This document provides an overview of Afaf Ibrahim Meleis' Transitions Theory. It discusses Meleis' background and career, the development and sources of Transitions Theory, major concepts and assumptions of the theory, theoretical assertions, and the theory's acceptance and applications in nursing practice and education. Transitions Theory examines the patterns and properties of life transitions and conditions that influence healthy transitions.
In her model of nursing, she explains that nursing is the practice of identification of a patient’s need for help through the observation of presenting behaviors and symptoms, exploration of the meaning of those symptoms with the patient, determining the cause of discomfort, and determining the patient’s ability to resolve the discomfort or if the patient has a need for help from the nurse or other health care professionals. The goal of nursing consists primarily of identifying a patient’s need for help.
The need for help is defined as “any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that affect health and wellness.” Need-for-help must be based on the individual patient’s perception of his or her own situation.
Wiedenbach’s theory identifies the patient as “any individual who is receiving help of some kind, be it care, instruction or advice from a member of the health profession or from a worker in the field of health.” A patient is any person who has entered the healthcare system and is receiving help, which means he or she does not need to be ill. A person receiving health-related education would qualify as a patient.
In her model of nursing, she explains that nursing is the practice of identification of a patient’s need for help through the observation of presenting behaviors and symptoms, exploration of the meaning of those symptoms with the patient, determining the cause of discomfort, and determining the patient’s ability to resolve the discomfort or if the patient has a need for help from the nurse or other health care professionals. The goal of nursing consists primarily of identifying a patient’s need for help.
The need for help is defined as “any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that affect health and wellness.” Need-for-help must be based on the individual patient’s perception of his or her own situation.
Wiedenbach’s theory identifies the patient as “any individual who is receiving help of some kind, be it care, instruction or advice from a member of the health profession or from a worker in the field of health.” A patient is any person who has entered the healthcare system and is receiving help, which means he or she does not need to be ill. A person receiving health-related education would qualify as a patient.
Madeleine Leininger’s Culture Care: Diversity and Universality TheoryBankye
“A substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways.”(P.58)
Grant, Pay for college, government grant
How to get a $25,000 FREE cash grant http://bit.ly/35YY2X1
The state of having addressed basic needs for ease, relief, and transcendence met in 4 contexts of experience (physical, psychospiritual, sociocultural, and environmental)
Comfort involves identifying the comprehensive needs of patients, families, and nurses and addressing those needs.
Ergonomics- comfort at the workplace, promotes optimum function or productivity (Kolcaba &Kolcaba, 1991)
NANDA- comfort in terms of pain management
Confortare Latin- to strengthen gently
Among the many models of health related quality of life, Pender’s Health promotion behavior model helps to identify factors influenced the decisions and actions of individuals that were made to prevent disease and promote a healthy lifestyle.
Myra LevineGrand Nursing Theory Based on Interactive Process.docxroushhsiu
Myra Levine
Grand Nursing Theory Based on Interactive Process
Biography — Early & Family Life
Myra Levine was born in 1920 in Chicago, IL (“Myra Estrin Levine,” 2016)
First of three children
Her father’s “persistent gastrointestinal illness” sparked her interest in pursuing a career in nursing
Myra Levine died on March 20, 1996, at age 75
(Gonzalo, 2019)
Biography — Education
Graduated from Cook County School of Nursing
Obtained BSN from the University of Chicago in 1944
Obtained MSN from Wayne State University in Detroit in 1962
Earned honorary doctorate from Loyola University in 1992
(“Myra Estrin Levine,” 2016)
Biography — Nursing Career
Oncology nurse at Gardiner General Hospital in Chicago
Became Director of Nursing Drexel Home in Chicago
Clinical instructor at Bryan Memorial Hospital in Lincoln, NE (“Myra Estrin Levine,” 2016)
Surgical supervisor at the University of Chicago and Henry Ford Hospital in Detroit (Gonzalo, 2019)
Chairperson of clinical nursing at Cook County School of Nursing (“Myra Estrin Levine,” 2016)
Chronological order
Biography — Publications, Awards, & Honors
Works: “The Pursuit of Wholeness,” “For Lack of Love Alone,” “Adaptation and Assessment: A Rationale for Nursing Intervention,” “The Four Conservation Principles of Nursing,” & “Introduction to Clinical Nursing”
Charter fellow of the American Academy of Nursing in 1973
Honorary recognition from the Illinois Nurses’ Association
Member of Sigma Theta Tau at Alpha Beta Chapter
Elected fellow in the Institute of Medicine of Chicago
First recipient of the Elizabeth Russel Belford Award for excellence in teaching from Sigma Theta Tau in 1977
(Gonzalo, 2019)
Best known for “The Four Conservation Principles of Nursing,” the others were preliminary works
She never planned on developing a nursing theory, she worked as a consultant for different hospitals and nursing schools and came up with an organizational structure for teaching med-surg nursing which was the basis for theory development
Philosophical Underpinnings
Understanding the era in which Myra Levine matured helps give background to her theory
Healthcare was based on authoritarianism and physician decisions were not questioned
Nurses were taskers, operating without a scientific origin
(Toon, 2014)
-In noting pioneers in nursing, it is suitable to recall the era in which theorists such as Myra Levine matured. In Levine’s case it is helpful to recall the era in sociological terms, cultural terms and recall the available technology and the discipline of medicine and how nurses ‘fit’ at the time. The environment of her maturation and development became the underpinning of her career and her Theory of Conservation for Nursing.
