Nursing Theory Analysis Essay

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Transactions have occurred when goals are attained" (King, 1992, p.23). The nursing practice occurs in a sequence where nurse-patient interpersonal relationships or dyads happen. While transactions continued between patients, nurses and family, it can be predicted whether the goal will be met or not or to what extent (King, 1997).

Thus goal attainment presented by King is described as a process of reaction-interaction-transaction, where the perceptions, interactions and communication between nurse and patient are the major factor that play key role in this process. The TGA denotes that patient's have different view points and opinions as compared to nurses besides the fact that they continuously interact with each other. In her theory, King emphasized that nursing professionals access data about patients' perceptions so as to make the provider and patient goals harmonious (King, 1992).

King's Theory of Goal Attainment Related to Nurse-Patient Interaction

Previously research has demonstrated nurse-patient interaction and communication play the most influential part in the patient satisfaction. In this regard King's Model of Goal Attainment provided the theoretical framework to understand how this may occur. Eriksen's (1995) also agree with King's TGA in defining patient satisfaction with nursing care, that is, transactions if occur between the nurse and patient will result in the outcomes of achievement of goal of patient satisfaction. This result can only be obtained by the communication, interactions, and perceptions between the nurse and patient. The goal of the process of interaction between the nurse and patient is patient satisfaction.Download full Download Microsoft Word File
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TOPIC: Essay on Nursing Theory Analysis Theory-Based Nursing Assignment

Several other authors supported and explained King's concept of communication and interaction between nurse and patient. For example, Webb and Hope (1995) elaborated King's idea as "purposeful communication and information sharing between the patient and the nurse" (Webb & Hope, 1995). According to King, the main component of nursing intervention can be described as teaching, guiding, and counseling. In a research study by Webb and Hope, a structured interview was conducted with 103 indoor patients. The study reported that the patients described nurses' listening to patients' worries; teaching them about their disease conditions and relieving them from pain as their most important nursing activities.

In earlier studies there are examples of inclusion of patient expectations as an independent variable but they did not adopt scientific methodologically (Linder-Pelz, 1982). There are few other earlier studies (Korsch, Gozzi, & Francis, 1968; Larsen & Rootman, 1976) which gathered expectation and satisfaction data in the same period of time that is why they were not reliable to be included in the review. It is also evident that assessing patient's perceptions and experiences at his time of discharge and admission would have come with the same results. In this regard one appropriate example is the study by Swan, Sawyer, Van Matre, and McGee (1985). They examined a path model which is set to examine the relationship between patients' expectations and their general satisfaction. The results of the research revealed that there was a strong link between the fulfillment of patients' expectations and their overall satisfaction. Yet, the validity of the study is not reliable because they assessed the patients after discharge by mailing them survey questionnaires.

Undoubtedly, the satisfaction of patients with nursing care is a complex phenomenon that has usually been in relation with the quality of nursing care. Satisfaction is influenced by patients' expectations and this has an inverse association with it i.e., if patients' expectations are low their satisfaction will be higher (Cleary, Horsfall, & Hunt, 2003; Han, Connolly, & Canham, 2003). However it is evident from several studies that patients' will be satisfied if actual performance meets or exceeds their expectations (S. Abramowitz, 1987; M. Cleary, et al., 2003; Greeneich, 1993; S.U. Linder-Pelz, 1982; Nguyen Thi, Briancon, Empereur, & Guillemin, 2002).

During the last several years research studies on patient satisfaction have researched a number of variables related to patient satisfaction. Majority of the research studies have come to conclusion that the most important factor in the patient satisfaction is their satisfaction with nursing care. For instance, Wolf. (1998) found a "highly statistically significant relationship between patient reports of nurse caring and satisfaction with nursing care" (pp. 103-104). Schmidt (2003, p. 393) also described the significance of patient satisfaction: "As nursing represents a constant presence in the experience of hospitalized patients, it seems logical that satisfaction with nursing care has a primary influence on patients? overall satisfaction with their experience."

