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CHAPTER 29 Pamela G. Reed 581

mortality. The research studies related self-transcen- failure (Gusick, 2008), liver transplant recipients
dence to depression among elders (Reed, 1986b, 1989, (Bean & Wagner, 2006), bullied middle-school boys
1991a). Other research reported similar relationships (Willis & Grace, 2011; Willis & Griffith, 2010), stem
in depressed older adults (Klaas, 1998; Stinson & cell transplant recipients (Williams, 2012), and per-
Kirk, 2006; Young & Reed, 1995), middle-aged adults sons with dementia (Walsh, Lamet, Lindgren, et al.,
(Ellermann & Reed, 2001), and individuals who lost 2011). Kim and colleagues (2011) found interdepen-
loved ones from HIV/AIDS (Kausch & Amer, 2007). dence within Korean caregiver-elder dyads on self-
Buchanan, Ferran, and Clark (1995) examined self- transcendence variables and well-being. Two other
transcendence and suicidal thought in older adults. reports examined the role of caregivers of end-of life
Upchurch (1999) and Upchurch & Mueller (2005) older adults and reported a positive relationship be-
explored the relationship between self-transcendence tween caregiver transcendence and well-being (Phillips
and activities of daily living in noninstitutionalized & Reed, 2009a, 2009b). Positive relationships among
older adults. Two studies explored self-transcendence transcendence and transformation and finding mean-
and older adults’ perceptions of positive physical and ing were also described in women with chronic condi-
mental health (Bickerstaff, Grasser, & McCabe, 2003; tions such as arthritis (Neill, 2002; Shearer, Fleury, &
Nygren et al., 2005). Walton, Shultz, Beck, and Walls Reed, 2009).
(1991) identified an inverse relationship between self- Intervention studies designed by nurses to promote
transcendence and loneliness in healthy older adults. self-transcendence views and behavior documented
Decker and Reed (2005) found that integrated moral changes in self-transcendence and well-being. One
reasoning, completion of a living will, and prior expe- intervention, a Self-Transcendence Theory–based
rience with a life-threatening illness were related to support group, had a small positive effect on self-
older adults’ desire for less aggressive treatment at the transcendence and well-being in women with newly
end of life. diagnosed breast cancer (Coward, 1998, 2003; Coward
A number of studies have demonstrated a positive & Kahn, 2004). Young and Reed (1995) found that
relationship among self-transcendence and well-being group psychotherapy facilitated self-transcendence in
or quality of life in persons with HIV or AIDS (Coward, a small sample of older adults. A personal narrative
1994, 1995; Coward & Lewis, 1993; McCormick, intervention increased self-transcendence scores in
Holder, Wetsel, et al., 2001; Mellors, Erlen, Coontz, women with HIV, multiple sclerosis, and systemic lu-
et al., 2001; Mellors, Riley, & Erlen, 1997; Sperry, 2011; pus erythematosus compared to women in a control
Stevens, 1999). Numerous studies have described group (Diener, 2003). Responses of several people
self-transcendence or related concepts in women with with late-stage Alzheimer’s disease following a similar
breast cancer (Carpenter, Brockopp, & Andrykowski, simple art intervention evidenced self-transcendence
1999; Coward, 1990, 1991; Coward & Kahn, 2004, 2005; and well-being (Walsh, Lamet, Lindgren, et al., 2011).
Farren, 2010; Kamienski, 1997; Kinney, 1996; Matthews A poetry-writing intervention for caregivers of older
& Cook, 2009; Pelusi, 1997; Taylor, 2000; Thomas, adults with dementia found themes of self-transcen-
Burton, Quinn-Griffin, et al., 2010). dence in caregivers following the intervention (Kidd,
Acton (2003), Acton and Wright (2000), and Kidd, Zauszniewski, Morris, et al., 2011).
Zauszniewski, and Morris (2011) explored self- Reed has mentored a number of master’s and
transcendence in caregivers of persons with dementia doctoral students in research on self-transcendence.
as well as in caregivers of terminally ill patients who Research results from these studies provide addi-
had died within the previous year (Enyert & Burman, tional empirical support for the theory and are cited
1999; Reed & Rousseau, 2007). Other populations earlier in the chapter and listed in the bibliography.
studied include healthy middle-aged adults (Coward,
1996), elderly men with prostate cancer (Chin-A-Loy
& Fernsler, 1998), female nursing students and faculty Further Development
(Kilpatrick, 2002), nurses (Hunnibell, Reed, Quinn- Reed’s initial conceptualization of self-transcendence
Griffin, et al., 2008; McGee, 2004), homeless adults focused on later adulthood and identified the impor-
(Runquist & Reed, 2007), elders with chronic heart tance of personal resources that expand self-boundaries