-nurses were primarily seen as the ‘handmaidens’ of doctors; neither patients nor nurses were anticipated to que ...
Madeleine Leininger’s Culture Care: Diversity and Universality TheoryBankye
“A substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways.”(P.58)
Grant, Pay for college, government grant
How to get a $25,000 FREE cash grant http://bit.ly/35YY2X1
The state of having addressed basic needs for ease, relief, and transcendence met in 4 contexts of experience (physical, psychospiritual, sociocultural, and environmental)
Comfort involves identifying the comprehensive needs of patients, families, and nurses and addressing those needs.
Ergonomics- comfort at the workplace, promotes optimum function or productivity (Kolcaba &Kolcaba, 1991)
NANDA- comfort in terms of pain management
Confortare Latin- to strengthen gently
Among the many models of health related quality of life, Pender’s Health promotion behavior model helps to identify factors influenced the decisions and actions of individuals that were made to prevent disease and promote a healthy lifestyle.
Myra LevineGrand Nursing Theory Based on Interactive Process.docxroushhsiu
Myra Levine
Grand Nursing Theory Based on Interactive Process
Biography — Early & Family Life
Myra Levine was born in 1920 in Chicago, IL (“Myra Estrin Levine,” 2016)
First of three children
Her father’s “persistent gastrointestinal illness” sparked her interest in pursuing a career in nursing
Myra Levine died on March 20, 1996, at age 75
(Gonzalo, 2019)
Biography — Education
Graduated from Cook County School of Nursing
Obtained BSN from the University of Chicago in 1944
Obtained MSN from Wayne State University in Detroit in 1962
Earned honorary doctorate from Loyola University in 1992
(“Myra Estrin Levine,” 2016)
Biography — Nursing Career
Oncology nurse at Gardiner General Hospital in Chicago
Became Director of Nursing Drexel Home in Chicago
Clinical instructor at Bryan Memorial Hospital in Lincoln, NE (“Myra Estrin Levine,” 2016)
Surgical supervisor at the University of Chicago and Henry Ford Hospital in Detroit (Gonzalo, 2019)
Chairperson of clinical nursing at Cook County School of Nursing (“Myra Estrin Levine,” 2016)
Chronological order
Biography — Publications, Awards, & Honors
Works: “The Pursuit of Wholeness,” “For Lack of Love Alone,” “Adaptation and Assessment: A Rationale for Nursing Intervention,” “The Four Conservation Principles of Nursing,” & “Introduction to Clinical Nursing”
Charter fellow of the American Academy of Nursing in 1973
Honorary recognition from the Illinois Nurses’ Association
Member of Sigma Theta Tau at Alpha Beta Chapter
Elected fellow in the Institute of Medicine of Chicago
First recipient of the Elizabeth Russel Belford Award for excellence in teaching from Sigma Theta Tau in 1977
(Gonzalo, 2019)
Best known for “The Four Conservation Principles of Nursing,” the others were preliminary works
She never planned on developing a nursing theory, she worked as a consultant for different hospitals and nursing schools and came up with an organizational structure for teaching med-surg nursing which was the basis for theory development
Philosophical Underpinnings
Understanding the era in which Myra Levine matured helps give background to her theory
Healthcare was based on authoritarianism and physician decisions were not questioned
Nurses were taskers, operating without a scientific origin
(Toon, 2014)
-In noting pioneers in nursing, it is suitable to recall the era in which theorists such as Myra Levine matured. In Levine’s case it is helpful to recall the era in sociological terms, cultural terms and recall the available technology and the discipline of medicine and how nurses ‘fit’ at the time. The environment of her maturation and development became the underpinning of her career and her Theory of Conservation for Nursing.
-nurses were primarily seen as the ‘handmaidens’ of doctors; neither patients nor nurses were anticipated to que ...
