I. Introduction Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of death worldwide, along with lower respiratory tract infections, tuberculosis and lung cancer (Global Burden of Diseases [GBD], 2004). In 2004, World Health Organization estimated that there are 64 million people with COPD (World Health Organization, 2011). In the Philippines, the Department of Health (DOH) considers COPD as one of the country’s major health problems. It is seventh among the top ten causes of mortality in the country (Department of Health, 2011) Considering the results of previous statistics, the researcher proposed a study that will address the patients who suffer from COPD. The theoretical framework guiding this study is Imogene King’s Theory of Goal Attainment. This study aims to focus on the attainment of goals, or outcomes, by nurse-patient partnerships.
II. Rationale COPD (Chronic Obstructive Pulmonary Disease) is an umbrella term used to describe chronic lung diseases that are characterized by progressive obstruction of the airflow into and out of the lungs and increased shortness of breath. The two main diseases included under the umbrella term of COPD include emphysema and chronic bronchitis (WebMD, 2012). Cigarette smoking or exposure to tobacco smoke is the primary cause of COPD. (WebMD, 2012) The upside is that COPD, though considered a chronic, debilitating and sometimes fatal disease, can be managed, controlled and slowed down.
The most important treatment for COPD is smoke cessation. Unfortunately, only about one third of the patients can abstain from smoking long-term. (COPD-International, 2002) The researcher decided to utilize Imogene King’s Theory of Goal Attainment in the treatment of this medical condition since it requires the interaction between the nurse and the patient and mutual goal setting. Nurses purposely interact with clients to mutually establish goals, and to explore and agree on means to achieve goals. Mutual goal setting is based on nurses’ assessment of clients’ concerns, problems, and disturbances in health, their perceptions of problems, and their sharing information to move toward goal attainment (King, 1981).
King’s theory was chosen for this study as the theory focuses on the interaction that occurs between the patient and the nurse and how these two work together and move towards goal attainment. Through perception and communication goal attainment is greatly influenced. (Bailey, 2003) King (1981) described: “Effective communication and accuracy in perceptions in situations determine learning as well as the growth of the patient and nurse” (p. 86). Misperceptions between patients and nurses on educational areas can possibly hinder goal attainment. Patient compliance with a recommended treatment regimen is higher when there is a strong nurse and patient relationship (Dracup, et al., 1994). Focusing on the interaction of the nurse and patient, there would be a greater chance for agreement and fulfillment by the patient with the specified treatment for COPD, which is smoke cessation.
III. Review of Related Literature
Several researches and studies have been conducted using Imogene King’s Theory of Goal Attainment. Eñego (2009) utilized the Theory of Goal Attainment in the care of a client with chronic renal failure. The purposeful interaction, which was goal-directed, helped him cope with biological and psychological changes and helped him attain, maintain, and restore health. Camelotes (2008) wrote that the theory could be used as an effective patient care model in the treatment of Type II Diabetes Mellitus.
The goals were successfully attained through patient involvement in making decisions regarding care with increased willingness to meet mutually set objectives. Similarly, Williams (2001) presented how King’s work could be applied in both emergency nursing and rural health care. The two concepts from King’s framework, which are communication and interaction, are very useful when working with rural clients and further leads to positive interactions. Overall, these studies provide evidence that the Goal Attainment Theory is indeed applicable in the field of nursing practice.
IV. Critical Evaluation
King (1981) suggested that the nurse functions primarily through interactions with individuals and groups within the environment. King (1984) believes that “nurses, who have knowledge of the concepts of this Theory of Goal Attainment, are able to accurately perceive what is happening to patients and family members and are able to suggest approaches for coping with the situations. Utilizing King’s theory, researchers were able to effectively help their patients attain, maintain, and restore health. Through purposeful interactions between the nurse and the client, the researcher is convinced that King’s theory will improve nursing practice.
V. Conclusion Therefore, Imogene King’s Theory of Goal Attainment is applicable in nursing practice involving patients diagnosed with Chronic Obstructive Pulmonary Disease.