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CHAPTER 20 Afaf Ibrahim Meleis 387

Piacentine, Lokken, et al., 2007). As mentioned ear- applicable in nursing practice. Transitions Theory
lier in the chapter, Transitions Theory was often used tends to be generalizable to people in transitions.
as a parent theory for situation-specific theories When diverse types of transitions are considered,
(Im & Meleis, 1999a; Im, 2006; Schumacher, Jones, & Transitions Theory is relevant for any population in
Meleis, 1999). A number of doctoral students, includ- transition, depending on the type of transition the
ing Shellye Vardaman at the University of Texas at population is experiencing. The research used to
Tyler, have used Transitions Theory in their doctoral derive Transitions Theory was based on the participa-
dissertations. tion of different gender and ethnic groups in various
settings. This makes Transitions Theory more easily
generalizable than theories developed for research
Further Development with specific client populations.
Transitions Theory was an emerging framework that
could be further developed, tested, and refined, Accessibility
reflecting Meleis’ philosophical position on theory Transitions Theory has been tested and supported by
development as cyclic, dynamic, and evolving. Transi- Meleis and others as a framework for explaining the
tions Theory continues to be refined and tested to transition experiences of diverse groups of popula-
explain the major concepts and relationships among tions in different types of transitions. Transitions
diverse groups of populations in various types of tran- Theory continues to evolve through planned pro-
sition. Because sufficient empirical support by a num- grams of research, and continuous empirical research
ber of studies using Transitions Theory exists, future studies will further refine the theory. The develop-
studies will aim at intervention studies to test Transi- ment of situation-specific theories derived from Tran-
tions Theory–based interventions, through which sitions Theory will further reduce its distance from
Transitions Theory gains power to direct nursing the empirical world as well.
practice. Also, as Meleis (2007) envisioned, situation-
specific theories continue to be developed based on Importance
Transitions Theory. Transitions Theory with a focus on people in diverse
types of transitions provides a comprehensive and
Critique evolving guide for all health-related disciplines. Health-
related disciplines always deal with a type of transition,
Clarity whether single or multiple. Especially with an increas-
The conceptual definitions of Transitions Theory are ing need for culturally competent health care for
clear and provide a comprehensive understanding of diverse groups of health care clients, Transitions Theory
the complexity of transitions. The relationships among provides a more appropriate theoretical fit for current
the major concepts are clearly depicted in a visually health care. The inherent consideration of diversities
simple diagram (see Figure 20–1). The variables are of health care clients and its basis in research among
independent of each other, yet the interactive effects diverse groups contribute to its importance.
among the variables are clearly depicted by arrows.
Simplicity Summary
Transitions Theory is simple and clear to understand. Current health care systems are frequently character-
The major concepts are logically linked, and the rela- ized by changes, diversities, and complexities. Transi-
tionships are obvious in their theoretical assertions. tions Theory, which evolved from research studies
among diverse groups of people in various types of
Generality transitions, could adequately direct nursing practice,
Transitions Theory is a middle-range theory in scope. education, and practice in the current health care
Middle-range theories have more limited scope and system. Meleis made her theoretical journey from the
less abstraction than grand theories, and they address 1960s, and her journey continues. Transitions Theory
specific phenomena or concepts, which make them continues to develop through a number of studies