The Roy Adaptation Model sees the person as a biopsychosocial being in continuous interaction with a changing environment. The environment includes focal, contextual and residual stimuli. A focal stimulus is the confrontation with one's internal and external environment.
Her Culture Care Diversity & Universality theory was one of the earliest nursing theories and it remains the only theory focused specifically on transcultural nursing with a culture care focus.
Her theory is used worldwide.
Dr. Leininger served as dean and professor of nursing at the university of Washington and Utah and she helped initiate and direct the first doctoral programs in nursing.
How does Cross-cultural Psychology Influence or Contribute Applications in He...rachelhch
Cross-Cultural Psychology and Health: Illness relate to Large-scale Culture, Mental Disorders, Temperament Dimensions, Thailand versus the United States and Attention Deficit Disorder (ADD)
Two Theoretical Frameworks: The ecocultural niche framework and the developmental niche framework
UNIT-IV M.Sc I year THEORIES APPLIED IN COMMUNITY HEALTH NURSING.pptxanjalatchi
What are theories and models of nursing?
Image result for community health nursing theories and models
Four major concepts are frequently interrelated and fundamental to nursing theory: person, environment, health, and nursing. These four are collectively referred to as metaparadigm for nursing. Person, Nursing, Environment, and Health – the four main concepts that make up the nursing metaparadigm.
Chapter 14 Self-care deficit theory of nursingVioleta A. BeEstelaJeffery653
Chapter 14: Self-care deficit theory of nursing
Violeta A. Berbiglia, Barbara Banfield*
PowerPoit by Dr. Sergio Osegueda
Dorothea E. Orem (1914–2007)
“Nursing is practical endeavor, but it is practical endeavor engaged in by persons who have specialized theoretic nursing knowledge with developed capabilities to put this knowledge to work in concrete situations of nursing practice.” (Orem, 2001)
Credentials and background of the theorist
Dorothea Elizabeth Orem was born in Baltimore, Maryland, in 1914.
She began her nursing career at Providence Hospital School of Nursing in Washington, DC, where she received a diploma of nursing in the early 1930s.
Orem received a bachelor of science degree in Nursing Education from Catholic University of America (CUA) in 1939, and she received a master’s of science degree in Nursing Education from the same university in 1946.
Background
Orem’s early nursing experiences included operating room nursing, private duty nursing (home and hospital), hospital staff nursing on pediatric and adult medical and surgical units, evening supervisor in the emergency room, and biological science teaching.
Orem held the directorship of both the nursing school and the Department of Nursing at Providence Hospital, Detroit, from 1940 to 1949. After leaving Detroit, she spent 8 years (1949–1957) in Indiana working at the Division of Hospital and Institutional Services of the Indiana State Board of Health.
In 1957, Orem moved to Washington, DC, to take a position at the Office of Education, U.S. Department of Health, Education, and Welfare, as a curriculum consultant. From 1958 to 1960, she worked on a project to upgrade practical nurse training.
That project stimulated a need to address the question: What is the subject matter of nursing? As a result, Guides for Developing Curricula for the Education of Practical Nurses was developed (Orem, 1959).
Background
In 1970, Orem left CUA and began her consulting firm. Orem’s first published book was Nursing: Concepts of Practice (Orem, 1971).
She was editor for the NDCG as they prepared and later revised Concept Formalization in Nursing: Process and Product (NDCG, 1973, 1979).
In 2004 a reprint of the second edition was produced and distributed by the International Orem Society for Nursing Science and Scholarship (IOS). Subsequent editions of Nursing: Concepts of Practice were published in 1980, 1985, 1991, 1995, and 2001. Orem retired in 1984 and continued developing the self-care deficit nursing theory (SCDNT).
Background
Georgetown University conferred the honorary degree of Doctor of Science on Orem in 1976.
She received the CUA Alumni Association Award for Nursing Theory in 1980.
Other honors included Honorary Doctor of Science, Incarnate Word College, 1980; Doctor of Humane Letters, Illinois Wesleyan University, 1988; Linda Richards Award, National League for Nursing, 1991; and Honorary Fellow of the American Academy of Nursing, 1992.
She was awa ...
