Self –Transcendence theory in nursing

SELF-TRANSCENDENCE THEORY

Pamela.G.Reed (1952-present).

Self –Transcendence theoryThe theory was postulated by Pamela G.Reed.She was born in Detroit,Michigan on june 13 1952. Graduated with her baccalaureate from Wayne State university in 1974She earned her Masters in psychiatric nursing and in nursing education She got Ph.D in 1982 with a concentration in nursing theory and researchShe worked in many administrative positions and also as a teacher

Major Concepts and Definitions1. Vulnerability It is defined as one’s awareness of

personal mortality. The concept of vulnerability include awareness about lifecrisis such as disability, chronic illness, child birth,etc.

2. Self-transcendence It refers to a fluctuation of a

percieved boundaries that extends the person beyond the immediate and constructed views of self and the world.

3.Well-being It is defined as “the sense of

feeling whole and healthy, in accord with one’s own criteria for wholeness and well-being”.

Well-being can be described interms of 2 kinds of change

a)Changes in complexity in a life

b)Changes in integration

4.Moderating-mediating factors These are the personal and

contextual variables, their interactions influence the process of self-transcendence.Eg: cognitive ability, age, gender, life experiences,social environment…

5. Points of interventionThere are two points of intervention.

Either the nursing actions focus directly on the person’s inner resource for self-transcendence or it focus on some of the personal and contextual factors

Model of self-transcendence theory

Vulnerability

Self-transcendenc

e

Well-being

Personal & Contextual factors

that mediate or moderate

relationships.Points of interventions to promote self-transcendence

Major Assumptions 1. Health Defined as a life process of both

positive and negative experiences from which individuals create unique values and environments that promote well-being.

2.Nursing The role of nursing activity was

to assist persons with the skills required for promoting health and well-being.

3.Person persons were conceived as

developing over their life-span in interaction with other persons and with in an environment of changing complexity that could both positively and negatively contribute to health and well-being.

4.Environment Family, social networks, physical

surroundings and community resources were environments that significantly contributed to health process.

Theoretical AssertionsThe first proposition of theory is

that self-transcendence is greater in persons facing end-of-own life issues than in persons not facing such issues.

The second proposition is that conceptual boundaries are related to well-being. Fluctuations in conceptual boundaries may influence positively or negatively across the life span

Third assumptions is that the personal and environmental factors function as moderators or mediators of the relationship between vulnerability, self-transcendence and well-being.

Acceptance by the nursing community1.Practice

Applicable in the field of education and psychiatric nursing practice.

Self-transcendence may be integral to healing in many life situations

Nurse activities that promote the perspectives of self-reflection,hope, altruism and faith in vulnerable persons are associated with increased sense of well-being

2.EducationRoger’s theory,Newman’s

theory,Watson’s theory and Parse’s theory share a common view in identifying self-transcendence as an appropriate philosophical foundation for the education.

The nurses must be well educated to promote self-transcendence views and behaviours in their clients.

3.Research So many studies were

conducted using this theory ( to demonstrate the relationship between quality of life and self-transcendence in person with AIDS,elderly men with prostate cancer, liver transplant reciepients).

Research results from the studies provide additional empirical support for the theory

Critique1.Clarity and Consistency In attempting to clarify concepts

such as health & self-transcendence she presented various definitions and examples which although theoretically consistent may confuse readers.

In terms of structural clarity(how understandable are the connections between concepts), some relationships between the concepts are not fully defined

Structural consistency(assessing the theory purpose,concept definitions,how identical are the assumptions etc.) is good in that the identified relationships are logical and consistent

Some definitions of the concepts (from life span developmental theory and Roger’s theory) are difficult for nurses to grasp.

2.Simplicity(Should have minimal number of concepts and interrelationships)

It is strong on simplicity as it involves only 3 major concepts(Vulnerability, Self-transcendence, Well-being) and 2 other concepts(personal & environmental factors and Point of intervention)

3.GeneralityThis theory can be applied to a wide variety of human health situations. It can be applied to various life events ranging from child birth to life threatening illness and dying.This theory has good generality..

4.Empirical precisionSelf-transcendence can be

measured by using self-transcendence scale and well-being can be measured by using variety of empirical indicators

5.Derivable consequencesThe theory tested in different

researches has led to new knowledge that can be useful in nursing practice.

The theory provides insight in to developmental nature of humans

Problem statementA correlational study to assess

the involvement of social support system and coping with end stage disease among lung cancer patients admitted in a tertiary hospital ,Kochi.