Transition Theory According To Meleis
Transitions Theory Case Study
This paper attempts to accomplish two goals as stated in the objectives of the assignment: to describe Transitions Theory and apply it on the selected Case Study. After reading the assigned readings and outside sources, here is my understanding and application of the mentioned theory. According to Meleis, Sawyer, Im, Messias, and Shumacher (2000) Transitions Theory is a theory that attempt to explain the exchanges that exist when people pass through changes, events and phases in any point in their lives that is somewhat connected to their health and their capability to carry on in life after the event has occurred and how nursing interactions, recognition of stressors, interventions and educations can help …show more content…
them move from one stable period in their life to another stable period as they may have delays in getting back on their feet and be at risk for more problems.
Changes in any aspect of life can be expected and unexpected, while some people are able to deal with these changes, other are not so fortunate and it totally overwhelms them and in turn affects their health and well-being. It may be poor coping skills or lack of resources that can be the reason, but whatever the situation may be, these people need assistance in transitioning to a placed where they have control or a grip of their situation in regards to what they just went through. It is a Nursing theory in the respect that it is applied in a nursing perspective of interacting, assessing, recognizing, planning, advocating, and assisting these patients in relation to the effects of how the changes and events are affecting them.
The theory is broken down into concepts that categorizes and details the types and natures of the stressors and how each stressor is addressed in the goal of assisting the patient in effectively transitioning, attaining and maintaining health and balance. Five concepts will be named, expounded and applied to the situation of Mr. Jorge Rojas and family.
Meleis et al. (2000) describes the concept of Type as one of the descriptors of the nature of the transitions that describes the kinds of and what aspect of human existence (developmental, situational, Health-illness, and Organizational) are affected by the changes that is occurring. All changes that happen in life fall in one of the four mentioned categories or aspects. In the case of Mr. Rojas and family, they have many changes that falls into various categories. For Mr. Rojas, the changes he is experiencing is enumerated by the following type: Developmentally he is aging at 45 years old; Situationally he was just laid off from his job and is facing foreclosure of his home and possible eviction; Health and illness-wise he was just diagnosed with Diabetes Type II, is overweight, and is struggling with a new diet that was recommended for him; Organizationally he is an immigrant with all of his family abroad. Mrs. Rojas is dealing with the changes of (health-illness) being overweight, new diet; (developmental) being pre-menopausal; (organization) with her being an immigrant with having issues with speaking or understanding the language. Both children are exposed to the changes of (developmental) being teenagers and all the changes that occurs in those ages; (health-illness) with being slightly overweight and in a new diet and just like their parent are new immigrants (organization) and the possibility of eviction from their home (situational).
The next concept selected was Patterns. This refers to the amount of stressors and changes a patient is experiencing and dealing with at any period of time (Meleis et al. 2000). It is important to know how many changes are occurring at any given time as it can change the interventions and goals. In assessing the transitions that the Rojas family is experiencing, the Nurse Practitioner notices that there are various Patterns seen in their situation that are Multiple, Sequential, Simultaneous, Related and Unrelated. The multiple aspect was seen as he has many stressors or transitions in life; an example of sequential is that as he is currently laid off, he can forclose on the house, be evicted and be homeless; the simultaneous aspect can be seen that these transitions are occurring at the same period; the related aspect can be seen with him being overweight, being diagnosed with Diabetes II, and placed on a new diet; the unrelated stressor are seen as he is having both health issues and occupation and living arrangement issues. His wife and children does not share the same complexity of Patterns of transitions though. Clearly the family is going through various Patterns of transitions
The next concept, Properties of Transition, refers to the level of recognition, orientedness to the change, time lines, milestones, the general feel and perception that the patient feels about the changes that are occurring.