Date October, 17 2021 PLAGIARISM SCAN REPORT41PlagOllieShoresna
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The aim of Transition theory offers a corrective focus that can enrich our understanding of development, formation, as well as stressful
responses to both predictable and unpredictable change in human life. Transition theory introduces a broader view of rationality that
includes relationships, change overtime, and the person in particular situations and contexts. Giving birth; becoming parents; growing up;
coping with chronic illnesses; recovering from injury or acute illness; changes in jobs and family structures, communities, or cultures all
demand studying persons in their social relationships, context, and their experience of transitioning into new self-understandings and new
life worlds. . Afaf Meleis transitions theory thereby helps patients adapt to changes during the transfer of one situation to the other .The goal
of transition theory is to prepare individuals and families for developmental, situational and health illness transition, and care of them during
the transition. The goal is to ensure they are able to cope with the change. the goal of transition theory also to describe, predict, and explain
the nursing phenomena because Nursing is concerned with growth and development, health promotion, coping with the demands of the
human experience of illness and recovery by providing a nursing practice foundation, help promote more knowledge, and illustrating in
which direction nursing should work to achieve their goals in the future. Nurses help people acquire or change roles by modeling behaviors,
allowing their clients to rehearse roles, and providing them with support while they are developing these roles. Structural and Functional
Components of the Theory The structural components of transition theory are well distinguished through several concepts. This includes
transition patterns, properties of transition experiences, conditions of transitions, and response patterns (Lindmark, 2019). The structural
components help the nurse to understand the individual and identify the appropriate assessment points and intervention points. Nurses help
people acquire or change roles by modeling behaviors, allowing their clients to rehearse roles, and providing them with support while they
are developing these roles. Transition theory addresses psychology and social science in nursing by offering a corrective focus to enrich
formation understanding and predictable and unpredictable changes Brenna, 2019). Thereby, transition theory is structured logically, which
involves formulation and framework used to provide an enabling environment. Change triggers initiate a process with patterns of responses
that are both observable and non-observable behaviors and either functional or dysfunctional. These responses start from the moment a
change trigger is ant ...
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. Outlines
• Credentials and Background of the Theorist
• Theory Development and Use of Empirical Evidence
• Major Concepts and Definitions
• Major Assumptions
• Theoretical Assertions
• Logical Form
• Acceptance by the Nursing Community
• Summary
• Critique
• Research Articles
3. Afaf Ibrahim Meleis
1942–present
• She was born in Alexandria, Egypt.
• Her mother was the first person in Egypt
to obtain nursing PhD from and Egyptian
university.
• Meleis completed her nursing degree at
the University of Alexandria, Egypt.
• She received an MS in nursing from the
University of California, Los Angeles in
1964 and MA in sociology in 1966,
• PhD in medical and social psychology in
1968.
4. • 1966 - 1968 administrator and acting instructor, University of
California, Los Angeles.
• 1968 - 1971 assistant professor
• In 1971, she moved to the University of California, San Francisco
(UCSF), where she spent the next 34 years.
• In 2002, Meleis was nominated and became dean of the School of
Nursing at the University of Pennsylvania.
• She is currently on the Counsel General of the International
Council on Women’s Health Issues.
• Meleis received numerous honors, medals, awards and honorary
doctorates.
(Alligood, 2014)
5. • Meleis’ research focuses on global health, immigrant and
international health, women’s health, and the theoretical
development of the nursing discipline.
• She authored more than 170 articles in social sciences, nursing,
and medical journals; 45 chapters; and numerous monographs,
proceedings, and books.
• Her award-winning book, Theoretical Nursing: Development and
Progress (1985, 1991, 1997, 2007, 2011).
• In addition, her book entitled Women’s Health and the World’s
Cities (Meleis, Birch, & Wachter, 2011) supports her recent efforts
on health issues of urban women.
(Alligood, 2014)
6. The development of
Transitions Theory
• Began in the mid-1960s, when Meleis was working on
her PhD.
• Her master’s and PhD research investigated
phenomena of planning pregnancies and mastering
parenting roles.
• She focused on spousal communication and
interaction in effective or ineffective planning of the
number of children in families (Meleis, 1975).
7. • Subsequently, her research focused on people who
do not make healthy transitions and the discovery of
interventions to facilitate healthy transitions.
• This shift in her theoretical thinking led her to role
theories as noted in her publications in the 1970s
and 1980s.
• During this period, her research population interests
shifted to immigrants and their health.
8. • She initiated the development of role supplementation
as a nursing therapeutic.
• Meleis’ theory of role supplementation was used in her
studies on:
1. The new role of parenting (Meleis & Swendsen, 1978).
2. Post–myocardial infarction patients (Dracup, Meleis,
Baker, & Edlefsen, 1985)
3. Older adults (Kaas & Rousseau, 1983)
• These studies using role supplementation theory led
Meleis to question the nature of transitions and the
human experience of transitions.
9. To further develop this theoretical work …
• Meleis initiated extensive literature searches with
Karen Schumacher, a doctoral student at the University
of California, San Francisco, to discover how
extensively transition was used as a concept or
framework in nursing literature.
• They reviewed 310 articles on transitions and developed
the transition framework (Schumacher & Meleis, 1994).
