-started in mid-1960s
-Phenomena of planning pregnancies and processes involved in becoming a new mother and mastering parenting roles
-Focused on people who do not make healthy transitions and interventions to facilitate transitions
-Defined transitions in relation to role attainment
-Developed transitions as a concept
Developed as a middle-range theory
-Used transitions theory to develop situation-specific theories
-explains the transition experience as a change from one role to another with individuals having unique circumstance that may facilitate or inhibit the ability to define and master a new role and integrate it into their identity (Meleis, 2007)
-formulated to promote healthy evolutions and well-being in individuals by using nursing and social support.
-provide education, skills, and strategies for the patient and family to understand and cope with the experience of transition
-nurses do this by providing an understanding of the nature of transition, conditions that potentially facilitate or inhibit positive change, and patterns of response, the nurse has a framework for preventing role insufficiency and anticipating the patient’s physical and psychosocial needs required for successful transition.
• properties of transition experiences
• transition conditions: facilitators and inhibitors
• process indicators
• outcome indicators
• nursing therapeutics
Cultural beliefs & Attitudes (ie: Birth Process)
Socioeconomic status (ie: Menopause)
Preparation & Knowledge (Nursing Home Entry)
Location and becoming situated
Developing confidence and coping
-Mastery – mastery of skills and behaviors needed to manage new situation/environment (ie: coping with and accepting the diagnosis, treatment and remission of cancer demonstrates mastery of a role (ie: Valerie H)
-Fluid Integrative Identities – reformulation of identities, added baggage (ie: identifies oneself as a survivor, parent, spouse exemplifies role integration)
-preparation for transition
-In some instances a trial transition may be possible and provides a means for assessing readiness
-Sufficient time is needed for gradual assumption of new responsibilities and implementation of new skills
-ask patient to teach back the skill after you teach something to a patient
-May be preventive and therapeutic
-All transitions are characterized by flow and movement over time
-Transitions cause changes in identities, roles, relationship, abilities, patterns of behavior
-Transitions involve a process of movement and changes in fundamental life patterns, which are manifested in all individuals
-The daily lives of clients, environments, and interactions are shaped by the nature, conditions, meanings and processes of their transition experience.
-Vulnerability is related to transition experiences, interactions, and environmental conditions that expose individuals to potential damage, problematic or extended recovery, or delayed or unhealthy coping.
-Nurses are the primary caregivers of clients and their families who are undergoing transitions
-peaceful death in this theory is similar to the holistic model
-ease: state of calm and contentment
-transcendence: state in which one rises above one’s problems or pain
-enhanced comfort: an immediate desirable outcome of nursing care, according to comfort theory. when comfort interventions are delivered consistently over time, they are theoretically correlated a trend toward increased comfort levels over time, and with desired health seeking behaviors
-Suffering is experienced by persons not merely by bodies, and has its source in challenges that threaten the intactness of the person as a complex social and psychologic entity.
-Suffering is not synonymous with pain but is closely associated with it. Physical pain is closely related to psychological, social, and spiritual distress. Pain that persists without meaning becomes suffering.
-May include pain but is not limited to pain
-Health care workers have an obligation to relieve suffering
-Recognizing personal meaning is critical to understanding human illness and suffering
-Often intensified during illness
-Common response to illness
-Suffering is common across phases of cancer; it is thoroughly individual and intensely personal.
-Nurses respond to suffering primarily through their presence.
-As witnesses to suffering, nurses serve as compassionate voices and advocates for patients and families.
-Nurses help patients regain control in the face of illness and cope with vulnerability and the uncertainty of life.
-In most instances, suffering is associated with loss. The loss may be of a relationship, of some aspect of the self, or of some aspect of the physical body. The loss may be evident only in the mind of the sufferer, but it nonetheless leaves a person diminished and with a sense of brokenness
-Suffering is an intensely personal experience.
-Suffering is accompanied by a range of intense emotions, including sadness, anguish, fear, abandonment, despair, and myriad other emotions.
-Suffering can be linked deeply to recognition of one’s own mortality. When threatened by serious illness, people may fear the end of life. Conversely, for others, living with serious illness may result in a yearning for death.
-Suffering often involves asking the question “why?” Illness or loss may be seen as untimely and undeserved. Suffering people frequently seek to find meaning and answers for that which is unknowable
-Suffering often is associated with separation from the
world. Individuals may express intense loneliness and
yearn for connection with others while also feeling intense distress about dependency on others
-Suffering often is accompanied by spiritual distress. Regardless of religious affiliation, individuals experiencing illness may feel a sense of hopelessness. When life is threatened, people may conduct self-evaluation of what has been lived and what remains undone. Becoming weak and vulnerable and facing mortality may cause a person to reevaluate his
or her relationship with a higher being.
-Suffering occurs when an individual feels voiceless. This may occur when a person is unable to give words to his or her experience or when the person’s “screams” are unheard.