Introduction
As a discipline, the nursing profession is founded on the framework of what care is, what the practitioners in the field can do, and why. In this case, nursing has its own body of knowledge on which care delivery is based. Various nursing theories help show how nursing is a unique discipline separate from other fields, including medicine. These models help define and guide nursing care and provide a foundation for clinical decision-making. As a theory-based practice, nurses are able to articulate what they do for patients and why, thereby improving the quality of care (Younas & Quennell, 2019).
This paper explores the theory of goal attainment (TGA) and culture care theory (CCT) and shows how they are used in the practice environment. Further, the discussion delves into an operational definition of each concept and its similarities and differences. Lastly, it will examine how an integrated model utilizing all these frameworks can benefit practice and how their dissimilarities can be addressed.
Theory of Goal Attainment
Many individuals pursue nursing as a career because they want to help patients get healthy. Therefore, it is essential to establish health goals with clients and take necessary steps to achieve those targets. Imogene King’s TGA concept emphasizes that healthcare professionals and care recipients should collectively set and achieve goals to deliver individualized care. Therefore, TGA allows those involved in the nursing process to identify specific targets and issues by communicating effectively and setting clear objectives to achieve common health-related goals (Park, 2021). In this nurse-patient relationship, professionals in the field first use their knowledge base to assess care recipients and make a diagnosis.
Secondly, a care plan including various remedies is formulated to address the health needs (Park, 2021). Thirdly, decisions about the means to achieve those goals are typically implemented, and patients’ input is encouraged in this stage, allowing for collaborative work towards the desired outcomes. After the implementation phase and the treatment has been administered, the final step often entails caregivers evaluating the process and determining whether or not it was successful.
Culture Care Theory
Madeleine Leininger’s framework emphasizes that culture and care are essential concepts in nursing. In this case, CCT aims to guide nurses to offer individualized healthcare services using culturally based care knowledge, which is supportive, assistive, and facilitative. This approach enables providers to tailor services to fit an individual’s or community’s cultural beliefs, values, and lifestyles (Potter et al., 2021).
Therefore, CCT aims to offer culturally congruent healthcare services to every patient. This is because cultural practices can influence individuals’ views and behavior about health and illnesses. For this reason, caregivers must be culturally competent to deliver effective service that meets their patients’ needs and expectations. As a profession, nursing entails attending to different health needs to ensure that the care provided fits with or is meaningful to patients of similar or diverse ethnic, racial, and religious backgrounds. Therefore, cultural awareness is crucial in tailoring care practices to be culturally compatible to enhance health outcomes.
Operational Definitions
This is the statement of procedures that can be used to define the key variables within these theories and make them measurable and observable in a practical sense. In this case, operational definitions are critical in knowing precisely the concepts being referred to in King’s and Leininger’s theories. This is because different definitions of terms might exist depending on the context in which they are used. Therefore, this approach can eliminate any misinterpretations about meanings.
TGA incorporates three core interactive systems: social, personal, and interpersonal, which have their own concepts(Park, 2021). For example, the interpersonal system may include communication and transaction (Fronczek, 2021). In this context, communication is the exchange of information and feelings between the nurse and patient, while transaction describes the give-and-take action where health professionals coordinate care and mutually work together with the care recipients to achieve common goals.
Leininger developed new terms for basic concepts that underlie the CCT. Some of these words that can be examined to determine what they mean include care and culturally congruent (Srivastava, 2022). In this case, the former is the essence and is fundamental to nursing practice; caring is critical to curing or improving human health conditions (Abualhaija, 2019). However, the latter can be defined as care that considers the key beliefs and values of the patient in the situation. Healthcare providers are not expected to be conscious of all aspects of patients’ values and assumptions embedded in their worldview; rather, the intent is to identify nurse and salient patient values that may impact the nursing process and audit their practice (Srivastava, 2022). Cultural congruence aims to remind nurses that unique values are made explicit and that care reflects goals established by clients and clinical teams.
Differences and Similarities
King’s and Leininger’s theories differ based on conceptual assumptions that reinforce their frameworks. In this case, TGA indicates that better healthcare outcomes are attained through appropriate nurse-patient relationships. Similarly, mutual understanding and similar expectations are required among the parties involved to enhance a therapeutic interaction (Park, 2021).