Transitions Theory Development
and Use of Empirical Evidence
10. Publication of transition framework was well received and
tested by scholars and researchers who began using it as a
conceptual framework in these studies :
• Description of immigrant transitions (Meleis, Lipson, &
Dallafar, 1998)
• Women’s experience of rheumatoid arthritis (Shaul, 1997)
• Recovery from cardiac surgery (Shih, Meleis, Yu, et al.,
1998)
• Family caregiving role for patients in chemotherapy
(Schumacher, 1995)
• Early memory loss for patients in Sweden (Robinson,
Ekman, Meleis, et al., 1997)
• Aging transitions (Schumacher, Jones, & Meleis, 1999)
• African-American women’s transition to motherhood
(Sawyer, 1997)
11. • By using the transition framework also, a middle-range
theory for transition was developed. The collective
work was published in 2000 (Meleis, Sawyer, Im, et al.,
2000).
• The theory was built on empirical evidence from five
research studies for conceptualization and theorizing
(Sawyer, 1997; Im, 1997; Messias, Gilliss, Sparacino, et
al., 1995; Messias, 1997; Schumacher, 1994). These
studies were conducted among culturally diverse
groups of people in transition, including African-
American mothers, Korean immigrant midlife women,
parents of children diagnosed with congenital heart
defects.
12. • Based on the early works of Transitions Theory,
situation-specific theories that Meleis (1997) had
called for were developed. Jones and Meleis (1999)
developed a situation-specific theory of elderly
transition.
• In 2010, Meleis collected all the theoretical works in
the literature related to Transitions Theory and
published them in a book entitled:
Transitions Theory: Middle-Range and Situation-
Specific Theories in Nursing Research and Practice.
13. Theoretical Sources for
Transition Theory
1. Meleis’ background in nursing, sociology, role
theory and her educational background.
2. A systematic, extensive literature review; During
Meleis’ mentoring process: mentoring of
Schumacher
3. Collaborative efforts among researchers who used
the transition theoretical framework and middle-
range Transitions Theory in their works.
(Aligood, 2014)
14. MAJOR CONCEPTS &
DEFINITIONS
• Major concepts of the middle-range theory of
transition include:
1. Types and patterns of transitions.
2. Properties of transition experiences
3. Transition conditions (facilitators and inhibitors)
4. Patterns of response (process indicators and
outcome indicators)
5. Nursing therapeutic.
15. Types of Transitions
• 1. Developmental transition: includes birth,
adolescence, menopause, aging, and death.
• 2. Health and illness transitions: include recovery
process, hospital discharge, and diagnosis of chronic
illness (Meleis &Trangenstein, 1994).
• 3. Situational transitions: involve the addition of
subtractions of persons in a preexisting constellations
of role and complements. (e.g loss of family member
through death) (Meleis, 2010)
• 4. Organizational transitions: to changing
environmental conditions that affect the lives of clients,
as well as workers within them (Schumacher & Meleis, 1994)
16. Patterns of Transitions
• Include multiplicity and complexity (Meleis, Sawyer, Im, et al.,
2000).
- People experience multiple transitions simultaneously
rather than experiencing a single transition.
-The transitions happen sequentially or simultaneously,
the degree of overlap among the transitions, and the
essence of the associations between the separate
events that initiate transitions for a person.
18. 1. Awareness is defined as “perception, knowledge, and
recognition of a transition experience,”
-Level of Awareness is frequently reflected in “the degree of
congruency between what is known about processes and
responses and what constitutes an expected set of responses
and perceptions of individuals undergoing similar
transitions” (Meleis, Sawyer, Im, et al., 2000).
2. Engagement: “the degree to which a person demonstrates
involvement in the process inherent in the transition.” Im, and
colleagues (2000).
* The level of awareness is considered to influence the level
of engagement; there is no engagement without awareness.
Properties of Transition Experiences
19. • 3. Changes and differences :
• Changes Person’s sense of movement or direction to
internal as well as external processes due to
experiences in her or his identities, roles, relationships,
abilities, and behaviors. (Schumacher & Meleis, 1994),
Transitions are both the result of change and result in
change (Meleis et al., 2000)
• Differences: challenging differences could be
demonstrated by unsatisfied or atypical expectations,
feeling different or seeing the world and others in
different ways.
Example: Immigrant women found differences in the
food, language, and social patterns. (Meleis et al., 2000)
Properties of Transition Experiences
20. 4. Time span: all transitions may be characterized as
flowing and moving over time (Meleis , Sawyer, Im, et al., 2000).
However, also noted that it would be problematic or
infeasible, and possibly even prejudicial, to frame the
time span of some transition experiences.
