Page 597 - alligood 8th edition_Neat

578 UNIT V Middle Range Nursing Theories
Person self-transcendence must be expressed like any other
Persons were conceived as developing over their life developmental capacity in life for a person to realize a
span in interaction with other persons and within an continuing sense of wholeness and connectedness.
environment of changing complexity and vibrancy This assumption is congruent with Frankl’s (1969)
that could both positively and negatively contribute to and Maslow’s (1971) conceptualizations of self-
health and well-being. transcendence as an innate human characteristic that,
when actualized, gives purpose and meaning to a
Health person’s existence.
In the early process model, health was defined implicitly
as a life process of both positive and negative experi-
ences from which individuals create unique values and Theoretical Assertions
environments that promote well-being. There are three basic concepts in the Self-Transcendence
Theory: vulnerability, self-transcendence, and well-
Environment being (Reed, 2003, 2008). Vulnerability is the aware-
Family, social networks, physical surroundings, and ness of personal mortality that arises with aging and
community resources were environments that signifi- other life phases, or during health events and life
cantly contributed to health processes that nurses in- crises (Reed, 2003). The concept of vulnerability
fluenced through “managing therapeutic interactions clarifies that the context within which self-transcen-
among people, objects, and [nursing] activities” dence is realized is not only when confronting end-
(Reed, 1987, p. 26). of-own-life issues but also includes life crises such as
This metaparadigmatic approach to knowledge disability, chronic illness, childbirth, and parenting.
development for a nursing specialty was innovative Self-transcendence refers to the fluctuations in per-
and foundational to Reed’s own future work with the ceived boundaries that extend persons beyond their
concepts of spirituality and self-transcendence. Self- immediate and constricted views of self and the
Transcendence Theory evolved from the perspective world. The fluctuations are pandimensional: outward
that self-transcendence is one of many processes (toward awareness of others and the environment),
related to health, and the overall goal of the theory inward (toward greater insight into one’s own beliefs,
was to provide nurses with another perspective on the values, and dreams), temporal (toward integration of
human capacity for well-being. past and future in a way that enhances the relative
In her initial explication of the emerging Self- present), and transpersonal (toward awareness of
Transcendence Theory, Reed (1991a) identified one dimensions beyond the typically discernible world)
key assumption based on Rogers’ conceptual system. (Reed, 1997b, 2003, 2008). Well-being is “feeling
This assumption was that persons are open systems whole and healthy, in accord with one’s own criteria
who impose conceptual boundaries upon themselves for wholeness and well-being” (Reed, 2003, p. 148).
to define their reality and to provide a sense of whole- The theory also allows for additional personal and
ness and connectedness within themselves and their contextual variables such as age, gender, life experi-
environment. Reed (2003) reaffirmed this assumption ences, and social environment that can influence the
in a later publication, restating Rogers’ basic assump- relationships among the three basic concepts. Interven-
tion that “human beings are integral with their environ- tions would focus on nursing activities that facilitate
ment” (p. 146). Self-conceptual boundaries fluctuate self-transcendence.
in form across the life span and are associated with Three major propositions of the theory were devel-
human health and development. Self-transcendence oped from the three basic concepts. The first proposi-
was proposed as an important indicator of a person’s tion is that self-transcendence is greater in persons
conceptual self-boundaries that could be assessed at facing end-of-own-life issues than in persons not fac-
specific times. ing such issues. End-of-own-life issues are interpreted
A second assumption identified in the later de- broadly, as they arise with life events, illness, aging, and
scription of the theory was that self-transcendence other experiences that increase awareness of personal
is a developmental imperative (Reed, 2003), that is, mortality.