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580 UNIT V Middle Range Nursing Theories

theory are related in a clear and logical manner, while persons with dementia (Acton & Wright, 2000) and
allowing for creativity in the way the theory is ap- bereaved individuals (Joffrion & Douglas, 1994). Acton
plied, tested, and further developed. Reed’s strategy of and Wright (2000) suggest arranging respite care for
constructing a nursing theory—from non-nursing caregivers so that they have time and energy for transper-
theories, a nursing conceptual model, research, and sonal activities. Applications of creative-bonding art
clinical and personal experiences—piqued nurses’ activities to promote self-transcendence were used in
interest in the phenomenon of developmental matu- studies with nursing students and older adults (Chen &
rity and provided impetus for further theorizing into Walsh, 2009; Walsh, Chen, Hacker, et al., 2008) and in
the variety of situations where awareness of personal late-stage Alzheimer’s disease (Walsh, Lamet, Lindgren,
mortality occurs. et al., 2011). McGee (2000) suggested that recovery in
alcoholism involves self-transcendence, facilitated by a
nurse-designed environment that supports the 12 steps
Acceptance by the Nursing Community and 12 traditions of Alcoholics Anonymous.
The quest for nursing is to facilitate human well-being
through what Reed calls “nursing processes,” of which Education
self-transcendence is one example (Reed, 1997a). Self-transcendence is in the writings of nurse theorists
Self-Transcendence Theory has been widely used in who are influential in nursing education (Erickson,
practice, education, and research. 2002; Erickson, Tomlin, & Swain, 1983; Newman,
1986; Parse, 1981; Rogers, 1970, 1980; Sarter, 1988;
Practice Watson, 1979, 1985). These theories share a common
Reed’s (1986a, 1987) process model for clinical specialty view identifying self-transcendence as a foundational
education and psychiatric–mental health nursing prac- concept for the discipline. All levels of education may
tice articulates relationships among the metaparadigm use the theory in courses to support care of the aging.
constructs of health, persons and their environments, Guo, Phillips, and Reed (2010) supported the need for
and nursing activity. Self-Transcendence Theory non-hospice nurses to improve their abilities and atti-
delineates specific concepts from Reed’s process tudes toward older adults and their family caregivers
model: constructs of health (i.e., well-being), per- related to end-of-life care. The art-activity with older
son (i.e., self-transcendence), and environment (i.e., adults at community senior centers is designed to
vulnerability), and it proposes relationships among develop more positive attitudes in nursing students
these concepts to direct nursing activities. Reed when caring for them (Chen & Walsh, 2009; Walsh,
(1991a) and Coward and Reed (1996) have sug- Chen, Hacker, et al., 2008).
gested nursing activities that facilitate expansion of Self-transcendence is a pathway for helping the
self-conceptual boundaries—journaling, art activi- healer, or healing the healer, so that nurses learn to
ties, meditation, life review, and religious expres- maintain a healthy lifestyle as they care for others
sion, to name a few. (Conti-O’Hare, 2002). Two studies provide support
Self-transcendence may be integral to healing in for nurses benefiting from self-transcendence atti-
many life situations. Nurse activities that promote the tudes and behaviors. Self-transcendence perspectives
activities of self-reflection, altruism, hope, and faith correlated with lower levels of burnout in hospice and
in vulnerable persons are associated with an increased oncology nurses (Hunnibell, Reed, Quinn-Griffin,
sense of well-being. Group psychotherapy (Stinson & et al., 2008) and with higher levels of work engage-
Kirk, 2006; Young & Reed, 1995) and breast cancer ment in acute care nurses (Palmer, Quinn, Reed,
support groups (Coward, 1998, 2003; Coward & Kahn et al., 2010).
2004; 2005) are interventions that nurse researchers
used to provide clients with opportunity for examin- Research
ing their values, for reaching out to share experience A number of research studies provide evidence to
with and help similar others, and for finding meaning support the association between self-transcendence
from their health situations. Others suggested similar and increased well-being in populations that typically
strategies to facilitate well-being in caregivers of are confronted with awareness of their own personal