Transition Theory

Dr. Afaf Ibrahim Meleis (Dr. Meleis) as a special guest speaker delivered a seminar for DNGL program that held by University of Hyogo on October 28-30, 2015. Transition Theory is a nursing theory primarily developed by Dr. Meleis during three decades of research in the late 21th century. She is a prominent nurse sociologist, educator, theorist, and researcher that began her nursing career in her native Egypt in the 1960’s. She is currently positioned as the Dean of Nursing at the University of Pennsylvania. She conceptualized the idea of Transition Theory as it applies to nursing practice. This theory is described as having five essential properties-awareness, engagement, change and difference, time span, and critical points and events. Transition Theory is based on the concept that all people go through life changes and during these changes, nurses have the opportunity to facilitate the transformation in terms of health and wellness. Transition conditions are unique to individuals and will alter how nursing approaches the plan of care for the patient.



* Transformative education programs in nursing
The goal of nursing education is to prepare graduates for leadership positions and to give them a voice to influence healthcare policy and increase their impact on patient care. The revolution of nursing science and education are now based on evidence and research. Technological advancements have also changed the way of teach. Through simulation, students learn to manage real life, complex situations without risk to themselves or patients.

* Transitions and health care challenges and opportunities for disaster nursing
We need to change the metaphors that describe nursing and differentiate nursing from medicine. The metaphor is that nursing is soft, compassionate, caring, historical, and touchy; and the metaphor for medicine is hard evidence of science. We do like the nursing metaphor. It should continue to be compassionate caring and giving, but it should also be attached to the metaphor that it is hard evidence, scientific, and it is a career. By empowering nurses and by allowing their voices to come forth on the policy table, we really could become such an amazing force in improving the quality of care in the world and increasing access to health care.

* Gender inequity and nursing
The analogy between women and nurses’ situation is partially similar. Nursing grew from a sacrificing war model as well as a church model: nurses as caregivers in wars and as nuns were expected to be compassionate caregivers. They are altruistic and they expect no immediate reward other than the reward of just really caring for others, and that should bring that intrinsic wonderful feeling. Compensation in monetary terms was not the main consideration. They were taught not to really expect immediate rewards and compensation, financially, as an immediate reward. So, nursing and mothering as a calling, not as careers really required little compensation other than the intrinsic reward from the act of giving to others. So, here are some of the similarities that prevented nurses from being compensated appropriately. Now, give nurses as we give women more power, give them better compensation, give them more autonomy, and some of that translates to their ability to do even better work in supporting the patients and in making a difference in society, making a difference in the health care system. It gives them the potential of having a voice, and it gives them the potential with that power to be able to effect the changes that they believe should happen in the health care system and society.

Impression
Transition Theory is a solid nursing theory as it has ease of use and is widely applicable to a variety of patient populations. The methodologies within the theory are clear, not difficult to learn and not painfully abstract. Change is inevitable. With change, opportunities to impact health in a negative way are to be expected and likely. Unhealthy outcomes can be avoided if the nurse can assist the patient in adapting to their transition. With further research, the theory has the potential to be a model for change in the coming years.
(Summarized by Hastoro Dwinantoaji)