On the other hand, the CCT emphasizes nursing service to be meaningful, impactful, and culturally congruent. In other words, the care provided should align with patients’ religious or cultural practices, beliefs, and values (Potter et al., 2021). Therefore, culture-specific care practices can help individuals face illness or death in a culturally meaningful way.
These frameworks are also different in regard to their applications. In this case, nurses can use TGA to facilitate communication, a key element of interaction and quality nursing care. The theory enhances effective engagement through conversation between healthcare professionals and patients and allows them to set unique goals that must be attained reciprocally to improve their well-being (Park, 2021). Conversely, CCT provides a guideline that can help nurses understand various cultural influences that can impact healthcare outcomes (Abualhaija, 2019). The framework enables nurses to reduce health disparities among minorities by practicing respectful and culturally sensitive care while incorporating patients’ cultural beliefs, values, and practices into the care plan.
Despite the differences, there are some commonalities between TGA and CCT. Firstly, both theories encourage patient-centered care by focusing on the unique needs of care recipients. For example, setting goals and providing culturally sensitive care are significant steps in assisting patients to manage their illnesses and achieve results that are meaningful to them. These approaches consider individuals’ self-efficacy, readiness to change, and beliefs about health and disease.
Secondly, these theoretical frameworks focus on building nurse-patient interpersonal relationships. For example, TGA promotes effective communication, which can enhance cooperation, explore options, and determine the means to achieve set goals (Park, 2021). On the other hand, CCT equips nurses with cultural awareness and improves their communication skills to build rapport with patients (Srivastava, 2022). This strategy can ensure that care recipients feel respected, which may enhance positive engagement and improve health outcomes.
Integrated Model
Nursing theories aim to amplify nursing interventions while increasing the quality of care. In this case, the Goal-Oriented and Cultural Care Model can be formed by integrating King’s and Leininger’s models. This newly formulated concept can offer a conceptual roadmap to understanding the intricacies of patient care. This integrated model may provide a structured framework to ensure nurses seek patients’ input, involve their family members when designing care plans, and evaluate how sociocultural dimensions can impact health outcomes and address them. When TGA and CCT are integrated into a single model, this can help provide whole-person care that is beneficial and culturally centered.
Practice
The integrated model can guide clinical decision-making and improve collaboration. In this context, the new concept can allow healthcare professionals to ensure that care plans are goal-oriented and culturally sensitive. For example, suppose a Muslim woman patient refuses to be examined by a male nurse; the care can be tailored to meet their preferences and needs by assigning a female nurse to conduct a medical examination. Therefore, this approach can enable caregivers to accommodate patients’ perspectives, which may enhance satisfaction with the service provided and improve health outcomes.
How Dissimilarities Can Be Addressed
The differences between TGA and CCT can be bridged by creating educational interventions to improve cultural competence among healthcare professionals. Therefore, such training can equip nurses with relevant and requisite attitudes and knowledge to efficiently respond to sociocultural issues emanating from clinical encounters (Abualhaija, 2019). In this context, if the significance of family support is part of patients ‘ cultural beliefs, providers should design culturally oriented care plans by involving family members in decision-making to help them achieve healthcare goals.
Conclusion
Leininger’s and King’s concepts are integral in guiding nursing practices and enhancing patients’ healthcare outcomes. In this case, CCT enables nurses to tailor their services to offer care that meets and respects individuals’ cultural values and lifestyles. Conversely, TGA enhances the nurse-patient relationship to achieve common health-related goals. However, when these two theories are integrated, they can ensure client inputs are considered when providing care and that they receive culturally-centered care while safeguarding their beliefs and values.
References
Abualhaija, N. (2019). The transformational expedition of cultural competence in nursing. International Journal of Nursing and Health Care Research, 2(11), 1-8.
Fronczek, A. E. (2021). Ushering in a new era for King’s conceptual system and theory of goal attainment. Nursing Science Quarterly, 35(1), 89–91.
Park B. M. (2021). Effects of nurse-led intervention programs based on goal attainment theory: A systematic review and meta-analysis. Healthcare, 9(6), 1-28.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2021). Fundamentals of nursing (11th ed.). Elsevier.
Srivastava, R. H. (2022). The health care professional’s guide to cultural competence (2nd ed.). Elsevier.
Younas, A., & Quennell, S. (2019). Usefulness of nursing theory-guided practice: An integrative review. Scandinavian Journal of Caring Sciences, 33(3), 540–555.