Properties of Transition Experiences
21. 5. Critical points and events: “markers intensifying
awareness of changes or dissimilarities; such as birth,
death, the cessation of menstruation, or the diagnosis
of an illness.”
Specific marker events might not be evident for some
transitions, although transitions usually have critical
points and events.
Meleis and colleagues (2000)
Properties of Transition Experiences
22. • “Circumstances that influence the way a person moves
through a transition, and that facilitate or inhibit
progress toward achieving a healthy transition”
(Schumacher & Meleis, 1994).
1. Personal conditions: include meanings, cultural beliefs
and attitudes, socioeconomic status, preparation, and
knowledge.
I. Cultural beliefs and attitudes such as stigma
associated with a transition experience (e.g., Chinese
stigmatization of cancer).
II. Socioeconomic status.
III. Anticipatory preparation or lack of preparation could
facilitate or inhibit people’s transition experiences.
2. Community conditions (e.g., community resources) or
sociacl conditions (e.g., marginalization of immigrants in
the host country). Meleis et al (2000)
Transition Conditions
23. Indicators of healthy transitions in the framework by
Schumacher and Meleis (1994) were replaced by
patterns of response in the middle-range theory of
transitions. They characterize healthy responses.
1. Process indicators: they direct clients into health or
toward vulnerability and risk, make nurses conduct
early assessment and intervention to expedite healthy
outcomes. They include “feeling connected, interacting,
being situated, and developing confidence and coping.”
“The need to feel and stay connected” is a process
indicator of a healthy transition.
Patterns of Response (Process and Outcome Indicators)
24. 2. Outcome indicators: may be used to check if a transition is a
healthy one or not.
• “A healthy completion of a transition” can be decided by the
extent of mastery of the skills and behaviors that people in
transition show to manage their new situations or
environments”.
• Outcome indicators could be associated with irrelevant
events in people’s lives if they are appraised early in a
transition. (Meleis, Sawyer, Im, 2000).
• They include mastery and fluid integrative identities.
• Identity reformulation can also represent a healthy
completion of a transition.
Patterns of Response( Process and Outcome Indicators)
25. Schumacher and Meleis (1994) conceptualized nursing
therapeutics as “three measures that are widely
applicable to therapeutic intervention during
transitions.”
1.Assessment of readiness.: needs to be
interdisciplinary efforts and based on a full
understanding of the client; it requires assessment of
each of the transition conditions in order to generate a
personal sketch of client readiness, and to allow
clinicians and researchers to determine diverse patterns
of the transition experience.
Nursing Therapeutics
26. 2. The preparation for transition: includes education as
the main modality for generating the best condition to be
ready for a transition.
3. Role supplementation: conveying of information or
experience and providing the support needed necessary
to bring the role incumbent and significant others to full
awareness of the anticipated behavior patterns, units,
sentiments, sensations, and goals involved in each role
and its complement.
(Alligood, 2014; Meleis, 2010)
Nursing Therapeutics
27. The summary of Meleis’ works published in the 1970s
defined role supplementation as any deliberate process
through which role insufficiency or potential role
insufficiency can be identified by the role incumbent and
significant others.
It includes both role clarification and role taking, which
may be preventive and therapeutic.
(Meleis, 2010)
Role insufficiency: any difficulty in the cognizance and/or
performance of a role or of the sentiments and goals
associated with the role behavior as perceived by the self
or by significant others.
28. • This conceptualization led Meleis to define the goal of
healthy transitions as mastery of behaviors,
sentiments, cues, and symbols associated with new
roles and identities and non-problematic processes.
• Nurses role is helping patients complete a healthy
transition.
(Meleis, 2010).
29.
30.
31. Nursing
• Nurses are the primary caregivers of clients and their
families who are undergoing transitions.
• Transitions both result in change and are the result of
change.
Person
• Transitions involve a process of movement and changes in
fundamental life patterns, which are manifested in all
individuals.
• Transitions cause changes in identities, roles, relationships,
abilities, and patterns of behavior.
• The daily lives of clients, environments, and interactions are
shaped by the nature, conditions, meanings, and processes
of their transition experiences.
Major Assumptions
32. Health
• Transitions are complex and
multidimensional. Transitions have patterns
of multiplicity and complexity.
• All transitions are characterized by flow
and movement over time.
- Meleis to defined health as mastery, and
she tested that definition through proxy
outcome variables such as fewer
symptoms, perceived well-being, and
ability to assume new roles.
Major Assumptions
33. Environment
• 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.
34. Theoretical Assertions
• Developmental, health and illness, and organizational
transitions are central to nursing practice.
• Patterns of transition include:
(a) whether the client is experiencing a single transition or multiple
transitions.
(b) whether multiple transitions are sequential or simultaneous.
