stress, time and space. The interpersonal system remarkably contributed to the advancement of goal attainment theory. King concluded that the interpersonal system was significantly more crucial to the quality of care than the personal and social systems. Furthermore, she added that the interpersonal system fundamentally assists in the nursing process. Therefore, perception, action, interaction, and transaction are the core concepts used in the interpersonal system and transactions are the essential preconditions in goal attainment.4
MATERIAL AND METHODS:
A pre-experimental study was designed using ‘Imogine King’s Interacting system as a conceptual model. The study aimed to assess the effectiveness of a structured teaching programme on knowledge regarding the prevention of neonatal hypothermia among nurses. It was integrated into the concepts mentioned in the theory of goal attainment according to the three interacting systems personal, interpersonal and social. The interpersonal system is utilized for the study and the concepts employed are perception, action, interaction, and transaction. In perception, the data is obtained from the nurses based on their past knowledge concerning the concept of educational background. In the action, the investigator prepares the knowledge questionnaire by reviewing the literature also, plans for the administration of STP. During the interaction, a pre-test is conducted followed by the intervention. In the transaction, the outcome of the action process is assessed through the post-test which is evidenced by the increase in the knowledge of the nurses which in turn improves practices as well as skills.
The utilization of the model in the present study is discussed below-
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CONCEPTS |
ACCORDING TO IMOGINE KING’S THEORY |
ACCORDING TO THE PRESENT STUDY |
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PERCEPTION |
Perception is the process in which the data obtained through the senses and memory are organized, interpreted and transformed, which are related to experiences, the concept of self and educational background. |
In the present study, the investigator and the nurses perceive the need to gain knowledge regarding the prevention of neonatal hypothermia. The investigator and the nurses set goals to gain knowledge and to improve the practice that aids in the prevention of hypothermia. |
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ACTION |
According to the King, Action is a sequence of behaviour or activities which includes recognizing and doing something to achieve desired goals. |
During the Action phase, first, the investigator reviews the literature, journal and books and prepares the knowledge questionnaire to assess the level of knowledge of nurses based on that she prepared a structured teaching programme (STP), validates the tool with experts, and plans for the administration of the STP. |
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INTERACTION |
Interaction is the process of perception and communication between two or more persons and the environment represented by goal-directed verbal and non-verbal behaviour. |
During the interaction, the investigator conducts a pre-test through the knowledge questionnaire to assess the level of knowledge and administers STP about the prevention and management of neonatal hypothermia. They actively participated, listened and asked questions. As a result of this teaching programme, the investigator and the nurses enter into the transaction phase. |
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TRANSACTION |
Transaction is the observable behaviour of the human being, interacting with the environment. When the interaction occurs, goals are attained. |
The present study refers to the increase in knowledge of nurses regarding the prevention of neonatal hypothermia, which refines their practice. This is achieved by the improvement in the post-test knowledge score of the subjects. Also, it explains the accomplishment of the goal which shows the upgradation in the understanding of the nurses. |
The conceptual framework for the present study was derived from the concept illustrated in Imogine King’s interacting system and theory of goal attainment. It has been practised in various studies to improve patient well-being and the quality of nursing care through communication and interaction between the nurse and the care recipients. King mentioned in the theory that nursing enables action, reaction, and interaction between the patient and caregiver by giving information through their perception. This facilitates the care provider and the patient to identify specific goals, issues, and errors in any situation through communication.
However, the current study utilized the concepts of an interpersonal interacting system to develop the framework to evaluate the efficacy of a structured teaching programme on the prevention of neonatal hypothermia among nurses. Smitha Sunny Joseph et.al (2021) conducted a pre-experimental study by utilizing King’s theory of goal attainment to assess the effect of nursing care protocol for peripheral intravenous therapy on the knowledge and practice of registered nurses. The study concluded that the above theory serves as a beneficial framework, as nurses contribute knowledge and skills that affect their perception, communication and relationship to perform the function.5 Khurshid Khowaja utilised King’s interacting system framework and theory of goal attainment to investigate the effectiveness of implementing clinical pathways for patients undergoing transurethral resection of prostate (TURP). The study revealed that communication is an essential factor in promoting trust and adaptability between the patient and the care providers. 3Mohen A Hajbaghery et.al conducted a study to assess the use of King’s theory in the nurse-patient relationship. The study concluded that the theory of goal attainment aids in effective nurse-patient relationships which assists nurses in interpreting patient’s status, upgrades the care quality and hence enhances the quality of life in patients.4 The current study findings are supportive of King’s theory and provide the direction for nursing practice by emphasizing and organizing structured teaching programmes with the use of communication, interaction and transaction. This will enhance the knowledge level of the nurses to provide better care which eventually influences the health outcomes of the patients in the hospital settings.
CONCLUSION:
Furthermore, the theory of goal attainment provides a framework for setting individualised goals that align with the specific needs and preferences of the learners. By tailoring the teaching program to meet the participants' unique requirements, the intervention's efficacy can be enhanced.
Overall, Imogene King's Interacting System and Theory of Goal Attainment provide a solid foundation for a structured teaching program aimed at improving knowledge regarding the prevention of neonatal hypothermia. By utilising this approach, healthcare professionals can contribute to reducing the incidence and adverse outcomes associated with neonatal hypothermia.
CONFLICT OF INTEREST:
The authors have no conflicts of interest.
REFERENCES:
1. Suresh K Sharma. Theories, Models, and Framework in Nursing Research. Nursing Research and Statistics. 3rd edition. ELSEVIER:2018
2. Nursing Research Society of India. Theoretical and Conceptual Frameworks. Nursing Research and Statistics. Pearson.:2013
3. Khowaja K. Utilization of King’s interacting systems framework and theory of goal attainment with new multidisciplinary model: Clinical pathway. Australian Journal of Advanced Nursing. 2006 March 24(2):44-50.
4. Adib-Hajbaghery M, Tahmouresi M. Nurse-patient relationship based on Imogene King’s theory of goal attainment. Nurs Midwifery Stud 2018; 7:141-4.
5. Smitha Sunny Joseph, Reshmy. A George. Application of a Nursing Care Protocol Based on King’s Theory of Goal Attainment: a Pre-Experimental Study. PJMHS 2021 Dec: 15(12): 3481-84.
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Received on 17.08.2024 Revised on 08.10.2024 Accepted on 25.11.2024 Published on 12.12.2024 Available online on December 30, 2024 Asian J. Nursing Education and Research. 2024;14(4):306-308. DOI: 10.52711/2349-2996.2024.00059 ©A and V Publications All right reserved
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