Page 403 - alligood 8th edition_Neat

384 UNIT IV Nursing Theories

MAJOR CONCEPTS & DEFINITIONS—cont’d
process. The process indicators suggested by Meleis Nursing Therapeutics
and colleagues (2000) include “feeling connected, Schumacher and Meleis (1994) conceptualized
interacting, being situated, and developing confi- nursing therapeutics as “three measures that are
dence and coping.” “The need to feel and stay con- widely applicable to therapeutic intervention dur-
nected” is a process indicator of a healthy transition; ing transitions.” First, they proposed assessment
if immigrants add new contacts to their old contacts of readiness as a nursing therapeutic. Assessment
with their family members and friends, they are of readiness needs to be interdisciplinary efforts
usually in a healthy transition. Through interac- and based on a full understanding of the client; it
tions, the meaning attached to the transition and the requires assessment of each of the transition condi-
behaviors caused by the transition can be disclosed, tions in order to generate a personal sketch of client
analyzed, and understood, which usually results in a readiness, and to allow clinicians and researchers
healthy transition. Location and being situated in to determine diverse patterns of the transition
terms of time, space, and relationships are usually experience. Second, the preparation for transition
important in most transitions; these indicate is suggested as a nursing therapeutic. The prepara-
whether the person is turned in the direction of a tion of transition includes education as the main
healthy transition. The extent of increased confi- modality for generating the best condition to
dence that people in transition are experiencing is be ready for a transition. Third, role supplementa-
another important process indicator of a healthy tion was proposed as a nursing therapeutic. Role
transition. The outcome indicators suggested by supplementation was suggested by Meleis (1975)
Meleis, Sawyer, Im, and colleagues (2000) include and used by several researchers (Brackley, 1992;
mastery and fluid integrative identities. “A healthy Dracup, Meleis, Clark, Clyburn, Shields, & Staley,
completion of a transition” can be decided by the 1985; Gaffney, 1992; Meleis & Swendsen, 1978). Yet,
extent of mastery of the skills and behaviors that in the middle-range theory of transitions, there is
people in transition show to manage their new situ- no further development of the concept of nursing
ations or environments. Identity reformulation can therapeutics.
also represent a healthy completion of a transition.

Use of Empirical Evidence 1997), the aging transition (Schumacher, Jones, &
In the development of the transition framework by Meleis, 1999), African-American women’s transition to
Schumacher and Meleis (1994), a systematic extensive motherhood (Sawyer, 1997), and adult medical-surgical
literature review of more than 300 articles related to patients’ perceptions of their readiness for hospital dis-
transitions provided empirical evidence of the con- charge (Weiss, Piacentine, Lokken, et al., 2007).
ceptualization and theorizing. Then, as mentioned Development of the middle-range theory of tran-
earlier in the chapter, the transition framework was sition builds on empirical evidence from five re-
tested in a number of studies to describe immigrants’ search studies for conceptualization and theorizing
transitions (Meleis, Lipson, & Dallafar, 1998), wom- (Sawyer, 1997; Im, 1997; Messias, Gilliss, Sparacino,
en’s experiences with rheumatoid arthritis (Shaul, et al., 1995; Messias, 1997; Schumacher, 1994). These
1997), recovery from cardiac surgery (Shih, Meleis, studies were conducted among culturally diverse
Yu, et al., 1998), development of the family caregiving groups of people in transition, including African-
role for chemotherapy patients (Schumacher, 1995), American mothers, Korean immigrant midlife
Korean immigrant low-income women in meno- women, parents of children diagnosed with con-
pausal transition (Im, 1997; Im & Meleis, 2000, 2001; genital heart defects, Brazilian women immigrating
Im, Meleis, & Lee, 1999), early memory loss for to the United States, and family caregivers of per-
patients in Sweden (Robinson, Ekman, Meleis, et al., sons receiving chemotherapy for cancer. Empirical