(c) the extent of overlap among transitions.
(d) the nature of the relationship between the different events that
are triggering transitions for a client.
• Properties of transition experience are interrelated parts of a
complex process.
• The level of awareness influences the level of engagement, in
which engagement may not happen without awareness.
35. • Humans’ perceptions of and meanings attached to
health and illness situations are influenced by/ and in
turn influence the conditions under which a transition
occurs.
• Healthy transition is characterized by both process
and outcome indicators.
• Negotiating successful transitions depends on the
development of an effective relationship between the
nurse and the client (nursing therapeutic). This
relationship is a highly reciprocal process that affects
both the client and the nurse.
Theoretical Assertions
36. Logical Form
• Transitions Theory was formulated and theorized
through induction using existing research literature
and findings.
• The theory provides a framework for understanding
the results of previous transitions research more
clearly and for proposing concepts for further study.
37. Acceptance by the Nursing Community
• Transitions Theory has been widely used throughout
the world. Transitions Theory was translated and used
extensively.
38. Practice
• Because of its comprehensiveness, applicability,
and affinity with health:
• Transitions Theory has been applied to many
human phenomena of interest and concern to
nurses, such as illness, recovery, birth, death, and
loss, as well as immigration.
• Transitions Theory is useful in explaining
health/illness transitions such as the recovery
process, hospital discharge, and diagnosis of
chronic disease (Meleis & Trangenstein, 1994).
39. Practice
• Studies have indicated that Transitions Theory could
be applied to nursing practice with diverse groups of
people, including geriatric populations, psychiatric
populations, maternal populations, family caregivers,
menopausal women, Alzheimer patients, and
immigrant women
• Transitions Theory leads to development of nursing
therapeutics that are congruent with the unique
experience of clients and their families in transition,
thus promoting healthy responses to transition.
40. Education
• Transitions Theory is used widely in graduate
education and undergraduate education
throughout the World nursing curricula across
countries University of Connecticut and Clayton
State University in Morrow, Georgia, for the past 15
years.
• Meleis taught an independent graduate elective
course on transitions and health at the University
of California, San Francisco.
41. Research
• Internationally, a number of researchers have used
Transitions Theory in their studies as a theoretical
basis for research.
• Researchers have tested the empirical precision of
Transitions Theory through their studies (Davies,
2005; Weiss, Piacentine, Lokken, et al., 2007).
• Transitions Theory was often used as a parent
theory for situation-specific theories.
• Doctoral dissertations.
42. Further Development
• Transitions Theory continues to be refined and
tested to explain the major concepts and
relationships among diverse groups of
populations in various types of transition.
• Also, as Meleis (2007) envisioned, situation
specific theories continue to be developed
based on Transitions Theory.
45. Critique
Clarity
• The conceptual definitions of Transitions Theory
are clear and provide a comprehensive
understanding of the complexity of transitions.
• The relationships among the major concepts are
clearly depicted in a visually simple diagram.
• The variables are independent of each other, yet
the interactive effects among the variables are
clearly depicted by arrows.
46. Simplicity
• Transitions Theory is simple and clear to
understand.
• The major concepts are logically linked, and the
relationships are obvious in their theoretical
assertions.
47. Generality
• Transitions Theory is a middle-range theory in
scope. Middle-range theories have more limited
scope and less abstraction than grand theories,
and they address specific phenomena or concepts,
which make them applicable in nursing practice.
• Transitions Theory tends to be generalizable to
people in transitions. When diverse types of
transitions are considered, Transitions Theory is
relevant for any population in transition.
48. Accessibility
• Transitions Theory has been tested and supported
by Meleis and others as a framework for explaining
the transition experiences of diverse groups of
populations in different types of transitions.
• Transitions Theory continues to evolve through
planned programs of research, and continuous
empirical research studies will further refine the
theory.
49. Importance
• Transitions Theory with a focus on people in diverse
types of transitions provides a comprehensive and
evolving guide for all health-related disciplines.
• The inherent consideration of diversities of health
care clients and its basis in research among diverse
groups contribute to its importance.
50. Critique using Fawcett Criteria
Significance.
• Metaparadigms, concepts, and propositions
addressed by the theory explicitly.
• Philosophical claims on which the theory is
based are explicit.
• The conceptual model from which the theory
was derived is explicit.
• Antecedent knowledge acknowledged and
bibliographical citations given.
51. Internal Consistency
• Context and content of the theory are
congruent.
• Concepts reflect semantic clarity and
semantic consistency.
• Propositions reflect structural consistency
53. Testability
• Research methodology reflect the middle-range
theory.
• Middle-range theory concepts observable through
instruments that are appropriate empirical indicators
of those concepts.
