The Role of Nursing Theories in Diabetes Care

Nursing theories are integral in shaping the framework for effective patient education and care, particularly in managing chronic conditions such as diabetes mellitus. As Anderson, Funnell, and Hernandez (2005) suggest, these theories are crucial in designing, understanding, and applying educational strategies for diabetes patients. Among the prominent nursing theorists, Imogene King stands out for her significant contributions through her Conceptual Framework and Theory of Goal Attainment (TGA). This theory is particularly valuable in diabetes care, as it emphasizes patient adherence to treatment plans.

In my clinical unit, King's Theory of Goal Attainment is frequently employed in caring for adults with diabetes mellitus due to its emphasis on the mutual and therapeutic relationship between nurses and patients.

Understanding King’s Theory of Goal Attainment

King's TGA is classified as a middle-range theory, focusing on the collaborative relationship between nurses and clients (Imogene King, n.d.). According to Mohsen and Mahsa (2018), King's theory encompasses four main elements: achieving health through an appropriate nurse-patient relationship, establishing a mutual understanding, aligning the goals and functions of both nurse and patient, and utilizing the nurse's comprehensive knowledge to set and achieve these goals. King posits that health is attained through an effective nurse-patient partnership, where mutual understanding and alignment of goals are crucial.

Today, nursing care has evolved into a collaborative effort involving healthcare professionals, patients, family members, and caregivers. This inclusive approach enhances patient satisfaction and fosters open communication. King’s TGA aligns with this shift by advocating for individualized care rather than a one-size-fits-all approach (Caceres, 2015). Nurses are encouraged to follow all five stages of the nursing process—assessment, diagnosis, planning, implementation, and evaluation. King asserts that the nursing process is essential for goal-setting and attainment, urging nurses to practice to their fullest potential for optimal outcomes (Caceres, 2015).

King defines human beings as open systems, action-oriented, and goal-driven, with optimal health as the ultimate goal. She acknowledges that despite being open systems, individuals' motivations, desires, and needs can differ significantly due to cultural influences. Therefore, when setting goals for patients, nurses must consider these factors. King emphasizes the importance of a patient's willingness to participate and learn about diabetes self-care. Effective communication, both verbal and non-verbal, is essential for establishing a trusting nurse-client relationship (Caceres, 2015).

Empirical Evidence and Application of King’s Theory

A study by Silva, Moreira, Almeida, Freitas, and Guedes (2018) provides empirical evidence of the effectiveness of nursing care based on King’s theory in managing diabetes. This randomized longitudinal experimental study aimed to control diabetes through patient adherence to medical treatment, lifestyle changes, and healthy behaviors. Nurses played a pivotal role in assisting patients and their families in diabetes self-care and facilitating learning. The study highlighted that communication is a powerful tool, with nurses purposefully interacting with patients to establish mutual goals such as dietary modifications, regular exercise, timely medication, and weight management.

This study underscores the responsibility of healthcare professionals to motivate patients to adhere to medical regimens through effective communication. It also identifies barriers to adherence, such as the cost of insulin, which many patients do not prioritize purchasing. The study demonstrates that by empowering patients in their treatment, they feel co-responsible, leading to improved adherence rates. It also reveals that a low level of education or knowledge about the disease process and its complications can hinder adherence. Nurses should encourage patients to actively participate in their care through verbal exchanges (Aragejo et al., 2018). The study concludes that King’s TGA fosters better adherence to diabetes management as patients become co-responsible for their treatment.

Conclusion

In conclusion, Imogene King’s Theory of Goal Attainment provides a robust framework for nursing care, particularly in managing chronic conditions like diabetes mellitus. By emphasizing mutual goal-setting and a collaborative nurse-patient relationship, King’s theory aligns with modern healthcare's shift towards individualized care. Empirical evidence supports its effectiveness in enhancing patient adherence to diabetes management plans. By addressing barriers such as cost and education, and fostering effective communication, nurses can empower patients to take responsibility for their health, leading to better outcomes. As healthcare continues to evolve, incorporating nursing theories like King’s TGA will remain essential in delivering patient-centered care and improving health outcomes.

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