These are entangled together and closely affect each other (Meleis et al. 2000). It is divided into sub-sections or aspects that get into detail every angle and details of the reaction and response to the change or stressor. The applicability of this concept to the family is as follows. All of the mentioned changes and transitions that the family is experiencing have the potential to get out of hand and be more serious, specially the complications of Diabetes, being overweight and homelessness. The only limitation I can see is the amount knowledge and education the family has received about this health issues. From this stand point, I do not believe that they are satisfying the Awareness aspect of the concept. Unfortunately, without full Awareness, they are not completely able to Engage and be involved in finding resources for aid. The family on a new diet, indicating they may have received limited amount of health education. They may have perceived that the recommended change in diet is a precursor to something worse or as an attempt to do damage control when it comes to their health. This change in lifestyle, along with the stigma of being laid off or potentially being homeless will definitely alter their perceptions towards themselves and their environment. This is how I believe the aspect of Change and Difference is affecting this family. In regards to the aspect of Timespan of the transition, I believe this is related and closely dependent on their level of Awareness of the changes, so the duration of transition is undetermined at this point. The Critical Point and Events aspect that applies in this case is the facts that that they are on a new diet and the laying off of Mr. Rojas from his job. This has served as a red flag or a warning
that there have been and there will be changes that have occurred and a response is needed. The concept of Property is multi-dimensional, in the respect of that it zooms into the life of the patient and helps a provider see what they really have and their current state. To me, as a Family Nurse Practitioner, this is where I can see and determine how the transition has impacted the patient and how are they dealing with it. The next concept discussed is Transition Conditions. This concept is geared towards comprehending and knowing the experiences of the subject whom the transition is happening to through the viewpoint of their self-perspective, their backgrounds and the community that they are set. This concept is broken into parts to further determine how the patient’s unique situation can either prepare or hinder them through the change process (Meleis et al. 2000). The application of this concept to the Rojas family yields this presentation. In the phase of the change in diet, the part of Meaning may play big role in the perspective of the family being new immigrants that grew up in a different culture, beliefs and diet. In some cultures, food in not just for satisfying hunger, it is also medicine and part of religious practices. In being told to change their diet, the family may see it as a blow and a separation from their social and culture and cherished beliefs. The family’s economic status is a hindrance and inhibitor to properly transitioning to situation where they can feel that they have control of their lives. Other perspectives needed to be accounted for are the fact that the family are new immigrants with no other family members to act as a support and are unlikely prepared or knowledgeable about the nature of the changes occurring or knowing what local resources are available to them The last concept discussed is Outcome Indicators. This concept determines the result of the transition process or its completion. It is a place where the patient attains a sense of balance after the changes that just happened through effective coping, gaining new abilities or still being in the process of learning (Geary & Schumacher, 2012). There are two listed outcomes a subject can fall into depending on how they are after the transition: Mastery or Fluid Integrative Identities. In application to the Rojas family situation, I believe that it is too early to tell if they have mastered anything in any of the mentioned transitions that are occurring. They do have hindrances that can limit their ability to transition effectively. The family is more likely to be in the Fluid Integrative Identity as they are likely integrate new aspects of living in a new country with their cherished cultures, values and beliefs from their native country. They are essentially wearing two hats in regards to living in a new place. This may well also be the case concerning their views towards the mentioned health and economic issues that they are facing. I feel that Transitions Theory is a really effective theory in caring for patients. I believe this because the theory touches upon the patient in a systematic and detailed method that ensures that the practitioner has an idea of where they are coming from, their views, awareness of the problem, resources and willingness to be better. I can see myself utilizing it in my practice as a Family Nurse Practitioner in the future.
This paper attempts to accomplish two goals as stated in the objectives of the assignment: to describe Transitions Theory and apply it on the selected Case Study. After reading the assigned readings and outside sources, here is my understanding and application of the mentioned theory. According to Meleis, Sawyer, Im, Messias, and Shumacher (2000) Transitions Theory is a theory that attempt to explain the exchanges that exist when people pass through changes, events and phases in any point in their lives that is somewhat connected to their health and their capability to carry on in life after the event has occurred and how nursing interactions, recognition of stressors, interventions and educations can help …show more content…
them move from one stable period in their life to another stable period as they may have delays in getting back on their feet and be at risk for more problems.
Changes in any aspect of life can be expected and unexpected, while some people are able to deal with these changes, other are not so fortunate and it totally overwhelms them and in turn affects their health and well-being. It may be poor coping skills or lack of resources that can be the reason, but whatever the situation may be, these people need assistance in transitioning to a placed where they have control or a grip of their situation in regards to what they just went through. It is a Nursing theory in the respect that it is applied in a nursing perspective of interacting, assessing, recognizing, planning, advocating, and assisting these patients in relation to the effects of how the changes and events are affecting them.
The theory is broken down into concepts that categorizes and details the types and natures of the stressors and how each stressor is addressed in the goal of assisting the patient in effectively transitioning, attaining and maintaining health and balance. Five concepts will be named, expounded and applied to the situation of Mr. Jorge Rojas and family.
Meleis et al. (2000) describes the concept of Type as one of the descriptors of the nature of the transitions that describes the kinds of and what aspect of human existence (developmental, situational, Health-illness, and Organizational) are affected by the changes that is occurring. All changes that happen in life fall in one of the four mentioned categories or aspects. In the case of Mr. Rojas and family, they have many changes that falls into various categories. For Mr. Rojas, the changes he is experiencing is enumerated by the following type: Developmentally he is aging at 45 years old; Situationally he was just laid off from his job and is facing foreclosure of his home and possible eviction; Health and illness-wise he was just diagnosed with Diabetes Type II, is overweight, and is struggling with a new diet that was recommended for him; Organizationally he is an immigrant with all of his family abroad. Mrs. Rojas is dealing with the changes of (health-illness) being overweight, new diet; (developmental) being pre-menopausal; (organization) with her being an immigrant with having issues with speaking or understanding the language. Both children are exposed to the changes of (developmental) being teenagers and all the changes that occurs in those ages; (health-illness) with being slightly overweight and in a new diet and just like their parent are new immigrants (organization) and the possibility of eviction from their home (situational).
