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584 UNIT V Middle Range Nursing Theories

and personal experiences of the theorist. The theoreti-
cal concepts are abstract, but concrete subconcepts asked him if he thought his wife would have had
have been developed and studied extensively in a a similar experience if he had been the first to die.
number of populations. Research findings support the His response was that his wife would have had an
hypothesized relationships among self-transcendence even more difficult time adjusting. The nurse and
views, behaviors, and well-being. These studies in- Mr. Jones then spent some time reflecting on and
crease nurses’ understanding that, no matter how talking about his response. The nurse’s initial ques-
desperate a health situation, people retain a capacity tion and Mr. Jones’s resulting insight that his grief
for personal development that is associated with feel- was not as bad as his wife’s would have helped him
ings of well-being. transcend his immediate experience of loss and find
Research findings have suggested ways in which some meaning in his grief.
nurses promote self-transcendence views and behav- This illustration is an example of an inward
iors in themselves and in their clients. Further re- expansion of self-conceptual boundaries indicative
search is planned to examine interventions promoting of self-transcendence. Other expressions of self-
self-transcendence and studies of personal and con- transcendence might help Mr. Jones facilitate his
textual factors that modify relationships among the own healing and regain a measure of well-being.
theory concepts. In addition, qualitative research ap- In terms of outward expansion, Mr. Jones, with
proaches assist in gaining a deeper understanding of some encouragement, might reach out to his son’s
the concept of self-transcendence as a nursing process family to begin to reconnect to the world outside
and as it expresses the depth and changing complexity himself. Walking to and from his home to theirs
of human beings. could expand his sensory world and provide op-
portunities to interact with other people and with
nature along the way. Spending time with his
CASE STUDY
grandchildren could be enlivening through the joy
Mr. Jones is a 65-year-old man whose wife died young children can bring to an older person, as
6 months ago after a long illness. The couple was mar- could a sense of satisfaction derived from being
ried 45 years, and they were devoted to each other. helpful to his son and daughter-in-law.
They had three children who are now in their 30s. Offering at a future time to use the skills he
Two of the children live several hundred miles away, learned while caring for his wife through volun-
but one son lives with his wife and two preschool teering with hospice would be an example of tran-
children less than 1 mile from Mr. Jones’s home. scending temporally. Integrating his memories of
Mr. Jones provided much of the care for his Mrs. Jones into his current life would be another
wife during her illness. Although her care was example of temporal self-transcendence.
time-consuming and fatiguing and kept him at Transpersonal self-transcendence is another
home much of the time, he was grateful that he important experience for Mr. Jones. Although he
could care for her. He now is alone in their home, was unable to attend church services for several
is very lonely, is uninterested in preparing meals years, he had in the past found worshiping with
or eating, and lacks energy to return to his former others a source of comfort. His spiritual life might
community and social activities or even to interact even be expanded to consider new spiritual dimen-
with his son and family. sions such as that found in the possibility of “being
The hospice nurse contacted Mr. Jones for fol- with” his wife again someday or in some way expe-
low-up bereavement counseling. She told him that riencing her presence in the present. Returning to
although he had “passed” a routine physical exami- church or to addressing spiritual dimensions out-
nation the week before, she was concerned about side of organized worship that relates Mr. Jones’s
his continuing sadness and lack of energy. The understanding of death to some greater or divine
nurse reassured him that it was not uncommon to design is another example of transpersonal self-
grieve for many months after a major loss. She transcendence.