Page 549 - Encyclopedia of Nursing Research

516 n TRANSITIONS AND HEALTH

of disruption and disorientation as well as students, and practicing nurses (Meleis, 2010).
discovery, and (c) a period of new beginnings An increasing emphasis on transitions in cul-
T in which the individual finds new mean- turally diverse populations is evident as well,
ings and a sense of control and challenge. including Chinese, Mexican, Taiwanese, and
Transitions also can be conceptualized in Saudi Arabian populations. The rapidly
terms of critical periods. Critical periods are growing scholarship on diverse interna-
turning points that can lead to either healthy tional populations experiencing transitions
or unhealthy outcomes. demonstrates the centrality of the concept of
The transition process takes place within transition for nursing worldwide.
the context of an individual’s history, present underlying the current interest in transi-
circumstances, and future possibilities. A tions and health are global societal changes
sense of disconnectedness from one’s famil- occurring with unprecedented rapidity
iar world may occur during transitions. A (Meleis, 2010). Some are the result of tech-
sense of loss or alienation from what had nological developments, such as the ease
been familiar and valued may also occur, with which information and communica-
along with fundamental changes in one’s tion flows around the world. Others are the
view of self and the world. ultimately, indi- result of wars, disasters, recessions, and dis-
viduals experiences changes in identity, location. These events precipitate transitional
roles, and patterns of behavior during a tran- processes that reach well beyond the individ-
sition. New knowledge and skills, new roles, uals directly experiencing them. global tran-
new relationships, and new coping strategies sitional processes may last for an extended
must be developed. period of time and impact health and well-
Nursing scholarship focuses on many being on a long-term basis. Far-reaching
types of transitions, including develop- changes during global societal transitions
mental, situational, health/illness, and have profound effects on organizations and
organizational transitions (Meleis, 2010). populations alike.
Developmental transitions that nurses fre- persons in transition experience a wide
quently encounter include the transition into range of health-related responses. They
motherhood, the menopausal transition, and may experience losses or gains, be more
the aging transition, among others. Situational or less aware of being in transition, suffer
transitions include hospital discharge, relo- from physical debilitation, have lower or
cation, immigration, and education. Health/ higher immune responses, feel an emer-
illness transitions include movement from gence or loss of spirituality, discover new
one phase of a health and illness trajectory to meanings, or experience traumatic stress
another, such as diagnosis, recovery, rehabil- symptoms. Outcomes indicating healthy
itation, lifestyle change, and development of responses to transitions include a sense of
self-care abilities. Organizational transitions meaning, subjective well-being, the devel-
include changes in environments for nurs- opment of a new identity, mastery of new
ing, initiated by changes in leadership, poli- roles, well-being in relationships, harmony
cies, procedures, practices, and technologies. with the environment, renewed energy,
Structural reorganization and new programs optimal physical and mental health and
also initiate transitional processes within functioning, and positive quality of life.
organizations. Adverse outcomes include marginalization,
Nurse researchers have investigated inability to separate from past identities
these types of transitions in an ever-increas- and ways of functioning, inability to make
ing range of populations, including women, decisions, ongoing role insufficiency, isola-
older adults, individuals living with heart fail- tion, and protracted duration of the tran-
ure, diabetes, cancer or rheumatoid arthritis, sition process. previous life patterns may