The next concept selected was Patterns. This refers to the amount of stressors and changes a patient is experiencing and dealing with at any period of time (Meleis et al. 2000). It is important to know how many changes are occurring at any given time as it can change the interventions and goals. In assessing the transitions that the Rojas family is experiencing, the Nurse Practitioner notices that there are various Patterns seen in their situation that are Multiple, Sequential, Simultaneous, Related and Unrelated. The multiple aspect was seen as he has many stressors or transitions in life; an example of sequential is that as he is currently laid off, he can forclose on the house, be evicted and be homeless; the simultaneous aspect can be seen that these transitions are occurring at the same period; the related aspect can be seen with him being overweight, being diagnosed with Diabetes II, and placed on a new diet; the unrelated stressor are seen as he is having both health issues and occupation and living arrangement issues. His wife and children does not share the same complexity of Patterns of transitions though. Clearly the family is going through various Patterns of transitions
The next concept, Properties of Transition, refers to the level of recognition, orientedness to the change, time lines, milestones, the general feel and perception that the patient feels about the changes that are occurring.
These are entangled together and closely affect each other (Meleis et al. 2000). It is divided into sub-sections or aspects that get into detail every angle and details of the reaction and response to the change or stressor. The applicability of this concept to the family is as follows. All of the mentioned changes and transitions that the family is experiencing have the potential to get out of hand and be more serious, specially the complications of Diabetes, being overweight and homelessness. The only limitation I can see is the amount knowledge and education the family has received about this health issues. From this stand point, I do not believe that they are satisfying the Awareness aspect of the concept. Unfortunately, without full Awareness, they are not completely able to Engage and be involved in finding resources for aid. The family on a new diet, indicating they may have received limited amount of health education. They may have perceived that the recommended change in diet is a precursor to something worse or as an attempt to do damage control when it comes to their health. This change in lifestyle, along with the stigma of being laid off or potentially being homeless will definitely alter their perceptions towards themselves and their environment. This is how I believe the aspect of Change and Difference is affecting this family. In regards to the aspect of Timespan of the transition, I believe this is related and closely dependent on their level of Awareness of the changes, so the duration of transition is undetermined at this point. The Critical Point and Events aspect that applies in this case is the facts that that they are on a new diet and the laying off of Mr. Rojas from his job. This has served as a red flag or a warning
that there have been and there will be changes that have occurred and a response is needed. The concept of Property is multi-dimensional, in the respect of that it zooms into the life of the patient and helps a provider see what they really have and their current state. To me, as a Family Nurse Practitioner, this is where I can see and determine how the transition has impacted the patient and how are they dealing with it. The next concept discussed is Transition Conditions. This concept is geared towards comprehending and knowing the experiences of the subject whom the transition is happening to through the viewpoint of their self-perspective, their backgrounds and the community that they are set. This concept is broken into parts to further determine how the patient’s unique situation can either prepare or hinder them through the change process (Meleis et al. 2000). The application of this concept to the Rojas family yields this presentation. In the phase of the change in diet, the part of Meaning may play big role in the perspective of the family being new immigrants that grew up in a different culture, beliefs and diet. In some cultures, food in not just for satisfying hunger, it is also medicine and part of religious practices. In being told to change their diet, the family may see it as a blow and a separation from their social and culture and cherished beliefs. The family’s economic status is a hindrance and inhibitor to properly transitioning to situation where they can feel that they have control of their lives. Other perspectives needed to be accounted for are the fact that the family are new immigrants with no other family members to act as a support and are unlikely prepared or knowledgeable about the nature of the changes occurring or knowing what local resources are available to them The last concept discussed is Outcome Indicators. This concept determines the result of the transition process or its completion. It is a place where the patient attains a sense of balance after the changes that just happened through effective coping, gaining new abilities or still being in the process of learning (Geary & Schumacher, 2012). There are two listed outcomes a subject can fall into depending on how they are after the transition: Mastery or Fluid Integrative Identities. In application to the Rojas family situation, I believe that it is too early to tell if they have mastered anything in any of the mentioned transitions that are occurring. They do have hindrances that can limit their ability to transition effectively. The family is more likely to be in the Fluid Integrative Identity as they are likely integrate new aspects of living in a new country with their cherished cultures, values and beliefs from their native country. They are essentially wearing two hats in regards to living in a new place. This may well also be the case concerning their views towards the mentioned health and economic issues that they are facing. I feel that Transitions Theory is a really effective theory in caring for patients. I believe this because the theory touches upon the patient in a systematic and detailed method that ensures that the practitioner has an idea of where they are coming from, their views, awareness of the problem, resources and willingness to be better. I can see myself utilizing it in my practice as a Family Nurse Practitioner in the future.