• Data analysis techniques permit measurement of
propositions.
55. Pragmatic Adequacy
• Education and special skill training required
before application of the theory in nursing
practice.
• Transitions theory has been applied in the real
world of nursing practice.
• It is generally feasible to implement practice
derived from the theory.
• The theory-based nursing actions can lead to
favorable outcomes.
56. Pragmatic Adequacy
• Understanding the properties of specific transitions
guides the nurse in planning effective interventions to
assist the patient in adapting to a change in identity
• It also provides a framework for planning nursing
interventions with the goal of healthy stability.
• It assists the nurse in assessing areas of
vulnerability, readiness, environment, and support.
• It demonstrates that education prior to, during and
following transition increases the likelihood of
successful role integration.
58. References
• Alligood, M. R. (2014). Nursing theorists and their work.
(8th edition). St. Louis: Mosby.
• Meleis, A. I. (2010). Transitions theory: Middle range and
situation specific theories in nursing research and
practice. Springer publishing company.
• Fawcett, J. (2005). Criteria for evaluation of theory.
Nursing Science Quarterly, 18(2), 131-135.
Editor's Notes
1990 medal of excellence 1990 hosni mubarak , egypt
Organizational transitions , caused by change in economical, political, social environment
implementation of new policy, models of nursing care
the introduction of new technology
People experience minimum 2 transitions, at the same time
Migration scholars have called attention to the multiple structural transitions involved in migration, such as transitions in employment, socioeconomic status, culture, and social networks
They are interrelated , not disconnected
1986 Meleis said that lack of awareness mean that the trans ion did not start
2000 Meles … lack of awaness does not mean that the transion did not start.
It can only occur if the person is aware of the changes that are taking place (noticing what has changed) .. This awareness is followed by engagement, where the person is immersed in the transition process and undertakes activities such as seeking information or support, identifying new ways of living .
level of awareness will influence level of engagement
congruency تطابق
All transitions involve change, whereas not all change is related to transition
One of the fathers described the impact of the diagnosis of CHD as having resulted in an abrupt change in family focus. However, the transition was a long-term process, which involved the father adapting to new roles and situations,
Transition has starting point, then, demonstration of transition, confusion , distress, then end point , then a period of instability
Socioeconomic Status : participants who have low socioeconomic status were more likely to experience psychological symptoms.
Anticipatory preparation or lack of preparation : Immigrant woman’s limited knowledge and understanding of geography, language, and culture
Community conditions community sup-port during critical times in their transitions
fluid integrative identities: resulting in identity reformulation as dynamic identity of immigrant Brazilian women
The goals of nursing therapeutics from a transition facilitate healthy transition process and to decrease unhealthy transitions,
1. ongoing process of assessment why ?
Role supplementation may be discussion of what is involved in being a nursing home resident
role incumbent اشغال الدور
deliberate مدروسه incumbent أخذ أو احتلال دور
role supplementation , . Ex. Enhancing positive outcomes in cadiac rehabilitation , by education
Role insufficiency denotes the behavior and sentiments (attitudes) affiliated with any felt discrepancy in fulfilling role obligations or expectations of self and/or significant others in a health-illness situation. EX. anxiety, depression, apathy, frustration
Role Clarification: Mastery of the knowledge or the specific informa-
role taking: involves the empathic متعاطف abilities of ego, both cognitively and affectively.
The self plans and enacts his role by vicariously assuming the role of the other.
healthy transitions : in elderly subjective well being. Ch.ch by developing new knowledge and skills
Unhealthy …….: unrealistic expectation, being passive, dependent, while he can help himself. And new knowledge and skills are avoided.
Nurses role is helping patients complete a healthy transition.
Theory was formulated with the goal of integrating what is known about transition experiences across different types of transitions with nursing therapeutics for people in transition.
Used extensively in Sweden, Taiwan, South Korea,
Transitions Theory could provide direction for nursing practice with people in various types of transitions by providing a comprehensive perspective
on the nature and type of transitions,
In different contexts
The current focus is culturally competent health care
As an evolving theory, there remain issues of consistency and clarity when researching the origins and evolution of concepts.
Transition theory aligns well with the partnership model of health care and holistic practice of nursing.
While conceived for the field of nursing, role transition is a theme in sociology and psychology that is applied in works concerning women and cultural issues (Meleis & Rogers, 1987; Im et al. 1999). In these applications, different inconsistent terminology and meaning made comprehension and identifying major concepts difficult.
. As this theory evolves and more elements are added, parsimony decreases.… there remain issues of consistency and clarity when researching the origins and evolution of concepts.
Transition is moderate in scope and defines a facet of nursing practice.
but too limited in scope