Similarly Carey and Posavac (1982) conducted a survey with 176 patients whose were discharged and reported that the patients' satisfaction with the nursing care provided during their treatment period was the most important factor from which they rated the hospital. In this study a standardized 54-item mail survey was utilized that was developed by a private corporation. The response rate of the research was 55%. From the respondents those who rated their hospital as excellent, 90% described nursing services as excellent while the respondents who were less satisfied, only 32% described nursing services as excellent. The participants described technical competence, supportive attitude, responsiveness, and information giving as the most important components and abilities of a nurse.

Doering (1983) also conducted a research in order to decide what factors influence the patients' satisfaction with care. They used a short 11-item, 4-point Likert scale survey that was designed by the hospital's committee on patient satisfaction committee. This study reported a response rate of 58%. Doering described results of the study in terms of measures of association and used Cramer's V coefficient. The study reported that patient's overall satisfaction was linked to their satisfaction with nursing care more than any other services provided during their hospital stay.

Frey (1995) reported a research that described that a big urban medical centre situated Florida implemented King's theory in their setting and applied Theory of Goal Attainment (Frey, Rooke, Sieloff, Messmer, & Kameoka, 1995). Frey (1995) conducted survey with the. surgical patients before and after the implementation of theory-based nursing. They used Hinshaw and Atwood's Patient Satisfaction Inventory (Hinshaw & Atwood, 1982). Both trial and control unit's patients were surveyed. Frey reported less satisfaction of control group was as compared to the experimental group (N = 180, M = 3.6, p<. 02) and conclude that if theory-based nursing practice is implemented it will help improve patient satisfaction.

Application of the nursing theory to patient care

It has been proved from the research that application of TGA helps to improve patient satisfaction with nursing care. It is also helpful from nurse-patient interaction and nursing perspective. The TGA is helpful in providing nurse with a theoretical framework to assess the individuality of their interaction with patients, their association with them as well as the outcome of this interaction. Similarly patients view points about nursing care are the result of their interaction with them and their expectations with the care that they are going to receive. It is also been proved that patients mostly like to select a hospital which fulfills their expectation of quality of nursing care. Once admitted in the hospital they start working on their earlier expectations. Similarly if they are admitted to a specific unit, they carry on collecting and modifying their perception as well as expectations and judgments. This process of modifying and creating perception continues until the nurse come to provide primary care to them. This process occurs sometime consciously and sometimes unconsciously.

Similarly as the patients have their perceptions and expectations about nurses, nurses also hold beliefs about patients' expectations and perception as how they should be cared for. Before nurse meet a specific meet there is a generalized perception about the patients' beliefs and expectations of the nursing care that is usually based on the nurse' previous experiences with innumerous patients. This process starts turning into modification and changing after the nurse meets the patient. After visiting the patient for first time they start modifying this belief by first assessing the patient's age, nationality, religion, appearance, and demeanor. When there is more communication and interaction with patient and nurse, nurses gather information about patient's expectations of the nursing care their beliefs also change and modify. It is important to know that TGA model described nurse's awareness of patients' expectations will have a great influence on the patient satisfaction. In brief consistent with interpersonal aspects of nursing care are important for patient satisfaction (Ahmad & Alasad, 2004; Aragon, 2003; Dozier Mahan's (1996) research study the most recent research studies have also pointed out that, 2001; Elder, 2004; Eriksson & Svedlund, 2007; Gonzalez-Valentin, 2005; Johansson, 2002; Liu & Wang, 2007; Martin, 1998; O'Connell,1999; Schmidt, 2003; Sitzia & Wood, 1999; Wagner & Bear, 2009; Zimlichman, 2003). King's theory was broadly appreciated and adopted by nursing care units and it reveals the importance of interpersonal interaction within patient and nurse and how this helps to explore patient's expectations and perceptions.

Schmele (1996) suggested that "in order to improve the competitive edge in the market place, it is vital that health care providers understand the notion of consumers'… [END OF PREVIEW] . . . READ MORE

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